A high-risk case’s tragic end

USA Today Series

A high-risk case’s tragic end

The late Roberto Ardizzone was a physical wreck – the type of high-risk patient who frequently undergoes shock today. The pizza chef from Sicily weighed 372 pounds and stood only 5 feet, 7 inches.

The 32-year-old giant had a big heart and a big temper. He’d do anything for friends, but when his mood swung, he might attempt suicide or punch out windows.

He’d had shock therapy in 1990 to help depression. He wanted it again. But he weighed 100 pounds more than last time. His doctors at the University of Texas-Medical Branch in Galveston refused to do it. He was “morbidly obese,” they said. The doctors believed his weight made it too dangerous.

Psychiatrist John Wamble agreed to do it. So did anesthesiologist Aslam Ilahi, who asked the hospital’s chief of anesthesiology for advice. “I told her, ‘Don’t do it. You’ll lose his airway,’ ” says Michael Chavin, then chief of anesthesiology at Baycoast Medical Center in Baytown, Texas.

The airway is a tube inserted to give the patient oxygen during the procedure. According to a Texas Department of Health report, Ardizzone’s pre-shock medical assessment stated: “Short, thick neck. May have difficult airway.”

Shock therapy went ahead at 11:30 a.m. July 23, 1993. Almost immediately, Ardizzone lost his airway.

“We almost lost him on the table,” says Chavin, who rushed in from another operating room to help.

Ardizzone awoke combative, struggling to breathe. He was sent to intensive care. For two days, he remained agitated, screaming, struggling to breathe. He told a nurse he couldn’t take it anymore. At 10:50 p.m. July 25, Ardizzone staggered to the nurse’s station – face pale, lips blue.

He collapsed and died.

His death certificate lists: “Respiratory Insufficiency, severe; (possible) pulmonary embolism; morbid obesity; hypertension.”

Wamble says the death “was an adverse drug reaction. If you look at ECT-related death . . . the major risk is putting someone to sleep.”

He says Ardizzone was insistent on shock: “He was a rather emotional fellow. But he was well liked by the nursing staff. If he wasn’t jumping up and down hollering, he got along very well with everyone.

“In retrospect, he had a smaller trachial airway than the average person,” Wamble says. “But presented with the same situation, I wouldn’t have done anything differently.”

Ilahi declined comment. After Ardizzone’s death, Baycoast stopped doing shock altogether.

Salvatore Ardizzone, the patient’s brother, is bitter. He thinks the doctors should have denied his troubled brother’s request. He filed a lawsuit in July over his brother’s death.

“This is the treatment saved for people society considers worthless. Roberto used to tell me, ‘Sal, I want to die. I want to be an angel.’ “They” gave him his wish.”

By Dennis Cauchon, USA TODAY

Shocking but true: Michelle Shocked

April 20 2003
The Age, Australia

Slavery, rape, arrest. They’re all just the ups and downs of life for Michelle Shocked, one of the music world’s true survivors.

By Larry Schwartz.

Fond though Americans are of citing various amendments to their constitution, singer-songwriter and sometime political activist Michelle Shocked had misgivings about calling on the 13th in the midst of a legal wrangle a few years back. The 1865 amendment marked no less a moment than the abolition of slavery in the US, and here was Shocked invoking it in the midst of a bid to free herself from a contract with her record company, Mercury.

“One of the criticisms I subjected myself to was, ‘Michelle, you’re not black. How dare you invoke this particular legacy for your little career and commercial purposes?’ But the answer is very clearly, ‘I’m sorry, but this is a right all Americans possess thanks to the sacrifice of those brave and noble African-Americans who gave their lives for the cause’.”

The Texan, who plays two shows in Melbourne this week, says she told herself the amendment issue came about when the record label blocked her plans to record a gospel album as a follow-up to her 1992 CD Arkansas Traveler. The label reportedly rejected her new songs on the ground that they were “inconsistent” with her style.

“I think Prince kind of put it most succinctly,” Shocked says, citing this time the musician who was, for several years, reduced to a symbol by his own clash with a record company. “If you don’t own your masters � he’s talking literally about your recorded masters, but he’s also talking poetically about the people who believe they own you as an artist � you’re a slave.”

The amendment says that “neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction”. Mercury settled, and Shocked released a collection called Mercury Poise � its title alluding to Graham Parker’s 1979 song Mercury Poisoning, which was itself a comment on his troubles with the label.

“They cost me seven years,” Shocked says now. “They cost me a lot and, what’s more, they wilfully did it knowing that I could never get those years back. But I had to find a faith. I had to find a joy that could not be taken away.”

In part, she found that in religion. Some Sundays, you’ll find Shocked, who is now in her early 40s, in the congregation near her Los Angeles home, where she finds she can “easily blend in” with celebrities such as Denzel Washington, Halle Berry or Stevie Wonder in the pews. Other Sundays she’s in a tiny “storefront” church near her second home, in New Orleans, where on a good day there’ll be 100 people and she’s invariably “the only white girl (and) everyone is glancing out of the side of their eye to see how you’re managing to enter into this world that’s not your own”.

Religion has been a constant presence in her life, though not always an easy one. Shocked divided her childhood years between her mother’s devout Mormon household in smalltown Kelsey and her “hippy atheist” father’s in Dallas.

“That’s the glaring contradiction of my biography,” she says. “That my mom was a fundamentalist Mormon and my father I actually sometimes describe as a fundamentalist atheist. He was so avowedly atheist that he could almost not tolerate the presence of a believer. It’s like kids like to rebel. But what’s to go against? Where can you go with that? You’re damned if you do and you’re damned if you don’t.”

In response, Shocked adhered to neither the religion nor the atheism of her upbringing. Instead, she sought her own spiritual path. “I don’t know that I was ever convinced by the Mormon story,” she says. “But what I say is this: I am by nature a spiritual person. I’m an idealist. I’m a romantic. I’m someone who looks at the big picture. Causes are far more compelling to me than commerce. I think all those are the qualities of someone who has a spiritual nature.”

But even spiritual people need to make a living, and the dispute with Mercury has often made that very difficult for Shocked. She was forced to sell her 1994 album Kind Hearted Woman at live shows. The record was released through a label called Private, which folded just months later (in the wash-up, she gained control of her catalogue, copyrights and publishing). In 2002 she recorded Deep Natural with guitarist and long-time collaborator Fiachna O’Braonain of the Irish band Hothouse Flowers, and released it with an alternate CD of instrumentals called Dub Natural to launch her own label, Mighty Sound.

Now she has plans to reissue The Texas Campfire Tapes (1986), an early tape of her music on a Walkman with weak batteries that emerged as a bootleg by a British independent label; Short Sharp Shocked (1988); Captain Swing (1989); and Arkansas Traveler (1992), a CD that featured artists as diverse as Pops Staples, Doc Watson, Gatemouth Brown and Taj Mahal.

Despite the intermittent output, Shocked retains a strong following in Australia, where fans treasurer memories of live performances including duets with Paul Kelly. “My associations with Australia, even from the earliest days, go back to my love for Paul Kelly’s music,” she says.

“I go by the MCG and I think, ‘There it is’. Or Adelaide. A lot of my impressions of Australia have to do with the body of work that Paul Kelly has made.

“But Australia is a lot like Texas,” she continues. “The attitudes. The people. They’re casual, not really pretentious. They start wars with boring dictators on the flimsiest of pretexts. No, I’m crossing boundaries there.”

Now in her early 40s, Shocked has endured more than her share of setbacks over the years, and not all of them at the hands of record companies. She was committed to a mental institution by her mother when she was in her teens; she left home at 16 and, after literature studies at the University of Texas, roamed through California playing mandolin and fiddle in street bands; she became a political activist with a mohawk hairdo, was arrested by police at a political convention in the US and was raped by a fellow activist after an anti-nuclear protest in Sicily.

All that, she says with surprising serenity, “is the highs and lows of the human condition. We all have really, really bad things to work through”.

When she was in the psychiatric hospital, she received shock treatment. So who was she before she was Shocked? She gives a roundabout answer, directing the curious to a “hidden track” on an early album in which she is introduced to an audience. “The announcer says, ‘Ladies and gentlemen, Michelle …’ And then he says my last name, before I was Michelle Shocked.”

She offers another clue. “I’ll give you a simpler answer,” she says, “because my brother is now a professional touring musician as well, originally with Uncle Tupelo, then Wilco, now with The Gourds. And, for what it’s worth, his name is Max Johnston, how’s that?”

I forgot giving birth after electric shock treatment – patient

New Zealand Herald

A woman who says she lost her memory after receiving electric shock treatment at Christchurch’s Hillmorton Hospital wants the practice outlawed.

But the doctor who oversees the treatment in Canterbury said banning it would “condemn several people to death”.

The woman, who asked to be called Carole, was given electro-convulsive therapy (ECT) for post-natal depression.

Two years later, she said she could not remember giving birth to her daughter and forgot what day it was and people’s names.

Carole, 31, of Christchurch, did not have custody of her daughter because of her condition.

She was given 15 ECT treatments in two months shortly after the birth of her daughter in October 2000.

She suffered from post-traumatic stress disorder before her daughter’s birth, and was diagnosed with post-natal psychosis after being admitted to the mother and baby unit at Christchurch’s Princess Margaret Hospital.

She was put on a variety of drugs for her condition.

When doctors told her she would benefit from a course of ECT she seized the opportunity, hoping it would make her better.

“I would have done anything to get well,” she said.

But the 15 treatments of ECT robbed her of precious memories, and she refused further treatments, she said.

“They said I would get two weeks’ memory loss. But I can’t remember what it was like to have my wee girl. I have lost the birth experience and what it was like to be in labour.

“I can’t remember how it feels to breast-feed. It is like she (my daughter) has popped out of nowhere.”

Richard Porter, who oversees ECT at Hillmorton, said it was suitable treatment for people with severe depression.

He said some people were so sick that drugs did not work or they physically could not take drugs.

“Some people find it (ECT) distasteful, but it is effective in about 80 per cent of cases,” he said. “Without it I think several people would be condemned to death.”

One of the side-effects of ECT was memory loss, but there was no evidence that it lasted, Dr Porter said.

Parliament’s health select committee has asked the Government to review the safety and effectiveness of ECT after receiving a 3000-signature petition from the Patients Advocacy Group in Hamilton.

The petition said the treatment had left people with brain damage and memory loss.

ECT is administered under general anaesthetic and patients are given a muscle relaxant. An electric pulse applied to the temples induces a brain seizure.

Health select committee chairwoman Steve Chadwick said the committee was concerned no national data was kept on ECT use.

She said district health boards (DHBs) should be required to publicly disclose ECT use.

“Without this it is not possible to monitor ECT outcomes… or make comparisons between DHBs (district health boards) about the rate of use of ECT,” she said in a report to the Government.

Dr Porter would not disclose how many Hillmorton patients had been treated with ECT in the past year.

“I don’t think it is appropriate,” he said. “It will be misinterpreted.”

Improvement’s a shock to system

Monash Journal
April 9, 2003

ELECTRO convulsive treatment (ECT) or electric shock therapy, as it was once known, conjures images of cruel doctors holding mentally ill patients down as they fry their brains with electricity.

Yet a little delving into the method will lead one to discover that the treatment is commonly used and effective in beating depression.

Tania (not her real name) from Mulgrave has suffered from depression for some time and earlier this year reached the lowest point of her life. After trying anti-depressants and spending months in and out of hospital, her doctor suggested she try ECT.

“My depression was at a very low point where I wanted to hurt myself, I had tried many anti-depressants, but they weren’t working.

“When it was suggested to me I was scared, but I felt optimistic that there might be another form of treatment which might work.”

Tania has received one round of treatment, which means six times over a two-week period and said it has been effective.

Psychiatric and ECT director at Dandenong Hospital George Osianlis said the treatment was effective in treating depression because it induced a seizure in the brain causing changes to brain chemistry and an “unjumbling of negative thoughts”.

Dandenong Hospital runs ECT treatments three days a week and Dr Osianlis said the hospital had been using it for 50 years.

“It is a lot more common and safe than people think. If somebody was to observe modern-day ECT they would see it is short, and the patient feels nothing throughout the procedure.”

He said that public perception needed to change and movies such as One Flew Over the Cuckoo’s Nest showed the procedure in a bad light.

Tania agrees: “I know I thought it was archaic, and all I could think of was the horrible scenes in movies. I think the public still view it as an outdated and dangerous treatment.”

Patients are given an anaesthetic and are connected to a thymation machine. Electric plates are put on their head and connected leads determine the dose of electricity to be sent to the brain.

Tania said she remembers nothing from her treatments but has experienced tiredness, headaches and short-term memory loss.

While these symptoms are common, Dr Osianlis said improvements to patients’ depressed state could be seen after only a couple of treatments.

New Sparks over electroshock

FEBRUARY 26, 2001
Time Magazine

The old treatment has come a long way since Cuckoo’s Nest. But some still question its safety

On some gut level, the whole idea of electroshock therapy is absurd. At a time when people with mental illnesses can choose from a pharmacological cornucopia, why would they have electricity run through their brain instead? Didn’t electroshock disappear around the same time as three-martini lunches?

Actually, electroconvulsive therapy, as psychiatrists call it, has remained a common treatment for those who are severely depressed and who don’t respond to (or can’t tolerate) drugs. Its use in the U.S. has been quietly on the rise in the past two decades. Because most states don’t require reporting on electroshock, there are no hard figures, but many people in the electroshock world agree that at least 100,000 Americans receive the treatment annually, up from a 1980 federal estimate of 33,000. Research on electroshock has also surged. Just last month the American Psychiatric Association released a second edition of its report on electroconvulsive therapy; it lists more than 1,000 citations.

Why all the interest? One reason is that electroshock remains a nagging scientific puzzle: it works a little bit like banging the side of a fuzzy TV–it just works, except when it doesn’t. Second, a small but persistent group of advocates wants to ban it–they say it causes brain damage–and a larger, more mainstream group of activists wants more research before the treatment spreads any further. Many of these folks are former patients (or survivors, to use a term of choice), and they have helped persuade a handful of state legislatures to consider a ban. No states have agreed, though at least four have enacted restrictions.

Psychiatrists and some former patients who found the treatment beneficial are rushing to try to prove the dissenters wrong. An ugly war of words has erupted. Dr. Peter Breggin, a psychiatrist who has written four books critical of electroshock and who favors therapy and human services instead, told Time that shock is used by “cold, aloof guys who seem to feel more comfortable with machines than patients.” Dr. Harold Sackeim, who runs the department of biological psychiatry at the New York State Psychiatric Institute, responds that caregivers who forgo the use of electroshock and other biological methods to treat the suicidally depressed “are going to end up with a lot of dead patients.”

If you are a filmgoer of a certain age, your image of electroshock was shaped by such movies as The Snake Pit or One Flew Over the Cuckoo’s Nest. In the latter, a small army of orderlies and nurses restrain Randle Patrick McMurphy (Jack Nicholson) as he is connected to the electrodes. The treatment is agonizing because McMurphy isn’t given anesthesia, which has been routine for years.

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 U.S Food and Drug Administration 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 an 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.”

Before Italian researchers first tried electricity in 1938, doctors used chemicals to induce the frightening, painful seizures. Electricity worked faster, but the pain of uncontrolled convulsions remained. Patients fractured their spine, bit their tongue, broke bones. Consequently, the devils who ran some asylums used electroshock as punishment. In many circles, it retains a frisson of barbarity. Writers such as Ernest Hemingway and Sylvia Plath reinforced the image. “It was a brilliant cure,” Hemingway wrote sarcastically in the days after his electroshock and before shooting himself, “but we lost the patient.”

Hartmann quotes that line in his fascinating, not yet published memoir, Life as Death. He knows some people don’t respond to electroshock, and he understands the risk he takes when he undergoes it (his most recent treatment was mid-2000; he currently takes medications). A tiny number of patients die: the U.S. National Institute of Mental Health says the figure is 1 in 10,000, about the same as any procedure involving anesthesia. Antishock activists cite Texas statistics from the mid-’90s, saying about 1 in 320 electroshock patients died in the two weeks after treatment, though the deaths weren’t necessarily caused by electroshock. The activists also say electroshock causes brain damage. Dr. Breggin says the damage produces delirium so severe that patients can’t fully experience depression or other higher mental functions during the several weeks after electroshock.

Yet a 1999 Surgeon General’s report argues that “there are virtually no absolute health contraindications” for electroshock. It notes that psychiatrists have revised their technique for delivering the electricity in the past generation so that less power is needed and, consequently, fewer side effects result. For his part, Hartmann says he has often gone to work around noon after morning electroshock sessions. “The people in the office are just agog that you can add two and two, that you’re not drooling,” he says. “But my concentration was actually improved, and I felt so much better.” Hartmann says the memory problems he has experienced have been minor–getting confused about what he ordered from the hospital menu, for instance.

More important to Hartmann is the fact that since he first experienced depression at 15, electroshock has been “the only thing that has ever let me feel 100% … Depression is like being a corpse with a pulse. I tried everything else. I had a loving family, thousands of hours of good psychotherapy, and none of it ever helped.” Hartmann believes he would have killed himself–perhaps by starving himself, as he tried once–if not for electroshock.

It’s no panacea, of course. Electroshock’s effects are short term, lasting weeks or months before depression can descend again. At $2,500 a treatment, it’s also expensive, though insurance usually covers it. Antishock activists say it’s just a cash cow for hospitals and that the response rates cited by the Surgeon General are inflated. In 1996, Lawrence of ect.org surveyed 41 former electroshock patients and found that 70% said the treatment had no effect on their depression. Joseph Rogers, executive director of the National Mental Health Consumers’ Self-Help Clearinghouse, says 3 out of 4 of the electroshock patients he speaks with had negative experiences: coercion by psychiatrists, confusion, memory loss. Rogers and Lawrence don’t want the treatment banned, but they believe few would undergo it if they knew all the risks beforehand.

It’s hard to know what steps people will take when despair rules. Novelist William Styron has long battled depression; his 1990 memoir about it, Darkness Visible, inspired Hartmann and millions of others. Last summer Styron underwent electroshock for the first time. He had asked several prominent psychiatrists about the option, and they agreed it could help. It didn’t, though he says he didn’t suffer any negative side effects. “Anyone who would ban it is ridiculously off base,” he says.

A ban seems unlikely–the psychiatric establishment uses its clout to quash the idea wherever it can–but more states could require more complete and open records on who gets electroshock. “The problem is it’s a roll of the dice,” says Brian Coopper, senior director of consumer advocacy for the National Mental Health Association. “Electroconvulsive therapy can be a quick fix, but you can’t tell who’s going to come out of it with part of his life missing.”


Descent into darkness
By Louise Kiernan
Chicago Tribune
February 16, 2003
First of two parts

The mothers are searching for their daughters.

They are always searching for their daughters, even though their daughters have been dead for more than a year now.

At a march on the lakefront, the two women share a hug and a murmured joke, heads close, hands woven together. On the telephone, they whisper so they won’t wake napping grandchildren.

In a meeting of mental health experts at a dingy medical library, they trade a quick wave across the room. They explain who they are.

“I’m Carol Blocker and I lost my daughter through postpartum psychosis.”

“I’m Joan Mudd and I lost my daughter to postpartum depression four weeks after Carol’s daughter, Melanie, took her life.”

Carol Blocker reaches for a discarded napkin to wipe her eyes. Joan Mudd pushes past the crack in her voice.

The two mothers aren’t friends so much as allies. They want the same answers. They want to know why their daughters, after giving birth to the children they desperately wanted and desperately wanted to love, became mentally ill and took their own lives. They want to make sure that no one else’s daughter dies.

In obvious ways, they are different. Carol is black, petite and precise, with hands that reach out unconsciously to smooth wrinkles and brush away crumbs. Joan is white, tall and blond, with a raucous laugh and the frame of the model she once was. But they are also alike, in their anger and determination and the pain in their eyes sharp as hooks.

Even their apartments are similar, airy, high-rise perches cluttered with evidence they have gathered in their struggle to understand: videotapes, pamphlets, articles from medical journals. A worn handout on how to deal with someone who is depressed, a laminated eulogy, a plastic bag with 12 bottles of pills and, everywhere, photographs.

Look at Jennifer Mudd Houghtaling in her wedding dress, her gloved arms flung wide in joy. Look at Melanie Stokes, her pregnant belly bursting bare from beneath a red scarf wrapped around her chest.

Look at Melanie at 20, a homecoming queen waving from a car, flowers tucked into the crook of her arm. Look at Jennifer at 12, sitting on a raft in a lake, a sheet of dark hair hanging to her shoulders, arms wrapped tight around her knees.

Look, because you can’t help but look, for a portent of what will happen. Look for a shadow, for the sadness lurking at the corner of a mouth.

Look for some hint that Jennifer Mudd Houghtaling, less than three months after delivering her first child, will stand in front of an elevated train, hands raised above her head and wait for it to kill her.

Look for the sign that Melanie Stokes will write six suicide notes, including one to a hotel clerk and one to God but not one to her infant daughter, line them up neatly on a nightstand and drop from a 12th-floor window.

There is no hint. There is no sign.

The college student waves. The bouquet blooms.

The girl smiles. The sun shines.

Rare cluster of tragedy

Melanie Stokes was the first to die, on June 11, 2001.

Over the next five weeks, three more new mothers in Chicago followed her.

On June 18, the day before her daughter’s first birthday, Amy Garvey went missing from her home in Algonquin. Her body was found floating in Lake Michigan two days later.

On July 7, Jennifer Mudd Houghtaling slipped out of her mother’s Gold Coast apartment and walked to the “L” station to kill herself.

Ariceli Erivas Sandoval disappeared on July 17, five days after she gave birth to quadruplets, and drowned herself in Lake Michigan. A blue sign reading “It’s a Boy!” was found on the floor of her car.

This cluster of apparent suicides was rare, the flash of attention it drew even rarer. What people know about mental illness among new mothers they know mostly from women who kill their children, like Andrea Yates, who drowned her five children in Houston nine days after Melanie Stokes committed suicide. In these cases, the horror of the deed often clouds the horror of the illness.

Most women who suffer postpartum mood disorders do not kill their children or themselves. They just suffer. And, with time and treatment, they get better.

Postpartum depression, some experts say, is the most common yet most frequently undiagnosed complication of pregnancy, affecting somewhere from 10 to 20 percent of women who give birth, or almost half a million women every year.

Postpartum psychosis, which usually involves hallucinations and delusions, is a much rarer condition but so severe that the woman is at risk of hurting herself and her baby.

The deaths of Melanie Stokes and Jennifer Mudd Houghtaling may have been unusual but they convey larger truths about postpartum mood disorders. These illnesses are often diagnosed late or not at all. Treatment, if it’s available, may be a matter of guesswork. People can get sick and sicker with the speed and unpredictability of an avalanche.

The volatility of these postpartum disorders is one way they differ from mental illnesses that strike at other times of life, some experts believe. Another is the context in which they occur, during the period of extraordinary physical, mental and emotional stress involved in caring for a newborn.

No one keeps track of how many new mothers in the United States kill themselves. But suicide may be more common than people believe. When officials in Great Britain examined the records of all women who died, from 1997 to 1999, within a year of giving birth, they found that suicide was the leading cause of death, accounting for an estimated 25 percent of the 303 deaths related to childbearing. Almost all the women died violently.

“This is the real shock,” says Margaret Oates, a perinatal psychiatrist involved in the study. “It’s an indication of the profound level of mental illness. This was not a cry for help. This was an intention to die.”

Melanie Stokes and Jennifer Mudd Houghtaling took different paths toward death. But, as they deteriorated, their families felt the same confusion about what was happening. They experienced the same frustration with medical care that, at times, seemed inadequate and uncaring. Ultimately, they felt the same despair.

Lifetime of anticipation

Sommer Skyy Stokes was delivered to her mother on Feb. 23, 2001, after 19 hours of labor and almost a lifetime of anticipation.

Melanie didn’t give birth until she was 40 but she had named her daughter before she was 14, for her favorite season.

Even as a freshman in high school, when the other girls talked about the careers they dreamed of, Melanie unabashedly declared she wanted to become a wife and mother.

After Melanie was admitted to Spelman College in Atlanta, she decided that, someday, Sommer would go to Spelman, too. Once, out shopping, she saw an antique pink feeding bowl and bought it for her daughter-to-be.

It seemed for a painfully long time, though, that Melanie would be granted every wish in life except the one she wanted most of all.

The daughter of an insurance agent and a teacher, Melanie grew up within an extended family that nurtured ideals of education, equality and achievement. At 3, Melanie went with her grandmother to Washington, D.C., to hear Dr. Martin Luther King Jr. speak. She and her younger brother, Eric, graduated from private schools in Chicago to attend two of the nation’s most prestigious historically black colleges.

She was so beautiful that one friend used to joke it took a strong constitution to stand next to her. Her sense of self-possession was such that she once delivered a plate of home-baked cookies to a neighborhood drug dealer with the request that he please cut down on the trade in front of her home.

Every aspect of her life was polished into perfection. Pajamas pressed and starched at the dry cleaners. Dinner, even takeout, eaten on the good china. No event went unmarked. When Melanie planted a tree in her yard, she hosted a party, complete with a poetry reading.

Melanie’s first marriage broke up after four years, in part because the couple couldn’t have children, friends and family say. Not long after, she met a urology resident at a conference sponsored by the pharmaceutical company where she worked as a district sales manager.

Sam Stokes saw Melanie across the room and decided he was looking at the woman who would become his wife. They were married within the year, in a small ceremony on Thanksgiving Day, at one of Melanie’s favorite places, Garfield Park Conservatory.

For almost three years, Melanie and Sam tried to have children. Melanie took fertility drugs but nothing happened.

As time wore on, she became more reconciled to the idea that she might not be able to have a child. She decided she would be content in her role as “Mimi” to Andy, Sam’s son by a previous relationship, and perhaps adopt.

A few days after she decided to give up her attempts to conceive, Melanie realized she might be pregnant. She bought a home-pregnancy test at a Wal-Mart in Springfield, where she was traveling for work. She was so excited that she performed the test in the store’s bathroom.

Melanie approached her pregnancy in the same thoughtful and methodical manner she did everything else. She made lists of the activities she hoped to share with her child someday (Tuesday would be shopping day). At her baby shower, Melanie insisted that no one buy her gifts. All she wanted from her friends was for each of them to write her a piece of parenting advice.

Although she had always dreamed of having a daughter, Melanie didn’t find out the sex of her baby, so it was a surprise when after a long and hard labor, her husband and then her mother called out, “It’s a girl!” At that moment, the culmination of everything she had wished for, Melanie was too worn out to manage much more than a weak smile.

Two days later, she and Sam brought Sommer home to their red-brick townhouse near the lakefront on the South Side. They bought it because Melanie’s mother, who is divorced from her father, lived in a condominium just across 32nd Street. The couple planned to move soon to Georgia, where Sam was going to start a urology practice with an old friend, but wanted to keep the townhouse for visits.

Melanie had been home about a week when her best friend from college, Dana Reed Wise, called from Indiana to see how she was doing. Melanie, usually effervescent, spoke in a monotone.

“I’m fine,” Wise remembers her saying. “I’m just tired.”

Then, in a voice so quiet it was almost a whisper, she said, “I don’t think I like this.”

“You don’t like what?” Dana asked her.

“Being a mother.”

Chronicle of despair

In the brown kraft paper journal her father gave her, Melanie tried to explain what happened.

“One day I wake up pacing then increasingly tired, then disturbed enough to go outside then I feel the thump in my head,” she wrote in small, tight handwriting across the bottom of a page.

“My whole life becoming altered.”

That was how it must have felt to her, like a blow, like something that jumped out at her from the dark. But, to almost everyone else, the encroachment of her mental illness was so stealthy that they did not see the shadow creeping over Melanie until she was almost engulfed.

She kept changing Sommer’s formula, insisting each one made her cry too much. When a friend asked to see the nursery, Melanie refused, saying it wasn’t neat enough. She stopped writing thank-you notes.

Sometimes, when Sam was paged at 2 or 3 a.m., he awoke to find Melanie already up, sitting on the edge of the bed, even though Sommer was asleep. Once, when the baby fell off the sofa where she had been sleeping and began screaming, Sam ran to comfort her, while Melanie looked on, seemingly unconcerned.

Sam thought Melanie was just having a hard time adjusting to motherhood. Her aunts Vera Anderson and Grace Alexander, who were helping her with Sommer, decided she had a touch of the “baby blues.”

At first, it can be hard to distinguish the normal stress of new motherhood from a mild case of the blues or a more serious mood disorder.

People often don’t know what to expect from parenthood. They aren’t sure if what they feel is normal. Some of the classic symptoms of depression–lack of sleep, appetite or sex drive–are common experiences for someone trying to care for a newborn.

If women do feel unhappy or anxious they may be reluctant to tell anyone. Everyone is telling them that motherhood should be the most joyful experience of their lives. They worry that someone will try to take away their baby.

During the first week or so after delivery, many women experience the baby blues and find they are unusually weepy, irritable and sensitive. The blues usually resolve themselves within a few weeks.

Carol suspected something wasn’t quite right with her daughter but she didn’t know what. She urged her to see a doctor but Melanie insisted on waiting for her six-week checkup with her obstetrician.

There wasn’t much Carol could do. Women in the United States are not routinely screened for symptoms of a postpartum mood disorder as they are, for example, in Great Britain.

They usually don’t see their obstetricians for six weeks after they give birth, and may not see them again for a year after that, a gap that Richard Silver, chairman of the Obstetrics and Gynecology Department at Evanston Northwestern Hospital, calls “an absolute void in care.”

The doctor women do see during the early months of motherhood–their child’s pediatrician–often is not trained to recognize symptoms. And many women are afraid to confide in their child’s doctor.

By the beginning of April, Carol became worried enough about Melanie that she didn’t like to leave her alone. So she brought her daughter and five-week-old granddaughter with her the night that report cards were distributed at Healy Elementary School, where she taught 4th grade.

There they sat, in Carol’s classroom, and Melanie just couldn’t seem to hold the baby right.

She rocked her. She switched her from side to side. She put her down in the Moses basket, and when she started crying, she picked her back up. She put her back down. Melanie’s eyes were vacant.

After that, she started to slip fast. Melanie told her mother the neighbors kept their blinds closed because they knew she was a bad mother and didn’t want to look at her. She decided that Sommer hated her.

By the time Melanie went to see her obstetrician on April 6, her mother and aunts were caring for Sommer. Finally, at Melanie’s checkup, with her mother by her side, the doctor asked her how she felt.

“Hopeless,” she answered.

‘No good to myself’

Later that afternoon, Melanie stood with her husband in their immaculate townhouse, which she had decorated in her confident, colorful style–a trio of giant tin giraffes in the bedroom and silk curtains the shade of saffron in the kitchen.

Her voice was as flat as her surroundings were vibrant.

She needed Sam to drive her to the emergency room, she said, because her obstetrician thought she should be evaluated by a psychiatrist for postpartum depression.

Sam didn’t know what to say.

His wife was beautiful. She was smart. She had a husband who loved her. A successful career. A comfortable home. Enough money to buy almost anything she wanted to buy and go almost anywhere she wanted to go. On top of everything else, she had the daughter she had dreamed of since childhood.

How could she be depressed?

Sam didn’t understand what was happening. As he and his wife left for the hospital in silence, they headed into a world that would offer Melanie and the people who loved her little in the way of answers.

The causes of postpartum mood disorders remain unknown, but recently, some experts have come to believe that the dramatic physiological changes that occur with birth and its aftermath may play a role in their onset.

During pregnancy, a woman’s estrogen and progesterone levels skyrocket, then plummet to pre-pregnancy levels within a few days of giving birth. Other hormones, including oxytocin, which is known to trigger maternal behavior in some mammals, and cortisol, which is released in times of stress, also change dramatically during pregnancy and afterward.

Hormones act upon the brain in ways that can influence mood and behavior. Some researchers think that in women who may already be vulnerable for some reason–because of a prior bout of mental illness, for example, or stressful life events–these biological shifts may trigger psychiatric illness.

Melanie came back home from the emergency room at Michael Reese Hospital that evening. The emergency room doctor didn’t think she was sick enough to admit, hospital records show, and referred her to a psychiatrist.

Whatever strength Melanie had mustered to maintain control evaporated. Over the weekend, she became more agitated and upset. She couldn’t stop pacing. Early Sunday morning, Sam awoke to find Melanie gone. He went outside and found her walking back from the lakefront in the dark.

Later that morning, they returned to the emergency room at Michael Reese and Melanie was admitted to the psychiatric unit.

By the time Melanie got help, she was so sick she needed to be hospitalized. Most women with postpartum mood disorders can be treated as outpatients, with a combination of medication, therapy and social support.

Drugs work in about 60 to 70 percent of cases, but they can be tricky to administer. Finding the right mix of medications and doses can be a matter of trial and error. Some medications produce serious side effects; most don’t take full effect for weeks.

At the hospital, Melanie told a social worker that she had become increasingly anxious about parenting, her medical records show. She thought that she should do that as well as she had done everything else in her life. She couldn’t tell anyone how desperate she felt. Finally, she said, she couldn’t function anymore.

“I can’t care for myself or my child feeling like this,” she said. At the hospital, doctors placed Melanie on antidepressant and antipsychotic drugs, as well as a nutritional supplement, because she wasn’t eating.

No one used the word “psychosis,” her family says. But depression didn’t seem to describe the distant, agitated woman who sat in the hospital room, stony-faced and fiddling with her hair.

“How can I explain to anybody how something has literally come inside my body,” Melanie wrote in her journal. “(T)ook away my tears, joy, ability to eat, drive, function at work, take care of my family. … I’m just a useless piece of rotting flesh. No good to anyone. No good to myself.”

From her 10th-floor condominium, Carol Blocker could see Melanie’s hospital room.

Every night, she stood at the window with a flashlight. She flicked it on and off so her daughter would know she was there.

Groping for an explanation

In a matter of seven weeks, Melanie was admitted three times to the psychiatric units of three different hospitals. Each stay followed the same pattern.

She deteriorated, then, as her discharge date approached, she seemed to get better. When she went home, whatever progress she had made disappeared.

Her family ricocheted from hope to despair to frustration. Carol says she once chased a doctor down a hallway, trying to get some sort of explanation for what was happening to her daughter. Melanie’s aunts assured themselves after each hospitalization that this time she seemed better. Sam told himself to be patient.

After she was discharged from Michael Reese following a five-day stay, Melanie stopped eating again. At meals, she daintily wiped her mouth with a napkin after each bite. Afterward, her aunt Grace would find the crumpled napkins full of food in the trash.

When Carol took her back to a hospital, this time to the University of Illinois at Chicago Medical Center, Melanie told the doctors she hadn’t eaten for a week.

She wanted to eat, she said, but she couldn’t swallow.

She was admitted overnight for dehydration and released the next morning for a scheduled appointment with a psychiatrist. The psychiatrist changed her medication and decided to start her on electroconvulsive therapy (ECT), more commonly known as shock treatment.

Once considered violent and inhumane, ECT has quietly regained popularity among many psychiatrists as a safe and effective treatment for severe depression and psychosis. In ECT, electricity is used to cause a short, controlled seizure in the brain while the patient sleeps under general anesthesia.

No one knows exactly why these seizures may relieve the symptoms of mental illness but they often do. Typically, someone will undergo five to 12 sessions of ECT over two or three weeks.

From the start, Melanie hated the treatments. She said it felt as though her brain were on fire. When she came home from the first ECT, she crawled into bed, exhausted.

Her aunts Vera and Grace crept upstairs to check on her. She was curled up in a ball, so small and thin she barely made a lump beneath the blankets.

Then, after her second treatment, Melanie came back to herself.

She started talking and laughing. In the recovery room, she drank half a dozen glasses of orange juice and ate packets of cookies and crackers from the vending machine, consuming more in three hours, Sam thought, than she probably had in the previous three weeks.

Because ECT can affect short-term memory, Melanie didn’t know where she was or what had happened to her.

“I have a baby?” she kept asking Sam. “I have a baby?”

After three hours or so, she slipped back into her silence. There was little improvement after her third treatment and when it came time for her fourth session, she refused.

“It’s killing me,” she told her husband.

By Mother’s Day, she was back on a psychiatric ward, at UIC.

Before she was a mother herself, Melanie had once celebrated Mother’s Day by buying flowerpots for the children in her neighborhood and helping them decorate the containers for their mothers.

This time, she sat on her hospital bed, blank-faced, when Carol brought Sommer to see her. In the nine days she had been hospitalized, she had never asked her mother about Sommer and now she had to be told to take her into her arms.

Melanie had resumed the ECT treatments and started another combination of medications. But her weight continued to drop. At 5 feet 6 inches tall, she now weighed 100 pounds. Whenever anyone asked her how she felt, she said she thought she would never get better.

She thought God was punishing her and, in her journal, made a list of her sins in an attempt to figure out why. She had lied once as a child about being kicked in the head. She had thrown a dissected frog at someone in high school.

“Hurt people who were trying to be kind,” she wrote.

Every night, Melanie’s father, Walter Blocker, sat with her in her room. He massaged her feet, whispering to her as if she were still an infant.

You’ll get better, he told her. This will end.

You’ll get better. It’s all right.

Trying to be a mom

Melanie spent 19 days at the University of Illinois at Chicago Medical Center. The day after she was released, she asked her neighbor for a gun.

It’s for Sam, she said. He likes to hunt and I’m thinking about buying him a gun for his birthday. The neighbor demurred, then called Sam at work. Sam told him that he had never gone hunting a day in his life. Not long after that, she visited her aunt Grace, who lives on the 22nd floor of a high-rise, and sat for hours, looking out her windows. After her mother learned that she had been wandering near the lake again, she told Melanie that the doctors were concerned about her blood pressure and took her back to the hospital.

UIC was full and sent her to Lutheran General Hospital in Park Ridge. When she arrived on May 27, she had already been through four different combinations of anti-psychotic, anti-anxiety and anti-depressant drugs, as well as the electroconvulsive therapy.

Twice, Melanie had stopped the ECT treatment and she refused to start up again at Lutheran General. At the hospital, she was suspected of spitting out her medication at least once.

She wanted to get out and, her mother thought, was trying to fool people to do it. At one point, her records show, she described her mood as “calm,” even though she sat with her hands clenched. When she was asked what she needed to get back to her old self, she answered, “Organization.”

To that end, she drew up a timetable of her plans to integrate herself into Sommer’s life. When she was released after five days, she took it with her.

Almost every day, Melanie visited her daughter, who was staying with one of her aunts, Joyce Oates. Melanie always plucked at Sommer’s clothes or fussed with her hair, tics that never quite masked the fact that she rarely held or cuddled her.

Her family could see that her smiles were forced and her arms stiff. Sometimes, the only physical attention she could give Sommer was to clip her fingernails.

If Melanie ever had thoughts of hurting her daughter, she didn’t tell anyone, but her aunt Joyce was concerned enough that she didn’t leave Melanie alone with the baby.

On June 6, five days after Melanie came home from the hospital, she told Joyce she wanted to learn her daughter’s bedtime routine. She watched as her aunt fed and bathed Sommer.

Joyce lay the baby’s nightgown on the bed and asked Melanie to put it on her. Melanie picked it up and stared at it. Then, she put the nightgown back on the bed.

“I can’t do it,” Joyce remembers her saying.

She turned around and went back to the living room.

It was the last time her daughter saw her.

Goodbyes to all

Melanie tried to say goodbye.

Early the next morning, she called her mother and told her she had been a good parent. Her father got a telephone call, too, while he was shaving. She said she loved him.

For Sam, there was a note tucked under a corner of a photo album she placed on the kitchen table.

He had walked in from a Thursday staff meeting at Cook County Hospital, expecting to pick up Melanie. They had planned a day out together. It wasn’t until he had made half a dozen telephone calls and two trips to the lakefront to look for her that he saw the note.

“Sam, I adore you, Sommer and Andy, Mel.”

Puzzlement dawned into panic. Her family contacted police and with her friends scattered around the city to search her favorite spots: the Osaka Garden in Jackson Park, Bloomingdale’s, the Garfield Park Conservatory.

A neighbor later told the family she saw Melanie getting into a cab. After that, she vanished, a thin woman in an orange peacoat, sweat shirt and jeans.

Melanie’s last stop

The woman who arrived at the Days Inn across from Lincoln Park late Saturday night was neatly dressed and clean, polite almost to a fault.

Her bag had been lost or stolen on the train, she said, and she didn’t have any identification on her. But she did have cash. Could she book a room?

Tim Anderson, the front desk supervisor, was sympathetic but skeptical. He told her he couldn’t allow someone to pay cash without photo identification. But she was welcome to wait there until she heard from the lost-and-found.

So, Melanie spent most of Sunday in the hotel’s cramped lobby, little more than an alcove with two armchairs and a sliding-glass door. Occasionally, she chatted with Anderson. She asked him where she could get something to eat and he directed her to a coffee shop around the corner. Later, she bought a chicken quesadilla from the restaurant next door and he let her eat in the break room.

From time to time, she left the hotel. At some point, she went to the Dominick’s at Fullerton and Sheffield Avenues, where an employee in the cafe later would find a blank card with a photograph of Melanie and Sam enclosed.

Melanie’s family had turned to the local newspapers and television stations asking for help in finding her. Her photograph was in the Sunday newspapers in the convenience store across the hotel lobby. No one recognized her.

She didn’t strike Anderson as someone who was hiding or homeless, but something about her just didn’t seem right.

Before Anderson left for the day, he says, he told his replacement not to allow her to check in unless she produced some identification. But just after 5:30 p.m., her bill shows, Melanie paid $113.76 for a room, in cash. She checked in under the name Mary Hall.

She was given Room 1206, on the top floor of the hotel. From her window, she could see the Lincoln Park Zoo, which was her father’s favorite place to spend his birthday, walking with Melanie.

Just before 6 the next morning, a cyclist riding by the hotel saw a woman perched on a window ledge and ran inside to tell the clerk.

Within minutes, firefighters were in Melanie’s room, trying to talk her back inside. She sat on the other side of a window, her back straight and pressed against the glass.

Paramedic Deborah Alvarez tried to reassure her. This woman, she thought, looks as frightened as a child. Melanie answered but the glass blocked her voice. Alvarez never heard what she said.

After about 20 minutes, a firefighter approached the window. Melanie turned a little, as if she were going to try to pull herself up. Then, she turned back, put her hands at her side and dropped from the ledge.

Gasps and screams rose from the small crowd that had gathered across the street. One of Melanie’s shoes fell off and bumped against the building.

Alvarez raced for the elevator, hoping against hope. When she ran outside, she saw that Melanie’s body had already been covered.

In her room, the bed was made. On the radiator cover was a copy of the Chicago Sun-Times. The front-page headline was about her.

On a night stand next to the digital clock sat a neat stack of notes, written on hotel stationery, with a pen laid perfectly straight in the middle.

Melanie wrote a note to her parents. It said, in part, “Please let Sommer know how much I loved her during the pregnancy.”

She wrote a note to her husband, telling him to continue with their plans to move to Georgia and thanking him for loving her in “such a generous, sweet way.”

She wrote a note to Tim Anderson, the employee who let her sit in the lobby.

“I am so sorry to have used your kindness in this way,” it said. “You really are a fabulous clerk–very good at what you do. Tell your boss this was not your fault.”

She wrote a note to herself.

“Everyone going along with normal happy lives. I wish I was normal again.”

In her apartment on Chicago’s Gold Coast, Joan Mudd read about Melanie’s death in the newspaper. She tore out the article and tucked it into a drawer. She didn’t want her daughter Jennifer to see it.



Postpartum Support International, Illinois chapter: (847) 205-4455, www.postpartum.net.

Depression After Delivery: (800) 944-4773, www.depressionafterdelivery.com

Jennifer Mudd Houghtaling Intervention Program for Postpartum Depression at Evanston Northwestern Healthcare, 24-hour toll-free hot line: (866) ENH-MOMS

Pregnancy and Postpartum Mood & Anxiety Disorder Program at Alexian Brothers Hospital Network, Elk Grove Village: (847) 981-3594 or (847) 956-5142 for Spanish speakers Perinatal Mental Health Program, Advocate Good Samaritan Hospital, Downers Grove: (630) 275-4436

Postpartum Hope, Northwest Community Hospital, Arlington Heights: (847) 618-5220

Scary stories – Lou Reed

Scary stories
Lou Reed talks about his latest walk on the wild side–a musical exploration of the life and works of Edgar Allan Poe

By Larry Flick
From The Advocate, February 18, 2003

As a public figure whose personal life has been the subject of media scrutiny, Lou Reed says he instantly rejected the idea of using The Raven (Warner Bros.), his elaborate two-CD ode to Edgar Allan Poe (also available in one condensed CD), as a vehicle of speculation about the mysterious writer’s life. “That’s a brand of titillation that I simply refuse to participate in. It’s demeaning,” asserts the enduring rocker, whose own sexuality has previously been the source of speculation, from his years as a member of the Velvet Underground and through a solo career that includes 1972′s gender-bending classic “Transformer” and the sexually charged hit “Walk on the Wild Side.” “It’s also unfair and disrespectful to anyone who chooses to maintain any degree of privacy.”

Reed has written about his parents forcing him to endure extensive therapy–including painful rounds of shock treatment–as a teenager, when they feared that Reed was exhibiting signs of homosexuality. Like Poe’s, the artist’s sexuality has continued to be a point of discussion and speculation even though he is living a heterosexual life with his companion, famed performance artist Laurie Anderson.

Still, Reed agrees that Poe’s privacy about his sexuality–and almost everything else–has perennially triggered heated debate. “There’s something about ambiguity that drives people crazy,” he says. “They want confirmation of whatever they suspect. They want tidy definitions. They want a black-and-white world, when shades of gray can be far more interesting. The problem is that once something or someone is so clearly defined, there are occasionally limitations and boundaries placed around a person and his or her work. In terms of me and this project, I found Poe’s work far more interesting and worthwhile of exploration. I’ll leave the speculation to others.”

Actually, in crafting The Raven, Reed took what might be a potentially greater risk. Instead of delving into the writer’s well-shrouded personal existence, Reed dared to occasionally revise and reinterpret Poe’s works.

“It was also infinitely fascinating and satisfying,” he says. “It required total immersion into his work and into his language, which I’ve always had a great affection for. To me, his use of words slips right into my idea of what rock and roll can be–rhythm and intensity and pure power.”

For The Raven, Reed enlisted a broad-ranging cast of musicians and actors to perform what is best described as a richly crafted theatrical piece for the mind. Among those appearing are Anderson, David Bowie (working with Reed for the first time since “Transformer”), Willem Dafoe, Ornette Coleman, Steve Buscemi, and Amanda Plummer. They are joined by two longtime Reed sidemen–guitarist Mike Rathke and bassist Fernando Saunders. “It was a dream collection of talent,” Reed says. “In my wildest dreams, we someday find a way to take this piece and put it onstage.”

The Raven offers such classic Poe pieces as “The Valley of Unrest,” read by Elizabeth Ashley, and “The Fall of the House of Usher,” read by Fisher Stevens. Perhaps most bold is a guitar-laced musical interpretation of “The Pit and the Pendulum” by Reed with the Blind Boys of Alabama.

“The intense detail of the work, whether it be composition or recording or mixing, could be maddening at times,” Reed says, noting the nearly four years it took to complete The Raven. “But it’s satisfying to feel a sense of completion. I can finally let out an exhaling breath and feel like I’ve done myself, this project, and Poe proud.”

Flick is senior talent editor at Billboard.

Come back story an award winner

By Geoff MacQueen
Miner and News
April 28, 2001

Wayne Lax doesn’t remember his wedding day. He doesn’t remember his suicide attempts. He doesn’t even remember much about his son.

That’s because over a 25-year period he was in hospital 108 times, medicated with up to 17 pills a day, and subject to 80 electroconvulsive shocks.

“I had more pills pumped into me than Elvis Presley.”

He says 70 per cent of his long-term memory was erased by the shocks, and his lower back was ruined when he wasn’t given enough muscle relaxant before one round.

At no time did he stop being an alcoholic.

He was also a cab driver.

“I was impaired on drugs, and they used to send me out to work.”

One day in 1992, everything changed. He was in a car accident, and lost his license. Without his livelihood, and realizing the danger he was posing to himself and to others, he was forced to re-evaluate his life. Lax chose to give up the prescription drugs and electric shocks that had controlled him for 25 years.

“When I left the pills alone, the urge to drink left,” he says.

What remained was a fierce will to help others who were going through the medical system he had survived. Since then, he has been speaking out about the psychiatric system, and especially about the dangers of electroconvulsive therapy.

“I just want to help other people, because I lived in hell for 25 years, and it put 30 people around me through hell.”

In order to help others, the man doctors said would never be able to live on his own is on the board for Changes Recovery Homes Kenora, is a regional representative for the Northwest Ontario Patient Council, and is a member of Sunset Country Psychiatric Survivors, The Association for Community Living, People Advocating for Change and Empowerment, and more other associations than even he can remember offhand. His legal battles for justice for his family and for himself still continue. He has been interviewed by newspapers and magazines across North America and Great Britain, and is one of the subjects of a recent book, The Last Taboo, by award winning journalist Scott Simmie.

His most recent accomplish-ment is the “Courage to Come Back” award he received, signed by rower Silken Laumann, honourary chairman. The award is presented by the Centre for Addiction and Mental Health in Toronto.

“I was quite honoured. My sister nominated me Joyce Roller in Thunder Bay.”

As part of the nomination process, she sent Lax’s story to the center. The award is “in recognition of his courage to come back.”

Lax not only came back, but came back with a story to tell.

He says he isn’t against all doctors or all psychiatrists, but some of them become dangerous because they have too much power. .

Lax said one doctor “was like God to me, he was like a father.”

This doctor, although not a psychiatric professional, was able to prescribe mind altering drugs to Lax, in spite of one psychiatrist’s insistence this was counterproductive.

While Lax acknowledges medication helps many people he thinks it makes no sense to prescribe to alcoholics.

“They’re giving you another addiction.”

He is against electroconvulsive therapy under all circumstances.

“It’s a barbaric treatment, and I’d like to see electroconvulsive therapy banned,” he says. “If shock is the answer, why are people in the system for 40 years?”

The answer for Lax was a combination of addiction counseling, self help groups and a great support system, starting with his family.

“They probably felt like giving up on me, but they didn’t.”

Although his life is together, Lax thinks society’s problem is getting worse, with funding cuts causing pressure on doctors to empty beds, even if only with a quick fix like electroconvulsive therapy. He says patients who can’t take care of themselves are being left homeless on the street, with no support. ‘

“It’s easy for people to say ‘People have to help themselves’,” he says. “When I could focus, then I could do something with my life, but you can’t under 17 pills a day.”

This is why he says he has to try to help other people caught in the system. He has support from people across Canada, the U.S. and England, and in turn he gives support to people who can’t help themselves.

“Sometimes I lie there at night with pain in my back, and I think ‘How can they do this to a human being?’ But I get up in the morning, and I think about how I’m going to help someone. You can’t dwell in the past.”

Speak Out Against Shock (ECT)

Without Restraint
Spring 2000

I spent 25 years in a state of confusion and despair. My brother died and I turned to alcohol. I had 108 admissions, and approximately 80 ECT treatments. They were treating me for an addiction; they did this with ECT treatments; the doctors kept giving me more and more medication (every drug under the sun), up to 17 different pills per day. As a result of the shock treatments, I am missing large portions of my memory and suffer chronic severe back pain from not enough relaxants. My children suffered from the effects of a loss of a parent. My friends didn’t know how to respond to my behaviour, the hallucinations and delusions. They (Psychiatrists) would shock me, get me all medicated up and send me home where I would drive a taxi. Finally after 25 years of this hell, I ended up in a bad car crash. I was charged and convicted of impaired driving. It was the best thing that could have happened to me … It was the beginning of the end. I stopped taking all the meds, refused any more shock, and then a year later – quit drinking. I have not been in a hospital since, except to visit. Still, today when I walk down the halls of Lakehead Psychiatric Hospital (LPH), patients come up to me and say “Hi”, they know me, but I have no idea of who they are. They don’t even look familiar. They say I spent a lot of time with them, but I have no memory. Part of me is missing forever. They treat us like guinea pigs, trying anything on us with no concern about the damage they do. Why do we give them this power? Why is it that medical doctors, whom are not experts on mental health, can prescribe any psycho tropic agents, even against a psychiatrist’s advice? Why aren’t they required to learn more about mental illnesses before they go around diagnosing and drugging us? I am not saying there aren’t competent professionals, or that you shouldn’t listen to your doctor. What I’m saying is that you should make sure you are making an informed decision, and ensure that the communication is there between your psychiatrist and GP. During my 25 years in the mental health system, some “professionals” recommended that I be taken off all the drugs, given no- more shock and receive proper counseling. My GP chose to ignore this advice without even informing me of their recommendations. This is unacceptable. What has personally helped me is counseling and the peer support I receive from the self-help group that I am actively involved with. I am dead against ECT under any circumstances. Even with the people it helps, the results are short-lived and the side effects long term. Why would delivering electricity through a brain be anything less than destructive and damaging?

If you would like to contact me, please e-mail me at seps@voyageur.ca or fax me at 807-468-2220.

Or write me at:

Wayne Lax
Comp. 4, Site 297, RR#2
Kenora, Ontario
P9N 3W8

Psychiatric Survivor tackles road safety

Duane Hicks
Aug. 4, 1999
Fort Frances Times and Rainy Lake Herald

“I don’t want to knock anybody. I want change.”

Wayne Lax of Kenora, after 25 years haunted by alcoholism, extensive drug therapy, and more than 80 shock treatments, is now taking a stand against impaired driving.

But it’s not specifically drinking and driving he has his sights on – Lax said patients taking prescription drugs also pose a hazard on the road.

“If you’re confused, you shouldn’t be driving,” he stressed. “The ministry has to enforce this – it’s the law. But (medicated drivers) are out there.”

Lax cited a case he knew of personally that still hasn’t ceased to amaze him. “(The person’s) been treated for epileptic seizures and he’s still driving – that’s like leaving the barn door open for the horses,” he remarked.

Joanne Jarvis, National Victim Services coordinator for Mothers Against Drunk Driving (MADD), has known Lax for about a year find agrees with his stance on road Safety.

“It’s the law that physicians, who are treating anyone who is taking medication that could their operation of a motor submit an application to the ministry to have that license suspended for a period of time,” Jarvis noted.

“Without supporting his case specifically, we support road safety across the board, and in Mr. Lax’s case, he’s certainly right in his support of the cause,” she said.

“As citizens, we have a responsibility to promote (responsible driving) and so do doctors. We don’t want to see anyone driving impaired,” she stressed.

Problems with alcohol-and then drugs-is something Lax Is familiar with. Now 58, he became an alcoholic when he was 25 after he round his brother dead, killed by carbon monoxide poisoning.

Soon afterwards, he was beset by hallucinations and voices telling him to kill himself He needed help.

But “help,” in his opinion, was not what he received after being treated for his drinking and depression with 25 years’ worth of different kinds of prescription medication and electroconvulsive therapy (ECT) treatments.

On a psychiatric treatment regimen, Lax was in a single vehicle car accident, charged with impaired driving and convicted in July, 1992. The month before, he had received ECT treatments at Lakehead Psychiatric Hospital in Thunder Bay and was still suffering from the effects, including dizziness, confusion, tremors, memory loss and worse.

“I realized ‘My God, where have I been?’” related Lax. After more than a year without medication, he cut out the drinking and the ‘voices’ in his head stopped.

And he hasn’t been in a hospital since.

But Lax’s ‘beef’ lies with fact that while he was a cab driver in Kenora the entire time he was getting treatment for his problems, at no time was his license revoked nor was he advised not to drive.

“I was definitely a menace on the road but I never knew it. I was told to go to work,” he recalled. “But I’m afraid to say it has happened to thousands of other people.”

Lax lost his license for one year at that time. “That’s when I began to think about others like me,” he said.

He has written countess letters to ask for support from several politicians, including Transportation minister Tony Clement, and received the following reply.

“Representatives from the Medical Review Section work closely with the medical community to ensure that legislation and medical review procedures are understood and adhered to,” he noted.

“The physicians’ reporting requirement is a crucial piece of safety legislation,” added Clement. “Your comments will be taken into consideration when this ministry reviews our proposed improvements to the reporting requirement.”

And Lax now feels that thanks to his letters and media exposure, the government has since gotten “a little better” in its enforcement of impaired driving.

Ironically, in March, 1996, the ministry’s licensing branch suspended his license after learning of his medical history but reinstated it two months later when the MTO received a psychiatric assessment citing Lax’s improved mental health.

“I know several people who lost their licenses for three months due to medication but whether they agree or not, it’s for the better,” he noted.

With his concerns duly noted by the MTO, Lax now looks to raise public awareness of impaired driving.

More than taking aim at psychiatric professionals, Lax stressed patients on medication can take responsibility for themselves and others, and consult their physician or pharmacist.

“Everybody has to work together – patients, families, pharmacists.”

The Lost Years

“I wanted it … I begged for it… I craved it.”

He wanted shock treatment – demanded to have volts of electricity charging through his body, convulsing muscles and disrupting brain functioning in an artificially induced seizure. They call it therapy but they admit that they don’t even know how it really works. Epileptics are given medication to suppress naturally occurring seizure activity because of potential damage yet psychiatric patients are given electroshock convulsive therapy (ECT) to cause the same effect.

It is still legal and is currently used for many different reasons. Lobotomies were also used similarly in past years until experience showed that this form of brain mutilation served the institution’s purpose more than any other. Similar dynamics have formed around ECT. Fear of shock treatment has kept many patients in line and cooperative when the going got tough. Recovering from shock takes so much energy that inmates didn’t have anything left to fight against perceived power abuses. The brain may be left physically intact but research indicates an unexplained permanent volume loss. Survivors of shock know of other losses–losses that can’t be measured in clinical studies. Shock affects brain functioning. Thinking abilities are altered until even the intrinsic identity of its victim is threatened. It steals the memories that tie a life together in a cohesive whole. For one man, 25 years of his life were taken from him, lost within a system that denies responsibility for the repercussions of his prescribed treatment.

“There was a freak snow storm in April. It was blowing hard and cold. I was a taxi driver and the storm was good business for me. People call for a cab instead of risking driving under those conditions and I was working it for all I could get because I had a family to support. My younger brother Allan was home from the Navy. We had talked earlier in the evening but I went out to work. Later, he left a message for me. I worked through the night and in the morning I went over to my parent’s place to see what my brother had wanted.”

Regret catches in Wayne’s throat He looks down before drawing a fortifying breath to speak through a pain that is as present as it was a quarter of a century ago.

I saw my brother’s car in front of the house. Snow had drifted around it in a shroud. As I ploughed through the snow to reach the vehicle, my father came out to help shovel out. We cleared the windows and saw my brother still behind the wheel. He seemed to be asleep against the window. I thought that maybe he had too much to drink and was sleeping it off. As we pulled open the door, he fell out… and he didn’t wake up…. My brother was dead.” Sadness lays heavy as he pauses to draw together the strength he needs to push past his relived sorrow.

“There had been a hole in the floor of his old clunker. The carbon monoxide would have killed him within five minutes–less than the time it would take to warm up a cold car. The Coroner ruled it accidental but that was soon forgotten as others misinterpreted what happened. ” He shakes his head in an effort to negate the maliciousness of others. “Would you believe that a social worker from LPH called my poor old mother years later and said that I was just trying to copy my brother’s suicide. She hit her with this opinion which was based on wrong information without even caring of the effect on my mother. Can you imagine how my mother felt? She’s going about her business in her own home and the phone rings. She picks it up and hears someone she’s never met dumping this garbage which was based on gossip on her. It was bad enough that I didn’t know what I was doing but my brother’s death was not a suicide!” Anger flashes against a system which labeled and mislabeled himself and members of his family until the paper people created by consecutive diagnosticians bore no resemblance to the humans who had entered the mental health maze.

“I missed my brother. We had been close and now he was gone in a stupid accident that I tortured myself over. If I had not chosen to chase bucks that night, we would have been together. He wouldn’t have been alone in that death trap of a car. I would have driven him. We would have talked. He would still be alive. It was all preventable and I blamed myself. He was only 24 years old.”

It was grief. Now you’d go to grief counseling and talk it out. Back then, a man drank it out and I could drink pretty good. Then the drinking got pretty bad ”

“I remember driving a bunch of Americans up to Minaki. They liked me and invited me to stay for some drinks. I drank and I drank some more. The cab was parked because I never did drive taxi when I had been drinking. It was my one good habit.” He glances up with a quick smile of remembrance in appreciation of the small measure of self-control that kept him from drunk driving while working. No matter how much of his world spun out, he was committed to road safety in his own way. “Anyways, about three in the morning, they found me under the cab, trying to hook a hose up to the exhaust so that I could join my brother. They took me in to the hospital and I was admitted. My first diagnosis was reactive depression. I won’t argue that-4 was depressed because my brother died. Drinking didn’t help and I’m not making excuses for that. I found out years later that booze is a depressant. I could have avoided a lot of pain if I had known that then. I was diagnosed in January 1967 and got my first course of shock treatments because they said that it would help with the depression. I just wanted the pain to end so I would have agreed to anything. I trusted the medical profession and never questioned what they were doing to me. I just followed their prescriptions and it was all downhill from there.”

“Each time I was released there were more drugs. One year I was on 17 different medications. The LPH kept sending more and more pills. My mother couldn’t keep up with sorting the mailings so she started dumping them down the drain. it was a never-ending supply. By this time I was a binge drunk-a drunk who downed more prescription pills than most junkies. I never covered it up. The doctors all knew of my boozing. I’d overdose and they’d send me home with more pills to replace what I wasted when they pumped out my stomach. It was craziness ”

“Hospitals were like home for me. Everything was taken care of There was nothing to worry about when you’re in there-except for wondering how your family was making out. Except for the shame you lived with every time you had to shower in front of others because inmates don’t have privacy. I trusted doctors and nurses to know what was best for me. Looking back I remember their sarcasm and threats when we didn’t behave like good patients.”

“They told me that ECT would help me. I don’t remember much of it except they tell me that I kept asking for it-that I would get mad if I didn’t get. I do know that I wanted the needle that comes before the treatment because nothing came after that. Nothing that I knew of anyways. It was just a forgettable nothing – oblivion. I am an addictive personality and I got addicted to shock. That’s why I begged for it.” He shakes his head in consternation. “Is that the reason they gave it to me–because I demanded it? Doctors don’t give out drugs just because a patient demands it so why give out shock? In 1984, the Clarke Institute said that ECT was a bad treatment for me but I got more of it after that. Why? I have so many questions.”

” My family kept trying to get it stopped because they could see what it was doing to me. My wife came to see me after one treatment. I didn’t know who she was. My niece says the same thing. I didn’t know her either. The so-called experts say that the amnesia after shock is temporary. I know different. I hardly remember most of my life now. I have to read my medical records to know what I was like or what they thought I was like. People tell me of things that happened and I have trouble believing but I don’t have any reason to doubt them because their memories are the only memories I can rely on now-mine were stolen by shock.”

Others do remember and witness to the effects of ECT and psychotropic drugs.

His sister Joyce and her family conscientiously visited Wayne whenever he was hospitalized in Thunderbay. Following his shock therapy sessions, disturbing patterns of behaviours occurred and reoccurred. His sister describes a typical visit amongst the many that the family made in their effort to support her brother in his anguish.

“When we visited him, he was in a locked ward. He appeared restless. His hands shook a lot and he paced back and forth steady. His face twitched and his eyes had a vagueness about them. His legs seemed to be moving constantly. Even if he did sit down, they still twitched. One time he didn’t even know who I was.” On discharge from the hospital, many of the behaviours which were not part of her brother’s personality prior to his shock and drug therapy were still apparent.

“It seems that Wayne talked a lot but nothing made a lot of sense. He was in a depressed state most of the time. He seemed confused and almost in a world of his own. My daughter remembers how his hands shook when he lifted his tea CUP during breakfast. He was shaky and fell in our bathtub. Once my daughter described how while she was driving him, Wayne kept putting his seat down to rest and then would immediately pop it back up and begin talking again. Up and down he went, rambling on. Another time my husband drove Wayne and his wife back to Kenora after they had both undergone their treatment courses. He said that they were both very lethargic and subdued-almost like zombies. Both were normally very gregarious and social.”

Medical files report repeated confusion after ECT treatments. Nurses, at various times, made notes as follows-(September 26, 1980)”mild confusion”, (September 28, 1980)”when questioned, patient does not know day, month or year, or what city he is in”, (September 29. 1980)”became very restless and confused”, (October 2,1980)”post ect confusion. presently hypomanic”, (January 29, 1982)”upon recovery patient thought that he was drunk”, (May 1, 1984)”patient was somewhat confused on recovery” and Way 9, 1984)”Skipped Mondays as patient becomes high with too frequent ECTs”.

Although, the experts claim that the after effects of shock are minimal and temporary, after recovery time and discharge, Wayne’s daughters could tell from their parent’s behaviour whether shock had been part of the treatment during their latest hospitalization.

“They couldn’t focus very well for awhile. Their worlds just seem to get really small with just them in it to survive because anything else was too much to handle, took too much energy to understand.”

Glynda, Wayne’s ex-wife and now still his best friend, recalls the stress of life after each shock treatment. “Right after he’d get out of the hospital, something would happen. One time after shock he jumped out of the boat when we were on the lake. I was going to jump in after him but Annette said don’t worry–he’ll float and he did. There were lots of times like that.” The stress of the multiple hospitalizations, the effects of the psychotropic drugs and the frustration of the alcohol abuse led to the breakdown of their marriage but they have remained enviably close and united in their respect and support of each other.

Wayne does have a physical reminder of his shock treatments-one that aches daily and affects his ability to return to his work as a taxi driver. “My back was injured during shock treatment sometime in the 70′s. I wasn’t even told at the time. A doctor whispered it to me in an aside, years later. I had complained about back pain for some time and just figured that I had injured it while I was drunk and nobody told me different. Later I find out that it was a fracture that happened due to insufficient muscle relaxants during ECT … You know what’s funny? I would ask for something for the pain but they never would give me anything because it might be addictive-what about all the other drugs?”

Like a weed, Wayne’s ECT therapy grew from being a doctor’s recommendation, to becoming a response to a patient’s demand to something darker, even more invasive. In 1984, the Clarke Institute recommended that ECT therapy be discontinued. The report was reviewed and filed within Wayne’s clinical record but the shock treatments continued.

“Once I got mad at the doctor at LPH. I said all you do is shock people, you don’t help anyone. She told me to settle down or she would Form I me. I started to wonder about the whole thing because these people were supposed to be there to help me and she’s threatened me just because I questioned her … Another time, I remember being put in a room with a friend. He had drank Drano to kill himself Months later he called me to tell me that he wanted to do it again. I said, call your doctor, call the OPP, go to the hospital-get help. The next morning, the psychiatrist told me not to tell anyone else to go to the hospital because the government was going broke … My friend finally did kill himself-shot himself I always wanted to ask that doctor how much money they saved by that suicide.”

There was an incident that Wayne recalls in which he knows that he did not request the shock therapy but he received it anyways under questionable circumstances. “Something happened to my wife at the hospital and nothing was being done about it. I went to raise hell about it. Thunderbay had said that they didn’t want me back but when I went to the local hospital to demand that something be done about the assault on my wife, I was suddenly sent back to Thunderbay for more shock treatment. It got me out of the way … The attendant who did it, did get disciplined but there were never any criminal charges.”

As a psychiatric patient, Wayne’s life had become an endless dreary circle. “I’d be admitted to the hospital and get my therapy. Then they’d decide that I was good enough to go home. I’d be thrown back into real life with no supports-and I’d be working as hard as I could to make up for the income I lost during hospitalization because I had a family to support. The pressure would get to me until I just wanted to be stress-free for a while. Then I’d overdose so I’d be sent back to the hospital. Again they’d send me home with more pills … To tell the truth. I wanted to die. Nothing ever seemed to change.”

In 1992 Wayne crashed-literally this time. A serious car accident resulted in a charge of impaired driving. Knowing that a conviction would cost him his livelihood, Wayne mobilized. The accident occurred ten days after he had received another two ECT treatments. Wondering if this may have impaired his driving ability, Wayne began asking questions. The charge held because of insufficient information. Wayne lost his license. Unable to work, he began to reconsider his life.

“I think what changed it for me was that I realized that I could have killed someone else in that accident. I never wanted to hurt anyone else and thank God I didn’t but I could have. That was it for me. I just decided – no more shock, no more drugs. ”

It took fourteen months to clear the drugs out of his system but he did it–on his own. He began seeing an addictions counselor which he found helpful at the time. Unexpectedly, as the medication’s effects left his system Wayne noticed that his urge to drink also left. Ms addictions counselor now wonders whether he was an alcoholic or if the drinking was a response to his treatment.

An unassuming man, Wayne looked only to himself to blame. He focused on the alcohol abuse and heaped burning coals of responsibility on his own head. He had noticed that without the drugs and shock, the urge to drink didn’t seem to pull him into binges as it had in the past. After awhile more he began to note how well he felt-there were no more voices, no more anxious spins into depression, no more freezing of motivation. He was puzzled but continued to focus on his sobriety.

He brought in this information and a list of his prescribed pills to a pal on the force. On reading the list, the OPP officer shook his head and told him that several of the medications were known to impair driving ability. Stunned, Wayne finally faced what his family and friends had been trying to tell him for many years-the treatment treadmill that he had been on was destroying him.

Strengthened by his success, Wayne requested his medical records and began demanding answers. The system was largely unresponsive. He returned to the doctor who had prescribed so many of his pills to ask why his recovery came only after he quit following the doctor’s prescriptions.

I went to my doctor to tell him how I changed my life. He said that it was a miracle. A miracle? … I tell you it was fourteen months of hell that did it. He didn’t want to give me any credit for my own recovery. He’d rather say that it was an unexplained miracle than take any blame for mistreatment.”

Angered by the system’s lack of accountability for his treatment, Wayne pursued justice. Pounding on doors that wouldn’t open, he persisted. On discovering that there is a legal obligation on doctors to report to the licensing bureau regarding any drivers whose medical or mental condition impaired their ability to drive, Wayne cited his psychiatrist for not reporting him.

“For cripe’s sake! I was a cab driver and they never warned me that any of those pills could affect my driving. They just kept sending me back to work.”

His legal suit was set aside for a lack of evidence but the psychiatrist suddenly reported Wayne to the Ministry of Transport-three years after he had last seen him as a patient. Now that he had recovered from the conditions which would have justified de-licensing, Wayne was stripped of his driver’s license. He has since regained his right to drive but is required to provide, at his own expense, an annual doctor’s report certifying his good health.

Wayne’s struggle to make the health care system accountable continues and several subsequent lawsuits have been filed. He continues his legal battling, not out of revenge, but out of his concern for others. His crusade on behalf of safe driving continues. Wayne wishes the medical profession to issue written cautions in addition to verbal warnings whenever treatment encroaches onto driving abilities. He explains, “You’re given a quick explanation or warning at a time when you are least likely to be able to focus on it. Verbal warnings about the side effects of drugs and shock therapies are given when you’re in crisis, not when you’re thinking straight. At least if there’s another warning in writing, there’s a chance you may read it later when your head is straightened out a bit. Any extra chance is worth it when you’re trying to keep the roads safer.”

Overcoming his inherent shyness, he speaks out on other broader issues. Active in Sunset Country Psychiatric Survivors, he advocates for the rights of those who are caught in system which can hurt as easily as it heals. He’s fierce in his defense of friends and Wayne has many friends-those who’ve stood by him through his desolate years, those he reached out to help despite the ache of his own needs and those he’s met since his return to community life.

Like most shock survivors, he wants to see ECT therapy banned. In his advocacy role, he hears more similar tales of debilitation following shock treatment. He stacks up piles of research whose findings frighten him as he gains understanding of the effects of ECT. Living with those losses which he know believes were preventable is difficult. He has rebuilt his life again but it will never be as it could have been.

“Sometimes I think-25 years gone. I think of my children, grown up without parental direction. I think how my parents never saw me well. I think of all that was lost and of all the suffering and I get so mad but we’ve got to go on-use our experience to help others-make people aware of what shock does to human beings and we are human beings … not just patients.”

Man leads crusade to reduce impaired driving

Rainy River Record
March 21, 2000

By Ken Johnston

Could you imagine drinking all night and then getting in your car and driving somewhere impaired?

While it does happen, most people are sensible and use a designated driver or get a ride some other way. However, for Kenora’s Wayne Lax, driving impaired was something he said he did for 25 years.

Lax who suffered from deep depression and extreme alcoholism after the death of his brother was treated by doctors with two types of medical practises. One involved pharmaceuticals arid the other was electro-shock therapy. At one point he was on 17 different drugs per day and all the while was shock treated 80 times in that period of time. With that in mind one would think that he was incapable of driving and that medical professionals would have notified the Ministry of Transportation of his constant impairment.

Well until 1992, when Lax had a severe motor accident and he was charged with impaired driving he was never told he could not drive, at least as not as far as he can remember and the MTO was not notified of his condition.

Lax says that he knows now that he should never have been operating a motor vehicle, much less have been a taxi driver, while on all those medications, but he swears that he can not recollect much of those years due to the electro-shock treatments: treatments he calls barbaric.

He is now actively leading a two-pronged crusade to have electro-shock treatments banned and to raise awareness about medicated impaired driving. Lax has joined a MoT group called the CAR Committee that has members from Mothers Against Drunk Driving, police, pharmacists and the MoT on it. Through their and his efforts Lax has received the attention of former Minister of Transportation Tony Clement and current MoT David Turnball. They have taken his material into consideration and Lax says they plan to use it when they review MoT policies and laws. According to Lax that takes place every two years and he is optimistic that they will be reviewed this year.

Lax is pushing for the government to take a tougher stance on the mandatory reporting by doctors patients who should not be driving while on medication. While it is the law, he said be was never once reported to MoT.

He plans to continue his efforts to raise awareness about these two important issues by working with self-help groups, visiting schools to talk to students and continue writing letters to officials until things change in a way that lives are saved.

Kenora man was ‘high as a kite’ cabbie

By Jim Mosher of The Enterprise

Wayne Lax shouldn’t have been ‘flying high’ in his taxi – but he was.

Lax, 57, spent more than 25 years in and out of psychiatric hospitals, where he was treated for alcoholism and severe depression.

But he says the psychiatrists who were treating him failed to inform the ministry of transportation that his mental state might affect his driving ability.

Lax says he drove cab in Kenora from 1959 till 1986, including much of the period during which he was under medication and receiving electroconvulsive therapy (ECT), also known as shock treatment.

Physicians and doctors are required by law to inform the ministry of transportation if they believe a patient is medically or mentally incapable of driving.

It wasn’t until two years after his last admission that a Thunder Bay psychiatrist, who had treated Lax four years before, contacted the ministry to express his concerns about Lax’s fitness to drive.

By that time, Lax says he had medication and alcohol-free for more years.

The ministry’s licensing branch suspended Lax’s license in March but subsequently reinstated it when MTO received a psychiatric assessment that cited Lax’s improved mental health.

“Not once during the time I was treated did any doctor tell me that I shouldn’t drive,” Lax said. “I was a cab driver and I was impaired for 25 years.”

“It wasn’t until I got my life together that they started harassing me about my license.”

Lax acknowledges that he likely would have been upset if his license was suspended earlier.

“But I wasn’t medically fit to drive,” he said. “I’m not knocking every psychiatrist, but I think they have to get more responsible. Consider how many people are killed each year on the highways. How many of them are medically impaired?

Letters in response:

Psychiatrist’s ‘late’ report raises questions

To the editor:

I am writing in response to the article published Sun, Jan. 25,1998, “High as a kite cabbie”. It is very interesting to me that a Thunder Bay psychiatrist who hasn’t seen someone in over four years all of a sudden reports him to the ministry of transportation to express his concern about Mr. Lax’s fitness to drive.

Thunder Bay is quite a drive from Kenora.

Why did he all of a sudden remember Mr. Lax? What happened? Did the psychiatrist all of a sudden feel that Mr. Lax was unfit? Did he have a guilty conscience? Was he trying to cover his tracks? Why did he not report Mr. Lax while he was his patient and under his care?

That would have been the opportune time to make such a report while he was treating Mr. Lax by giving him ECTs (electroconvulsive therapy or shock treatment) and prescribing medication for depression.

This sounds like some type of harassment to me. Would you not think that he would require an assessment prior to making such a damaging statement four years later?

Do you wait until someone gets well and on their feet again then report them and try to screw everything up again for him and his family? The care that Mr. Lax was receiving was unnerving and unprofessional.

I have read that ECTs cause a quick response to depression. How many ECTs does someone have to go though before they realize that it’s not working? ‘Twenty? Twenty-five? Dah!!

Mr. Lax also received medication that at times caused confusion and hallucinations and other side-effects. Combined with shock treatments, he was a danger to himself and others.

Since Mr. Lax took things into his own hands, he has changed 110 per cent. He is now in control of his own life, not putting his life into the control of others. This should tell us all something.

I know about Mr. Lax’s condition firsthand because he is my uncle. I have always been a part of his life and have always loved him. But, at times, I didn’t really know who he was because he was so confused for many years. I remember my mom saying to me that Uncle Wayne is back up there in the hospital again. We went to see him once in the hospital and he didn’t even know who I was. Who says ECTs don’t cause brain damage?

Today, he is a changed man – happy and in control. I am very proud of him. There is a determination in his voice and manner. He is helping others to help themselves. He is doing this by telling his story about the more than 25 years of abuse that he received from the psychiatric community in Thunder Bay and in Kenora.

Margaret Hajdinjak
Thunder Bay, Ontario

Cabbie’s sister proud of brother’s long journey to recovery

Dear Mr. Mosher:

I was pleased to read your article “Kenora man was High as a kite cabbie” (Enterprise, January 25).

1 have a very personal interest in this story and the events surrounding it, because I am Wayne Lax’s sister and know from first-hand experience the pain and suffering Wayne endured for so many years.

For me to see him today, I can honestly say he is “Kenora man, a walking miracle”. It is so gratifying to see how he has had the courage and strength to pull himself up from the distressing circumstances which controlled his life for so many years. All of the family members saw how he suffered, but it has only been recently that we have come to understand the reasons for his behaviour and actions.

In spite of the obstacles in his way to lead a normal life, he struggled and, for a lot of the time, he worked and supported his family. How he did this really have to wonder, considering all the medication and treatment he has had over the years. It was his own strength and belief in himself, which overcame the obstacles and made him determined to find a “better way”. When he became “drug free”, he was able to focus and understand what had happened to him for more than 25 years.

I know he suffered from depression, which I believe first started as a “grieving process” after the death of our youngest brother in 1966. Instead of being counseled and helped through this process the administration of medication and shock therapy began. Wayne has often remarked to me: “All I wanted to do was talk to someone.” Wayne returned from hospitalization in Thunder Bay on many occasions, and immediately went back to work with no counseling or follow-up taking place. Counseling was recommended, but not put in place.

Wayne lives with chronic back pain which we believe could be the result of the lack of muscle relaxant during administration of shock therapy. To quote one doctor’s remarks to Wayne: They probably did not give you enough muscle relaxant… Shock treatment kills billions of brain cells and breaks bones.”

After reading another article of interest (Enterprise, July 20, 1997) relating to Dr. Peter Breggin’s theory on shock treatment stating it is little more than an electrical lobotomy: “It’s barbaric,” said Dr. Breggin. We, Wayne Lax’s family, strongly agree.

I have so much respect and love for my brother and support and wish him well in his mission to make people more aware of his story and the impact too much medication and shock therapy has had on himself and many others.

Joyce Roller
Thunder Bay, Ontario

‘Survivor’ cites, incompetence

Dear Editor:

Jim Mosher’s alarming story about psychiatric survivor and friend Wayne Lax (“Kenora man was ‘high as a kite’ cabbie”, Jan. 25/98), once again shows us just how incompetent, negligent and uncaring all too many psychiatrists are.

First, the psychiatrists electroshocked and drugged the hell out of Wayne for more than 25 years. Then they threw him out and failed to protect him by not telling the ministry of transportation that their ‘safe and effective’ treatments had disabled him so much he couldn’t immediately and safely drive a cab – until many years later when Wayne had been well and working for many years.

Considering the professional incompetence, abuse and suffering he was, forced to endure at the hands of several psychiatrists, Wayne Lax is damn lucky to be alive and working today.

This fact speaks volumes for his incredible strength and courage. It’s not the Wayne Laxes of this world who are dangerous and whom we should fear, but the many psychiatrists who lock up and forcibly treat thousands of us against our will – for our ‘own good’ of course.

Wayne Lax deserves a lot of community support and respect – he knows he has mine.

Don Weitz

Psychiatric survivor

Shock therapy hindered recovery, Kenora man says

By Jim Mosher
Kenora Enterprise
July 20, 1997

A Kenora man who says he endured almost 25 years of progressive memory loss, coupled with hallucinations and bouts of confusion and depression, thinks he shock treatment he underwent may have contributed to his troubles.

He says the routine use of shock treatment and potentially hallucinatory medication to treat alcoholism and periods of mild depression should be banned.

Jerry Gaudrain’s first brush with psychiatry and ‘electroconvulsive therapy’ (ECT or, more commonly, shock treatment) came 10 years ago, after he discovered his brother dead at their Kenora home.

Gaudrain (not his real name) says he fell quickly into a deep and lasting depression after discovering his brother dead. He began to drink a lot – not every day, but in large quantity during binges that lasted several days. He became suicidal. Soon enough, he found himself in a Kenora hospital where he was initially diagnosed as suffering from a mild form of psychosis called reactive depression.

Doctors at Winnipeg General Hospital – now the Health Sciences Centre – authorized shock treatment. That set Gaudrain, now 57 years old, on a course of treatment he believes kept him ill for 25 years.

“I’d be hearing voices,” Gaudrain said during a series of recent interviews in Kenora. “I’d see things. I didn’t want to live. I didn’t know what I was talking about half the time.”

ECT is essentially an electrical stimulation of the brain. It’s used to induce cerebral seizures that disrupt normal electrical activity in the brain. A patient is first given an intravenous anaesthetic. Once the patient is asleep, a muscle relaxant is administered intravenously and pure oxygen is given through a face mask. An electrical stimulus is then briefly applied to the scalp, causing seizure activity in the brain and mild muscle contractions. The seizure usually lasts 30 seconds to one minute. The patient is awake five to 20 minutes after the procedure.

Gaudrain says that instead of treating the alcoholism that was at the core of his suffering, psychiatrists in Winnipeg, Kenora and Thunder Bay routinely ordered ECT to ‘cure’ his illness.

Gaudrain was prescribed a variety of drugs, many of them known to induce hallucinations in small doses, among these so-called psychotropic drugs and antidepressants such as Prozac, librium and lithium.

After more than 50 ECT treatments from 1967 to his last in the summer of 1992, Gaudrain managed to take charge of his own health. But it took a life-threatening car accident to change the course of his life, he says.

Hospitalized on more than 75 occasions during the 2-year course of his apparent illness, Gaudrain says he was routinely released with a veritable pharmacopoeia of drugs prescribed. That surprises Gaudrain now. He worked as a cab driver in Kenora. His doctor never told him not to drive, he says.

“They’d just send me home with more drugs,” he said. “If you’re alcoholic, why are they sending you home with pills?”

‘Voices’ gone

Gaudrain says that since he’s been drug and alcohol free, the ‘voices’ that dogged him for a quarter century have gone.

“It’s a miracle I’m still alive,” he says of the many years of drug and electroconvulsive therapy. He says it took a year to feel better after his accident five years ago on Redditt Road.

“But without the pills, the urge for alcohol left,” he says. “What really helped me was being referred to an addiction counselor in 1992. That’s something I needed.”

Gaudrain has spent the last four years attending a day self-help and peer support program.

An outreach worker with that program says Gaudrain’s experience is far too common. “There are fewer places to file people away,” she said. “There are still people being caught in the trap. They’re getting this pill and shock routine. Maybe all these people need is someone to talk to.”

“I’m one of the fortunate ones,” says Gaudrain today. “When I did get off the drugs and ECT, I just never had the urge to drink.”

He acknowledges that he did ask for ECT treatments. “They had me so brainwashed. Now I just want to see ECT banned.”

While Gaudrain struggles to get his life back together, there are some things that are simply irretrievable.

“There are so many things I can’t remember,” he says now. “My family went through hell. They can’t believe I’m the same person.”

“With the ECT and all the drugs, you walk around like a zombie,” he said. “I’m the one-in-a-million that comes out of it.”

Treatment considered part of the psychiatric arsenal

by Jim Mosher
The Enterprise

Kenora psychiatrist Crosbie Watler acknowledges electroconvulsive therapy (ECT) was appropriately used in the past, but that’s no reason to turn away from its demonstrated therapeutic benefits.

“As we use it today, ECT is a very safe, very effective and very well-researched treatment, ” Watler, chief of psychiatry at Lake in the Woods Hospital, said. “There are some demons in the closet from decades ago, but we shouldn’t throw the baby out with the bath water.”

Dr. Watler says ECT is used at the Kenora hospital because it can provide “a prompt, life-saving” treatment for people who are in the throes of extreme depression; those who are suicidal, in particular.

“ECT is a mainstream treatment in psychiatry,” Watler said. “In the ’50s, ’60s and ’70s, it was used inappropriately. But over the last 15 years the indicators for ECT have been extremely well stated.”

People at extreme risk of self-harm and those suffering extreme forms of mania are among the candidates for the electrical therapy.

“There’s not been a single documented case, with the way ECT is used currently, of brain damage,” the Kenora psychiatrist said, noting past ECT therapy was performed without oxygenation (supplying oxygen to the brain) and with greater electrical current.

Treatments are now administered under general anaesthetic.

Patients also receive a muscle relaxant to eliminate or reduce muscle spasms and convulsions, such as accompanied past treatments.

Watler is not alone in his profession. Psychiatric associations in Canada and the United States endorse the treatment, even though both groups acknowledge no one fully understands why ECT is effective.

“The mechanism of action of ECT remains uncertain, as do the mechanisms of action of antidepressant medications,” says Dr. John Lipsey, associate professor of psychiatry at Johns Hopkins University School of Medicine in Baltimore. “However, ECT remains an effective and often lifesaving treatment for the most severely ill psychiatric patients. Eventually, it will be replaced by more specific physical treatments so that induction of a generalized seizure will no longer be necessary. In the meantime, the continued careful use of ECT in selected cases is imperative to save lives and alleviate suffering.”

Former cabbie on crusade against impaired drivers

Westend Weekly
By Marlene Deschamps
Feb 23, 2000

Wayne Lax from Kenora is a psychiatric survivor. He spent from the mid 1960s until 1992 in and out of hospitals in Kenora, Thunder Bay and Winnipeg. During those hospital stays he was subject to about 80 shock treatments. He was prescribed various medications at various times without any monitoring of the results of those medications. At one point he was on 17 different medications that were supposed to overcome his depression. He was also consuming alcohol on a regular basis.

During this period Wayne held a taxi license and this was his occupation between hospital stays. At no time during the 25 years of treatment did his occupation change because no one made any steps to get his license revoked.

Despite file notations during his stay at the Lakehead Psychiatric Hospital in 1992 that he suffered memory loss and confusion after a series of electric shock treatments he was discharged and no efforts were made to regain his license. Ten days after he discharged himself from LPH he was involved in a single vehicle car accident in which he was injured. He was charged with impaired driving and convicted.

When Wayne finally was free of medications and alcohol for a two year period he got his driver’s license back. This was in 1998. He is thankful that no one was injured as a result of his impaired driving during the years he was driving taxi cabs.

Since this is public transportation he maintains that for public safety there should be mechanisms in place to take drivers off the road who are impaired because of medication. This has been one of the crusades Wayne has been on over the past two years.

Current legislation makes it mandatory for physicians to report to the Registrar of Motor Vehicles any individual over the age of 16 who has been treated for a medical condition which may impair their ability to drive. The point at which a physician believes that a medical condition may impair an individual’s ability to drive depends on the condition and the person’s response to prescribed treatment.

Wayne did not respond well to his medication and as file notes indicated he was confused and did not even know where he was. Yet the doctor responsible for his medical care never once over the years notified MTO that his license should be revoked.

Wayne feels that a better system of monitoring the requirement needs to be developed. He has been in touch over the past two years with Howard Hampton MPP, Tony Clement MPP, Frank Miclash, former MPP, Robert Runerman, MPP and more recently David Turnbull, MPP and Minster of Transportation. Wayne gets thanks for bringing the issue to the various Ministers’ attention but he would like to see a more timely response.

The latest letter was from David Turnbull sent on September 13, 1999 in which he acknowledges Wayne’s concerns, mentions the legislation covering his concerns and states the issue will be studied further. Turnbull adds that the requirement for physicians is very broad and relates to all medical conditions. HE also writes that Wayne’s comments will be taken into consideration when the medical reporting requirements are reviewed. Such a process would include extensive consultations with the medical community and would cover a wide range of medical conditions.

Wayne feels that this is an issue that should be pushed because there is no request to change anything in regard to the legislation. He just wants it adhered to. If the responsibility lays in the medical profession to notify MTO of persons that should have their license revoked then they should do that. They are being lax in their responsibilities and should be taken to task. The legislation is to provide safety to the public but does not do so if it is not adhered to.

Wayne feels that there should be better communication between the hospitals, the doctor’s office and MTO. He continues to meet with people, to write letters and to ask the public to support him on his crusade for more accountability from doctors to comply with legislation that is there to protect the public from impaired drivers.