London psychiatric pioneer gets recognition at long last

London psychiatric pioneer gets recognition at long last

By Paula Schuck
The London Free Press, April 20, 1999

Dr. Ruth Kajander, 74, now of Thunder Bay, stands with Dr. Sussman in the historical section of the London Psychiatric Hospital. At one time, patients were immersed in warm baths and were held there under canvas covers in the belief this would be relaxing for them. Kajander remembers when such treatment was still being used in Canadian hospitals.

A London author and psychiatric historian is setting the record straight about a long-overlooked female pioneer who helped revolutionize psychiatry.

Ruth Kajander, now 71 and living in Thunder Bay, did her residency at London Psychiatric Hospital (LPH) in 1952 and 1953. There, she helped pioneer the use of Largactil, a powerful tranquilizer which, for the first time, allowed mentally ill patients to function outside institutions.

Kajander, who still practices psychiatry, reconciled herself to to "being forgotten by history" many years ago, but a phone call from Sam Sussman changed that.

Sussman, a former social work director at LPH, who works as an adjunct professor at University of Western Ontario and medical placement recruiter, wondered why Kajander and London weren't credited for her accomplishments.

"I think it's a bit of a shame that the fact that Largactil was pioneered and developed in London, is not well known...

"It's the penicillin of the psychiatric industry," Sussman said during break from interviews for the book he's writing about Kajander and London's claim to fame.

When Kajander first came to Canada to study psychiatry she was astonished many treatments she considered "medieval" were still being used.

Patients drugged with morphine and opium were left so sedated they couldn't eat or drink and in many cases they died.

At the time, psychiatry no longer used restraining devices like the patient crib, which resembled a small wooden cage complete with lock. But hydrotherapy was still being used in Kajander's early career.

At the London hospital, the room where hydrotherapy patients were once restrained beneath a heavy canvas and immersed in a full bathtub still exists. So does the crib, but its in the hospital's archives. Neither has been used for decades.

Kajander was spurred to seek medications they would allow patients to function consciously in a society without restraints, either physical of pharmaceutical.

Largactil, also known as chloropromazine, was used as an anesthetic, but Kajander wondered if it might be effective at soothing anxiety symptoms and psychotic states in the mentally ill.

At almost the same time, a Montreal doctor, Hans Lehman, was working on adapting Largactil for use in psychiatry.

Lehman is widely credited with developing the drug, but Sussman's research shows Kajander and LPH had a one-month jump on him.

"Up until the mid 50's, psychiatric hospitals like this one had populations of 1,700 to 1,800 patients whose chances of being discharged were virtually nil." Sussman said.

Almost half of all hospital beds were occupied by the mentally ill, so the adaptation of Largactil led to "a massive exodus of patients." Sussman said.

Growing up in Germany, witnessing Adolph Hitler's rise to power peaked Kajander's interest in the human mind. "I wanted to know what on earth make someone like Hitler tick?"

As one of the few females in psychiatry in 1950 and a German immigrant to Canada after the Second World war, Kajander was used to handling discrimination. She was discouraged from pursuing a career in academics.

"I was told as a woman and as a German, there would never be a place for me at the University of Toronto."

The same factors have denied Kajander recognition for her groundbreaking contributions to the field, Sussman said. "We are trying to rectify this situation."

Sussman's book is to be launched at the Canadian Psychiatric Association's general conference in Toronto in September.