3000 Colby Street
Suite 305
Berkeley, CA 94705
Phone: 510-644-2282
Fax: 510-644-1744
E-mail: drjohn@idiom.com
"There he goes admiring his diplomas again."
OFFICE MANAGER
PETRA DITTRICH
Med student, U of R Library circa 1970
Test Strip
Neuron on the Beach
Annual Meeting of AAN, Miami Beach, Flordia
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A BIOGRAPHY OF SORTS
I have practiced clinical neurology in Berkeley almost every weekday (and not a few weekends and nights) since 1979. I try to participate in all legitimate reimbursement plans from Medi-Cal to HMO's so that I won't have to turn anyone down.
I also do medical/legal work for plaintiff and defense. I have been admitted as a neurology expert on the adverse effects of electrconvulsive shock treatment (ECT) in courts in 6 states. I am affiliated with Medical Legal Experts - a group of colleagues representing several specialties available for medical-legal work.
I graduated from Yale University where I was a French major. I then went to medical school at the University of Rochester where I graduated in 1971 and came to the Bay Area. I interned at what is now Pacific Medical Center in San Francisco.
NEUROLOGY ROUNDS PACIFIC MEDICAL CENTER
1971
That's me with the hair on the right
Forbes (Ted) Norris, M.D. on the left
Pacific Medical Center, San Francisco, 1972.
(Dr. Norris died a few years ago but his name is honored in the Forbes Norris ALS Center)
After completing a straight medicine internship (translate sleep deprivation every third night for a year) I passed the state examinations and received my California License in 1971.
I was almost thirty. I thought I was old. But I was free at last.
I've always loved Big Sur. So I followed a friend who found us jobs with the County Hospital of Monterey, on Natividad Road in Salinas. I did a little of everything: covered the ER, set simple fractures, delivered 50 babies. Had a good year.
The word delivery is too transitive for the minimalist obstetrics required of me - let's say I was present when babies decided to "leap into the dangerous world..." ( William Blake.) I was more of a cheer leader:
"Empuje, empuje - descanse, descanse."
Nearby was Point Lobos and the same awesome Big Sur Coast which delivered many great photographers and even more lesser ones. It got me started. I lived on Casanova Street in Carmel, around the corner from Clint Eastwood's Hogsbreath Inn.
Ever since reading The Myth of Mental Illness by Thomas Szasz, M.D. in medical school, I'd been troubled by the pseudoscientific pretensions of psychiatry. Sometime in the early 1970's, Dr. Szasz wrote a piece called "From the Slaughterhouse to the Madhouse" about the invention of ECT in Rome, in 1938. I decided it was time to do something with my life. Oh, I could reduce a subluxed shoulder, recognize strep throat, set simple fractures, "deliver" a baby and talk learnedly forever - but it felt like plowing the ocean. I wanted more.
As an aspiring neurologist, my job description included protecting the human brain - from viruses and bacteria, from head injury, electrical trauma and from epileptic seizures. If I could send ECT the way of leeching I'd be preventing literally hundreds of thousands of convulsions every year! I was optimistic that the truth would out. The truth would deliver itself. It was all so logical.
Just as locking people up without due process (commitment) - specifically the Fourth Amendment guarantee of freedom from search and seizure - is the Achilles' Heel of psychotherapy, so ECT is the Achilles' heel of the medical model of mental illness. The medical model - "just like diabetes" - is the "Shma Yisroel" of the greatest global religion of all time: psychiatry. Mental illness is nothing more or less than the modern equivalent of hell, a concept used to terrify and control people.
Think about it:
1) If mental illness is "a real disease just like diabetes," how come it has never been seen twice?
The Greeks could diagnose diabetes 2000 years ago. They observed that ants gathered around the urine of diabetics because it is sweet. There was something to see, something to taste and something to test.
But who has ever seen or tasted schizophrenia? Or invented a single reliable test!
To be sure, there are sightings galore in every issue of every psychiatric journal and glimpses are reported on experimental fuzzgrams and arcane blood tests usually accomparnied by urgent calls for more money.
But the discoveries disappear and re-emerge contradicted in somebody else's doctoral thesis six months later.
Schizophrenia, manic-depression, obsessive compulsive disorder, multiple personality disorder, clinical depression - not one of these so-called diseased has ever turned up on an autopsy table in 150 years and it hasn't been for want of carving up brains. Schizophrenia, the big Kahoona, isn't even indexed in the 1519 pages of the 4th Edition of Robbins authoritative Pathologic Basis of Disease (1989).
2) Even if we assume someone's brain is diseased with a mental illness; assume some delicate imbalance of chemicals, how in heaven's name can imparting the energy equivalent of a kick in the head help? (20 joules is threshold but the machines can deliver up to 250 and 1 Joule= .73732 foot-pounds.) Or at least, how can it be called treatment?
3) If mental illness is a brain disease how come neurologists don't have any tests for it and most, if they're prudent, don't pretend to treat it?
Seeing through the myth of mental illness allows one to see through all kinds of popular neuromythology but you don't have to agree with me on fundamentals to doubt the claims for therapeutic convulsions. Everyone but the village idiot knows convulsions aren't good for you.
So that gave me the title of my one and only book: Shock Treatment Is Not Good For Your Brain.
Unfortunately, the book itself is long out of print but nothing has changed in 20 years. The brain is just as soft and vulnerable as ever. The shock machines are, if anything, more powerful. And the propaganda is unabated.
In 1975 I started a neurology residency at the University of Oregon, invited especially by my friend and mentor, Robert Grimm, M.D.
So I completed the residency in 1978. After three years in the rain in Portland I was drooling over billboards showing sunshine and making trips to the airport just to watch planes take off. I moved tout de suite back to the Bay Area which has always felt like home.
After the requisite two years in practice I took and passed my boards on the first try. Not bad for someone who believes mental illness is an hypothesis at best. At the time the board examination was a two day ordeal including 3 live patients and examiners behind one-way mirrors. The psychiatrists saw two psych patients and one neuro and the neurologists the other way around.
The examination was a real rite of passage. The Board Certification is awarded by the American Academy of Neurology and Psychiatry - I may not agree with psychiatric dogma, but I know what psychiatrists think they know. I had to.
My first job as a neurologist was with Kaiser Hospital in Richmond and I am still on the courtesy staff there. I also ran a clinic at Fairmount County Hospital where I met Hussam El-Gohary, M.D., a wonderful physician, friend and associate.
And since 1979 I have been on the active staff at Alta Bates Medical Center in good standing, no malpractice judgments, no suspensions.
NOT TO DWELL ON THE DARK SIDE BUT
I AM ALSO AGAINST CAPITAL PUNISHMENT
Nearly 300 years ago, the wonderful Italian Enlightenment writer, Beccaria, called the death penalty: "A useless prodigality of punishment."
Prodigality is the operative word today. With more than 3000 people on death row in the United States there would have to be 10 executions every day jus to stay even. The prodigality has become an impracticality. Besides, it sets a bad example. It's atavistic. It's unjust - there will always be mistakes. It's abhorrent. It's counterproductive. Its out of fashion - we're pretty much the last country on earth clinging to human sacrifice. And it's abhorrent.
An opportunity came my way a couple of years ago to do something about the death penalty. I was asked by the ACLU to review over 100 San Quentin execution records. I am convinced that while highly variable, the time to loss of consciousness may have been 7-10 minutes in some instances. 7 minutes by today's standards is very very long: lethal injection is quicker by far (when not botched) although I'm hardly in favor of switching. Lethal injection, is a pseudo-medical masquerade. Assisting in execution is forbidden to doctors by the ethics provisions of most medical societies.
Since suffering is proportional to duration and since the intentional infliction of suffering is called torture, cyanide sometimes takes too long to meet the constitutional prohibition against torture. I like to think my testimony helped to convince the federal judges involved that contrary to the official impression, execution by cyanide gas involves prolonged conscious suffering and meets the Supreme Court's century-old definition of "cruel and unusual."
To anyone interested in this subject I would recommend Dead Man Walking by Helen PreJean (rent it or read it or go hear her speak) and Albert Camus' essay on the subject.
In contrast to our awesome material progress, it doesn't always seem that we humans are making comparable progress on ourselves. But I think we are making progress. We've given up cannibalism and most human sacrifice; we've given up our common acceptance of slavery and torture and genocide; and I know we will give up the death penalty. I just don't know when.
HOBBIES
I'm an avid snowboarder and can do things like the Granite Chief fall line (Squaw Valley) I wouldn't have dared on skis. Boarding is easier (after the first two days but we don't really want too easy) safer (goodbye Anterior Cruciate Ligament - ACL - tears) cheaper (you don't need perfect slopes or perfect snow or perfect clothes for that matter) more convenient (one board is all there is to forget - the boots you can wear home, just dry thoroughly between uses) AND MOST OF ALL, and I can testify, boarding is a whole lot more fun. Like the internet it's growing exponentially. Other hobbies include speaking Spanish, translating French (see Casanova), writing HTML, photography, and gardening.
Cherry tomato volunteers, picked hot and aromatic from vine on a late summer afternoon - mmmmmmm. The best.
The problem is the deer know this too. Deer. Don't get me started. Pigs with antlers and fleas with Lyme disease and I feed them. They like everything I do. They found my pistachio nut trees (male and female are needed) before they were 2 feet tall and return each spring to eat them back into the ground.
Deer! Now I'm started. One option is to grow only poisonous plants such as Oleander, Hydrangea (cyanide), or the lovely Foxglove, two leaves of which can kill.
FOXGLOVE
Foxglove was the original source of DIGITALIS, one of the handful of truly great drugs and a perfect case in point that all drugs are also poisons.
Here's the second and last option for gardening in deer country - and I speak from 15 years of frustration: an ELECTRIC FENCE - the only appropriate application of electroshock "treatment."
And finally I love STARGAZING from the
hot tub!
I thank Ms. Cherie Barnard for her help in turning me on to Laura LeMay's book: Writing HTML in one Week (it's true) way back in 1995, within months of the first wide release of the Netscape Browser. She also helped configure the search engine (below) which was really driving me crazy. I also want to thank my IP (internet provider) IDIOM COMMUNICATIONS and its founder David Muir-Sharnoff.
Cherie Barnard
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