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Electric Stimulus Energy and the Clinical Response to Electroconvulsive Therapy

June 1992 Report of Proceedings of the Discipline Committee of the College of Physicians and Surgeons of Ontario (1) describes a strange occurence on which your readers may wish to comment. A physician, brought before the discipline committee on several charges of sexually assaulting the mother of one of his young patients, had evidence given on his behalfby "five different psychologists and psychiatrists," two ofwhom had examined him. As a result of this evidence, the discipline committee concluded that the doctor "did not suffer from a mental disorder and the reasons for his abhorrent behaviour are not to be found in any disinhibition by alcohol or drugs." In spite of this conclusion, "all the experts recommended treatment for Doctor [X]." Psychiatry continues to struggle for credibility within medicine and often with the public. Some of our critics accuse us of wanting to "medicalize" all behaviour. Are we guilty of this? Reading the above-mentioned case report brought to mind an experience from my residency days. Dr. Bernard Glueck Sr., renowned for his having given evidence in the famous Leopold and Loeb murder case of the 1920s, was conducting a case conference pertaining to a young man who had indulged in much antisocial behaviour. After hearing the young man's lengthy attempt to rationalize his behaviour, Dr. Glueck leaned over to him and asked: "Son, by any chance are you just plain bad?" Many psychiatrists may find it hard to believe, but we do have bad people in this less than perfect world.