Another Kind of Madness by Stephen Hinshaw

Author:Stephen Hinshaw
Language: eng
Format: epub
Publisher: St. Martin's Press

8

The Iron Suit

During holiday visits to Columbus Dad and I sometimes saved our final talk until he drove me back to the airport, affording half an hour in the cocoon of the car. The streets and freeways faded in the intensity of the discussions. Ever more, I became initiated into the secret world of madness.

In one of our conversations when I was close to finishing college, it became clear that Dad wished to bring up additional information about the treatments he’d received. ECT was at the top of the list. Although stereotyped as barbaric in One Flew Over the Cuckoo’s Nest and other aspects of popular culture, ECT can be an extremely effective intervention for severe forms of depression. Yet during much of the twentieth century it was used indiscriminately and even punitively for almost any form of irrationality. Back then it featured overly long pulses of current, which often caused major side effects such as memory loss. In the earliest days, before anesthetics were used, patients might break a limb from the seizure-induced thrashing. It’s still not known exactly how ECT works. Placing an electric charge through a person’s skull and thereby inducing a brief grand mal seizure alters a great many neurotransmitters and brain processes. But which of these explains its beneficial effects on serious mood disorders remains a mystery.

Dad told me of his terror regarding the procedure back in the fifties. One such session at Columbus State Hospital, when Sally and I were quite young, stayed on his mind. The technicians, he told me, would place a steel arc on top of his head and clamp cold, metallic electrodes to his temples. After waiting—always the waiting—a surge of current would commence at his psychiatrist’s signal, sending his brain into a convulsion. His doctors had surmised that the medications he was taking weren’t doing enough. Talk therapy, such as it was, only scratched the surface. At the time, his diagnosis was chronic schizophrenia, but little matter: ECT was used indiscriminately during that era.

On the morning Dad was recollecting, he was lying flat on a gurney, listening to the squeak of its wheels echoing through the corridor. Pushed by an attendant, he was heading to the special room, the place he dreaded above all others. With his arms and legs strapped, he saw the globe lights glaring down from the ceiling, passing above his face every few seconds as the slow journey unfolded.

Above all, he must show no fear. Keeping his pride intact, he said, was essential. Once inside the room he’d be injected with medication, enough to make it impossible to sit up. He’d be powerless once more.

Finally inside the door, he braced himself. He saw the nurses, scurrying to record his vital signs. The technician entered, the one who would trip the switch to allow the current to flow into the wires attached to the clamps. Would the crackle of electricity produce smoke from the side of his skull? His head, in fact, felt like scorched earth each time he awakened.

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