The patient, the doctor, and his “facsimile”

lma ellen page 94
Ellen Evans Roff, from the Stone Asylum casebook, 1903. This image appears with permission from London Metropolitan Archives (City of London).

Tracy and I recently spoke about The Cowkeeper’s Wish to the wonderfully enthusiastic and knowledgeable group, the British Isles Family History Society of Greater Ottawa (BIFHSGO), and in preparation for the event, I was reminded of our work researching Stone Asylum in Dartford, Kent, where one of our relatives, Ellen Roff nee Evans, spent a number of years in the early 1900s, “suffering from melancholia with marked depression,” the case notes say.

On our research trip back in 2012, were fortunate enough to read through these casebooks ourselves at London Metropolitan Archives, and to see the red-rimmed photographs that accompanied the notes. As we turned the rippled pages wearing our white gloves, we learned a little about some of the other women who were at Stone in the same years Ellen was. One grinned out at the camera with a challenging expression, and another glowered with her arms folded. An elderly patient sat with a nurse standing behind her, to prop up her chin for the portrait. She was “harmless and weak,” the notes say, but also “dirty and demented.” The most astonishing portrait showed a young woman pressing a hand over her eyes, and hugging her torso with her other arm. The notes say, “She believes she is here to have her light taken out.”

I wanted to dive into each of these stories, and find out as much as I could about these women — but of course we had enough work on our hands telling our own family story. So we took some photographs, jotted some notes to give context to Ellen’s experience, and closed the book. Years later, though, I think of the women often.

One of them gave her name as Annie Elizabeth Hancock nee Strachan. She was 39 years old in 1907, when she was admitted to Newport Asylum in Wales. The record gives her address at the time as 1 Woodland Road, Newport, but there’s no doubt she was a London woman, which must be why, in 1909, she was transferred to Stone Asylum, where Ellen was. She was diagnosed with delusional insanity, with causes listed as “family troubles and a love affair (prolonged mental illness).” Case notes tell us she believed she was “able to hear in her own head the thoughts of others.” Tucked in with the doctors’ notes was a letter she’d written herself, warning Stone Asylum’s Medical Officer of Health about a possible impostor among them.

Dear Sir,

There has been so much shuffling over my not going home that there must be some reason for it, on Dr. Nelis’s part. Early last August Dr. Nelis went for a 3 weeks holiday. He was a fat man with a very red face, bright blue eyes with remarkable clear whites and dark hair and moustache with a short clipped beard. At the end of August, his facsimile came back, but it must have been either his twin brother or a very near relation, but there were differences in the two men, slight, it’s true, and most people meeting him casually perhaps would not notice. The man that returned had always a pale face, hair greyer, beard much greyer, eyes of cloudy grey with a touch of blue; the whites were dull with brownish splotches; his shoulders seemed broader, and he walked with a quicker step than Nelis. Now this second man had been about the asylum on isolated occasions before the August holiday, because I had noticed the difference in face and beard. But the two men were so similar I knew it was no good making remarks. On the last Sunday in September, the bright blue eyed man reappeared and I had a good look at him because I asked him if I could have a room upstairs in 6 as I got smoke in my sideroom in Ward I. This man I never saw again in the asylum, & if that was the first Nelis returned for some purpose of his own, he had dyed his beard and moustache jet black, because the original Nelis’s moustache & beard were dark brown. Dr. Nelis was Dr. Glendinning’s assistant at Abergavenny for 25 years, [so Glendinning] ought to know if it was the same man. . … Anyone can see what a muddle such a state of affairs might cause. … If they are two men, where is the first Nelis, & what did he go for? & if the second man is not a doctor at all, he can be prosecuted for practicing without certificates. …”

stone patient letter crop
Annie Elizabeth Strachan, from the Stone Asylum casebook, courtesy London Metropolitan Archives (City of London).

Annie wrote this letter in March 1909, shortly after being admitted to Stone. Dr. William Francis Nelis worked at Newport, not at Stone, so one would guess Annie was attempting to convince the powers that be at Stone that something untoward had gone on at Newport, and was preventing her discharge. I wish now that I’d photographed all the pages about Annie in the Stone Asylum casebook, but I’m left with only fragments, and a growing curiosity about both the patient and the doctor with the bright blue eyes — not to mention his pale facsimile.

Annie Elizabeth Strachan was the eldest of five, born in London to Archibald and Elizabeth Charlotte Strachan in 1867. Her father was a butcher, and the family lived on Albany Street for many years. In 1891, though, they appear with her grandparents in Lambeth, and Annie, 23, is listed as “artist — oil and watercolour.” By 1901, her mother has died, and she is working at home as a lace milliner. The surprising detail here is that, though she is living with her father, her grandfather, and a grown-up brother, Annie herself, the only female, is listed as head of the household.

So what happened to land her in Newport and then Stone Asylum? The clue lies somewhere in the “family troubles and a love affair” note in her file, and perhaps in her surname, Hancock. I can find no appropriate record of an Annie Elizabeth Strachan marrying a man named Hancock, and a note in her file states “proper name is Miss Annie Elizabeth Strachan” — note the underscoring. So was Hancock the man she had the affair with and simply wished she was married to? Certainly our own Ellen, estranged from her husband Fred Roff, used a different surname — Humphreys — when she met and had children with another man, though they never officially married. Maybe something similar happened with Annie. The probate record for her mother’s death in 1894 includes the name Robert John Hancock, coachman, but so far I can’t officially link him with Annie.

Of Dr. Nelis, more surfaces. William Francis Nelis was born in Australia in 1855 to Irish parents. His mother and baby sister died when he was just three, and he and his father eventually moved to Scotland. Nelis studied medicine, and was drawn to the field of psychiatry. After a brief stint as a ship’s surgeon, he took a position at Carmarthen Mental Hospital, and then at Abergavenny, where he remained for 25 years,  the very detail Annie Elizabeth Strachan included in her letter. But the curious thing is, Annie does not seem to have been a patient at Abergavenny, so how did she know that Nelis had worked there for 25 years? According to the obituary, she was right, too, that at Abergavenny, Nelis was assistant to Dr. James Glendinning — the man Annie felt certain could spot a fake Nelis, because they’d worked together for so long. But again, how did she know of Glendinning? In 1905, Nelis was appointed Medical Officer at the newly opened institution at Newport, which must be where he and Annie encountered each other, since she entered that asylum in 1907. Nelis remained at Newport for the rest of the his career, retiring in 1929, just three years before his death.

The new hospital was apparently his life’s work, and according to his obituary, he treated the patients there with an uncommon kindness: “his ear was ever ready to listen to their grievances, however trivial.” Obituaries always emphasize nice things about people, but the write-up but goes on to say that he was a profoundly knowledgeable psychiatrist, and that modesty and shyness kept him in the shadows. “He realized there was a long road to travel before the secrets of mental diseases were laid bare.” He was also interested in botany, and had an “artistic bent,” like Annie the painter, perhaps; he oversaw the landscaping of the grounds at Newport, where a long avenue of trees led to the asylum, and shrubs were arranged artistically around it.

“Dr. Nelis was under middle height, but in spite of lack of inches, he had a dignified personality; his eyes were keen and shrewd, and he was endowed with common sense and excellent judgment. In addition he was blessed with an extraordinarily retentive memory, which remained unimpaired to the end. He could recall by name patients who had left the hospital many years before, together with their peculiarities.”

No doubt he would have remembered Annie Elizabeth Strachan just as clearly as she remembered him.

When Dr. Nelis died, he willed some of his money to his longtime housemaid, and to others who’d worked for and with him at the asylum; other portions went to a number of different hospitals, nursing funds, a society for the blind, and a hospice for the dying. The largest portion by far went to the Committee of Visitors of the Newport Mental Hospital, Caerleon. They were asked to use the money at their discretion to assist “necessitous mental patients on their discharge from the hospital.”

Once again it strikes me that a man is often much easier to research than a woman, especially when he has money and an important position, and she has neither. I have yet to discover when — or whether — Annie Strachan left Stone Asylum, or if her suspicions about Nelis and his facsimile were ever put to rest. She doesn’t appear at Stone on the 1911 census, but I haven’t found her with certainty anywhere else either. One positive note is that her case file suggests her recovery is “probable,” so maybe she fared better than our Ellen, who left Stone in 1910 only to re-enter the workhouse, where she lived out the remainder of her years. Perhaps in Annie’s case the “family troubles” mentioned in her file got resolved? Her record shows she entered Stone as a pauper patient, but was re-classified as a private patient in 1910. So someone, somewhere was contributing to her care.

stone asylum
Courtesy the Wellcome Library


City of London Mental Hospital [later Stone House Hospital], Patient Records, Female Casebooks: CLA/001, London Metropolitan Archives

William Francis Nelis obituary: Journal of Mental Science, Volume 78, Issue 322, July 1932 , pp. 766-767

“Large Charitable Bequests.” Western Morning News, 29 June, 1932.


11 thoughts on “The patient, the doctor, and his “facsimile”

  1. Marilyn Charbonneau

    Curiouser and curiouser….how interesting. The letter she wrote sounds as if she was quite intelligent. I hope Annie Elizabeth was somehow cured of her delusions and life got better for her.

    Liked by 2 people

      1. Alison

        So glad you are enjoying it. I loved his latest novel ‘Days Without End’ too and have also read ‘On Canaan’s Side’.. I would also thoroughly recommend Patrick Gale’s ‘A Place Called Winter’ which is semi-biographical about his grandfather who emigrated to the newly colonised Canadian prairies, abandoning his family. It’s very moving. I’d welcome any recommendations too!


  2. Very curious… there may have been some truth in what Annie wrote. But which parts and how much? Speaking and/or writing through the lens of mental illness doesn’t necessarily mean there isn’t truth, only that the listener or reader requires their own mental dexterity find it. My heart goes out to Annie, Ellen and all the others who endured this confusion and Stone Asylum.

    Liked by 2 people

    1. Yes, I wondered the same. Maybe he did go off somewhere, and something happened during the time he was away that made him seem different when he returned. And she picked up on that because she was sensitive and intelligent.


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