In Care of Friends:
INTRODUCTION
The
mentally ill have always been with us, but for no family is this truer
than for the Eustace Family. For five generations, for nearly two
hundred years, they have cared for the mentally ill, have lived with
them and have accepted them as part of their normal daily lives. While
the treatment and care of mental illness is, in our day, accepted as one
of the duties of a caring society, we must remember, that when John
Eustace opened the doors of Hampstead Hospital in 1825, old attitudes
were only beginning to change. The mentally ill were still outcasts,
still ‘lunatics’, the majority of them being treated with coercion and
restraint. The State’s policy of providing asylums was only developing
and it would be a long time before these became caring and therapeutic
institutions.
John Eustace was, however, a Quaker, and was
influenced greatly by the Quaker philosophy of ‘Moral Treatment’ -
compassion rather than punishment- expounded by William Tuke in The York
Retreat. Tuke’s basic belief that the care of the disturbed patient
should be holistic rather than purely medical has been central to the
development of the Eustace family’s approach to the mentally ill. In
this context, holistic extended to include sympathetic surroundings with
space to work, space to walk, space to relax. Hence the beautiful lands
of the Eustace Estate formed, from the start, an integral part of the
treatment; and because the Eustaces always lived on the Estate, indeed,
for a long time in the same houses as the patients, the history of the
Eustace family is inseparable from a history of the development of the
Eustace Hospital Group
itself.
THE FIRST GENERATION
JOHN EUSTACE (1791 - 1867)
John
Eustace, who was born in 1791, was the son of Cork Quaker, Benjamin
Eustace, and his wife Mary Fawcett. The Eustaces of Cork were originally
merchants and John was to become the first doctor in the family,
studying first in Edinburgh and later in Trinity from whence he
qualified in 1815. The family’s connections included other influential
Quaker families like the Pims and Harveys who were among the moving
spirits in the establishment of Bloomfield Private Mental Hospital in
1812. Through these connections, John Eustace’s Aunt Jane successfully
applied for the post of housekeeper to the hospital shortly after it
opened. She subsequently recommended her nephew John, for the post of
lay superintendent, a position he took up in May 1813.
Once he had qualified as a doctor in 1815, John
continued on at Bloomfield as visiting physician but from 1816 it was
only on the condition that he would have sufficient time (11 to 4 daily)
to develop his own private practice. Even at this early stage in his
career, it is clear that he was sympathetic to the idea of a “Moral
Treatment.”
He began to emulate the ideas of the Quaker
superintendent of the York Retreat, Dr Daniel Hake-Tuke, the first
medical doctor of the Tuke Family. The Bloomfield Committee Papers show
that John was arguing in 1816 for the enlargement of the hospital
grounds so that a more effective employment of moral treatment’ could be
practised. It is also clear from the reports that, as his own private
practice developed, relations with Bloomfield deteriorated, mainly
because John was unable to attend regularly, and indeed, poor attendance
was the reason cited when his services were discontinued in 1831. From
1822, John also added the position of Temporary Physician to the Cork
Fever Hospital to his work load, so it is not surprising that his time
was limited.
At the same time, John was preparing the way for
the establishment of Hampstead Hospital. Along with Dr. Isaac Ryall and
Dr. Richard Grattan, a Deed of Partnership was entered into on November
1st 1825, to form an Establishment at Hampstead, to be named, The Asylum
and House of Recovery for Persons affected with ‘Disorders of the Mind’.
Dr. Ryall had already bought the land, which included Hampstead House,
from Sir Robert Smith Steele, and he co-leased the house and an acre of
land to the two other doctors. It was three months before the first
patient, the son of a baronet, was admitted on 2nd February 1826. This
patient was discharged, much improved three months later.
The partnership, however, was to be short lived.
Isaac Ryall left in August 1826 and went to live in Devon, while Dr.
Grattan left the partnership in December 1830. So, at the age of 29,
John Eustace became the sole proprietor of Hampstead Asylum. In the
beginning the asylum had found it difficult to attract patients,
probably because the fees were five guineas a week John now took
advantage of his Quaker connections and wrote to London Quaker, Thomas
Johnson, asking him to distribute advertising brochures to “thy medical
acquaintances”. By the time John had been asked to leave Bloomfield,
Hampstead seems to have provided him with a quite comfortable income. He
quickly added more land to the estate, taking over in 1836, the ease on
an adjoining 23 acres, including – Hampstead Lodge, (now called
Hillside). John could now boast in his advertising literature that his
establishment was in “an elevated and very salubrious situation with the
purest air, particularly suitable to nervous constitutions”. In 1844 he
built The New House, Hampstead Cottage and Hopetoun Cottage.
At the beginning, Dr. Eustace did not live on the
premises, but his two sisters Jane and Mary did. In 1852, he was joined
by his son, John II. John Eustace was a firm exponent of the moral
treatment where every comfort was offered to patients in a family
setting. There was no restraint on patients, no “locking up”. From the
mid 1850’s when Marcus Eustace joined his father and brother, the two
second generation doctors were living on the premises with the patients.
This was deemed necessary to secure the “oversight and personal
superintendence upon which so much depends; also promoting social
intercourse between the patients and the family”.
The Moral Treatment, did not, of course, mean that
no medicine was used. The Eustaces were, first and foremost doctors, and
took advantage of the medical advances of the day. Patients were also
encouraged to seek outside medical advice if they so wished. Dr. Eustace
had tried other methods earlier on in his career which were not
completely orthodox. One of these unorthodox methods, commonly used in
mental institutions at the time, and believed to work, involved the use
of a circulating chair. The chair - resembled a metal cage in which the
patient was suspended and rotated rapidly. It was thought that the shock
would result in a cure.
Dr. Eustace was advised by the inspector to the
hospital that the practice was unacceptable, and he immediately ceased
using it. Shortly after this, John gave up any belief that a medical
cure for insanity would be found. However, he did write many articles,
based on his observations of the mentally ill, which were published in
various journals of the day including The Lancet.
During this period the villa system of treatment
(which allowed patients to live in separate supervised accommodation)
was becoming quite popular, and several cottages were available on the
Eustace estate for this purpose.
Having the patients living with the family could,
of course, lead to problems. There is a endearing little “Suffering”
which John put down on paper, and which can be seen in the Quaker
Library in Bloomfield, in which he laments the stealing of some of his
silver spoons. He neither condemns nor accuses in the note, but is
clearly upset about their disappearance, almost as if he has been
betrayed - reflecting perhaps a certain naiveté in expecting patients
with mental problems to have the same respect for other’s property as
would the sane person. On the other hand, of course, it indicates that
John was a very astute business man who knew exactly what he owned,
(even down to the cutlery), and who ran a very tight ship.
By the time of John I’s death in 1867, the Eustace
ethos of holistic care was firmly established, the farm giving work and
therapy to the patients, (as well as providing food for the hospital),
while the well set out grounds were the perfect setting for exercise and
relaxation. From a very early stage, male and female patients were
catered for in separate buildings, and the pleasure grounds were
strictly segregated also. It would appear that the farm was always a
very successful operation. During the famine years, the Eustace Family
offered the government several tons of home grown potatoes to relieve
the crisis, unfortunately, the offer was turned down. This is a telling
episode, which shows more clearly than words could express, the very
real stigma attached to mental asylums and anything associated with
them.
THE SECOND GENERATION
JOHN EUSTACE (1827-1899) & MARCUS EUSTACE (1831-1885)
John
Eustace I joined his father in Hampstead in 1852, followed by Marcus
in1853, both having qualified from The Royal College of Surgeons. John I
now relinquished his sole control of the hospital, and a Deed of
Partnership between the three was drawn up on 14th March 1853. The
advertising of these years shows the change, not just in leadership, but
in the new thinking of the second generation. In 1852, the brochures
were for an Asylum for the Care and Cure of
patients under the proprietorship of John I. By 1855, a subtle change
had taken place. The brochures then advertised a Private Medical
Establishment for the Treatment, Cure and Residence of patients,
conducted by the proprietors i.e. the three Doctor Eustaces in
partnership.
Shortly
after this, in 1857, John I retired. The two brothers very quickly put
their partnership on a professional footing by drawing up Articles of
Agreement in 1861, in which, among things, each had to agree to the
other’s marriage. A legal name for the business - ‘Doctors J & M
Eustace’, which is still extant, was agreed upon. Before long, a new
phase of development gathered momentum with the leasing of Highfield and
10 acres of surrounding land from Dublin Corporation. Highfield was then
opened as a separate establishment for ladies only to be followed
shortly by major improvements.
It would
appear that John I was the prime mover in the aggrandisement of the
estate - when he discovered Highfield needed a new roof in 1865, he
decided to take the opportunity when repairing it, to add a third
storey. He and Marcus then lived in the third storey, Marcus later
moving to Elmhu By 1892, seven years after Marcus’s death, “Doctors J &
M Eustace” owned 150 acres of land, extending over the townlands old
Hampstead and Drishogue on one side of the Swords Road, and into
Clonturk and Highfield on the other side. To the west of Hampstead
House, land had also been bought. On this land were located the ruins of
Hampstead Castle.
Another
major development at this time was the building of Elmhurst. The stones
from the derelict Hampstead Castle were used to build Elmhurst house in
1869. The house was built with the financial help of a wealthy patient,
who agreed to be pay for it on the condition that Dr. Eustace would live
in the house with him to take care of his needs. Marcus was the first
Eustace to live in Elmhurst. Inspector’s reports from then until the
patient’s death in 1905, pay tribute to the high living standards this
man enjoyed, with his own suite of rooms and bathroom in the house.
Elmhurst was used as a private house until 1924 when it was registered
as a hospital.
John
Eustace II was a most meticulous man, who recorded every detail
regarding his business. Carbon copies of every letter he wrote can still
be seen in the many ledgers he left behind. Presumably this was
necessary in the partnership, but the letters continue after his
brother’s death right up to his own death in 1899. John became a Justice
of the Peace in 1855 and, like his father before him, wrote many
articles which were printed in the medical journals of the day.
Marcus, who
was the first of the Eustaces to live in Elmhurst, died in 1885 at the
age of 54. After the probate of his will, all the property on the
estate, which had been jointly owned by Marcus and John, had to be
reassigned to the business of “Doctors J & M Eustace”. This was as a
result of the terms of the agreement of 1861 in which a ‘survivor take
all’ clause was inserted. Marcus’s widow was to receive £10,000 for
Marcus’ share, but John Eustace while a business man was also a fair man
and he duly added another £2,000 so there would be no feelings. This
clause led to difficulties later and it was eventually removed.
Dr. Marcus
Eustace had a large family, and two of his sons, John Marcus and George
Wallace (named after Marcus’ wife Elizabeth née Wallace) became doctors.
John Marcus went to Persia, losing his children to yellow fever. George
Wallace served in the British Army in the First World War and settled in
Arundel where he became Lord Mayor. His only son died at 18. Marcus
third son Gerald Needham Eustace, died unmarried and so, Marcus’s direct
Eustace line died out. Marcus was the first of the family to marry
outside the Quaker faith.
Shortly
after Marcus’ death, John developed diphtheria and the hospitals were
run for seven years by a series of locums including, from 1887 to 1890,
the famous Doctor Leeper who would became so well respected for his work
in St. Patrick’s Hospital. A copy of the reference written for him by
John, when the former was applying for the post in St. Patrick is
amongst the papers John left for posterity.
When John
returned to take charge, he was soon joined by his sons John Neilson
Eustace in 1892, and Henry Marcus Eustace in 1895. John II continued to
be active right up to his death at the age of 74 in 1899
John I
displayed, like his father before him, an almost uncanny business sense.
He, very early on, saw that the only way to avoid fragmentation of the
estate and to ensure the continued success of the hospitals was to make
the above mentioned agreement of 1861 which was binding on each partner.
The survivor take all clause, was, to him, the business equivalent of
primogeniture. This agreement was drawn up by John II’s father-in-law, a
solicitor named William Neilson. The clause worked very well at the
beginning as there were only two families concerned. Any problems
relating to it did not surface until later years, by which time the
clause had achieved its end in consolidating the fame and fortune of the
hospitals.
THE THIRD GENERATION
JOHN NEILSON EUSTACE (1867-1894)
HENRY MARCUS EUSTACE (1869-1927)
BENJAMIN FAWCETT EUSTACE (1870-1919)
WILLIAM NEILSON EUSTACE (1875-1948)
By the time
the third generation of the family came along, it was obvious that the
medical profession was a family trend, and that the family business
would continue for a long time to come. Three of John II’s four sons
became doctors, while the fourth, Benjamin, took on the running of the
farm.
One of the
advantages of living on the estate was, of course, that the Eustace
children grew up being aware of the mentally infirm, and had not the
narrow, prejudiced views of many others in society towards mental
illness. This attitude set the Eustaces’ Hospitals apart from other
private institutions, many of which were seen as being run by
“speculators who carry on a trade in lunatics”. (Report of International
Congress, Chicago, 1893),
The third
generation carried on in the same caring and benevolent way as their
predecessors. John Neilson Eustace (RCSI) who was the first to join his
father in Hampstead and Highfield, did so in 1892, shortly after John
II’s return to health. Before this he had been a ship surgeon up the
Amazon, and then had done some locum work. John Neilson was greatly
interested in hypnotism as a means of treatment, but his father did not
approve of it. It was, however tried in Highfield, without much success.
John Neilson unfortunately, contracted T.B shortly after this. In spite
of going first to Crief Hydro in Scotland and then to Switzerland to
find a cure, he died in 1894 at the young age of 27.
Henry
Marcus Eustace qualified from Trinity in 1890 and shortly after, he too,
went as a ship’s surgeon, this time to Canada. He subsequently worked in
Morningside with Dr. Clouston but was asked to return to Hampstead to go
to Switzerland with his brother John. When John Neilson Eustace died,
Henry Marcus joined his father, and after his brother’s death continued
on his own until William Eustace joined him in 1902. Henry Marcus was a
very private man who was extremely conscientious in his treatment of his
patients. While he did not have the drive of his father, nor, later of
his brother William, he, in his own quiet way did just as much to ensure
the continued success of all the establishments. It was he who ran the
business when William joined the Royal Army Medical Corps, and he who
took over the running of the estate when Benjamin was not available,
continuing to do so after Benjamin’s death in 1919 with the help of
Benjamin’s widow and stewards. He continued his father’s practice of
taking the patients away to a summer house in Killiney and also arranged
entertainment on a regular basis in the hospitals. Among the many
letters left behind is a hand-written one from Percy French from his
home in Mespil Road, arranging a date for a recital. Henry Marcus
Eustace was married but had no children. He lived in Highfield with the
patients until the death of his mother in 1912, when he moved to
Elmhurst. The same year Shournagh was built to accommodate his two
sisters, Eleanor and Annie. Henry Marcus Eustace died as he lived, among
his patients suffering a stroke in the dining room of Highfield, causing
much consternation and excitement until he was removed to Elmhurst.
Benjamin
Eustace, in spite of family pressure to become a solicitor like his
Neilson grandfather refused to do so and instead, in 1890, took over the
running of Hillside Farm and the family Estate. He was a very able
farmer and after a fire which burned down lot of the out offices,
organised the building of many new haysheds and buildings.
His
reputation as a farmer was widely recognised, not just because he was a
prominent member of the Royal Dublin Society, but also because animals
from Hillside were frequently among the prize winners at shows. His
success in his chosen career was recognised by his peers when in 1912 he
was elected President of the Irish Farmer’s Association, and Chairman of
the Co. Dublin Farmers’ Union. He also had time to make alterations to
Hillside house adding an extension at the front in 1902. He was the
first family member to administer the land on a full time basis, but,
unfortunately died from diabetes in 1919 at the age of 49, leaving a
widow and a young family of five.
William
Neilson Eustace qualified in 1901 from the Royal College of Surgeons and
worked for a time in Bicton Heath Mental Hospital before joining his
brother Henry in 1902. He built Lisronagh in 1908 and moved into it when
he married in 1909. The following year, the three brothers formally
entered into legal partnership, just as their father and uncle had done
fifty years before. This time, there was a time limit of twenty years on
the partnership, during which time if any partner died, his share would
be purchased by the remaining partners. William joined the RAMC during
the First World War and shortly after his return, in 1919, Benjamin
died. The two remaining partners worked on together, both being
qualified psychiatrists, and consolidated the reputation of Hampstead
and Highfield as “Private Hospitals for the care and cure of Patients of
the upper class suffering from Mental and Nervous Diseases”. When Henry
Marcus died in 1927, William Neilson was the last remaining partner, and
therefore; sole owner of the hospitals as the partnership would not have
expired until 1930. Henry’s widow was offered a settlement on her
husband’s death, which was increased later onto take account of land
which had been sold shortly before Henry’s death.
After Henry
death in 1927, William began to make considerable improvements to the
establishments. He built the Badminton Hall and added onto the billiard
room which John I had built. He moved the entrance to Hampstead to the
East side and installed the ornate steps which are there today, adding
the porch at the same time. In 1938 he also added a sun room to
Highfield. During this time, be ran the hospitals with the help of
assistants and engaged stewards to manage the estate, aided also by
Benjamin’s widow Edith Maud, who curiously was treated as still being a
partner until her death in 1945. In spite of having received full
payment for her husband’s share on his death, she was paid a very
substantial share of the profits annually for quite a long time after.
The main reason for this was, of course, that Edith had a very young
family to rear by herself, and these arrangements allowed her to retain
her pride by giving her the independent means to do so. Of her five
children; three sons and two daughters, only one Jocelyn Eustace became
a doctor. Jocelyn would, in time, become one of the fourth generation
doctors who worked in Hampstead and Highfield.
William
Eustace also had three sons, two of whom became doctors. One of these,
Philip Faulder Eustace chose to work in England, while William Desmond
Eustace would work in the family hospitals. The third son Terence
Eustace, became an engineer and then, like his uncle Benjamin, took on
the running of the farm and estate.
THE FOURTH GENERATION
WILLIAM DESMOND EUSTACE (1912-1990)
TERENCE NEILSON EUSTACE (1914-1988)
HENRY JOCELYN EUSTACE (1908-1996)
Jocelyn
Eustace was the first, (and also, due his longevity, the last) of
the fourth generation to take an active part in the running of
Hampstead. Jocelyn was the academic of the family and was to become a
lecturer in Trinity, and Consultant Psychiatrist in the Rotunda, Sir
Patrick Duns, The Royal Victoria Eye and Ear, and the Dublin Fever
Hospital. Due to his high academic profile, he was much sought after for
medical committees and was president of the section of psychiatry of the
Royal Academy of Medicine of Ireland in 1972. Although never a partner
in the business, he helped his uncle William Eustace during the war
years and he would, along with Desmond, after William’s death, introduce
the latest medical thinking to the hospitals. During these years,
William was also helped in the hospitals by Dr. Mary Brown, the niece of
Henry Marcus Eustace’s widow, Susan. Jocelyn’s brother Frank was to help
also at this time, taking over the running over the estate for two
years.
William
Neilson Eustace had his sons educated at Military Colleges in England
and then in Dublin. While the Army tradition was very strong in the
Eustace family, William had not foreseen that his two elder sons Terence
and Desmond would serve in a Second World War when he sent his children
to school in England. Philip Faulder Eustace, who was the youngest,
would eventually decide to practise in England, while Desmond and
Terence would return to Hampstead.
Desmond,
who qualified in 1936 from The Royal College of Surgeons, first served
as a Captain in Catterick Military Hospital before going to Singapore.
Once war broke out, he was recalled and then sent to North Africa where,
after eighteen months, he contracted amoebic dysentery in 1942.
Recovering from the illness after two months, he spent the rest of the
war years working in military hospitals in Britain and Northern Ireland
caring for those suffering from what is now called Post Traumatic
Stress Disorder It was during these years that Desmond acquired his
wealth of psychiatric experience. He was honourably discharged in 1945
with the rank of major, and returned home. When his father suffered a
stroke in November 1946, Desmond had immediately to take over the
running of the three hospitals.
Terence,
who had served in the R.A.F. in the later years of the war; returned to
take over the management of the land. He had previously worked in the
Far East laying runways, being a qualified engineer from Dublin’s
Trinity College. When he came back to Hampstead and took on the farm, he
became the second family member to take on this role on a full time
basis. While Terence was to give to his job the same dedication as his
uncle Benjamin, changing times and later the EEC’s agricultural
policies, made his job much harder. The growth of the city around
Hampstead, and the increasing demand for more housing, led to the sale
of land during these years, while a serious outbreak of brucellosis
decimated the herd. The large number of badgers in the vicinity and the
alleged relationship between them and the spread of the disease, made it
unwise to rebuild the dairy herd. In retrospect the change in farm
output was inevitable with the days of the viable small farm being
numbered. While the farm is still very much a going concern, it is now
mainly an arable farm. Even without the brucellosis outbreak, the change
in patient profile with fewer being fit to help on the farm, the
introduction of milk quotas, land set aside, and other EC restrictions
would have changed the direction the farm took.
However,
the beauty of the estate and the attention to nature was never lost in
these years. Desmond Eustace replanted a lot of the estate, where Dutch
elm disease and root damage had wreaked a lot of damage. This care of
the environment, the knowledge that we have to plant today for tomorrow,
is another fascinating feature of the Eustace family. It can be seen as
far back as John Neilson who died so young, in 1694. He was the first to
seriously replant the estate, bringing back many rare plants and trees
from abroad. Terence, too, had this inherent family love of animals and
nature which seems to permeate all generations of Eustaces. Essentially
a very quiet, private man, farming and the solitary nature of it suited
Terence very well. He continued to manage the estate, latterly with the
help of his wife’s nephew, Dermot Kelly, until Terence’s death in 1988.
After
William’s death, Jocelyn and Desmond worked together in the hospitals.
They had two very different personalities - Jocelyn’s ambitious drive
would lead him to pursue the intellectual side of medicine. Desmond, the
responsibility of running the hospitals, sought a less public profile.
He often would take patients with him down to the docks
It is
perhaps fortuitous that the two should have been so different for it
ensured that each allowed the other enough space to develop in his own
way and get the most out of his chosen way of living. Jocelyn would
receive many well deserved accolades; become an expert in so many
different areas including antiques and history. Desmond, was the
complete antithesis of his cousin, an environmentalist before the word
became fashionable, gentle and warm, happy to spend his free time
working outdoors on the estate.
While
neither were Quakers, both espousing the Church of Ireland faith, there
could never have been any doubt that they both were of Quaker descent.
Their courtesy, their quiet manner and their sense of caring were
redolent of their Quaker ancestors. Whereas Jocelyn had the sharpness of
speech which so often goes with sharpness of mind, Desmond appears to
have had warmth of character which made him a great favourite with the
patients. He continued the practice of taking them out for drives, only,
this time; he took them himself in his own car. When he was asked to
take over a shipping medical practice, he often would take patients with
him down to the docks for the diversion it would give them, While this
may not have been totally orthodox, Desmond quite obviously knew his
patients well and chose his companions carefully. His attitudes towards
them are a clear vindication, if any were needed, that dose interaction
{both socially and medically), between patients and doctors, worked, and
worked well.
Desmond’s
children have vivid memories of Christmas mornings in Shournagh, serving
refreshments to the guests - all the male patients - and of their mother
serving afternoon tea to the ladies on St. Stephen Day. Their acceptance
of these practices as being part of the Christmas ritual shows that
normality is relative. To the Eustace family, the appearance of the
patients in the family home was the accepted norm. There can be no doubt
that the fourth generation of Eustaces gave to their patients a real
sense of normal living, which was not experienced in many other mental
institutions.
Jocelyn,
for all he was an academic and someone who, in his day, rubbed shoulders
with men like Freud and Jung never lost sight of his patients. They were
always his first concern, He was proud to represent his country at
conferences abroad, was rightly honoured with a Foundation Fellowship of
the Royal College of Psychiatry and would hold many prestigious
positions on medical committees. However, Jocelyn always believed that
his greatest, and most positive achievement, was to be the first in
Ireland to hold psychiatric out-patient clinics, and the first to do
out-patient E.C.T. Like the generations of Eustaces before him, he had
the caring ethos which is so central to this family’s way of life. Right
up to his death at the beginning of 1996, at the age of 87, he always
took a very keen interest in the developments in the hospital, took
delight in the fifth generation’s achievements, and, right to the end,
was keenly interested in the health and well-being of all the patients.
The post
war years were to be a most exciting time for psychiatric medicine, a
time when a new drug would revolutionize the way of treating the
mentally ill. Before the 1950’s, the normal way of treating the patients
was through medical or psycho therapeutic methods. Both of these methods
were practiced in the Eustace hospitals. In 1954, the great change came
with the introduction of a group of medications called phenothiazines.
Their most surprising effect was to help those suffering from mental
illness. By using them, schizophrenia could at last be treated
decisively. Before long, a whole new phenomenon was to take place - the
doors of mental hospitals were opened and by the 1960s patients were let
out to take their place in society again. The success of this new drug,
and later the tricyclic anti-depressants can be measured by the
statistics relating to the length of stay of patients in hospital. In
the 1940s the average stay was 6 months to 2 years. By the 1960’s it was
down to 6 to 8 weeks, and now it is down to almost three weeks.
For Desmond
and Jocelyn Eustace, living through this era, it must have been both a
very exciting and a very challenging time. While they were delighted to
see the rapid recovery of their patients, the opening of hospital doors
threw up another problem which had not been foreseen. Long term
patients, who had become institutionalised, could not cope out in the
world, and the trauma which they experienced led to a new type of
patient - the new’ long stay patient. As fewer and fewer new patients
needed to be hospitalised, a change in patient profile took place. More
and more, the incurables, who were invariably the old who could not
recover, made up the majority of the patients at Highfield, Hampstead
and Elmhurst. In the space of a generation, the whole emphasis in the
hospitals thus changed from acute to chronic psychiatry; to the
psychiatry of old age. This was the position when the fifth generation
took over. The way in which they rapidly responded to the challenge this
posed, shows once again how in tune the Eustaces are with their patients
needs.
THE FIFTH GENERATION
MICHAEL PETER EUSTACE B. 1946 & DENIS PATRICK EUSTACE B. 1949
Desmond was
the only member of this fourth generation of Eustaces who worked at
Hampstead who had a family, although Philip in England also had a
daughter. Desmond had four children. John, the eldest, is a doctor
working in general practice. John did two years as locum in the
hospitals and, although no longer actively involved, he continues to
take a keen interest in the day to day running of the business At the
tine of writing, John’s eldest son Andrew is the first of the sixth
generation to continue in the family tradition, having qualified from
The Royal College of Surgeons in 1993. Judy, Desmond’s only daughter
worked with Ib Jorgenson and was well known in the fashion world as a
dress designer. The other two sons, Michael and Denis, are the two fifth
generation members working in the hospitals.
As his
children got older, Desmond must have been concerned about the future of
the hospitals as a family business. None of his children showed any
inclination, at this time, of joining him at Hampstead. John and Denis
showed no interest in psychiatry, while Michael on leaving school had
not decided on any specific career. However, the curious twists and
turns of life were to lead both Michael and Denis back to Hampstead a
destination neither had foreseen, nor expected.
Michael,
unsure of what he wanted from life, first joined the Royal Enniskillen
Fusiliers, serving in Spandau Prison in Berlin where he was to look
after Hess, Von Schirer and Speer. In 1967 he returned home and obtained
a post in the sales department at Wavin. This company was experiencing
the boom of the sixties, expanding rapidly and, therefore, needing many
more employees While at Wavin he trained in the Irish Management
Institute and then took a degree in Personnel Management. By the early
70’s Michael was responsible for all recruitment, industrial relations
and training of staff at Wavin.
Denis, in
the meantime, had qualified from The Royal College of Surgeons in 1974,
being the fourth generation of Eustaces to have done so. He had no
desire to study post graduate psychiatry. Indeed, be was not impressed
by what he saw as a student attending the large state psychiatric
hospitals in Dublin in the early 70’s.
He did not
begin to reassess his career until, working in Jervis Street Hospital in
the drug addiction centre, he was moved by the numerous victims who were
both physically and psychologically damaged by the ravages of heroin
abuse. Subsequently, he chose a four year rotational training programme
in St. Patrick and St. James Hospital. In 1960, he received his
membership of the Royal College of Psychiatrists and the following year
obtained a consultant psychiatrist’s position in Canada, at the young
age of 32.
Whilst
Denis was working in Canada, Michael’s ability to take on new roles and
responsibilities was soon to be put to the test, in a totally unexpected
way. By the early 80’s his father was expressing grave concern about the
viability of the hospitals. The new medications available had lead to
low admission levels and empty beds. Finance and administration had
never interested Desmond and Terence, while Jocelyn’s many other
commitments left him little time to assist in this area. Desmond, to his
eternal credit, appealed to his son to help him sort out the problems.
Coincidentally, Michael was, at this time, becoming disillusioned
working for a multi-national company in a climate of recession, He took
up the challenge, identifying very quickly the hospitals major
difficulties. He firstly decided that the family needed Denis back home
and as a result of Michael’s strong persuasion, in 1983 Denis arrived
back in Ireland.
Michael
continued on in Wavin until July 1984. He then started full time in
Hampstead. He and Denis saw that the three hospitals were over-staffed,
and most were losing money. Denis knew immediately that he would have to
start from scratch to attract new patients, and without delay began an
out-patient clinic, while Michael began to plan the changes in the
hospitals.
Elmhurst,
with only nine patients, was closed and all the patients transferred to
Highfield. Seeing the need for a high standard convalescent home on the
north of the city, Elmhurst was completely refurbished, New kitchens
were installed, the heating system updated and the building was rewired.
Subsequently, double rooms were divided into single rooms resulting in
accommodation for 16 patients. The new convalescent home was opened in
May 1985. This was followed in 1985-B6 by extensive improvements to
Highfield, where a passenger lift was installed and numerous bedrooms
were reorganised. Hampstead, which had always been very busy, was in
1987-88 refurbished: with old staff quarters being changed over to
bedrooms.
Within a
space of four years, a complete about-face had taken place. Major
financial problems were dealt with, and archaic office systems were
changed. For the first time a full-time secretary was employed and the
telephone service was also updated. The farm, however was still being
run separately and it was not until Terence died in 1988, that Michael
was able to become administrator of the whole estate. There continues to
be a farm manager, Dermot Kelly, nephew of Terence, who reports directly
to Michael.
Michael and
Denis next identified a gap in their range of care. Within their
existing hospitals, there was no suitable area to care for mobile people
with dementia. The buildings were full of stairs and dead ends - quite
unsuitable for patients who needed to work off the incessant
restlessness which is the hall-mark of dementia. Denis had, while in
Canada seen purpose-built dementia care centres, and with these models
in mind, he and Michael soon decided that this was the way forward for
them. Over a few years, they began to research the design of such a
building. They visited similar centres in England, Northern Ireland and
other European locations, attending numerous conferences on how to care
for this new type of patient. They launched the idea of a purpose built
centre at the International Alxheimer’s Conference held in Trinity in
1989. The resultant publicity and positive response made them decide
that the development was worthwhile. Construction of the building
commenced in August 1990. Sadly Desmond did not live to see it open,
dying suddenly in October 1990. The Alzheimer Care Centre opened in May
1991 the first of its kind in the Republic of Ireland. With its bright
airy design and central garden atrium, the Care Centre gives the peace
and tranquility so necessary for those suffering from this devastating
illness and enables their dignity be maintained for as long as possible.
The Care
Centre was the first new Eustace hospital since the building of Elmhurst
in 1869 and marked a watershed in two ways. It firstly showed the new
direction which the Eustaces were following, and secondly, it led to a
streamlining of the administration. An administration block
incorporating offices and a chapel was included in the new building. The
business team had already been strengthened by the employment of a full
time book-keeper. This was further strengthened in 1993 when a
development manager was employed to promote the services of the
hospitals, to the public in general, and to general practitioners in
particular. In 1995, the first full time accountant was employed.
Denis’
workload expanded rapidly over this decade and, as Medical Director he
is now solely responsible for all four separate units and 135 beds. The
bulk of his work involves dementia sufferers. He has set up a
comprehensive assessment and day care programme. He also has introduced
a carers’ information package--- a first in Ireland), a telephone help
line and he holds structured monthly support groups. Denis is deeply
committed to individual family counseling in this area, and believes
that this type of counseling is essentially important. He is a strong
exponent of the power of personal contact and insists on seeing every
patient daily, believing that a friendly face and the touch of the hand
is vitally important to the patient’s welfare.
During
these last years too, Michael Eustace strengthened and consolidated the
administrative side of the business. He has welded the four separate
hospitals into a single entity known as the
Highfield Hospital Group,
and applied consistent procedures and standards throughout. He is a
founder member of the Independent Hospitals Association of Ireland
becoming Honorary Treasurer, thus giving the group a strong identity
among the top providers of private healthcare in the country.
Aware of
ever increasing legislative requirements in the areas of health and
safety, he presided over a major capital investment programme, involving
structural and other improvements throughout the other buildings of
Hampstead, Highfield and Elmhurst including the residences Shournagh,
Lisronagh, Hopetoun, Hampstead Cottage, Hillside Farm, - modernising,
refurbishing and maintaining them for future generations.
As the
Alzheimer Care Centre started to prove successful, Michael and Denis
then concentrated their thoughts on Elmhurst. Knowing that Elmhurst
could never hope to cater for more than 16 patients, plans for a 22
bedroom extension in the style of the Care Centre were drawn up.
Planning permission was sought, and as a result, this premier centre
opened in the summer of 1996.
During the
last 12 years, Michael and Denis have addressed many challenges However,
the greatest challenge of all, and the one which presents the biggest
threat yet to the future of the business - that of inheritance taxation
and succession planning - remains to be conquered. It is incumbent on
this generation to; once and for all, secure the overall business and
land for future generations. It will inevitably involve taking some very
hard decisions, but one can have little doubt that these decisions will
be made and that a sixth generation will be at Hampstead and Highfield
to meet the needs and challenges of the 21st century.
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