Minogue, Sylvester John

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MB 1922 MS 1922 DP 1925

Sylvester Minogue, a psychiatrist, is credited with establishing the first Alcoholics Anonymous group in Australia in 1945.[1]

Sylvester graduated in medicine in 1922 gaining honours in Surgery and winning the Hinder Memorial Prize for Clinical Surgery. He then completed his residency at Sydney Hospital, working under surgeon Howard Bullock. Even at this early stage, Sylvester was interested in psychiatry and chose not to accept a position at Sydney Hospital but to commence work for the NSW Health Department while undergoing his training in psychiatry. He accepted postings as a Resident Medical Officer, first at Gladesville Hospital and then later at Callan Park Hospital. He received his Diploma of Psychiatry in 1925.

Sylvester then transferred to Stockton Hospital, where he treated people with intellectual and other disabilities and rose to the level of Medical Superintendent. It was common for NSW Health Department practitioners to be transferred around various regional hospitals and Sylvester’s career reflects this. In 1935 he was posted as Medical Superintendent to the (later named) James Fletcher Hospital in Watt Street, Newcastle and in 1937, moved to Kenmore Mental Hospital in Goulburn. Whilst there:

He spent all his spare time researching medical text books and journals gleaning all he could about alcoholism. He explored the use of hypnosis, electro-convulsive therapy, group therapy and the use of drugs such as Antabuse. None of them seemed to have any lasting effect… [At the hospital] he had established recreation areas for patients and reduced the number of padded cells, locked doors and barred windows.[1]

Although his methods and reforms were not wholeheartedly embraced by the NSW Health Department, it was evident that Sylvester’s reforms were producing better outcomes for recovery and rehabilitation for patients. Yet, with the outbreak of World War II, the Australian Army took over Kenmore Hospital and Sylvester was transferred to Rydalmere Mental Hospital.

However, just before he left Kenmore Hospital he read an article in the Readers Digest about alcoholism and AA. His interest was aroused further when he read a more scholarly article in the American Journal of Psychiatry by American psychiatrist, Dr Harry Teibout. Sylvester was excited about the prospect of treating alcoholism in this manner and the prospect of beginning an organisation like AA in Australia. The following is an extract of the letter he wrote to the Editor of the American Journal of Psychiatry in the USA in December 1942 requesting information about AA:

Dear Sir I am interested in the formation of a Branch of the Alcoholic Anonymous in New South Wales. I would particularly like to know the steps to be taken to form such a Society, its rules and organisation, how members are recruited and once the Branch having been formed, how Members are kept interested.

Also, and this seems to be the most difficult point for us to understand, where the treatment of acutely alcoholic members is undertaken? If a Hospital is necessary who pays the cost of its maintenance? What finance must the Society have for its activities? Is this levied from the Members or does it receive State or any other assistance? All this information as well as any other relevant matter or literature would be of vital interest to us.[1]

His expression of interest was passed on to the New York office Secretary of the fledgling movement Alcoholics Anonymous, which then numbered some 8000 members. The Secretary of the USA Central Office, Bobby Berger wrote back to Sylvester promising to send him a complimentary copy of the book Alcoholics Anonymous. In March 1943, Sylvester contacted the USA headquarters stating that the book “had arrived and was proving to be a mine of information” for him. This was the beginning of a fruitful correspondence between Sylvester and the New York General Secretary for several years as they exchanged information and ideas for treatment. As a psychiatrist with long experience working in public health hospitals, Sylvester was able to share his clinical observations, particularly that “…acute alcoholics recover rapidly in hospital, and relapse just as rapidly on their discharge!!”[1]

The first Australian AA group met at Sylvester’s hospital residence at Rydalmere, NSW in 1945. According to an early member, they “held a few meetings there but it was an inconvenient place to travel at night and another venue was found”.

AA owes a great debt of honour to this very caring psychiatrist. He helped members to understand the nature of the disease of alcoholism. He was a man before his time in the field of alcoholism. He not only helped to establish AA but he attended meetings for many years to help and encourage many members who turned to him for help. I don’t believe he ever turned anyone away.[1]

Sylvester remained Medical Superintendent at Rydalmere Hospital until 1947, when he decided to enter private practice as a psychiatrist in Macquarie Street, Sydney. His friend and colleague Matron Sadie Kessell[1] has described Sylvester as ‘kind and sympathetic’ and suggests that his move into private practice was partly because he felt that it would free him from the restrictions and bureaucracy of the public health system. With Matron Kessell he ran a private hospital for alcoholics in Strathfield where many prominent citizens were treated.[1]

Sylvester continued his private practices but took on an additional role when he succeeded William Page as Honorary Psychiatrist at St Vincent’s Hospital, Sydney in 1949. At St Vincent’s he pursued his work with chronic alcoholism and introduced meetings of Alcoholics Anonymous into the Hospital. In those days, the department of Psychiatry had no specific site within the Hospital, nor any substantial inpatient capacity. Nevertheless, along with Bill Page and John Kerridge (and their colleagues), Sylvester is acknowledged for his establishment of ‘consultation-liaison psychiatry’ and psychiatric outpatient clinics.[1] He retired from St Vincent’s Hospital in 1960.

Sylvester continued his private consultations until 1974. However, his most lasting legacy is the ongoing Australian Branch of Alcoholics Anonymous. Since its beginning in 1945 with 13 members, AA Australia has flourished to become the (approximately) 18,000 member strong society it is today.[1]

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Citation: Mellor, Lise (2008) Minogue, Sylvester John. Faculty of Medicine Online Museum and Archive, University of Sydney.

An alternate version appears in: Mellor, L. 150 Years, 150 Firsts: The People of the Faculty of Medicine (2006) Sydney, Sydney University Press.