Thomas A. Ban: The Ewen Cameron Story
Hector Warnes’ Comment on Edward Shorter’s Comment
Nobody but Ned Shorter, who wrote A History of Psychiatry, would be more qualified to write on D. Ewen Cameron's fall from grace in the early 60s.
I must honestly say, however, that I did not like the title of his comments: Scientist or Monster. We have to consider the Zeitgeist of the times by reading Lothar Kalinowsky and Paul Hoch’s classical Shock Treatments and Other Somatic Procedures in Psychiatry published in 1946 or William Sargant and Eliot Slater's 1944 An introduction to physical methods of treatment in psychiatry or the about the 2,900 lobotomies performed by Walter Freeman with a total of 490 fatalities; the last lobotomy was performed in 1967 -- some patients had severe adverse effects and some were left in a persistent vegetative state. Yet Antonio Egas Moniz, the Portuguese neurosurgeon who first performed this surgery in 1935 in intractable psychiatry patients, won a Nobel Prize for this treatment.
Another so-called breakthrough was sleep therapy with barbiturates introduced in a systematic way by Jakob Klaesi, a Swiss Psychiatrist, that also had many casualties, along with insulin therapy, Cardiazol shock therapy and so on.
At times, due to political or social issues, the media uses unfortunate treatment outcomes to become, instead of a fourth power, the principal power to judge and describe with tendentious tenacity the patient's experiences of treatment. There were such events written about even with the use of sertraline (Zoloft) and fluoxetine (Prozac) because of the observation that some patients were driven to commit suicide.
We are all aware that Clozapine and Lithium, or for that matter Tegretol or Valcote, have caused severe if not lethal side effects on the hematological system, the liver, the kidneys and even the metabolic system which causes a metabolic syndrome in the long run. We are all aware of the patient fatalities in hospitals, not because of the illness for which they were admitted, but because of the relative absence of aseptic conditions in the surgical room. More and more bacteria which develop resistance to the use of antibiotics (e.g., patients who have an appendix removed or a C-section for childbirth may end up dying).
For centuries there have been "reckless" investigators who at times were themselves victims (such as Marie Curie who did not know the potential harm of radioactivity and yet her own daughter, who must have learned, succumbed to the same illness).
Since the 70s and 80s, in spite of the strict protocols for investigating any substance, the patient who is desperate to get well or his family have to sign a consent form.
I have not read for decades about the brain lesions caused by ECT administered every day for months in many refractory cases. I recall that this was studied decades ago, and, with few exceptions, neuroplasticity won over. I have not read follow up studies of the patients treated by D. Ewen Cameron at the Allan Memorial Institute where he combined sleep treatment with ECT (depatterning) and subliminal psychotherapy (psychic driving).
The word depatterning reminds me of John Hughlings Jackson who, along with Paul MacLean (the Triune Brain), introduced the study of the evolution of species in the neurosciences. Jackson was a brilliant neurologist who influenced S. Freud and Henri Ey in their theories. Dissolution (or regression) is the reverse of the process of evolution. From the lowest (the reptilian or primal brain) to the highest centers (the prefrontal cortex) there is increasing complexity, differentiation or specialization; during anesthesia one can see these hierarchical levels of the central nervous system
Unfortunately, great scientists who make great discoveries are often overambitious; they have a kind of “furor therapeutics” which I would dare to call the Icarus Complex. I am sad to see that other experimental treatments were luckier than the one Cameron dared to carry out in spite of having had much worst outcomes (e.g., prefrontal leucotomies). I am sad to see that Cameron died and could not defend himself nor that any of his closest collaborators defended him in a scientific and comparative study.
At the time the Allan Memorial Institute was doing research on sensory isolation based on Donald Hebbs’ observations in animals; lithium was introduced; chlorpromazine was studied by Heinz Lehmann at the Verdun Protestant Hospital; imipramine was researched; and countless other pioneer research was introduced in the biochemical, neurophysiological, pharmacological and neuroscientific sections.
I would hope that someday a fairer assessment of the contributions of D. Ewen Cameron to our relative new discipline shall be written.
References:
Kalinowsky LB, Hoch PH. Shock Treatments and Other Somatic Procedures in Psychiatry. New York: Grune & Stratton, Inc.,1946.
Sargant W, Slater E. An introduction to physical methods of treatment in psychiatry. Edinburgh: E & S Livingstone Ltd.,1944.
January 9, 2020