I am the first patient of the morning. No one else is around. They clip to my finger a device that measures the oxygen in my blood. They stick a bunch of electrical leads on my legs, arms, and over my heart. The anesthesiologist comes over and says, "I'm going to give you a shot of sodium pentothal. You'll be asleep within seconds." I am lying down. He says to think of something bright and cheerful. I think about Michael and our anniversary.
It was the medical madness of an earlier era, a remedy forever equated with thrashing limbs and obliterated memories.
Now, at the same Harvard teaching hospital that Kitty Dukakis gets her treatment, 20 patients a week volunteer for shock therapy. All are tormented by depression too deep to defy or another disabling disease of the mind, and all, like Kitty, are counting on 20 volts of electricity to jolt their brains back into equilibrium. Muscle relaxant ensures that the only signal of their seizure will be a twitch of the toe; anesthesia guarantees they will not remember that paralysis or anything else leading to the convulsion. Scores more line up for similar sessions at two dozen other hospitals across the state. Even at nearby McLean, one of America's most exalted citadels of psychiatry, 50 patients a week are transfused with enough current to kindle a 60-watt bulb and, if the procedure is true to its well-established form, vanquish the demons of the moment.
In Massachusetts as in the rest of the nation the evidence is unmistakable: ECT is back.
A procedure pioneered in the 1930s that seemed on the edge of extinction just a generation ago is being performed today at medical centers large and small, on patients staying in the hospital and on a growing number who simply show up an hour before treatment and leave an hour after. More than 100,000 Americans a year get ECT for ailments ranging from mania to catatonia, with 10 to 20 times that many worldwide. Electroconvulsive therapy is now as ordinary as hysterectomy and twice as common as knee replacement surgery. And it all is happening just enough out of sight that it has taken many medical professionals by surprise. Madness no more, electric shock is quietly being resurrected as a restorative wonder that someday could rank right up there with penicillin and Prozac.
How one of the most reviled psychiatric procedures is fast becoming one of its mainstays is an astounding yet untold chapter of American medical history. It is a narrative that begins with an epidemic of mental illness that has stubbornly resisted a cure, and a handful of doctors who have equally stubbornly refused to give up on a remedy that most had banished as barbaric. Researchers still have not filled in the puzzle of how or why ECT provides relief, although the proof is compelling that it does, faster and more surely than drugs or talk therapy. Questions also remain about the price that shock patients pay in memories lost, in rare cases permanently, and whether such risks can be minimized or eliminated entirely. The rise, fall, and rise again of ECT thus remains an epic without an ending, as practitioners and potential patients alike wait to see if hopes for success are sustained and it can come back all the way.