(2 of 4)
But even today, when the worst pain is usually a headache after patients awaken, some say they are coerced into electroshock and lied to about it. "The doctor told my family it was an absolute cure for depression," says Juli Lawrence, who underwent electroshock in 1994. But the following week she attempted suicide. She says her doctor also failed to warn her about the memory loss usually associated with electroshock, which can range from forgetting where you parked your car to forgetting that you own a car at all. The memory loss is often temporary, but not always. (A 1999 Surgeon General's report says there are "no reliable data" on the incidence of severe memory impairment.) Lawrence says she can't recall any events from nearly two years before and from several months after her treatment. She now runs ect.org a website critical of electroshock that works to stop the treatment from being forced on people. (Roughly 1% of those who undergo electroshock are ordered by a judge to do so, according to state figures published on ect.org.
Of course, uninformed medical consent is a problem not exclusive to electroshock, and judges can force other kinds of treatment as well. But electroshock is an unusually retro procedure, one that some psychiatrists avoid. According to the Surgeon General, the response rate for electroshock is an impressive 60% to 70%--about the same as today's superpills, including Prozac and its kin. But that fact itself embarrasses some psychiatrists, who would rather not think of themselves as well-educated electricians. Not all psychiatric residents learn electroshock. Younger psychiatrists are more ambivalent about it than older ones, according to a 1999 survey. After all, even the latest electroshock devices look something like Led Zeppelin-era stereo equipment. They are based on technology so old the FDA says they predate its regulatory authority (the agency has classified the devices in the category it uses for equipment whose risks are high or unknown). The website for the Thymatron, the Cadillac of electroshock devices, still features a painfully outdated page on how to test the device for Y2K compliance.
But when performed properly, psychiatrists say, electroshock is simple, safe and looks a lot more boring than its cinematic counterpart. Curtis Hartmann, 47, a Westfield, Mass., lawyer who has received about 100 electroshocks since 1976 to help control his bipolar illness, knows the procedure well. Hartmann fasts the night before, a routine practice before general anesthesia. He leaves his home around 4 a.m. and drives to nearby Holyoke Hospital. He goes to the second floor and turns left toward the short-stay surgery unit. His body is prepared for electroshock in three ways: an anesthesiologist puts him to sleep; a chemical relaxes his muscles; a respirator helps him breathe.
All these steps are taken to protect him from the physical side effects of having a seizure, which is what happens when the electrodes are attached to Hartmann's head and electricity courses into him. For reasons no one quite understands--just as no one is precisely sure how all antidepressants work or why some people improve with good old-fashioned talk therapy and others don't--the seizure is key. Hartmann explains it this way: "The seizure just kind of dynamites the depression out of my brain somehow."