Movies are amazing at shaping your perceptions.  One Flew Over the Cuckoo’s Nest, the 1975 winner of Best Picture, Best Actor, Best Actress, Best Director, and Best Screenplay taught me everything I thought I needed to know about electroconvulsive therapy (ECT).  The practice was barbaric and designed to inflict pain on patients at mental health facilities in order to break their will and maintain order.  Nurse Ratched made a magnificent villain.  She holds the prospect of a trip to the “shock shop” over the patient’s heads in order to control them. A patient named McMurphy (Jack Nicholson) is a thorn in her side and becomes her favorite target.

During my early years at the Probate and Family Court, which has jurisdiction over guardianships of the mentally ill and extraordinary treatment decisions for the mentally ill, I was amazed to learn that electroconvulsive therapy was alive and well.  I had imagined, without any basis in reality, that ECT had been relegated to the waste bin by modern and humane views of treatment.

Early in my career when I worked as an Assistant Register of Probate, a woman came into my office and requested guidance on how to get her ETC treatments stopped.  She was clear, sharp, and coherent.  I was new to my job and still ignorant of the benefits ETC provides to, among others, those individuals who are extremely depressed.  I helped her draft a pleading to bring her case back before a judge for review prior to her next scheduled course of treatment. After review, the judge hearing the case left the treatment plan in place.

For a several years thereafter, the woman became a regular visitor to my office, seeking to file one pleading or another.  I would always refer any of her legal requests to her court appointed attorney but I enjoyed talking with the woman.  In observing her appearance and behavior, it always easy to tell when the ECT treatment was wearing off or had been discontinued.  Her appearance was disheveled and unkempt and she was not interested in talking about her family or anything else including her children.  

ECT treatment has improved dramatically since the days of Nurse Ratched but the treatment still carries side effects with the most significant one being long term memory loss.  Extensive efforts to minimize memory loss are ongoing and progress continues to be made.  In the meantime, patients and their families along with Probate and Family Court judges frequently face tough choices. 

What would you do if you had to choose between sitting in a dark room and having no interest in keeping yourself clean or interacting with your loved ones, or, accepting ECT and being vibrant and loving for four or five months knowing your memory would be impaired?  No easy choice – but as for me, I would choose to visit the “shock shop”.