Shock treatments…

I have wit­nessed at least 20 elec­tric shock treat­ments in my life.  In my younger days I worked as a psy­chi­atric aide for six years at the Mid-Mis­souri Men­tal Health Cen­ter.  (When I tell my stu­dents this, some­one always comes up with the wiseguy ques­tion:  “Are you sure you worked there?”  My stock answer:  “There’s not much dif­fer­ence between my cur­rent job and my old one.”)  As I recall, the elec­tric shock treat­ments were gen­er­al­ly pre­scribed for one of two con­di­tions:  severe depres­sion or bi-polar dis­or­der (usu­al­ly in the man­ic phase).  I should amend that—I swear that some­times the psy­chi­a­trists (one in par­tic­u­lar) would try EST when he didn’t know what else to do.  My job was sim­ple; pre­pare the patient (NPO after mid­night, clean him up, wheel him in there), pre- and post-treat­ment vital signs, sit and watch him sleep afterwards.

It is real­ly a grue­some treat­ment.  The patient is deposit­ed onto a treat­ment table, var­i­ous elec­trodes and mon­i­tor­ing devices are attached, I.V. is start­ed, doc­tor says a few inane words, anes­thet­ic is admin­is­tered, patient counts back from 100 (six counts is good), mouth­piece is insert­ed, and then BAM!  It isn’t pret­ty when the volt­age hits the flesh.  The face con­torts, the mus­cles con­tract, the teeth are bared, the whole body seizes up—it prob­a­bly lasts five to sev­en sec­onds, but it seems a lot longer than that.  Then the patient goes limp.  I wheel him back to his room, put him in his bed, mon­i­tor vital signs every 15 min­utes for the first hour, every hour after that.  I don’t think I ever knew a patient who made it out of bed dur­ing the same shift after a treatment.

Ah, but the next day!  Talk about your mod­ern day Lazarus.  The first EST I ever observed was on an elder­ly woman so mor­bid­ly depressed I thought a gun to the head would have been a mer­cy.  The next day Eunice came out onto the ward neat­ly-dressed, full of smiles, cheer­ful as a mead­owlark!  She was solic­i­tous of oth­ers; she was the soul of coop­er­a­tion with her treat­ment team; she was trans­formed.  Look­ing at her, I won­dered what EST might do for me.  (But not for long—remember what I saw!)

Not for long…there was the rub.  Eunice was re-admit­ted to the hos­pi­tal about three months lat­er, suf­fer­ing from depres­sion.  Time and time again I watched peo­ple receive the shock ther­a­py, make a remark­able recov­ery, and then sink slow­ly, inex­orably, back into their pre­vi­ous con­di­tions.  A tem­po­rary salve.  My own response to observ­ing the treat­ments went from unpleas­ant to revul­sive, and I request­ed that I no longer be the aide select­ed to accom­pa­ny the vic­tim into the elec­tric cham­ber.  Most of the time they hon­ored my request.

Some­thing about elec­tric shock ther­a­py just does not com­pute.  How can that jolt of elec­tric­i­ty, which slams and con­torts and con­vuls­es your body, end up hav­ing a ben­e­fi­cial effect?  It seems like a bib­li­cal conun­drum:  can some­thing good come out of some­thing that appears so evil?

But I have to be fair-mind­ed.  My own father received elec­tric shock treat­ments.  Around the time he turned fifty, my dad sank into a deep depres­sion.  I was sev­en­teen at the time and total­ly absorbed in my own teenage angst, but I do remem­ber talk­ing with him one time about what was both­er­ing him.  He saw no pur­pose and no point to his life; he had no desire to do any­thing; his job was mean­ing­less; his rou­tine was dead­en­ing; his fam­i­ly would be bet­ter off with­out him.  He scared the hell out of me.  My moth­er had him admit­ted to a men­tal hos­pi­tal.  Weeks lat­er he had elec­tric shock treat­ments, and then he came home.  He was fine.  Same old Dad.  And he stayed that way for the rest of his life.  So what do I know?

From a broad­er per­spec­tive, we all get shock treat­ments in our lives.  Love ends (and it almost nev­er ends on a mutu­al basis).  Cat­a­stro­phe strikes.  Death of a loved one hap­pens.  Are we made bet­ter by these “shocks”?  It seems it can go either way—strength or debil­i­ta­tion.  I like to think we have some con­trol in the mat­ter, but I’m not so sure.  Most­ly I just want to avoid the treatment.

In the final scene of the sea­son finale of my cur­rent “favorite ever” tele­vi­sion series, my hero gets an elec­tric shock treat­ment.  The med­ical one.  And I feel like I’m sit­ting by her bed while she lies there uncon­scious, and I’m won­der­ing how she’s going to turn out.  I’m not optimistic.

Comments

  • Hey Dallin!

    I appre­ci­ate your obser­va­tions. I was the ECT nurse in Den­ver for awhile at some hos­pi­tals, the thing that was dif­fer­ent was that now treat­ments are giv­en after admin­is­ter­ing a form of curare so that the mus­cles don’t con­tort at all. At most you might see a toe twitch. The per­son does­n’t have mus­cle aches and pains the fol­low­ing day either. 

    Now there is also tran­scra­nial mag­net­ic stim­u­la­tion, not done with anes­the­sia as it is unnec­es­sary… used for severe and per­sis­tent depres­sion, PTSD … I appre­ci­ate all the inno­v­a­tive ways peo­ple are devel­op­ing to aid in psy­chi­atric care. 

    I don’t know if you know but I became a psych nurse prac­ti­tion­er 10 years ago and work in an office in Col­orado Springs, CO. I love being able to help people. ;-)

    Kathy (Roush) Myatt29 July, 2019
    • Thanks for the info, Kathy. I’m glad to know it has become a more gen­tle treat­ment. If I had become a nurse, I def­i­nite­ly would have cho­sen psych nurs­ing. I thought the work was fas­ci­nat­ing, even though I was just a psych aide. Great to hear from you! I see from Face­book that you are doing well.

      Dallin Malmgren29 July, 2019
  • Thank you for the infor­ma­tion, and the web­page cer­tain­ly looks good. Just what wp theme are you utilizing?

    Jeffrey Smith15 February, 2012

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