Tuesday, January 6, 2009

ECT (Electroshock Treatments): Humane or Inhumane?

In April 2004 I came home after a three month stay and ECT in a Connecticut hospital. This is my account of it in two relatively brief blog entries plus the comments that accompanied it. I did not enter the comments that preceded it, which came in the wake of my long absence, but they were many.

After three months of an in-patient stay, I am thoroughly sick of hospitals. In an out of restraints and room seclusion innumerable times, on one-to-one with a sitter for weeks, having more than 13 ECT treatments, half by court order and deemed necessary by my sister and conservator, it was a miserable time all around right up to the last day there. I emphatically do not recommend it! I would like to get back to regularly blogging, but for now simply want to announce that I am home and ready to resume where I left off. I did do a radio interview by phone while at St RaphaelĂ­s, with Bill Lichtenstein's INFINITE MIND series (*in 2008 BL's series was removed from NPR after discovery of a hidden conflict of interest between the main psychiatrist in it being paid by drug companies and the promotion of certain drug-related psychiatric prescriptives, which could no longer be seen as unbiassed or objective). You can find it by doing a google search for Infinite Mind, then once at the Welcome screen, doing a search for FOUR LIVES and clicking on the link that allows you to listen on-line. Any feedback from listeners will be greatly appreciated. My twin sister and I are featured in the second half of the hour-long show. But for now, here endeth my 14th blog entry, short as it is, with promises to resume at greater length ASAP. Glad to be home and back on-line!

I had a chaplain friend in the hospital who said that saying Fuck God was at least a relationship, and a meaningful one. Hope this doesn't overly offend anyone. But read the poem and you'll see how I mean it.

By Pamela Spiro Wagner

"Fuck God," you say, the worst thing
you can think of, and "Jesus F. Christ!"
when everyone knows what blasphemy
the F stands for. And because the lightning bolt
doesn’t strike you down as you’ve been
promised, you decide he, or she, if God,
doesn’t much cut it in the omnipotence
department. You would smack anyone else
who said such a thing, meaning
you, yet God doesn’t even send a thunderclap
or an ominous massing of clouds
off to the northeast just to remind you
Who’s Who.
So now you stand sheepishly
in church between the pews while others do
things you’ve completely forgotten, mumbling
the Lord’s Prayer which is all you have not,
and pray no one you knew as an atheist
sees you with your head in a hymnal.
God you swore off as a militant teen and are ashamed
to be seen going back to just for succor
in a time when all your friends
nod at you in the street but won’t stop
to speak except to explain prior engagements
like the house fire they’re running
towards or from, or the big C
they had an MRI for with ambiguous results.
Even death won’t shake them
from the strenuousness of their disbelief.
They’re convinced God is for children and idiots
with substandard IQ’s or people who need
their heads examined. So in church, kneeling
because others are kneeling, you examine
your head for shit-for-brains
when through the open door tumbles
a small bird, landing on your shoulder,
in its beak it bears a twig,
and in its eyes a look you almost recognize.


My chaplain friend says I am courageous to dread ECT as much as I do and yet submit to it, but I’m going to disappoint her in that, because despite being court-ordered to treatment sessions, I’m quitting any but the most forced participation and even that I shall do my best to sabotage. I can’t tolerate it any longer; it is a torment going to sleep and an even greater one waking up in enormous if amorphous distress and confusion, and it later fills my days with nausea, headache and olfactory hallucinations. I simply cannot see how unlimited once-monthly sessions can benefit me, at least not any more than they supposedly already have. And the dread discolors my days for weeks in advance. I don’t care that it’s the best they can offer me right now: I don’t want it and don’t feel I need it or that the benefits outweigh the costs and/or uncertainties. And if they try to send the police after me (since I shall neither arrange a ride nor the required daily companion) I shall simply eat a large breakfast, effectively sabotaging any efforts on their part since I know they cannot give me anesthesia on a full stomach. That is how I thwarted them in the hospital when I wanted to refuse: I’d simply grab some food from the kitchen and quickly down it before they could stop me, and that short-circuited the day’s treatment session.

If I have to, if things start breaking down seriously, I can take a low dose of Zyprexa, which though it induces weight gain, is preferable to ECT’s horrors. And there’s no proof that I shall need that at all, since I am quite compliant on my Geodon and several mood stabilizers. I just can no longer live in this constant state of dread and fear, not when I know how to alleviate them and when I see little use in allowing such a state to continue.

Let me describe a session for you, just in case there are those of you who have never experienced it before.

First all of all, no food or drink after midnight (effectively after dinner) and no anti-convulsants the night before, no medications on the morning the treatment is scheduled. Nothing by mouth at all. Then you arrive at the clinic and the first thing they do is give you a shot of Robinal to dry up any oral or bodily secretions that might interfere with the ECT session in some way. If you’re lucky, they can take you in a half hour later. Then you get up on the stretcher and lie down with your head on this little pillow and they start searching for an appropriate vein into which they will direct the anesthesia. Meanwhile, they squeeze some electrical jelly onto a headstrap and tighten that around your forehead. They place some electrical detection pads and leads on your chest as well and once the IV is inserted tell you you’ll be going off to sleep soon. Then you smell/taste something awful as the anesthesia briefly registers before you lose consciousness. Nothingness follows, until the nurse shakes you awake telling you it’s all over, the treatment has been done and you’re almost ready to go home. You’re moaning, half asleep still, and uncertain the worst is past, and it takes you some time before you’re conscious enough and steady enough on your feet to get down off the treatment table and toddle on through to where your companion is waiting for you. Several times I’ve retched immediately, though not every time. I know I’m never quite sure I’ve actually had the treatment or if they are still making me wait for it, interminably and cruelly. The anesthesia smell follows you for quite a while, and though they counsel one to eat a light breakfast, eating is the last thing on my mind. All I want to do is lie down and sleep off my headache and queasy stomach. I don’t feel immediately better as they claim I look (I think that is wishful thinking on their parts) and in fact I’m not sure I’ve felt better at all after session #13 or so. I’m not convinced I wouldn’t have gotten just as much better with some closer nursing contacts and some kinder people to talk to during the last 3 months.

Anyhow, that's my brief synopsis of an ECT treatment session. I know it doesn’t sound so terrible, but to me it is frightening in the extreme and I want no more part of it. If EP-MRI’s were available I’d jump to use them as they’ve been shown to be far less invasive and just as effective (at least according to a Scientific American article last month.) But so far no one’s offering them. So I’m stuck with either accepting or rejecting ECT and my choice is now to reject the treatment as not worth the cost/benefit ratio. I know some people will disagree strenuously, but they are they and can tolerate what has become intolerable to me, and of little obvious benefit. God bless them. They are perhaps better people than I am, but I’ve reached the end of my rope and the end of believing that this is something worthwhile doing.

seeLink to Wordpress Wagblog post on ECT

1 comment:

Anonymous said...

I think it's really great how you overcame this huge obsticale. I to struggle with schizophrenia. I have tried all sorts of medications which none worked for me I had thought that I was out of choices but then I had a doctors appointment we discussed medication treatment that's where latuda was mentioned so I tried it and your right within a few days I notice a difference within my thoughts and behavior one last thing before I go thanks for your story it was insperationai