Away For a While

November 20, 2014

Dear followers & readers:

At the moment a bad physical illness, severe depression, and some other problems combined are keeping me from properly maintaining my blogs. I will be away… and silent… for at least several more weeks. I hope that when better times come along, I will meet you here once again.

We never give up, right?

In the meantime, don’t forget that many of my posts from the past few years are still very valid and really worth reading. Go to the Contents (top bar) and give them a try!

My absence also means that probably I won’t be able to daily check your comments before letting them appear. I cannot simply let all comments pass (not even with an automatic filter in place) because this would drown us in a flood of spam.

The consequence is that if in the next weeks you post a comment, it may take a very long time before your comment actually will appear here. Sorry!

Henk
(your StayonTop and
HistoryofMentalHealth blogger)


1935: António Egas Moniz, Piercing the Brain

November 12, 1935 – On this day, Portuguese neurologist António Egas Moniz (1874-1955) did the first “leucotomy” (better known as lobotomy) brain operation on a psychiatric patient. Because Egas Moniz hands were too deformed by gout to do precision work, he had his assistant Pedro de Almeida Lima (1903-1983) perform the first operations under his direction.

António Egas Moniz

We don’t know the name of his first leucotomy patient, but the first 20 test patients, among them 7 schizophrenics, all came from the Miguel Bombarda psychiatric hospital in Lisbon.

Unlike later lobotomy operations (where the eye sockets were used to access the brain) these first involved operations drilling two holes in the skull and injecting alcohol into the brain’s frontal lobes. Later, Moniz introduced a pick-like instrument with a wire loop to cut some of the synapses in the brain.

António Egas MonizWhen in 1936 he published his first research report on these operations, he claimed that of the 20 patients they had cured 7 patients, brought some improvement to 8, and had not helped 6 of them. He thought that the side effects such as incontinence, apathy and memory loss all were only temporary.

Because at that time it was still very difficult to find effective cures for serious mental disorders, lobotomy was hailed as a great step forward. It soon became popular in many countries. In the USA lobotomy was popularized in the 1940s by Walter Freeman (1895-1972, I’ll write a separate post about him).

But primitive brain operations of this kind were really risky. They often had unexpected, devastating, and permanent effects. One very well-known American victim was the future President Kennedy’s sister, Rosemary Kennedy, who in 1941 (at the age of 23) was completely incapacitated by a failed lobotomy operation. Meant to cure her violent mood swings, instead it left her incontinent and unable to speak for the rest of her life, reduced to the mental level of a two-year-old child.

Rosemary KennedyRosemary Kennedy before she got a lobotomy

On the other hand, to be fair, there were a few success stories. For an example of a more successful lobotomy, see my post about Canadian singer Alys Robi.

Recognition

Egas Moniz was awarded the 1949 Nobel prize for his innovative leucotomy idea– just before neurologists, psychiatrists and many others began to seriously criticize his work and the usefulness and ethic implications of lobotomies.

After about 1960, when safer and more effective psychiatric medication became available, this kind of surgical last-resort solutions rapidly fell into disuse. People began to understand that the risks often did not outweigh the benefits.

In Portugal however, Egas Moniz was not discredited. While elsewhere in the world anti-lobotomy activists tried (in vain) to get his Nobel prize revoked, the Portuguese honored his 100th birthday in 1974 with a series of three postage stamps. Here are two of them.

Now take a good look at the left one. It shows the wire-loop bodkin he used to penetrate his patients’ brain:

Egas Moniz stamps

I’m not sure if I would have liked to put that particular brain surgery stamp on my mail. But the Portuguese went further. They even managed to literally monetize this controversial piece of psychiatric history!

You know, I’m too fond of curiosities to resist this – here is Egas Moniz, together with an anonymous brain, on an old Portuguese 10,000 escudos bill:

Egas Moniz on money bill

Unfortunately in 1949, the same year Egas Moniz got his Nobel prize, a confused psychotic patient fired four shots at him. He never fully recovered from this assassination attempt and had to use a wheelchair until his death in 1955, at the age of 81.

A Song

I want to conclude this post in a fitting way: with a melancholic Portuguese fado song. Here is singer Fernando Machado Soares (born 1930 and as I write this, still going strong) with his Balada da Despedida (“Farewell Ballad”).

I won’t translate all the lyrics about the town of Coimbra. But let me note that this sad song includes an observation that “beyond the moonlight, there always is a dark night”.

I play this song here not to honor António Egas Moniz, but rather in memory of the thousands of nameless mentally ill patients who suffered from disastrous consequences of a crude lobotomy operation.

 
Fernando Machado Soares – Balada da Despedida

Footnotes:

 


(intermezzo)

Nov 7 2014

Dear readers: today I was going to write something about the tragic life of a great psychoanalyst, Sabina Spielrein (born November 7 1885, murdered in 1942 by the SS Einsatzgruppe-D).

I will tell you her story, but not today.

Right now I’m too depressed to write anything that makes sense. So please excuse me. I am taking a few days off. I hope (hope) to back with another post next Monday or Tuesday.

A Song Instead

To make up for this lapse, allow me to leave you with a song. It has to be a totally irrelevant, nonsensical one – for in my present state anything more serious will bring tears or worse, bottomless desperation.

So here is the ever-optimistic Gogol Bordello band with their Supertheory of Supereverything, a song from their 2007 album Super Taranta!

See you in a few days. Thanks for your understanding.

Gogol Bordello 
Gogol Bordello – Supertheory of Supereverything

 


1963: Lena Zavaroni

November 4, 1963 – Birth date of Scottish child singer Lena Zavaroni, whose talents were exploited by record and TV show producers since she was 9. In 1974, at the age of 10, she became the youngest singer ever to make it to the UK Albums Chart Top Ten.

Lena Zavaroni

Within two years, she had gone from living on the small Scottish Isle of Bute to performing at a concert with Frank Sinatra and Liza Minelli and singing for American President Gerald Ford at the White House. Or, as she told it later herself:

 
“Everything changed so quickly. I had never seen lifts or escalators or even traffic lights. I went from a council house on an isolated island to a posh hotel in Piccadilly, with shopping trips to Harrods.”
 

At age 13 she began to show clear signs of anorexia, and at 15 she also developed severe clinical depression. Both illnesses would keep tormenting her for the rest of her short and tragic life.

Lena ZavaroniShe later explained how she came to develop anorexia:

 
“When they tried to fit me into these costumes, they would talk about my weight.
 
I kept wondering how they expected me to fit into these dresses. I was a plump little girl and I was also developing into a woman. I wanted to be just right for them but I had to go to all these breakfasts, dinners and lunches.
 
I only became fanatical about not eating when the pressure got too much. I just wanted to have a nice shape.”
 

In spite of Zavaroni’s ongoing battles against anorexia and depression she managed to keep performing and to do TV shows until the 1980s; the last of her seven albums appeared in 1982 when she was 19.

But in her early twenties, her career was over. Her mental and physical health deteriorated rapidly.

Looking back, I think it is safe to assume that Zavaroni was a typical victim of the “child star syndrome”. Excessive prepubertal fame and attention had destroyed her chances to enjoy a normal youth, and hampered harmonious development.

Anti-Depression Operation

Lena ZavaroniIn 1989 she married a businessman (a marriage that soon failed). Around the same time her mother died from an overdose of tranquilizers. Ten years later, after some non-effective electroshock treatments and a suicide attempt by overdose herself, her depression had become so unbearable that she began to beg for a drastic solution.

In September 1999 she underwent “a pioneering psychosurgical operation” that amounted to a modern alternative for the old, notorious lobotomy surgical brain operations. This operation was primarily meant to cure her chronic depression, not her anorexia.

The University Hospital of Wales in Cardiff allowed this surgery even though Zavaroni was seriously weakened by her anorexia.

In the first days after the operation she appeared to slowly recover and seemed less unhappy; she even asked a doctor if it would be possible to resume her career.

But she would never leave the hospital. Within three weeks, on October 1, 1999 she died from a pneumonia infection. She was 35. At the time of her death she weighed only five stone (70 lb, 32 kg).

Medical Wisdom

At the inquest, the coroner found no direct relation between the brain operation and the death by pneumonia. Although many people questioned the wisdom of performing a brain operation on someone who was already seriously weakened by anorexia, the hospital’s procedure was never formally subjected to a legal inquiry.

University Hospital, Cardiffthe Cardiff University Hospital, where Zavaroni died

At a hearing in Cardiff the responsible neurosurgeon, Brian Simpson, defended himself by saying that all previous depression therapies for Zavaroni had failed, that she had felt depersonalized and hopeless and tormented by her depression, and how she had convinced him there was no alternative:

 
“Ms. Zavaroni was very, very keen indeed to have this operation performed. She had taken an overdose of drugs shortly before that and expressed the view that if she couldn’t have the operation, or if it wasn’t successful, then she would kill herself.”
 

I am strongly inclined to add a harsh comment here about medical responsibility and how to professionally handle a patient’s suicide threats, but I will leave it at this.

Music

One of the songs on Lena Zavaroni’s 1974 debut album Ma! He’s Making Eyes At Me was a cover of the 1970 Kris Kristofferson song Help Me Make It Through The Night. Here she is, a 10-year-old girl singing the lines:

 
I don’t care what’s right or wrong
I don’t try to understand
Let the devil take tomorrow
Lord, tonight I need a friend
Yesterday is dead and gone
And tomorrow’s out of sight
And it’s sad to be alone
Help me make it through the night
 

Lena Zavaroni's first album 
Lena Zavaroni – Help Me Make It Through The Night

I hate having to add the obvious here: yes, I do feel that no one ever truly helped little Lena to make it through the night.

Footnote:

  • There still is a dedicated Lena Zavaroni fan website: Lena Zavaroni – The Brightest Star, 1963-1999. This site has lots of photos, videos, mementos, recollections, tributes and more.
  • For the physician who back in 1873 was the first to describe anorexia nervosa as a specific disorder, see William Gull.

 


1953: Samaritans Helpline

November 2, 1953 – This day, a new helpline for suicidal people in London got its first call. It really was something new: the first 24-hour suicide hotline in Britain, and perhaps in the world. The initiative was named “Samaritans” by a Daily Mirror newspaper journalist a month later, and the name stuck.

It was founded by Anglican priest Chad Varah (1911-2007).

Chad Varah

Back in 1935, at one of his first services as a young priest, Varah had to assist with the funeral of 14-year-old girl who had killed herself because she thought her first menstruation was a horrible venereal disease. This had convinced him of the need for both better sex education and suicide prevention:

 
“I stood at the end of the grave and I said, little girl, I never knew you, but I promise you that you have changed my life and I shall teach children about sex.”
 

Initially Varah concentrated on various ways to improve sex education, and if necessary he actually did provide it himself.

But in the early 1950s as a vicar in London (where three suicides happened every day) he shifted his focus towards suicide prevention. He came up with the idea of a telephone number that should be open for help calls day and night.

In November 1953 he began to run his hotline from the crypt of his church, the St. Stephen Walbrook in London. Although the telephone (“MAN 9000”) happened to be in a church, it was distinctly meant to be a non-religious help service for anyone contemplating suicide.

St. Stephen Walbrook church, Londonthe 1697 St. Stephen, Walbrook church in London

At first Chad and his secretary Vivian took many of the calls themselves but soon they gathered enough volunteers to adequately man the phone. The December newspaper article about their work triggered a dramatic rise in the number of calls. In February 1954, Varah decided to leave all the phone-answering to volunteers and to devote himself entirely to managing the organization.

Varah instructed his volunteers to never be moralistic or judgmental, and never talk too much themselves, but first and foremost to listen to their callers in an empathic and open-minded way.

In the 1950s and 1960s the organization kept steadily growing. It spread all over Britain, and since 1974 developed branches in many other countries too. Today the Samaritans are still going strong and they still work with volunteers, but over the years their goal became a little more general.

Today their website says:

 
“People talk to us anytime they like, in their own way, and off the record – about whatever’s getting to them. You don’t have to be suicidal.”
 

Varah remained actively involved with the Samaritans (and his London church) for nearly all his life. He was nearly 96 when he died in 2007. Here he is proudly showing the original hotline phone from the early days:

Chad Varah

Footnotes:

  • The present Samaritans phone number in the UK is 08457 90 90 90. A list of similar helpline phone numbers in many other countries can be found here: International Suicide Hotlines.
  • A history page at the Samaritans website offers Varah’s own account: How and why I started The Samaritans, by Chad Varah. For more details about his biography (and other links) see his Wikipedia page: Chad Varah.
  • Varah’s old black phone is now preserved as a kind of museum piece in a glass case at its original location: the St. Stephen, Walbrook church in London.
  • I really regret that even with intensive searching I could find no info at all about Chad’s secretary Vivian, who helped him answering the phone in the first months of the helpline. It looks like no one bothered to even note her full name. Doesn’t she deserve a proper mention? Can someone help me out here?

 


1857: Georges Gilles de la Tourette

The Doctor Who Lost His Mind

October 30, 1857 – Birth date of French physician and neurologist Georges Gilles de la Tourette.

As one of the pupils of famous French neurologist Jean-Martin Charcot (1825-1893) at the Paris Salpêtrière hospital, Tourette experimented with the use of hypnosis as a method in psychotherapy. One of his specialisms was working with patients who suffered from hysteria. People considered him brilliant, though not always friendly.

Georges Gilles de la Tourette

As a young assistant in 1884, he was the first to analyze a condition characterized by recurring involuntary movements and tics (sometimes with rude, offensive vocalizations). Named after him, this illness is still known today as the “Tourette Syndrome”.

A Shot

When in the early evening of December 6, 1893 Tourette returned home from the hospital, he found a young woman waiting for him. This girl was 19-year-old Rose Kamper (1864-1955), a former Sainte-Anne asylum patient who had participated in one of Tourette’s hypnotism sessions. After a brief exchange in which she asked Tourette for money, she produced a pistol and shot him in the neck. The wound was not fatal.

After the shot, Rose Kamper kept sitting quietly in Tourette’s waiting room. She later explained that she suspected Tourette to be in love with her, that she had been hypnotized without her consent to take over control of her will “at distance”, and that there was another person in her who had made her shoot.

Kamper was diagnosed with what we today would call paranoid schizophrenia and quickly locked in the asylum again. She would spend much of the rest of her life going in and out of mental hospitals, once stabbing a nurse with a fork; in 1910 she would cause a large-scale police hunt when she managed to escape from an asylum.

Meanwhile the news of a patient shooting a therapist had gotten very much publicity in the French popular press. It was sensationalized like this:

Kamper shooting Tourette“A Hypnotism Drama”

Going Downhill

Tourette survived the shot, but the incident was used by others to discredit and ridicule the therapeutic use of hypnosis. So it also damaged Tourette’s reputation, and worse, the experience had shaken him enough to mark the beginning of his becoming mentally unbalanced himself. Gradually, he began to suffer from depressions and manic moods himself.

This probably was not just caused by some kind of posttraumatic stress. Several of his colleagues suspected that Tourette was in fact developing “paretic dementia”, the dreaded mental illness caused by a sexually transmitted disease: by syphilis infecting the brain.

Georges Gilles de la TouretteIronically, in 1899 Tourette himself published an article on the advance of syphilis into neurosyphilis and insanity. Some wonder if by then he did recognize the symptoms in himself and if this perhaps worsened his depressions; we just don’t know.

Anyway, around that time Tourette’s behavior became ever more erratic and bizarre. He sometimes bothered people by following them on the street, and occasionally stole little items.

Newspapers began to write about “the deranged doctor” and in the end he lost his hospital job. Friends and family decided something had to be done.

On May 28, 1901 Tourette was lured into the Swiss Asile d’Aliénés de Cery (an insane asylum near Lausanne, Switzerland) under the pretense that some “famous patient” was waiting there for a consult with him. Once inside, he was involuntary committed.

The asylum staff observed he was suffering from “melancholia with suicidal tendencies” and “bouts of megalomania”. He was indeed diagnosed with “paretic neurosyphilis”.

Asile d'Aliénés de Cery (1873)The Cery asylum as it was built in 1873

Tourette became (not surprisingly) very agitated over his involuntary commitment, and after a few days had to be put in an isolation cell.

The next few years he was kept in this Swiss asylum, where at first he vainly kept writing letters pleading for his release. He began to lose his last shreds of sanity and became almost psychotic, with rambling speech and convulsions.

Three years later (May 22, 1904) he died in the asylum after an epileptic seizure. He was 46.

Footnotes:

 


1965: Frank Wisner

October 29, 1965 – Mental problems can be fatal even in the world of James Bond. On this day Frank Gardiner Wisner (56) who had been one of the main figures in the CIA, used a 20-gauge shotgun to shoot himself in the right temple. He had been suffering from serious mental illness since at least nine years.

Frank Wisner

As a young Navy officer during World War II Wisner had joined the OSS, the secret American government organization that later would become the CIA.

He made a quick career as a spy and head of spies. Near the end of the war, he was chief of American intelligence in Turkey and Romania. There in 1944 he was one of the first who clearly understood that after the defeat of the Nazis, the Soviet Union was going to take control over all Eastern European countries.

Since 1947 Wisner headed several secret operations for the CIA, such as establishing spy networks in various European countries at both sides of the Iron Curtain. From 1952-1957 he successfully led the most important covert department of the CIA, that for example in 1953 played a decisive role in organizing a pro-American coup in Iran. He also was involved in the planning of the U-2 spy plane program.

But in December 1956 Wisner suffered a truly serious mental breakdown. He had to break off his work and was diagnosed as “manic-depressive”: what we today would call bipolar disorder.

Cause?

Frank WisnerAccording to some, Wisner’s illness had been triggered by his deep disappointment over the Soviet’s brutal crushing of the Hungarian uprising (October-November 1956). He was equally disappointed by America’s inability to intervene and help the Hungarians.

Frankly, assuming that Wisner’s bipolar diagnosis was correct, this explanation looks a bit incomplete. Maybe political disappointment did indeed bring a sense of failure, that in turn triggered one of the depressive episodes that are typical for bipolar disorder. But the suggestion that this political disappointment was what triggered the illness itself seems implausible.

Generally, bipolar disorder is not an illness that just breaks out suddenly. It is a more chronic condition, one that develops over a long time. So my own guess would be that Wisner had already been suffering from the associated mood swings and hyperactivity episodes since many years, maybe even for most of his life.

After his breakdown, Wisner got therapies on all possible levels – from psychotherapy to electroshocks. Unfortunately lithium, that in some cases of bipolar disorder can be a simple and effective form of medication, was not yet known at the time.

Wisner had to be hospitalized in a famous psychiatric clinic in Baltimore, the Sheppard Pratt Hospital (a very old one, founded 1853 as the Sheppard Asylum).

The Sheppard Pratt HospitalThe Sheppard and Enoch Pratt Hospital, Towson (Baltimore)

Final Years

In 1958, after six months in this clinic, Wisner was allowed to return home. But because had not recovered fully (he still was unstable) the CIA had to find him a less demanding, less pivotal job. In September 1959 he finally went to work again, as head of the London CIA station. After a while however it became clear he could not function well anymore. In 1962 he was recalled from London and retired.

In his last years Wisner kept suffering from deep depressions. Apparently, no therapeutic help was adequate.

When on October 28, 1965 (the day before his suicide) he drove from his town house to the family’s Maryland farm, his wife was worried. She called the caretaker, asking to remove the guns from the farm before her husband’s arrival. But Wisner found the shotgun of one of his sons and used it to kill himself the next day.

According to his niece Jean Lindsey this may not have been a sudden impulse. She later described him as:

 
“Entirely rational, if you can say such a thing. He realized that his life would be circumscribed by increasing cycles of depression. I saw Frank three days before he died and he seemed in good spirits. He talked about his children. Perhaps he had made up his mind to kill himself.”
 

Wisner was buried at Arlington Cemetery with military honors as a naval commander, his wartime rank. Because so many CIA people were present, guards were posted all around to make sure that no Russian spies would register who attended the funeral.

Footnote:

 


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