Now comes Anne Donahue and her middle way. The Republican lawmaker from Vermont entered the world of ECT a decade ago, when she came home for a breather from overseeing programs for runaway kids in New York and Los Angeles. She started teaching, and playing a game during her commutes on the interstate: "I dared myself how long I could close my eyes before panicking and opening them. It was not a direct attempt at suicide, but I wanted to have a terrible car accident so I would be taken care of. People would realize how desperately I needed help."
She confided in a friend, who convinced her to go to the hospital. That led to a series of hospitalizations and medication trials to treat the depression she had been suffering since the mid-1980s. When they failed, her doctors convinced her to try ECT. She got 33 treatments in all in 1995 and 1996.
Her ECT was a triumph and a miscarriage. The treatment was able "to break the stranglehold of a seemingly intractable and severe depression." It saved her mental health and her very life. But it sliced into the life she had lived starting a full six years before her ECT. Memories from the year before treatment have not come back at all, those from two to four years before are hit-and-miss. Donahue is philosophical about the trade-off, comparing herself to a "cancer victim who must choose the horrible side effects of chemotherapy over certain death to the disease."
Most ex-patients would stop there, focusing on their personal recoveries. Holding things in is not Donahue's way. So she pressed hospitals and state regulators in Vermont to agree to one of America's strictest informed-consent requirements for ECT. She filed a malpractice suit against the teaching hospital in New Hampshire where she got her treatment, agreeing to a settlement under which it adopted Vermont's consent form and created a more candid video for prospective patients. She ended up as a reviewer of the American Psychiatric Association's latest book on ECT, and in 2002 was elected to the Vermont House of Representatives.
In the process, she has become a pariah. ECT critics cannot stomach the good things she says about the therapy, including that she would have it again. Boosters are at least as disdainful, suggesting that because her memory loss is worse than most, she must be imagining it. The truth is that the Vermont legislator represents a substantial minority of ECT patients who applaud what the treatment did for them but bemoan what it did to them. Even those who cheerlead for ECT generally have some complications to report, just as many who are bitterly opposed acknowledge that ECT did some good for them or someone they know.
It is not just patients who are eager to find middle ground in the ECT debate, but a growing number of psychiatrists. They know that ECT is one of their profession's most effective remedies but also know that too many patients suffer side effects. They are adjusting techniques in ways that demonstrably minimize those losses, in the process doing battle with fellow doctors who insist that attempts to lessen its impact on memory will lessen its impact on disease.