The Celebrity Patient

In March 2016, Dr Muiris Houston wrote an interesting piece in the Irish Times entitled “Celebrity doctors: the perils of treating the famous” . In it, he referred to the cautionary tales of some doctors and their celebrity patients. For example, he reminded us of Dr George Constantine Nichopoulos, personal physician to Elvis Presley from 1970 onwards. Presley, as we know, died on 16 August 1977 and his post-mortem later revealed some fourteen different prescription drugs in his body. Subsequently, Dr Nichopoulos was found guilty by the Tennessee Board of Medical Examiners of overprescribing medication to his famous patient. Similarly, Michael Jackson’s personal physician Dr Conrad Murray was indicted following the discovery of the powerful anaesthetic propofol in the singer’s body upon his sudden death at the tender age of fifty.

According to Groves et al (2002) in their review entitled “Celebrity Patients, VIPs and Potentiates”, famous patients pose challenges similar to patients with personality disorders . Analysing the available literature, the authors cited three principal types of “special” patient who can stir up irrational feelings in the caregiver. “Celebrities” may lead to public scrutiny of the doctor, especially when outcomes are poor; “VIPs” can invoke a sense of awe which attenuates the objectivity normally essential for sound medical judgement; and “potentiates” (powerful or wealthy – but not necessarily famous – patients) can yield feelings of narcissism within the doctor-patient relationship. The authors advised both awareness and caution when treating famous patients.

Perusing the bookshops, we are reminded by Houston of the famous “patient” from a different viewpoint. Psychiatrist in the Chair: The Official Biography of Anthony Clare by Brendan Kelly and Muiris Houston gives a detailed and absorbing account of Ireland’s most famous psychiatrist . Clare, of course, was a writer, academic and award-winning debater. As a psychiatrist and broadcaster, he was a household name both in Ireland and the United Kingdom during the 1980s and beyond. His BBC Radio 4 series In the Psychiatrist’s Chair ran from 1982 until 2001 and featured such celebrities as Anthony Hopkins, Glenda Jackson, Spike Milligan, Stephen Fry, Bob Monkhouse, Uri Geller, Arthur Ashe and Ann Widdecombe . The list, indeed, extends to hundreds. Perhaps Clare’s most chilling interview was that with the notorious Jimmy Savile in 1991.

By and large, the radio series was very well received. By asking gentle-but-probing questions that other celebrity interviewers would not dare, Clare highlighted to his listenership the manner in which famous people are vulnerable too. This seems obvious now, but it was a new concept back then. Not everybody was enthusiastic; Val Arnold-Forster of the Guardian described the idea as “poor” and “artificial”. The agony aunt, Claire Raynor, who was interviewed in 1988, became upset during the interview and later “worried that people would never trust her again”. But for the most part, it seems that Clare’s guests enjoyed the experience while some even felt healed by their brief therapeutic encounter.

Strictly speaking, of course, these were not Clare’s patients. But the dynamic was similar, at least for the hour or two it took to record the sessions. Beyond this, Kelly and Houston are not afraid to ask probing questions about the psychiatrist himself. Who was he really? What were his motivations in life? And so, for anyone who enjoys the concept of the celebrity patient, Psychiatrist in the Chair will make an excellent stocking-filler this (or any) Christmas.

There can be few people in Ireland who have not heard of Prof Anthony Clare. Ireland’s most famous psychiatrist was also a broadcaster, an academic, a writer, a philosopher and a family man. Readers under the age of forty might not fully appreciate how much of a household name Clare was both in Ireland and the United Kingdom, how he was a proud export of a country and a profession alike. And so, this autumn sees the publication of a much-anticipated and long-awaited official biography of Clare, carefully researched and beautifully written by Prof Brendan Kelly and Dr Muiris Houston.

The authors themselves require little introduction, whether or not you are lucky enough to be under forty. Aside from Kelly’s occasional television and radio appearances, he has been a prolific contributor to countless periodicals – medical, mainstream, peer-reviewed and otherwise – over the past two decades or more. His subject matter is diverse, ranging from clinical matters, to ethics, law, history, governance, mindfulness, the psychology of vampires and the medical qualifications of doctors in Mills and Boon novels. Kelly rarely fails both to inform and to entertain.

As for Muiris Houston, need I even continue? He is a household name in his own right. A graduate of Trinity College Dublin and the University of Sydney, he is an occupational medicine specialist, a health strategist, Adjunct Professor of Narrative Medicine at Trinity, and writer-in-residence at Evidence Synthesis Ireland at the National University of Ireland, Galway. He pens regular columns in Irish Times and the Medical Independent and, as if these were not enough, he is co-founder and co-curator of the wonderful dotMD conference with which many Irish readers will be familiar.

Clare was born in Dublin on Christmas Eve, 1942. His BBC Radio 4 series In the Psychiatrist’s Chair ran from 1982 until 2001 and featured celebrities as varied as Anthony Hopkins, Glenda Jackson, Stephen Fry, Bob Monkhouse, Maya Angelou, Barbara Cartland, Esther Rantzen and the 1975 Wimbledon champion Arthur Ashe. He interviewed politicians like Edwina Currie, Paddy Ashdown, Nigel Lawson and Ann Widdecombe. Perhaps the sessions best remembered were with the comedian Spike Milligan (with whom Clare would later co-author a book), the psychic illusionist and spoon-bender Uri Geller, and the disquieting and notorious Jimmy Savile. Each of these interviews, among hundreds, was conducted over ninety minutes (edited to forty) in a small office at the BBC, with Clare’s lightness of touch gently masking expert, incisive enquiry. Kelly and Houston describe an endlessly-curious, energetic, engaging, empathic, humane man who left an indelible impression on all whom he interviewed. It seems that many of Clare’s guests felt cleansed or even healed by their brief therapeutic encounter.

Above all, Clare was a brilliant communicator. He was pivotal in changing the way celebrity interviews were conducted in mainstream media but, as Kelly and Houston highlight in their biography, Clare’s bigger contribution was the demystification of psychiatry to a general audience. This was true not just in his broadcasting, but also in his written work, not least his magnum opus Psychiatry in Dissent: Controversial Issues in Thought and Practice, published when he was thirty-three years old. Meanwhile, Clare was busy seeing his day-to-day patients (those without celebrity status), first at the Bethlem Royal Hospital, the Institute of Psychiatry and St Bartholomew’s Hospital in London, and later at St Patrick’s Hospital and St Edmundsbury Hospital in Dublin. He passed away quite suddenly in Paris on 28 October 2007 – two months shy of his planned retirement.

In the course of eight chapters, Kelly and Houston take us through Clare’s Jesuit background and education, his college debating, his medical and psychiatric training, the writing of Psychiatry in Dissent, his clinical, academic and broadcasting careers, the people he interviewed and his effect on the manner in which psychiatry is perceived by the public on this side of the Atlantic and beyond. And then there is the man behind all of this, a kind man whose apparent self-confidence belied a surprising self-consciousness. Kelly and Houston are not afraid to ask probing questions about the psychiatrist himself. Who was he really? Did he have more than one persona? What were his motivations in life? And, what can we learn from his life, his career and his legacy?

All in all, this biography is a compelling story expertly told, with a level of enquiry and analysis of which Clare himself would have undoubtedly approved. It is researched to a high standard, involving broad consultation with those whom Clare encountered during his unique life. Extensive public records and family archives have been intricately threaded into the pages of this narrative. As such, this is not one of those stuffy biographies condemned to gather dust on our bookshelves. It is much more than interesting: it is gripping. And so, Kelly and Houston have served up an accessible, comprehensive, thoroughly-researched biography that is both sensitive and thought-provoking. For those with any interest in the human condition, Psychiatrist in the Chair is essential reading.