10:26am

Fri October 25, 2013
TED Radio Hour

What Does Electroshock Therapy Feel Like?

Originally published on Tue December 17, 2013 9:49 am

Part 1 of the TED Radio Hour episode Turning Points. Watch Sherwin Nuland's other TEDTalk on hope.

About Sherwin Nuland's TEDTalk

Sherwin Nuland is a successful surgeon and author known for his bestselling books on the nature of life and death. But 40 years ago, he faced spending the rest of his life in a mental institution. Nuland describes how electroshock therapy gave him a second lease on life.

About Sherwin Nuland

Sherwin Nuland was a practicing surgeon for 30 years and treated more than 10,000 patients. He then turned to writing about life, death, morality and aging, exploring what there is to people beyond their anatomy.

His 1995 book How We Die: Reflections on Life's Final Chapter demystifies the process of dying. Through stories of real patients and his own family, he examines the seven most common causes of death and their effects. The book won the National Book Award and was a finalist for the Pulitzer Prize. His latest book is The Art of Aging: A Doctor's Prescription for Well-Being.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

GUY RAZ, HOST:

It's the TED Radio Hour from NPR. I'm Guy Raz. One Sunday, 40 years ago, Sherwin Nuland's life arrived at a turning point. You described a moment that you will never forget.

SHERWIN NULAND: Yes.

RAZ: It was a Sunday morning in January 1974. What happened?

NULAND: Well, on Sundays, we were allowed to sleep late. And breakfast was kept in a little kitchen and people would just go in, get a roll or a Danish and some coffee. And I was in there by myself, and I thought, I think I'm well enough so that when I start having an obsessive thought I can just tell it to go away.

RAZ: Sherwin Nuland is 82 now, but at the time he was 43. And he was brilliant. He was an accomplished surgeon with a whole future of awards and accolades ahead of him. And yet, on that Sunday morning, Sherwin Nuland was in a mental hospital.

NULAND: And any depressive will tell you that they begin ruminating about things and going over and over and over their self-image, the way someone spoke to them yesterday, gee, did he realize - I'm not what I was - the kinds of things that - I'm not what I was - 10, 11-year-old kids did. You know, there's a line on the sidewalk and you don't want to step on that line, or you hear sound and you attribute certain things to that sound that they don't have. And I got fixated on numbers, two numbers, actually. And I kept running into them.

Plus, of course, obsessively ruminating about how my life was falling apart and I seemed not be able to do anything about it, even though I had, in the past, thought of myself as a very strong-willed person who had great emotional resiliency.

RAZ: Sherwin had spent almost an entire year in that mental hospital. And then it happened.

NULAND: I had always felt, you know, I've got to give in to this thought. I've got to go over it again and again. But now I thought, well, why don't I just blow it away. And I said, I know the formula.

RAZ: What was the formula?

NULAND: Well, I don't want to shock your listeners, but if you give me permission, I'll tell you just what it was.

RAZ: Sure, sure, yeah.

NULAND: Well, on one of my walks, I had walked over to a service station that was right near the hospital, and I was joking around with a fellow who pumped gas who said to me, you know, Doc, you can get better - just say, ah [bleep] it. And I laughed. But that morning I thought, ah [bleep] it. I can do that. It was very hard at first. It was very hard to drive obsessional thoughts out of my head, but I just determined that I was well enough now that I could control it. And I did that. After that, it was just a few months later that I was out of the hospital. Thirteen months I'd been there.

RAZ: And that was it. It was like a line drawn down the center of his personal timeline. And on the show today, we'll hear from TED speakers like Sherwin Nuland, people who now look back on the person they once were and think, who was I? So what drove Sherwin Nuland to his turning point?

NULAND: Well, I probably was prone to depression. I'd had a very difficult childhood. My parents didn't read and write English. They were totally unassimilated. My father had a chronic neurological disease that made life very difficult for him. Why should I call it a chronic neurological disease? I...

RAZ: He had syphilis.

NULAND: He had syphilis and he was subject to rages. For most of my early childhood, he didn't even speak to the other people who lived in the house, my aunt and my grandmother. So it was hard. It was hard for a little kid to understand.

RAZ: What does electroshock therapy feel like?

NULAND: Well, actually, it doesn't feel like anything, because anesthesia is used. The only thing one feels is the last little bit of consciousness waning rapidly. There's an electrode on each temple, and the current runs right through the center of your brain, yes, and causes all kinds of fascinating things to happen, the nature of most of which we're just uncertain of. As one psychiatrist friend told me, electroshock therapy is the only miracle that psychiatry has.

RAZ: Take me back to when you gave your talk back in 2002.

NULAND: Sure.

RAZ: Before that moment, you had neither written about that...

NULAND: No. I had never written...

RAZ: ...Or spoken about it publicly.

NULAND: That's right.

(SOUNDBITE OF TED TALK)

NULAND: So the whole idea of electroconvulsive electroshock therapy...

NULAND: After I had been asked to do that, I debated for some time with myself. Oh, my God, should I get up and talk about this? And the more I thought about it over those days, the more I decided I absolutely had to.

(SOUNDBITE OF TED TALK)

NULAND: Now why am I telling you this story at this meeting? The reason really is that I am a man who, almost 30 years ago, had his life saved by two long courses of electroshock therapy. And let me tell you this...

NULAND: I thought by talking publicly, there were probably going to be some people who would be helped by that.

(SOUNDBITE OF TED TALK)

NULAND: ...And it was clear that I would need long-term hospitalization in that awful place called a mental hospital. So I was admitted in 1973, in the spring of 1973, to the...

RAZ: Tell me about what was going on in your life at the time.

NULAND: Well, I made the mistake of falling in love at first sight, which may work for some people, but it didn't work for me. I was 28 years old. I should've known better. And when the marriage fell apart, it was pretty natural, as I think many people do, to blame myself. It was I who was responsible. It was I who was working too hard. It was I who was not giving my wife the proper evidence of closeness and affection.

After a time, when I sought therapy, I did move out of the house, and that was dreadful because I was completely alone. And the worst thing, of course, a depressive can do is to find himself or herself physically alone. And I found myself giving in to this depression, in the sense that I couldn't get out of bed in the morning.

I could barely make myself go to the store to buy what little food I was eating. Everything was completely disintegrating. And finally, I reached the point where I couldn't work anymore and obviously had to be hospitalized.

RAZ: I know you'd mentioned in your TED Talk that the doctors prescribed the best antidepressants that were available at the time and they didn't help. Nothing?

NULAND: Nothing at all, no. So they, all of them, got together and said, this man will have a frontal lobotomy. And that was the plan.

RAZ: After they made this decision, there was a resident who had been seeing you and he objected. What did he say to the other doctors?

NULAND: He said, I know this man far better than any of you do, and I'm convinced that he is not crazy, I'm convinced that he is depressed. And they said, well, we'll, well, I guess, humor him, and we'll give this fellow a course of electroshock therapy, which, at that time, was meant to be about six or eight treatments, maybe 10.

RAZ: Let me go back to the first time.

NULAND: Sure.

RAZ: So you sat down and they put you out and that was it.

NULAND: I laid down, they put me out, right.

RAZ: And you woke up and nothing.

NULAND: Nothing had happened, no. And even after the second, third, fourth, fifth...

RAZ: Nothing.

NULAND: ...Sixth. Nothing.

RAZ: Seventh.

NULAND: Nothing.

RAZ: Eighth.

NULAND: Nothing. I was desperate, desperate enough to have accepted that lobotomy. Just anything to stop the pain...stop the pain...the pain...the pain...the pain...

RAZ: What happened at nine?

NULAND: I don't think anything very much. I must've noticed something. But at 10, I definitely noticed something. I definitely felt there had been a change.

RAZ: At 11, it got better.

NULAND: Yeah, 11, 12, 13, 14, yes. A few more treatments after that, I was responding now to talk therapy and after about 20 was even given permission to go off the campus of the hospital, walk around. And on one of my walks, I had walked over to a service station that was right near the hospital, and I was joking around with a fellow who pumped gas...

NULAND: It was incredible. I use the term miracle, the only miracle that psychiatry has. And yes, to me, it was a miracle.

RAZ: Do you see that age as Sherwin Nuland before 43 and then Sherwin Nuland after 43?

NULAND: Oh, absolutely, without question. I am a very different person. When I came out of the institute, I found myself far more open to new perspectives, to the concept of uncertainty, as a matter of fact, living comfortably with uncertainty. I found I was a lot more social than I had been, a lot more accepting of other people. The old curiosity that I had had before starting medical school was blooming, and there was so much I wanted to learn, so much I wanted to know. And to this day, I feel sometimes like a kid in seventh grade, just learning stuff every day and becoming better every day.

(SOUNDBITE OF TED TALK)

NULAND: Anything can happen to you. Things change. Accidents happen. Something from childhood comes back to haunt you. You can be thrown off the track. There are resurrection themes in every society that has ever been studied, and it is because not just only do we fantasize about the possibility of resurrection and recovery, but it actually happens, and it happens a lot.

RAZ: Writer and former surgeon Sherwin Nuland from his TED Talk. He and his second wife celebrated their 36th anniversary in May. You can check out his entire talk and another one he gave on hope at TED.com. I 'm Guy Raz. More turning points in a moment on the Ted Radio Hour from NPR. Transcript provided by NPR, Copyright NPR.