THE TROUBLE WITH SPIKOL

The Shocking Truth, Part IV
Forced electroshock isn't just the stuff of movies.

BY LIZ SPIKOL
lspikol@philadelphiaweekly.com

I've always been somewhat awed by the Hippocratic Oath. Unlike the presidential Oath of Office, forever tarnished by Bill's perjury, the Hippocratic Oath is still imbued with dignity. I saw this at work on 60 Minutes Sunday, in a story about a mentally ill man who had been moved from death row to a psychiatric facility once it was discovered he was incompetent to stand trial.

His doctor had the ability to make him well enough to stand trial, but told Leslie Stahl that making a man well in order to have him killed violated his notion of the Hippocratic Oath's primary dictum: Do no harm. Why don't doctors who perform electroshock therapy feel the same way?

New York State Supreme Court Justice W. Bromley Hall decided April 16 that Pilgrim Psychiatric Center on Long Island can resume its shock treatments of Paul Henri Thomas, despite Thomas' opposition. Thomas is a 49-year-old inpatient at Pilgrim, which is under the jurisdiction of New York State Office of Mental Health (OMH). He emigrated to the U.S. from Haiti in 1982. Though he has been diagnosed with schizoaffective disorder and bipolar mania (among other diagnoses), he does not believe he is mentally ill. This, according to doctors at Pilgrim, is part of his illness.

Thomas did initially consent to ECT in June 1999. At that time, he was considered competent to consent. But after three treatments he decided he'd had enough--at which point the Pilgrim doctors decided Thomas was incompetent.

Newsday staff writer Zachary R. Dowdy characterized the situation as "a kind of Catch-22--the strange circumstance that Thomas was fine when he consented to the procedure but mentally incompetent when he refused it." Since 1999, Thomas has received nearly 60 forced electroshocks.

Part of the doctor's defense of Thomas' forced ECT was the patient's erratic behavior. Justice Hall agreed, writing in his decision, "He was wearing three pairs of pants which he believed provided therapy for him. At the same time he was found, in the ward, wearing layers of shirts which were inside-out, together with jackets, gloves and sunglasses."

Oh my God! Someone stop this man before his commits another fashion faux pas! Strap him down, put him in a diaper, shove a mouthguard between his teeth, administer sedatives and then induce a grand mal seizure in him against his will. Surely after that he'll be calm enough to reconsider his wardrobe.

As his case heated up, Thomas issued a public statement in which he said, "I am currently undergoing forced electroshock treatment. ... It is horrible. ... I am strong. But no human being is invincible. ... I ask God to bless you in anticipation of your helping me in my torture and traumatization. ...Do whatever is possible!"

Anne Krauss worked as a peer advocate in the New York OMH and was assigned to Thomas' case. Krauss supported Thomas' fight against forced ECT but was ordered by her superiors to cease action on his behalf.

On March 21, Krauss resigned. In her letter of resignation, she wrote, "The New York State OMH is taking the position that for me to actively advocate (on my own time and at my own expense) on behalf of Paul Thomas creates a conflict of interest for me in my job .... Given the choice between continuing to work for an agency which so discounts recipients' voices that it will repeatedly force electroshock on someone who has clearly said that he experiences it as torture, or advocating for this person's right to make his own decision about whether electricity should be run through his brain, I am choosing to advocate."

Referring to Thomas' history as a human rights activist, Krauss said, "I am following Mr. Thomas' own example in putting ideals of human rights and liberty before my desire for personal comfort or job security."

Doctors say Thomas' liver would be "further damaged" by giving him antipsychotics. ECT is approved, recommended and effective primarily for depression. It has never been definitively proved, in any clinical study, to be effective for psychosis. Did someone fail to tell the judge that ECT does not equal treatment with antipsychotics?

They also say one of the reasons Thomas denies his illness is because in Haiti, cultural perceptions of mental illness are different. Additionally, doctors admitted that if Thomas were at a private facility, he'd be unlikely to receive ECT.

Is it fair to discriminate against someone simply because he doesn't have money for private care? Or because he comes from a different culture?

If this seems like an isolated case, one need look no farther than down the proverbial hall--where 25-year-old Adam Szyszko also fights forced electroshock at Pilgrim. Szyszko was granted a temporary restraining order. His mother told the Associated Press, "I think it's horrible they are holding my son prisoner. I want the treatments stopped." Her son, a diagnosed schizophrenic, is allergic to the medications Pilgrim would prescribe. Forget the fact that Szyszko and family prefer he try psychotherapy instead of drugs.

Why is Paul Henri Thomas being forcibly shocked while Adam Szyszko--while admittedly in a horrible situation--is not? I wonder if it's because Thomas is black and Szyszko is young and white. Isn't it more wrenching to read about a young man who played classical piano and won awards in grade school? The New York Post sees fit to blare, "MOM'S IN TEARS AS DOCS 'TREAT' HER CAPTIVE SON" about Szyszko, but says nothing about Thomas.

"do no harm." Can anyone at Pilgrim be said, like the doctor on 60 Minutes, to be guarding the integrity of the Hippocratic Oath? It would seem that in New York, the oath has long been forgotten. PW