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Re: ECT response rate

Posted by BGB on July 5, 2008, at 18:31:12

In reply to Re: ECT response rate, posted by linkadge on July 5, 2008, at 17:10:12

> For some patients (Hemmingway is a prime example) the failure of ECT coupled with the the prospect of permanant brain damage is infact what prompts suicide.

I would have to respectably disagree with you, as far as using Hemingway as an example. Far too little is known about his physical condition at his time of death to make assumptions about his diagnosis of depression, OCD, or bipolar disorder. It has been documented that Hemingway's ECT may have failed because his depression was a result of hematomachrosis, a genetic disease which results in increased iron levels in the blood, which can cause severe and debilitating depression. Bloodletting is the only treatment for hematomachrosis, even to this day. ECT has never been advocated as a treatment for hematomachrosis. Hemingway was most likely treated for his symptom, depression, rather than his true illness as it was unknown to his physicians at the time. While no autopsy was done at his time of death due to his family's request, the disease is genetic and runs rampant in his family. It is extremely likely (although not confirmed) that he had the disease, which would explain why his ECT treatments failed. Hemingway's father, who also committed suicide, had the disease, and it is known to be passed down paternally.

Heart disease is also known to cause depressive symptoms, and it is documented that Hemingway had high blood pressure, extremely high cholesterol levels, and severe aortal inflammation.

Hemingway also survived not one but TWO plane crashes, causing trauma to his head and crushing his vertebrae, among other very serious injuries. His head injuries were so severe that he lost his vision and hearing on his left side for a period of time. Hemingway's injuries were so extensive that many American newspapers jumped the gun and actually published his obituary. Such severe trauma to the brain could not only explain his depression, it could also explain his memory loss during ECT. Patients with severe head trauma are known to experience greater memory loss with ECT than typical patients.

Additionally, it is known that Hemingway was a very heavy drinker his entire life, and became a raging alcoholic in his final years. Not only can alcoholism cause depression, but heavy drinking is contraindicated with ECT treatment. This could have played a HUGE role in his memory loss.

Furthermore, it is well accepted by physicians that memory loss often reverses itself in the days and weeks after ECT in many patients. Hemingway killed himself only a few days after his last ECT treatment. There is a possibility that his memory would have come back to him in time, at least partially.

Hemingway is used constantly as a reference by ECT critics, but we know far, far too little about him and his condition to judge ECT by his opinion. There are far too many extenuating circumstances to proclaim that ECT caused Hemingway's death, especially when you consider that his father, two of his siblings, and his granddaughter all took their own life.

While I acknowledge that Hemingway himself blamed his ECT on his suicide, he was far too sick at the time to be able to make clear and well-thought-out statements. I'm sure that he did feel as though ECT killed him, but that simply does not make it fact, especially when you consider the plethora of severe illnesses and injuries he had shortly before the time of his death.

Oh, and an interesting bit of Hemingway trivia for anyone who is interested--Hemingway purchased the shotgun that he used to kill himself at Abercrombie and Fitch!




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