ELECTROSHOCK
Picture a dark and stormy night, an elderly woman down in a puddle, convulsing. Next to her head, we see a live power-line, still sparking. Entry/exit points on the victim's temples are evidenced by faint first degree burn marks.
You're the doctor.
What do you do? Apply the end of the power cord to her temples again?
OF COURSE NOT.
You give life support, insert an IV, maybe administer an anti- convulsant.
You bring her to the Emergency Room where a brain scan is performed. Later an EEG will be done to see if there is slowing or residual seizure activity. She is closely watched. Confusion is to be expected, the only question is how much and for how long.
Recurrent seizures - called epilepsy -are something neurologists are supposed to do their best to prevent.Yet many
1 psychiatrists are systematically programming entire series of convulsions.
It isn't that easy to kindle a human brain into convulsing. The brain's natural resistance to seizing must be overcome with a threshold amount of energy.
The minimum, or threshold amount of energy, - 20 Joules (more for the elderly) necessary to trigger a convulsion is damaging, typically producing an organic brain syndrome usually limited to amnesia and apathy (or in 10 per cent, euphoria) but there have been numerous documented instances of acute cerebral hemorrhages (see illus. and ref. below) and infarcts, ongoing cognitive problems, even spontaneous epileptic seizures both acute and chronic.
Leeching was rationalized on the basis of Medieval notions of humors and very similarly ECT is rationalized on the basis of myths of mental illness. There can be no such THING as a mental illness although as a label it's equivalent to hanging a sign around a person's neck: "garbage."
I don't care what they say: the mental health business is the stigmatization business and nothing more or less. It's hardest to see the air we breathe. If you think you have an open mind, test it by reading something by Thomas S. Szasz, M.D.
2 Consider the possibility that there are no such things as "bipolar disorder" and "schizophrenia," except in the imagination of psychiatrists. Consider the possiblity that these words don't stand for diseases "just like diabetes," that they have no concrete referents.
The brain can have disease and it can be proven by testing. The mind cannot have a disease in anything but a metaphorical sense. "Schizophrenia, bipolar disorder, inadequate personality" and all the other nonsense syllables in the psychiatric lexicon exist only in the minds of believers. They've never turned up on a brain scan or a blood test and they lead to equally imaginary "treatments."
Electroconvulsive shock is the "auto da fe" of such psychiatric "treatments." It is no less harmful in 1996 than it was when Cerletti and Bini invented it in Rome in 1938.
"There's lies, damn lies and statistics." -Mark Twain-
The Cerletti-Bini sine-wave voltage regulated straight-from-the- wall machine put out 70 Joules while today's machines are quite capable of administering 150! A Joule is a common measure of energy allowing for comparison of energy in its various forms e.g. heat, electrical, mechanical etc. One Joule =.7373 foot pounds so that 150 Joules might be expressed as a 110 lb weight (.7373X150) falling one foot - on your head.
3 (reference - among others - Cameron, Douglas. in ECT: Sham Statistics, the Myth of Convulsive Therapy and the Case for Consumer Misinformation published in the Winter/Spring 94/95 Journal of Mind and Behavior, (V 15 p 177).
Doug was on Hard Copy this past February 26. He and Diann'a Loper were instrumental in getting the Texas law in place protecting children from ECT.
See also: Horror Stories From the Mental Health System: Electroconvulsive Therapy: 200 First person Accounts of Permanent Memory Loss - Edited by Cameron.
These THALAMIC HEMORRHAGES were found at autopsy carried out one hour after the death of a previously healthy 57 year old man who received 5 electroshocks (120 Volts, .2 seconds) in October 1949....."but soon afterwards his mental state deteriorated again, and it was decided to give him another series..."
(after the second shock on November 6) "The patient awoke as usual, and went home. Contrary to his former behavior he kept to his bed this time and fell slowly into a condition of unrelieved drowsiness....Two days later he began to vomit spontaneously ..."
He lapsed into a deep coma and died on November 12, six days after his last (the 7th total) shock.
The authors (Liban E, Halpern L, Rozanski J:Vascular changes in the brain in a fatality following electroshock. J
4 Neuropathology and Experimental Neurology 1951 V 10 pp 309- 318) comment:
"The clinical picture and its obvious development in connection with electroshock treatment indicated a subarachnoid hemorrhage."
The massive bleeding illustrated above is probably* rare, but some breakdown of the BBB occurs with each and every shock.
Reporting deaths from ECT is rarely done voluntarily. Texas now requires such reports and according to the Houston Chronicle for Tuesday, March 7, 1995: "Eight people died in Texas within two weeks of receiving electroshock therapy...."
These eight deaths among 1600 "recipients" yields a death rate of 1/200, far higher than accounted for by anesthesia alone (3/100,000 x number of "treatments"), but EXACTLY the same statistic found in Impastato's 1958 review.
Electricity follows the shortest course (fronto-temporal lobes and diencephalon including the thalamus) and the least resistant course (blood vessels, not insulated axons). It induces spasm in the vessel walls, a pressure spike consistently over 200 systolic, and subsequent lactic acid buildup. The blood vessel walls become fatigued, swollen and leaky. This is known as a breakdown of the blood brain barrier (BBB) and it isn't good for the brain.
MRI scans in 14 patients showed edema peaking 4-6 hours after each and every shock "consistent with an extensive but temporary breakdown of the blood-brain barrier during ECT." I
5 found Mander's paper (British Journal of Psychiatry, 987: V 151, pp 69-71) cited in the 1990 FDA proposal to reclassify ECT as justifying it's safety!
ECT is being used with increasing frequency on the elderly who have a hard time getting respect for anything least of all their minds. And it is actually being promoted as an instrument for screening memory drugs.
ECT is an excellent laboratory paradigm or model for both epilepsy and amnesia. For many years pharmaceutical researchers with drug companies have been using ECT on animals (they sometimes call it ECS, Electroconvulsive Shock, same thing) as an effective screen for anticonvulsants. DILANTIN was discovered by Putnam and Merrit in this way in 1938.
Now with demographics driving, the race is on for memory enhancing drugs and ECT is being used to screen for them.Rats are taught to jump before their floor grid is zapped by learning a signal (a light or buzzer etc - this is called conditioned avoidance.)
Then the experimental animals are given electroshock and a predictable percentage actually forget to jump. Then they are given test drugs, shock and the grid again to see if they do any better. This is OK with me. If a smart drug or a neuroprotective drug really turns up, the Nobel Prize is in order.
The troublesome thing is that the National Institute of Mental Health has awarded MANY millions of taxpayer dollars in grants to Harold ("Are ECT Devices Underpowered?") Sackeim, Ph.D. (refer to his deposition in Rohovit v. Mecta et al - (Mecta settled) in the Iowa District Court for Johnson County, Law No. 54289 ).
6 Dr. Sackheim is the Director of the public facility, the New York State Psychiatric Institute. Most of the awards are for unspecified work with ECT induced amnesia - probably in humans. The foundation has been well laid: see almost anything recent by Harold Sackeim Ph.D. or check Laura Frochtman, M.D.: Animal studies of ECT: foundation for future research in Psychopharmacology Bulletin, 1994. V30 No 3 pp 321-444)
CLASSIC 1938 ANIMAL
EXPERIMENT By ECT Pioneer - "I was there" - Lothar Kalinowsky for those with Netscape 2.0 or better
bunny.wav
You really need to see this animation with its granular old time feel and old world charm of a Hitler home movie. This appears to have been the sum total of pre-market trials for the ECT machine. At least on rabbits. They also did a lamb. And coming soon: kittens.
Thesis-antithesis - we may be seeing a backlash to the orchestrated promotion of ECT over the past decade if USA TODAY is any indication of mainstream sentiment. Their
7 excellent series and Editorial the week of December 4-8, 1995 was a terrific exposé.
The effect of a course of ECT on the EEG is dramatic with slow waves persisting up to 6 months afterward.
Anyone reading this probably has a surge protector on their computer. ECT is a power surge 10,000X the brain's background energy. Convinced?
If you would like to get in touch with those who are working to end the BIGGEST BOGUS TREATMENT OF ALL TIME contact David Oaks or check his website.
*The career path for critics of ECT is usually short which partially explains why autopsy reports on ECT deaths all but disappeared after 1955. Certainly, the deaths continued.
This CT scan (left) and MRI (right) of a VERY LARGE BLOOD CLOT from ECT can be found in: Weisberg, L. Elliott, D and Mielke, D: Intracerebral hemorrhage following electroconvulsive therapy. November 1991, Neurology V 41 p 1849.
8 AMARILLO SHOCK SHOP Dallas Morning News
May 24, 1997
___ Shock therapy scrutinized in wake of woman’s death
Lawmakers want to halt unnecessary treatments
By Scott Parks
AMARILLO - The death of a chronically ill 79-year-old woman in a mental hospital has focused new attention on the emotional debate over electroshocktherapy as a treatment for depression. The woman, whose identity is protected by confidentiality laws, died 24 hours after a shock treatment Dec. 30, 1995. Medical records described her as confused and disoriented when she signed into The Pavilion on Dec. 27.
The Pavilion is an 85-bed, private psychiatric hospital in Amarillo, the heart of the Texas Panhandle. The woman was kept in the hospital’s locked geriatric ward - a place called Passages. State legislators are pointing to her death and others like it across the state as they consider new laws to prevent hospitals and psychiatrists from giving unnecessary shock treatments to elderly people covered by Medicare.
"It [shock therapy] could be a moneymaker for those who use it unscrupulously; that is correct," said Sen. Jerry Patterson, R-Pasadena, who is sponsoring legislation to put more regulations on shock therapy for the elderly. Pavilion administrators deny that shock therapy is a high-profit procedure. They say medical reviews found no evidence that shock treatment contributed to the 79- year-old woman’s death. Still, critics have designated Amarillo and The Pavilion as "the shock capital of Texas." State records say psychiatrists gave the treatment to 201 Pavilion patients during the year ending Aug. 31, 1996 - more than any other Texas hospital. Memorial Southwest Hospital in Houston ranked second with 126 shock patients.
Under fire from Texas and federal regulators, the hospital announced that it stopped providing shock therapy May 1.
"It is a corporate business decision," said Richard Failla, The Pavilion’s top administrator. "There has been a lot of [anti-shock therapy] propaganda over the
9 last 18 months. And harassment of hospitals that do it." State records kept during a three-year period ending Sept. 1, 1996, show that 17 Texas mental patients died within 14 days of receiving a shock treatment. The records, which include the Amarillo woman, do not allege cause-and-effect between the treatments and death. Mr. Patterson’s bill would require two doctors to certify that shock treatment is medically necessary for patients 65 or older. It also requires the doctors to inform patients or their legal guardian whether shock treatment might worsen other medical conditions. The proposed law passed the Senate last month and was reported out of a House committee with no amendments. It awaits consideration by the full House. The Legislature adjourns June 2. Patient gave consent
Texas Department of Health inspectors examined a random series of patient records at The Pavilion in February and March. The 79-year-old woman was among them. Inspectors said she had undergone knee replacement surgery, suffered a post-surgical heart attack and "an exacerbation of congestive heart failure." She also had a urinary tract infection.
The woman was put in a nursing home. Records said her medical problems had stabilized and that depression had become "her major health problem." The nursing home transferred her to The Pavilion on Dec. 27, 1995. Medical records said she was suffering from unstable blood sugar related to diabetes, incontinence, bedsores on her buttocks and swollen hands and feet. "She was able to ambulate only 3-4 steps only with maximum assistance, choking easily on food or fluid, needing total assistance with personal care." She was also disoriented and confused, according to inspection reports.
"This patient, although not competent to give informed consent, was allowed to sign herself into the psychiatric unit and to sign for [shock therapy]," inspectors wrote. Inspectors said The Pavilion violated a 3-year-old state law by allowing the woman and several other mentally incompetent patients to sign themselves into the hospital and then sign papers consenting to shock therapy. The woman took her first shock treatment Dec. 29 - two days after arriving at The Pavilion. Nurses found her "unresponsive" at 7:15 a.m. the next day. She died several hours later.
The federal Health Care Financing Administration, which monitors the Medicare program, considered the case serious enough to put the hospital on "the short track" toward terminating Medicare reimbursements for patient care.
Andrew R. Perez, a federal official who monitors hospital quality, sent The Pavilion a warning letter April 11. He said the hospital constituted "a serious and immediate jeopardy to patient health and safety." He gave The Pavilion 10 days to submit a corrective plan of action or face loss of its Medicare privileges by May 8. "The case itself is terrible, obviously," Mr. Perez said.
10 "It’s very serious anytime we take an action like this." Health care experts say most hospitals depend on Medicare for 35 percent to 50 percent of annual revenue. Termination would be devastating for a hospital, they say.
Regulators oversee 500 Texas hospitals. The Pavilion was one of 11 put on the short termination track since July, federal officials said. Dr. Michael Jenkins, The Pavilion’s medical director, said the hospital changed its admitting policy. Patients must now be "factually competent" - meaning they must know the time, place, who they are talking to and the nature of their medical problem - before they can sign themselves into the hospital. The newpolicy leaves few treatment options, Dr. Jenkins said.
CROCODILE TEARS
"These rules tell me to send the patient back to the nursing home," he said. "Medical literature tells me to treat the patient. So what do I do?" He concluded, "I think some patients are going to die in the nursing home when they could have been helped."
Inspectors came back to The Pavilion early in May and found enough positive changes to take it off the termination track. "We’ve gotten word that the termination action will not be pursued," Mr. Failla said. "They are satisfied that we responded to their concerns and are now in compliance with Medicare regulations." Some say therapy safe The health care industry’s formal name for shock treatment is electro-convulsive therapy, or ECT. Psychiatrists say they prescribe it only after psychoactive drugs fail to relieve debilitating depression or manic depression.
To the chagrin of shock treatment opponents, nationally recognized professional associations of psychiatrists and physicians all recognize ECT as safe and effective. The therapy typically comes in a series of five to 10 treatments - a treatment every other day over a two-or three-week period. Sometimes, doctors give a single "maintenance treatment" on an outpatient basis. Psychiatrists administer the procedure in a hospital’s surgical suite. After anesthesia, electrodes are attached to the unconscious patient’s head. At the other end of the wires is a briefcase-sized machine that provides the electric pulse. The electricity is applied for about a second, inducing a seizure that lasts 20-30 seconds.
Opponents say those seizures can result in brain damage, epilepsy and prolonged memory loss. ECT advocates say the electricity-induced seizures changes the brain’s chemistry for the better, eliminating suicidal tendencies and improving the patient’s life. Last month, the Texas Senate’s committee on health and human services heard testimony on Mr. Patterson’s bill requiring two physicians to review medical records before the elderly receive ECT. Some patients said ECT is the only thing standing between them and suicide.
11 "It is better for me to have the treatments because the other choice I have is death," Virginia West, a manic depressive, told the committee. Others said ECT impaired their ability to think, work or perform routine tasks such as getting dressed. "It has devastated my life," said Jane Betzen, a former ECT patient. "It’s inhumane. It needs to be stopped." In recent years, the Texas Legislature has banned ECT for patients under age 16 and passed new regulations to keep hospitals from exploiting the mentally ill.
Sen. Patterson says he does not favor banning ECT for everyone. "My bill is meant to reduce the likelihood of manipulation of an elderly population that may have recently become eligible for a medicare benefit that covers this [ECT]," Mr. Patterson said. Numbers questioned State regulators accused The Pavilion of giving shock treatment to too many patients. Pavilion administrators said the number - 201 patients in the most recent 12-month reporting period - looked big because the hospital serves a vast area of the Texas Panhandle, western Oklahoma, southern Colorado, eastern New Mexico and the southwest corner of Kansas. Pavilion administrators say their company didn’t even own the hospital when the 79-year-old woman died Dec. 30, 1995. Records show Pennsylvania- based Universal Health Services Inc. bought the Pavilion and its parent, Northwest Texas Hospital, from the publicly owned Amarillo Hospital District about a year ago - some four months after the death.
The Pavilion and 45 other Texas hospitals reported giving shock treatments to a total of 1,781 patients from Sept. 1, 1995, to Aug. 31, 1996, according to reports on file at Texas Department of Mental Health and Mental Retardation. County, state and federal tax dollars paid for a vast majority of the treatments. Most of the patients were white females; many of them elderly, according to state records. Health care experts estimate 10 ECT sessions for an inpatient would run $10,000 to $20,000 during a 15-to 20-day period.
"No one’s getting rich treating elderly patients on Medicare," said Dr. Jenkins, The Pavilion psychiatrist. "There is no doubt ECT saves lives. I know it. I’ve seen it."
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