Killing Cures

Major steps in scientific progress are sometimes followed closely by outbursts of foolishness. New discoveries have a way of exciting the imagination of the well-meaning and misguided, who see theoretical potentialities in new knowledge that may prove impossible to attain. On occasion, the seemingly imminent is later shown to be far further off than originally thought, yet still possible to achieve. More frequently, the apparent prospect is revealed to be the result of unrealistic hypotheses based more on wishful thinking than on fact. In no branch of human thought have erroneous leaps of this kind been more prevalent than in that peculiar mix of science and art that goes by the name of medicine.

Aesculapius, the ancient Greek god of healing, named one of his daughters Panacea, meaning “remedy for all diseases,” as if in recognition of man’s eternal quest for a universal method that would cure all of his afflictions. Though the search for such cures was long ago recognized as being futile, there have always been zealous advocates who promote particular medicines or regimens claimed to be so broadly effective that they approach the old concept of a cure-all. In the Middle Ages and Renaissance, for example, the preferred means for combating the wide variety of the poisonings so prevalent in those times was a prescription called theriaca, a mixture of some sixty primarily botanic in-gredients that came to be applied in many situations where the blood was thought to be contaminated. Nowadays we look to the promise of stem cells and genetic engineering to provide the kinds of universal cures that have always been sought.

Psychiatry is a discipline—if we can call it that—that is particularly susceptible to such fantasies. The mechanisms of mental illness are poorly understood and the modes of treatment are uncertain, both in their predictability and in their scientific basis. Two recently published books deal with the propensity to seek methods of cure that are allegedly applicable to a spectrum of psychiatric problems that may in fact be unrelated to one another, whether in their causes or in the details of their symptoms. These books, by Andrew Scull and Jack El-Hai, deal also with two particularly dangerous and foolish attempts to cure mental illness. That those responsible for them were highly motivated, highly skilled, and high-minded in their intentions, at least at the beginning of their work, did not in any way make their theories or themselves less foolish or dangerous.

In both cases, initial enthusiasm and seeming success gave way to obsessive determination to persist long after their proposed panacea had been proven to be far less promising than supposed, and even fraught with perilous consequences. And in both cases, a kind of madness supervened, leading to either professional or personal ruin and devastating effects on the lives of thousands of the patients they were so fiercely determined to rescue. Instead of the scientific immortality they pursued and expected, Henry Cotton and Walter Freeman are today remembered as frightening …

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Letters

Killing Cures’: An Exchange November 3, 2005