Alexander Goldfeder Mezey

Alex Mezey died in his sleep at home on 23 February 2008, aged 86. He was appointed Consultant in Psychological Medicine at the North Middlesex Hospital and Consultant Psychiatrist at Claybury Hospital in 1960, posts which later were amalgamated at St Anne's and Prince of Wales Hospitals. He was elected FRCP(Edin) in 1968 and FRCPsych in 1971. He retired from the National Health Service in 1987.

Alex's life was an example of how British psychiatry benefited from the influx of European refugees fleeing the fascist regimes in Germany and its wartime satellites. He was born in 1922 in Oradea (Transylvania), Romania, and when, in 1940, Romania barred Jews from entering the medical profession, Alex's parents had the foresight to send him to Switzerland. There, he obtained his doctorate in medicine in Geneva in 1945 and went on to posts in pharmacology and medical clinics in Switzerland until 1950, during which time he also had an appointment at the Hôpital Broussai in Paris.

He came to Liverpool in 1951 intending to build a career in chest medicine. He obtained the Edinburgh MRCP in 1954. Keen competition in medical posts and the need to support a young family led him to sample psychiatry at St George's Hospital, Morpeth. He soon applied to the Maudsley Hospital where his application form contained the poignant entry that he was stateless, pending the proceedings for naturalisation.

At the Maudsley, Alex made rapid progress, soon being promoted to Senior Registrar. Aubrey Lewis had obtained a large grant (large for those days) from the Ford Foundation and employed Alex as a research assistant with a brief to study problems of oxygen uptake in anxiety. In a reference Aubrey said of Alex: ‘he has a steady, unruffled and painstaking style and he devotes himself to his work most diligently but without any blare of trumpets’. This was a perceptive awareness of his humility and reluctance to push himself forward.

The Maudsley was asked at short notice to provide a psychiatric service for Hungarians requiring help after the unsuccessful Hungarian uprising in November 1956 when 20 000 Hungarians were admitted into the UK. Psychiatric care of the refugees was difficult because of the language barrier. Dr David Davies, the Dean, knew that Alex would be able to help as a Hungarian psychiatrist, albeit with barely 2 years experience of the subject. Later Dr Davis wrote: ‘Dr Mezey handled the whole affair quietly, modestly and without fuss, even visiting provincial centres to give forensic reports’.

Alex did more than provide an advisory service. He wished to shed light on the ecological aspects of mental illness in the same way as Ødegaard who had estimated psychotic breakdown in Norwegian immigrants to Minnesota, USA. This was not possible in the absence of known prevalence rates of psychiatric breakdown in the population of Hungary. Nevertheless, the study yielded a wealth of clinical information about this unfortunate refugee population.

Alex examined 82 Hungarian refugees with psychiatric needs in the course of 2 years (1957–1959). Half of them gave a history of a previous mental illness. They had often dropped in social class when comparing their occupational status in Britain with that in Hungary. Severe mental illnesses were frequent: 28% affective disorders and 17% schizophrenia. Suicidal attempts had occurred in 11%. Paranoid ideas were an interesting reflection of the plight of these refugees finding themselves in a different culture with a language barrier. Hallucinated voices were often said to speak in English, and although the patients were unable to understand English, there was no doubt about their derogatory meaning.

For this study Alex devised an index of social adaptation in every patient including his time in Hungary. He found that they tended to be ‘marginal’ people already in Hungary before falling victims to the culture of isolation resulting from migration. He also thought his findings supported the ‘selection’ hypothesis for the differential incidence of schizophrenia in migrants. This work was published in the Journal of Mental Science in 1960.

After his consultant appointment at the North Middlesex in 1960, Alex's written output diminished. This was to be expected in view of his heavy clinical and administrative responsibilities including the Chairmanship of the Psychiatric Advisory Committee to the North East Metropolitan Regional Board. He had also built up a busy medico-legal practice over the course of 30 years. He acted as an expert witness in personal injury cases including the Zeebrugge ferry disaster, and the King's Cross Station fire.

Alex was merely biding his time for his magnum opus – his book on the psychopathology of creativity – Muse in Torment. In this book he reviewed a huge number of poets and novelists writing in the all the main European languages. He was a superb linguist: his mother tongues were Hungarian and Romanian, but he acquired a mastery of English and French and became conversant in German and Italian. In the introduction to his book he writes modestly that, when no reference is given to the translation of poetry, the translation is his own.

The aim of Muse in Torment was to demonstrate the continuity between the psychology of the author and his creation. His method was to provide a series of short but captivating biographies in which he revives the stories of the lives of writers and intertwines them with their main works. These biographies include an account of the authors’ families, early upbringing and privations, together with details of their personal lives including psychological disturbances and not sparing features of their sexual passions and proclivities.

Alex related the experiences of writers whose lives were afflicted with mental illness, but he went well beyond this, drawing attention to their unusual personality traits and personalities. Although it is sometimes said that the writer's personality should not obtrude into his work, Alex examined how unusual personality traits influenced the choice of subject matter. Thus, the work may betray the writer's motives whether they be those of the confessional or in order to draw attention to himself.

When discussing the roots of the writer's creativity, Alex examined parental influence, especially in the case of writers who lost their parents in childhood. He identified the strange paradox of a writer whose life of dissipation, or disordered conduct, is not incompatible with refinements of artistic creation.

He summarised his final conclusion by stating that mental distress or illness influences the what and when of creative writing. Knowing about the writer's mental life can enrich our understanding and appreciation of his work.

Alex's book was written in an elegant style and with a richness of language. He remained cautious in his interpretations and keenly aware that an assessment of the mental life of writers must take into account differences in the cultural and moral climates of the times they lived in.

Alex is survived by his wife, Daisy, who like him was a refugee from Hungary and whom he met in Switzerland. They have three daughters (one is Gillian Mezey, forensic psychiatrist) and five granddaughters. They are enormously proud of him and his achievements.