Max Fink; The Grandfather of American ECT

Max Fink, the grandfather of American ECT

Grandpa Max used to claim that ECT worked by causing brain damage. He argued for years that the therapeutic effect from ECT is produced by brain dysfunction and damage. He pointed out in his 1979 textbook that "patients become more compliant and acquiescent with treatment," and he connected the improvement with "denial, disorientation," and other signs of traumatic brain injury and an organic brain syndrome.

Fink was even more explicit in earlier studies. In 1956, he stated that the basis for improvement from ECT is "cranio-cerebral trauma." In 1966, Fink cited his own research indicating that "there is a relation between clinical improvement and the production of brain damage or an altered state of brain function." He does not, however, make such statements in public, in court, or in the 1990 APA Task Force Report.

Max has also been busy with other ventures. Born in 1923, he is currently professor (emeritus) of psychiatry at SUNY at Stony Brook. His CV is too long to list here, but here are a few interesting appointments:

• Founding Editor, Convulsive Therapy
  Consultant to the FDA
  U.S. Army on the Feasibility of Using Incapacitating Agents Against Terrorists.
  Captain, U.S. Army.

• The Finkeroo owns a company called SciData, based in Atlanta, Georgia. Organized in 1967, the last year's sales were listed at $170,000.

• Fink helps out his buddy, Richard Abrams, with Somatics, Inc. He narrates Abrams' videotapes for Somatics, Inc., which sell for $350 to health professionals, or $360 for patients and families. Or you can buy a "preview version" for $25.

Max has a habit of being a little less than honest at times. For example, he is responsible for the famed 1 in 200 statistic, which the APA uses in its literature. This statistic, long criticized by ECT advocates and survivors, supposedly reflects the number of patients who suffer memory loss. Recently, Max admitted the number was *not* based on any scientific studies, as had been widely claimed, but rather, was an "impressionistic" number - meaning he made it up.

Here's another example, in a post of his from the shock doc mailing list:

"2. The second question is how to achieve an effective treatment in the face of the limited output of brief-pulse devices.

The usual approaches are to use bilateral placement; change anesthetic from methohexital to etomidate; determine the dosing of benzodiazepines and if these were used, block with the antagonist flumazenil; enhance seizure duration by either caffeine or theophylline; and when these fail, double stimulation. If the lack of adequate energy is a frequent issue in practice, the THYMATRON can be modified to the British version, or the MECTA can have the Sackeim modification added -- for research purposes."

For research purposes, Max??? That's his way of covering his butt. He's telling other shock docs how to boost the juice way past the machinery's capabilities....for "research" purposes. This post was in response to a query from another doctor with legitimate patient concerns.

Max also doesn't take confidentiality very seriously. He's often harassed a certain ECT survivor, shutting down question and answer periods when she arrived. But he's gone beyond that by shouting at her and telling the entire workshop medical information from her confidential medical records.

All in the name of science for Max Fink.

Here is an example of his condescension towards mental patients: during a session on ECT for doctors, a doctor is explaining a patient he has who is afraid she'll die if the machine shuts down, and the need for backup batteries. Max finds this to be a chuckle. He also sees himself as a celeb of sorts, illustrating how "fans" approach him after seeing his old video.

Reporters are frequently invited by Max Fink to witness patients being given the treatment. Psychiatrist Peter Breggin has urged him to allow them to see his patients *after* they have received a full course of shocks. Under pressure, Fink agreed, but with a catch. While he charges nothing for the media to watch a patient undergo the procedure, he decided to charge $25,000 for himself and $15,000 for the patient for a single interview with the patient awake after a course of ECT.

This old goat needs to be put out to pasture....

next: My Turn: ECT Editorial Casts Shadow on Author and JAMA's Credibility
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