Re: a plea in mitigation


Subject: Re: a plea in mitigation
From: Tim O'Connor (oconnort@nyu.edu)
Date: Tue Nov 13 2001 - 15:12:28 GMT


On Tue, Nov 13, 2001 at 09:53:21AM +0000, Scottie Bowman wrote:
 
> I think, actually, my real exasperation is with the commonality
> who by keeping abreast of the Health pages of the NY Times
> feel themselves on the cutting edge -- having forgotten what
> Proust pointed out long ago: that the history of medicine is
> simply the sequential replacement of one fashionable view by its
> contradiction.

Good (and uncommon) point!

> Wonder drugs & CAT scans & stereotactic surgery
> still play only limited & rather doubtful roles in psychiatry.
> Humanity & imaginative understanding remain irreplaceable.
> You can still come across them under the starchiest of uniforms
> & the wildest of hairdos.

I'll second that. I've met some really, supremely wonderful people in
your field, as well as one or two certifiable loons. (Who were
nonetheless brilliant, despite their obvious inability to fit into the
world easily.)

And (to stray away from the topic of psychiatry but still keep in the
area of "wonder treatment") I've encountered at least one person, whom
I would not trust to weed a garden, at the controls of stereotactic
surgery gear; I kept a loved one far from the hands of this goon, whose
chief medical interest, it appeared, was in churning up more surgical
business, regardless of the state of the patient -- who, not incidentally,
happened to be far beyond the help of the most sophisticated radiosurgical
regimen. But many people facing an abyss will buy just about any
treatment claims when they've run out of choices and don't want to face
harsh reality.

Nothing replaces the good human element in either field, to echo what
you said.

As far as ECT and Kesey's book, I will say that I was infinitely more
influenced in my thoughts about that procedure by (a) The Bell Jar; (b)
biographies of Sylvia Plath that detailed *her* response to ECT, which
led to the creation of The Bell Jar; and, most of all, (c) anecdotal
information from people who had relatives who underwent ECT and were
never quite the same, particularly in terms of memory. I was also a
little unnerved by what I read in the recent book THE NOONDAY DEMON,
which documented various approaches, through history, in treating
depression.

I guess that if I were in the depths of despair -- more than my usual
quota -- I might accept ECT before going the Frances Farmer route, if
ECT were my only choice and if I had utterly exhausted all reasonable
pharmaceutical and talk-treatment options. I don't know about anyone
else in this banana republic of ours, but I most particularly cherish
my grasp of memory -- and have experienced illness that has attempted
to pry that memory from my grasp, with middling success -- and so I'm
not keen to subject myself to some procedure that might, or might not,
muck with what and how I remember.

Then again, I'm fortunate to be speaking now from a safely vertical
position behind a keyboard.

If I were horizontal and enrobed, and in the trough of unusual despair,
I grant that my opinion on the subject might be considerably different.
I am certain that the "humanity & imaginative understanding" (as you
more than aptly put it) of the doctor would be a key factor in deciding
what to do.

Thanks for adding an especially insightful and provocative comment to
a conversation I've been following quite keenly, if (until now)
silently!

--tim

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