REPLY TO THE FOREGOING

Abstract

SIR: Dr. Douglas M. Kelley wrote a comprehensive review of my book, “Practical Lessons in Psychiatry,” which appeared in the June, 1950, issue of the JOURNAL. His critique shows that he read and digested the material thoroughly. However, I must point out a serious misconstruction of the contents of the chapter on electrocoma therapy. Dr. Kelley says, “While these chapters are excellent in themselves, they are definitely out of place in the present volume.” The reason for this opinion, as given by Dr. Kelley, is, “There seems no doubt that the average general practitioner reading the book will assume that it indicates his potential ability to handle shock therapy.” Such a statement has no basis expressed or implied in the book. On the contrary, the detailed description of the procedure, from the selection of the psychotic patient to the technical phase of the treatment, is assigned as a major task of psychiatry. In contrast to Dr. Kelley’s deduction, this is what the text actually states (page 165): “Merely possessing an electroshock machine does not assure results. There is needed an experienced psychiatrist who knows his patient, the dosage and course of the illness-and how best to employ electrocoma therapy along with psychotherapy.” On pages 172 and 173, clearly expressed in italics, is the following: “I would advise any psychiatrist who wants to use this method successfully to train with one who is thoroughly familiar with the apparatus, the pretreatment medication, the dosage, the timing. Merely procuring the apparatus and an instruction sheet is inadequate preparation in the .ise of a method whose potential for good is so great. Properly administered, electrocoma therapy can contribute tremendously towards recovery. Electrocoma therapy used in a haphazard fashion, minor reactions, incomplete series of treatments, neglect of after care will lead to a higher percentage of failures than need be.” The aim of this chapter was to provide a clear understanding for nurses, psychologists, and practitioners in a field where there has been considerable misunderstanding. How closely this aim was reached may be inferred from the following sentence from the review of my book in the Southern Medical Journal (May, 1950): “The section on electroshock therapy, with an introduction by Dr. Foster Kennedy, is the best yet seen by the reviewer.” JOSEPH L. FETTERMAN, M. D. Cleveland, Ohio.