Star Tribune from Minneapolis, Minnesota on December 10, 1978 · Page 93
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Star Tribune from Minneapolis, Minnesota · Page 93

Minneapolis, Minnesota
Issue Date:
Sunday, December 10, 1978
Page 93
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Minneapolis Tribune Sun., Dec. 10, 1978 13F Shock From 1JF . . , . glvea against a patient's will. "The ' forcible 'treatment' of any Individual with any 'therapeutic' tool Is by my definition torture and should be out ' lawed," wrote Dr. David L Rich- man. a Berkeley, Calif., psycliophy. siologlst who helped form a group called the Network Against Psychlat- Bernstein, who also is one of the few Minnesota psychiatrists prescribing psychosurgery, disagrees. "I as a '. psychiatrist believe that people have a right to good medical treatment," he said. "And sometimes people can't judge what is good medical treatment." i In Minnesota, "forcible" shock treatment is legal, but not without a quasi-judicial hearing The consensus is that shock is Inappropriate for "situational depression" grief over the death of a loved one, for example, or brooding over catastrophic financial loss. It Is more apt to be recommended- for organic or "endogenous"' depressions, those coming "from within." The Comprehensive Textbook of Psychiatry calls such use of EOT "one of the most spectacular therapeutic responses In metilcine." Benson Is lying on his back, about to get bis second shock treatment. He's in a small room, not nearly so frightening as an operating room.' Positioned about him are Fisher, his psychiatrist; Dr. Harold Coulter, anes thesiologist; a nursing supervisor, and a male attendant. Coulter quickly finds a vein In Ben son's wrist and Infuses his blood with Sodium Pentothal, which renders him unconscious, then with Anec- tine, a muscle relaxant. An elastic "gag" has been placed In Benson's mouth so he won't bite his tongue. Coulter now stands behind Benson's head to "breathe" for him by rhythmically squeezing a flexible mask covering the patient's nose and mouth. Fisher flips the switch sending cur rent through Benson s brain, when the spasms die down, he Is wheeled unconscious Into an adjacent recov ery room, where he Joins two or three unconscious middle-aged wom en. Nobody knows exactly how ECT works to ease depression or other mental Ills. Bernstein, In an Interview, called it "serendipity or some thing." noting that emotions nowa days are believed to be "some kind of electrical current" Bernstein, an associate of Fisher. was Imprecise about how often he uses shock. But "because of the pressures" (from outside groups) we are probably using less than we should," he said. Because he elves shock. Bernstein said, his malpractice Insurance cists I 11,200 a year, compared witn ihuo for his psychiatrist wife, Dorothy, who doesn t give it. Dr Margaret Keenan. another Min neapolis psychiatrist. Is skeptical, at best, about ect. "I haven't run across a oetlent in 4V4 years of practice that I would give shock to," she told an .Interviewer, "it's some sort of infringement of an individual's potential for change and srowth" to be treated with "some thing potentially traumatic like shock," she said. i ECT should be used "as a last resort for somebody who la suffering in tensely and not responding to other forms of treatment," Keenan saw. She and others prefer to emphasize Individual counseling, in conjunction with drugs. If necessary, to help the patient face problems that lead to depression. i - To hospitalize a depressed patient for shock after a one-hour Interview Is "lazy psychiatry and Inhumane patient care," she said. Keenan recalled her days as a psy chiatric resident In a Minneapolis-area hospital. The hospital's pro-shock doctor was secretly dubbed "Reddy Kilowatt," she said, and resi dents were required, on rotation, to show up at 7 a.m. for their turns at pressing the shock button ror a pa tient they might not know. x After a tew minutes In the recovery room, Benson returns on foot to his hosoltal room with the help or a hospital aide. His gaze Is foggy, and he moves hatlneiy. appearing oerua- died that a visitor Is waiting at his bedside. It It the same visitor he talked with at length less than an hour earlier. "Remember, me?" the visitor asks. Benson doesn t. "You got a shock treatment," the visitor says. "I did?" Benson says. "I didn't even realize that." "You know where you are?" "No... a hospital." "You know which one?" "I'll remember If I think about It ' At St Paul-Ramsey Hospital, Dr. Stephen Butzer, director of in-patient psychiatry, said many shock patients are "inappropriately diagnosed," Including those who have "situational" depression, not the "organic" variety. And It's to the psychiatrist's financial advantage, Butzer said, to prescribe ECT rather than more time-consuming therapy. At St. Paul-Ramsey, he said, a psychiatrist gets $37.50 for each shock treatment. And that, Butzer said, "Is $37.90 for pushing the button," a job he said could be done just as well by the anesthesiologist. k At his hospital, Butzer said, a psychiatrist also gets $30 a day, eeven days a 'week, while a patient Is hospitalized for shock, which normally is given three times a week. But of nearly 1,500 psychiatric patients in ' - ( 'J -i, ' Dr. Margaret Keenan 187?, .only six got ECT at St. Paul-Ramsey, Butzer said. Late afternoon, Sept. 29. Benson Is resting alter ECT that morning, lying fully dressed on his hospital bed. He props a pillow under his armpit so he can talk with the stranger who has returned to his bedside. His eyes are clearer now, but he still remembers nothing about the moments just before the morning's shock treatment. He doesn't smile much, and his voice Is flat. Reviewing the events that landed him in the hospital, he relentlessly blames his "mistakes. " Shock 15F Expert shoe repairs. Visit our newly remodeled ahoe repair dept. Save Mon., Tues., Wed. While you walt-or-shop service. Halfaolee.compoaltloru rtA Women'eheellifta q v ' Men's pr.O.99 (ixoptnti pr. C9 . Leather SlMtri Women'a e n Toe pieces and q ' half soles pr. 9.99 plates, women's pr. 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