Dr William Sargant was the most important figure in post-war psychiatry. He was a rebel with a cause. He had the build of a rugby forward, narrowly missed a blue at Cambridge, but went on to play for the Barbarians and represented Middlesex and St Mary’s Hospital. He was over 6ft tall, huge by any standards in stature and charisma. He was born at home in Highgate. His mother was Alice, née Walters.His father was Norman Sargant, a Methodist whose hero was John Wesley, and Will became very interested in religious conversion early on in his psychiatric career. He had several uncles who entered the church, and one of his brothers became the Bishop of Mysore, Church of South India.
Will went to a boarding school from the age of 7 years, initially at St Wilfred’s School, Seaford, where he was thrashed for his rebelliousness until he reformed and became head of house and captain of football. At Leys College, Cambridge, where he was also head of house and captain of most sports teams, he chose medicine as a career because he was so bad at Greek. At St John’s College, Cambridge, he failed anatomy fairly regularly while captaining the rugby team and being president of the Cambridge University Medical Society.
Before deciding to take up psychiatry, Will was house surgeon to the surgical unit at St Mary’s, where he worked for Dickson Wright and Lord Porritt. He later became assistant on the medical unit, and was St Mary’s youngest medical superintendent in charge of all admissions and nursing and junior medical staff. He took charge of the biochemistry laboratory for the medical unit. Not surprisingly, after this whirlwind career, he became ill with tuberculosis, which was to affect him again in 1954.
After three months of inactivity, he did a locum job at Hanwell Mental Hospital, where he was horrified by the lack of treatment, the incarceration and suffering. He was later delighted when Edward Mapother [Munk's Roll, Vol.V, p.266], who was to become his mentor, invited him to join the staff of the Maudsley Hospital. His therapeutic enthusiasm soon became evident in psychiatric circles. He used amphetamines for depression in 1936; insulin treatment for schizophrenia in 1938; and then the convulsive therapy (ECT) for severe depression. He helped phase out bromides in favour of barbiturates for sedation and did research on anorexia nervosa and the physiological basis of depression.
In 1938 Will Sargant was awarded a Rockefeller fellowship to Harvard. He returned to England as soon as war was declared, to work at the Maudsley Hospital’s neurosis unit, Sutton Emergency Hospital, later to become Belmont Hospital, with Eliot Slater [Munk’s Roll, Vol.VII, p.541]. There he saw thousands of acutely disturbed shell-shocked soldiers, and developed acute sedation with pentothal and amytal and ether abreaction with Joe Shorvon. His methods of early treatment must have saved thousands of psychiatric casualties after the second world war. He published An Introduction to physical methods of treatment in psychiatry, with Eliot Slater, Edinburgh and London, E&S Livingstone, 1944. It was to have a profound influence on postwar psychiatry and ran into five editions, five translations and five reprints.
Will’s hectic schedule was cut short by pneumonia complicated by infectious hepatitis. He spent his convalescence reading Wesley and Pavlov, and finally published The Battle for the Mind, London, Heinemann, 1957, which has had an extraordinary influence on psychiatric thinking to the present day. Eliot Slater, then editor of the British Journal of Psychiatry, said of Will: ‘You have done so much to help patients, to teach, and to keep British psychiatry on a sane road.’
Will Sargant had a lovely sense of humour, which was infectious. He had a deep affection for dogs and understood them better then most, and he did more than anyone else to bring Pavlovian physiology into clinical psychiatry.
He was the outstanding clinician and teacher of his generation. Even Sir Aubrey Lewis [Munk's Roll, Vol.VI, p.284], the greatest intellect of postwar psychiatry, asked the question‘How did Will Sargant do it?’. Will was an excellent communicator. Even if you could not speak a word of English and had to communicate with him through an interpreter, and your culture was totally alien to Anglo-Saxon ways, there was no bar to being healed.
His work at St Thomas’s Hospital was legendary. When he was physician in charge of the department of psychological medicine, more medical students entered psychiatry than from any other medical school. He had massive self-confidence, sometimes amounting to recklessness, therapeutic fervour, stubborn persistence and clinical intuition. It was this last quality that was the most remarkable. He had am amazing sixth sense - a talent for taking short cuts to knowledge. So many of his former patients have said ‘Dr Sargant saved my life.’ A rare statement in the case of other psychiatrists, but a commonplace with Will. Most of all, he gave his patients hope.
Among Will’s registrars were David Owen, who later became Foreign Secretary and Minister for Health; Jim Birley, president of the Royal College of Psychiatrists, and Peter Gautier-Smith, later to become dean of the Institute of Neurology, The National Hospitals, Queen Square.
In Will’s early days, he met opposition and therapeutic nihilism. He had to do what the New Testament calls ‘Doing good by stealth’. He was driven by the fact that, as he put it, ‘No suffering can compare with the suffering of the mind or what has been called the dark night of the soul. It is well, sometimes, to wake up haunted by what still has to be endured, by neurotically and mentally sick patients either in hospitals or in their own homes.’ So he wrote in his autobiography The Unquiet Mind, London, Heinemann,1967.
As David Owen put it: ‘He understood the awful pain of depression which drove him to take risks for those who were depressed - because he knew they would take risks with their lives. Yet for him the truest tribute was to be honoured by those who knew him best - the patients and physicians who worked for him.’
Hs wife Peggy sustained him through all his battles. In his autobiography he wrote: ‘My thanks are due to my wife who didn’t want to be talked about too much in the book but whose presence permeates every page since without her I could no longer be myself.’
Desmond Kelly
[The Times, 31 Aug 1988; The Independent, 5 Sept 1988; The Guardian, 2 Sept 1988; Brit.med.J., 1988,297,789-90; Lancet, 1988,2,695-6,859; St Thomas's Hospital Gazette, Spring 1967,65,No.l; World Medicine, 18 June 1975]