EARLY MEDICAL CARE

In October of 1933 there were 495 patients, 327 men and 168 women, at the Fairfield Hills State Hospital. Although two physicians were employed to care for these patients, at the time the necessary medical equipment was not available on-site. The institution primarily relied on community resources to diagnose and treat the patients. All surgical and medical problems were treated at the Danbury Hospital. Local medical physicians volunteered to be on call for medical consultations, and two Newtown dentists offered their services and came to the hospital once a week.

In early 1934, three additional physicians were employed, making a total of five physicians on staff, but the attrition rate was so high, by August of 1934, only one physician remained on staff. The problem of recruiting and retaining staff was not unique to just physicians, the nursing personnel were of poor quality too. Many of the nursing attendants were dismissed for insubordination and ill-treatment of the patients, and some resigned.

Two years after its opening, in July of 1935, Fairfield Hills received equipment for an operating room, a dental office, and a mobile x-ray unit. All surgical and dental work could then be performed at the hospital. A full time dentist was appointed, but private physicians were still called for surgical and medical consultations.

OCCUPATIONAL THERAPY IN 1933

Occupational therapy for female patients consisted of a sewing room in the Reception Hospital. The women did mending under the supervision of a seamstress and there was an arrangement for a teacher to hold small classes in basket weaving. The women were not paid for this work.

Occupational therapy for male patients consisted of working on the hospital's farm, helping with landscaping the grounds, and making small articles for the wards of the carpentry shop. The men were not paid for this work.

MUSIC AND DANCING

Some orchestras from Newtown and Greenwich provided musical entertainments for the patients, and played at patient dances at no expense.

PATIENT APPEARANCE

Before 1935, male patients were shaved only once a week. Early in 1935, in an effort to improve the personal appearance of the patients, then Superintendent Dr. Roy L. Leak requested permission to employ 2 barbers. He hoped to employ one female barber, so that the women also could have haircuts. In July of 1935 the 2 barber positions were filled.

In December of 1949, after the opening of Bridgewater House, two additional hydrotherapy rooms were added. Located on the second floor was one room with 4 special hydrotherapy tubs, and a room with accommodations for six patients in cold wet sheet packs was located on each floor. Hydrotherapy rooms were used continuously 24 hours a day, 6 days a week. During the fiscal year ending June 30, 1950, hydrotherapy reduced the number of hours of seclusion from more than 27,000 hours to less than 16,000 hours, or by more than 43%.

METRAZOL SHOCK THERAPY

In August of 1937, Dr. Stanley R. Dean, who a month earlier had joined the physician staff as an Assistant Hospital Physician, began an "Irritative Therapy" employing the drug metrazol. Metrazol Shock Therapy was discovered in 1934 by the Hungarian researcher Ladislas J. Meduna. The therapy involves injecting a patient with a high dose of metrazol. The metrazol quickly induces powerful convulsions in the patient. A convulsion is a sudden, violent, involuntary contraction of the muscles of the body, often accompanied by loss of consciousness. After a convulsion, most patients would have gone into a deep sleep and he or she would probably be disoriented for awhile after awakening.

INSULIN SHOCK THERAPY

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In 1937 Dr. Clifford D. Moore, the Hospital Superintendent, in hoping to develop an Insulin Therapy Unit, sent one physician, Dr. Victor E. Smilgin to the Hartford Retreat for instruction in the technique of Insulin Therapy. Dr. Charles C. Burlingame gave the instruction. Discovered by a Polish researcher Manfred Sakel in 1933, Insulin Shock Therapy involves injecting a patient with massive amounts of insulin, which causes convulsions and coma.

Insulin Shock Therapy began at Fairfield Hills in September of 1937, but was discontinued in April of 1938, because the patients who received the treatment did not improve. Sometime afterwards, Insulin Shock Therapy was again implemented. By the 1950's, on average each month, 12 patients, 6 men and 6 women, on the admission ward, received Insulin Shock Therapy.

RESTRAINTS AND SECLUSION ROOMS

In 1939, the Board of Trustees expressed concern over the use of restraints and seclusion rooms. Then Hospital Superintendent, Dr. Clifford D. Moore explained that restraints and seclusion were only used for those patients who might harm themselves or others.

Continuing through the 1940's, restraints and seclusion rooms were used to counteract acting out behavior. Although a written medical order was required for the use of restraints and seclusion, most of the time the decision to use restraints and seclusion was made by a nurse or attendant. Physicians frequently wrote standing orders for restraints and seclusion, so that the procedures could be carried out whenever necessary. Staff at times threatened disturbed patients with seclusion to control bad behavior. However, some staff believed that if a patient started to act out, it was best to put the patient in seclusion immediately, rather than wait until the patient became unmanageable.

Seclusion rooms were empty rooms with only a "strong blanket" on the floor. There was a heavy wire screen over the inside of the room's window. A small unbreakable glass window was located eye level in the heavy door to the corridor, thus making it possible for staff to check the patient without opening the door. A patient being placed in a seclusion room was stripped of all clothing and searched for any article with which the patient could injure himself. Meals were served on paper plates placed on the floor inside the door of the seclusion room. Periodically the patient was taken out, showered, and transferred to a clean seclusion room.

ELECTRIC SHOCK THERAPY

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In 1941 Electric Shock Therapy was started at Fairfield Hills. Also known as Electroconvulsive Therapy, Electroshock Therapy or ECT, the therapy's aim is to induce a grand mal seizure (convulsions) in a patient, by passing electricity through the brain.

Historically, ECT was developed in the 1930s by Italian neurologist Ugo Cerletti. Cerletti saw electric shocks given to hogs before slaughter. This rendered them unconscious but did not kill them. Cerletti found such electric shocks caused his obsessive and difficult mental patients to become meek and manageable.

Introduced as a treatment for schizophrenia in the 1930s, ECT then became a common treatment for mood disorders, and a dreaded mechanism for disciplining unruly psychiatric patients. Following the seizure, there is a short period of time during which cortical electrical activity in the brain ceases and an EEG reading is flat. After treatment, patients have no memory of the seizure or events immediately preceding it.

Before the discovery of muscle relaxants ECT was given unmodified. The patients were rendered instantly unconscious by the electrical current, and the strength of the muscle contractions from the electricity and the subsequent fit at times led to complications such as compression fractures of the spine, pulled muscles, broken bones, or damage to the teeth.

Hollywood depicted ECT in a 1975 movie "One Flew Over the Cuckoo's Nest" staring Jack Nicholson. The movie was based on a novel by Ken Kesey, which in turn was based loosely on the author's own experiences in various mental hospitals during the 1960s.

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In real life, Ernest Hemingway, who underwent 20 ECT treatments, is known to have stated:

"Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient...." He committed suicide shortly afterwards; the year was 1961.

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At Fairfield Hills, a staff physician told the Board of Trustees that the therapy was used mostly on depressed patients. By the 1950's, the use of Electro-Convulsive Therapy (ECT) at Fairfield Hills, appears more widespread. The program was extended to all services, and by 1953 approximately 275 patients were receiving ECT treatments three times a week, twice a week, or daily!

TREATMENT FOR ALCOHOLICS IN EARLY 1940's

In the early 1940's, there was no special treatment for the alcoholics who came to Fairfield Hills. Admitted through direct admissions, alcoholics were normally discharged within a few days, unless considered psychotic. Although Dr. Moore had been approached by Alcoholics Anonymous, concerning setting up a special program in which their members might participate, at the time it was thought best not to do that, as the alcoholics were in the hospital for such a short time.

PSYCHOSURGERY - FRONTAL LOBOTOMY

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Psychosurgery is surgery performed on a patient's brain to treat or alleviate severe cases of mental disease. Frontal Lobotomy is a surgical procedure severing the connection between the prefrontal cortex and the rest of the brain.

Hollywood’s 1975 movie "One Flew Over the Cuckoo's Nest" staring Jack Nicholson, culminates with a frontal lobotomy performed on Jack, and the Chief ending Jack’s mutilated existence.

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At Fairfield Hills, Dr. Samuel Friedman, Clinical Director and Dr. William Green became interested in frontal lobotomy operations as a treatment for selected mental patients. Their interest was induced by a dramatic improvement in one of the patients at Fairfield Hills. Following a lobotomy operation on the patient, performed at Boston Psychopathic Hospital, the patient was later discharged from Fairfield Hills State Hospital as "cured".

In May of 1946, Dr. Bernard S. Brody, a neurosurgical consultant from New Haven, was invited to attend a meeting of the Board of Trustees at Fairfield Hills. At the meeting, Dr. Brody gave a short history and description of lobotomy operations. During that same month, Dr. Brody also performed the first of a series of eight Frontal Lobotomy operations at Fairfield Hills. By July 1, 1947, merely one-year since that first lobotomy, a total of 107 patients had had lobotomy surgery at Fairfield Hills. Of the 107 patients, it was reported that 35% were discharged, 35% were slightly improved, 26% were unimproved, and almost 4% died, as a result of post-operative complications.

The patients selected for a lobotomy were generally destructive, disturbed and spent most of their time in seclusion rooms. Most of the nursing staff was afraid of these patients, as some of the patients had caused injury to staff members.

Lobotomy surgeries were performed in the operating room of Greenwich House. Student nurses were assigned to special for lobotomy patients during the initial 48 hours after surgery. As soon as possible, the patients were returned to their own ward. Staff then had to feed, bathe and dress these patients, as considerable time was needed to reeducate a lobotomy patient to care for himself. Due to the number of patients on a ward, and the shortage of staff to care for them, self-care was not always achieved. Some staff believed it was less time consuming to do everything for the lobotomy patients, rather than teach them to care for themselves.

During the late 1940's and early 1950's, at least 20 lobotomies were performed each year at Fairfield Hills.

_ __ The era of lobotomy is now generally regarded as a barbaric episode in psychiatric history.

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THIS PAGE LAST UPDATED: TUESDAY, JUNE 12, 2007

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