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Boston Globe
29-06-2025
- Health
- Boston Globe
Max Fink, champion of electroconvulsive therapy, dies at 102
'Many severely depressed patients are maintained for weeks, for months and even years on antidepressant drugs,' he told a conference on depression in Philadelphia in 1988. 'Are we not unfair when we do this to our patients when ECT remains an active and excellent treatment?' He first witnessed the use of ECT in 1952, on his first day as a neurology and psychiatry resident at Hillside Hospital (now Zucker Hillside Hospital, a part of Northwell) in the New York City borough of Queens. One by one, he watched as five patients — under restraints, with rubber bite-blocks in their mouths and electrodes applied to their temples — received enough electrical current to induce a grand mal seizure. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up 'Observing a full grand mal seizure in each patient jarred me,' he wrote in 2017 in an unpublished memoir for Stony Brook University in New York, where he worked for many years. But over the next few months, he said, 'I had learned that ECT effectively reduced suicide thoughts, relieved negativism, aggression, depressed and manic moods. Of the hospital populations, the patients treated with electroshock improved the most.' Advertisement Although Dr. Fink was convinced of ECT's positive effects, others in the psychiatric profession weren't. Advertisement 'Max was trained in an era when the main theme of psychiatry was orthodox Freudian psychoanalysis,' said Dr. Charles Nemeroff, chair of the department of psychiatry and behavioral sciences at Dell Medical School at the University of Texas at Austin, who collaborated with Dr. Fink on a paper about ECT. 'But he was part of a small group of academic psychiatrists who recognized that severe depression and schizophrenia were brain diseases.' Dr. Fink, author of many scientific articles about ECT and founding editor of the quarterly Convulsive Therapy (now The Journal of ECT), faced opposition from other doctors, Scientologists and protesters at conferences. 'We had a problem getting this accepted by the public, and I was protested at meetings across the United States and Europe,' he said in 2019, when he received an award for lifetime achievement from the Institute of Living, a psychiatric center in Hartford, Connecticut. Some opponents of ECT said it was ineffective or left people with memory loss and trauma. Others described it as a brutal practice, an enduring view reinforced by the 1975 film 'One Flew Over the Cuckoo's Nest,' in which a patient at a psychiatric hospital, played by Jack Nicholson, undergoes ECT without anesthesia as a punishment for his rebelliousness. In his book 'Electroshock: Healing Mental Illness' (1999), Dr. Fink wrote that 'the picture of a pleading patient being dragged to a treatment room, where he is forcibly administered electric currents, as his jaw clenches, his back arches, his body shakes, all the while he is held down by burly attendants, may be dramatic but it is wholly false. Patients aren't coerced into treatment.' Advertisement Critics of Dr. Fink's passionate support of ECT said he downplayed the risks, including memory loss and cognitive impairment. 'One of Fink's books describes going to get ECT as no more significant than going to the dentist, which I thought was pretty glib,' said Jonathan Sadowsky, author of 'Electroconvulsive Therapy in America: The Anatomy of a Medical Controversy' (2017). 'And there are a lot of scientific studies about memory loss from ECT.' Dr. Fink insisted that antidepressants and antipsychotics could cause more damage, including memory loss, than ECT did. Nemeroff — who described Dr. Fink as 'an irascible, dominant figure' as well as 'the world's leader in electroconvulsive therapy' — said Dr. Fink's focus was firmly on the effectiveness of the treatment. 'He was a zealot, no question about it,' Nemeroff said. 'He thought ECT was a panacea.' ECT's effectiveness in treating serious mental illness has been recognized by, among others, the American Psychiatric Association, the American Medical Association and the National Institute of Mental Health. But although it is useful for treating serious mental illness, it does not prevent recurrence. Consequently, most people treated with ECT need to continue the procedure or use another type of maintenance treatment. Maximilian Fink was born Jan. 16, 1923, in Vienna. His father, Julius, was a doctor in general practice who was trained in radiology. His mother, Bronislava (Lowenthal) Fink, known as Bronia, left medical school at the University of Vienna after three years; later, in the mid-1950s, she became a social worker. Max and his mother immigrated to the United States in 1924, joining his father there. (His brother, Sidney, who was born in 1927, also became a doctor, specializing in gastroenterology.) Advertisement As a boy, Max developed X-ray film in his father's office. He started college at 16, at New York University's University Heights campus in the Bronx, and graduated in three years, with a bachelor's degree in biology, in 1942. After earning his medical degree at the NYU College of Medicine (now the Grossman School of Medicine) three years later and interning at Morrisania Hospital in the Bronx, he served in the Army from 1946-47, attending the School of Military Neuropsychiatry. After his discharge from the Army, he worked as a surgeon on three passenger ships. From 1948-53, Dr. Fink served as a resident at Montefiore, Bellevue, Hillside and Mount Sinai hospitals. From 1954-62, he ran the division of experimental psychiatry at Hillside. He later served as director of the Missouri Institute of Psychiatry and as a professor of psychiatry at New York Medical College. From 1972-97, he was a professor of psychiatry and neurology at Stony Brook University, where he later became a professor emeritus. Dr. Fink's research had unusual breadth. He showed early in his research career that penicillin, still an experimental drug, was better than sulfa for patients with pleural cavity infections. He studied the pharmacology of LSD, marijuana and opioids; used electroencephalograms, or EEG tests, to measure the changes caused by electroshock, insulin coma and psychoactive drugs; and wrote about the effects of changing the placements of electrodes in ECT. He was also among the scholars who successfully argued for the recognition of catatonia — a syndrome characterized by irregular movements and immobility — by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or DSM, as separate from schizophrenia. Advertisement Dr. Fink's other books include 'Convulsive Therapy: Theory and Practice' (1979), 'Electroshock: Restoring the Mind' (1999), 'Ethics in Electroconvulsive Therapy' (2004, with Jan-Otto Ottosson) and 'The Madness of Fear: A History of Catatonia' (2018, with Edward Shorter). He wrote or collaborated on about 800 scientific papers, including one on catatonia that was accepted for publication by Journal of the Academy of Consultation-Liaison Psychiatry shortly before his death. In addition to his son, Dr. Fink is survived by two daughters, Rachel and Linda, and four grandchildren. His wife, Martha (Gross) Fink, died in 2016. In a 2018 interview for Stony Brook, Dr. Fink reflected on his career and its influence. 'I think I was very lucky,' he said. 'However I worked it out, I was always able to find projects and kept busy.' He later added: 'We've saved lives knowingly. It's been a very interesting life.' This article originally appeared in
Business Wire
17-06-2025
- Health
- Business Wire
Study Reveals Empathy-Focused Interventions Have the Same Impact as Prescription Medications for Diabetes Control
AUSTIN, Texas--(BUSINESS WIRE)--A recent clinical trial from the founders of Beheld and a research team at the Dell Medical School has demonstrated that science-backed human connection can drive clinically relevant health improvements for health plan members. The study, published in JAMA Network Open, found that consistent, empathy-focused phone calls led to significant improvement in mental health and blood sugar control for adults with diabetes. This research highlights a cost-effective model for managing various conditions, especially for individuals with limited access to traditional mental health and support services. This research builds on Kahlon's previous work studying the broader benefits of empathetic phone calls. In 2021, Kahlon and her team published a study that found 10-minute Sunshine Connections improved mental health for elderly patients. Share During the six-month clinical trial, 260 patients of the Federally Qualified Health Center (FQHC) Lone Star Circle Care with uncontrolled diabetes were split randomly into two groups—one receiving standard care and the other receiving both standard care and consistent phone calls. Referred to as Sunshine Connections, these calls were made by empathetically talented nonmedical staff, creating opportunities for participants to share their experiences and day-to-day challenges in living with diabetes. This human-centered approach empowered trial participants to receive support at their own pace, fostering a strong personal connection and ongoing engagement with their callers beyond the clinical setting. At the end of six months, the participants receiving Sunshine Connections saw: Improved Blood Sugar Control: Patients saw an average HbA1c reduction of 0.7%, compared with no significant change in the control group. Greater Impact for Patients with Mild or Greater Depressive Symptoms: Patients reporting mild depressive symptoms saw even larger reductions, with average HbA1c improvements of 1.1%. High Satisfaction: Nearly all participants receiving Sunshine Connections rated them as very or extremely beneficial to their well-being. 'At a time when workforce shortages challenge health care delivery, this study underscores the profound clinical impact nonclinical staff can make,' said Jon Calvin, CEO of Lone Star Circle of Care. 'By leveraging trained laypeople, we're demonstrating that empathy, connection and intentional engagement can lead to measurable health improvements. In a world where medicine is increasingly fast-paced and technology-driven, this work reminds us that human connection remains at the heart of effective care. Empathy not only enhances patient engagement but empowers individuals to take meaningful steps toward better health outcomes.' This research builds on the study's lead author, Maninder Kahlon, Ph.D., previous work studying the broader benefits of empathetic phone calls. In 2021, Kahlon and her team published a study that found 10-minute Sunshine Connections improved loneliness, depression, anxiety and overall mental health among mostly homebound, older adults. After just a four-week trial, participants reported feeling 20% less lonely on average. Symptoms of anxiety and depression also notably decreased, with more than a 30% decrease on the GAD-7 scale and 24% decrease on the PHQ-8 scale, respectively. Beheld is also working on a study examining the impact of Sunshine Connections on maternal health outcomes for Medicaid populations—this data is expected to be available by the end of summer 2025. 'Care relationships have deteriorated because healthcare rewards high-cost care over long-term human connection—and technology often deepens that gap. Approaches that lack connection lead to worse health outcomes, and at this point, the traditional healthcare system is too under-resourced to solve it. Beheld is changing that,' said Maninder 'Mini' Kahlon, Ph.D., lead author of the study, co-founder and CEO of Beheld, and associate professor in the Department of Population Health at Dell Med. 'Our study found that engaging nonmedical talented individuals to provide empathetic support has a meaningful impact on health conditions like diabetes; the impact is the clinical equivalent to improvements you would see from prescription medications. This approach holds massive potential for health plans looking to address other conditions in Medicaid and Medicare Advantage member populations.' To learn more about Beheld, visit About Beheld Beheld delivers clinically relevant health improvements for members through the power of consistent, science-backed human connection. Co-founded by Dr. Maninder Kahlon, founding Vice Dean of Dell Medical School at UT Austin, Beheld aims to redefine traditional healthcare delivery using technology as an enabler for deeper understanding and trust. Partnering with health plans to tackle their biggest challenges, Beheld leverages its empathetically talented workforce and innovative technology to source unique insights into member populations to improve outcomes, quality metrics, and cost savings. To learn more, visit
Yahoo
27-05-2025
- General
- Yahoo
Austin doctor studying a new kind of medication for major depressive disorder
Austin psychiatrist Dr. Donald J. Garcia is enrolling patients in a study on a new kind of medication for major depressive disorder. While drug companies have created many medications that help increase serotonin, that neurotransmitter chemical that is our natural mood stabilizer in the brain, only about 60% to 70% of patients will respond to those medications, Garcia said. The major depressive disorder medication, BHV-7000, is different than those that focus on serotonin because it focuses on potassium channels, which help regulate the activity of neurons in the brain. The channels "could help calm the brain and get it back to a normal state," Garcia said. "This is an interesting hypothesis." Garcia and his company Austin Clinical Trial Partners are enrolling up to 306 people ages 18 to 75 in a trial to study the drug, which is made by the biopharmaceutical company Biohaven. For the trial, Garcia is looking for people who are having a major depressive disorder episode lasting two months up to 24 months. They must stop taking their depression medication at least two weeks prior to enrolling in the study, and cannot be having suicidal thoughts. Interested participants will receive a physical exam and testing to make sure they are medically stable before beginning the study. Garcia noted that having major depressive disorder doesn't just mean you are depressed, which is a description of a mood state. It's "depression plus other symptoms that become a clinical syndrome," he said. Those symptoms may include insomnia, a loss of interest in things you used to love, or simply not taking pleasure in daily life. They are constant, lasting for longer than just one or two days, and can creep up on you, Garcia said. Can a magnet help my mental health? How transcranial magnetic stimulation works in Austin. Half of the people in the study will receive the BHV-7000 medication and half will receive a placebo. No one will know which group they have been assigned to. Enrollees will continue taking the medication or the placebo for six weeks. After that part of the study concludes, they may opt to continue with the study and would be guaranteed to receive the medication for 52 weeks. Garcia said he feels better knowing that he can offer the medication to all participants after the initial study period ends. While in the study, participants will receive free psychiatric care. Such clinical trials "bring us closer to the understanding of how depression might come about," Garcia said. "It might be caused by a number of different mechanisms or issues." Dell Medical School clinic at UT Austin joins global bipolar study for treatments To find out more about the study and if they qualify, people can visit or This article originally appeared on Austin American-Statesman: Austin doctor studying major depressive disorder medication
Yahoo
27-01-2025
- Health
- Yahoo
Most U.S. hospital emergency rooms aren't prepared to treat children, study finds. Why?
Is your local hospital prepared to treat your child in its emergency room? A recent study of 4,840 emergency departments in the U.S. found that only 17.4% of ERs had a high level of readiness to treat pediatric patients. It estimated that 2,143 kids' lives could be saved each year if ERs were prepared to treat children. In Texas, spending $2.44 per child for ERs to meet the readiness standard could save 27 kids' lives a year, said Dr. Katherine Remick, a Dell Medical School associate professor who is the co-director of the National Pediatric Readiness Project. "There are no universal regulatory requirements," she said of why almost 83% of emergency rooms aren't prepared to treat children. "That's the misconception most parents and caregivers have: If it says 'Emergency' it is there to treat any and all emergencies regardless of our age," she said. That doesn't mean that only emergency rooms attached to a children's hospital are equipped to handle a pediatric emergency, she said. Some emergency departments in other hospitals have the training, the procedures and the equipment to handle a child in an emergency, but there's no signage or visible indication of which ERs meet that high level of readiness. Remick suggests families do their research with their pediatrician to see which local emergency rooms to take their children to in an emergency, and if in a true emergency, "call 911 and hope that the EMS system is able to help navigate your child to the right ER." "Pediatric readiness is really a system design framework of having policies and protocols in place," Remick said. Yes, it's having pediatric-size equipment, medication and other supplies, but it's also having providers who are trained to handle pediatric emergencies and having safety measures in place to evaluate and give medication based on a child's symptoms, age and weight, not those of an adult. Emergency rooms do not have to have pediatric specialists or pediatric emergency doctors to be pediatric-ready, she said. Instead, staffers can be trained to handle the immediate need to resuscitate and stabilize a child in an emergency before a transfer to a children's hospital for ongoing care. Children who die in emergency rooms typically do so in the first few hours of care, and that's why this is so important, Remick said. Those first minutes of care in the most dire situations include establishing an airway, stopping bleeding and keeping the organs functioning. That's where this really matters, Remick said. Remick remembers being in training in the mid-1980s and working at Brackenridge Hospital, then Austin's main trauma center, when an 11-year-old who had been hit by a car was brought in. At that time, she said, most emergency providers were not trained in working with kids. She said she was lucky her treatment of the patient worked, "but we shouldn't have to rely on luck to ensure the best outcomes." Texas does have a requirement that by Sept. 1 all designated trauma centers must meet pediatric readiness standards, which include training and having access to equipment and resources at the facility. Children's hospitals also must have the training and resources to treat adults. In trauma facilities in counties with fewer than 30,000 people, the hospitals can use telehealth to connect experts and the doctors on the ground to treat pediatric patients. In Central Texas, hospitals with trauma designations are: Level I (Highest level) Dell Children's Medical Center Dell Seton Medical Center Level II Ascension Seton Hays Ascension Seton Williamson St. David's Round Rock Medical Center St. David's South Austin Medical Center Level III Dell Children's North Campus Level IV Ascension Seton Medical Center Ascension Seton Edgar B. Davis Ascension Seton Highland Lakes Ascension Seton Northwest Ascension Seton Southwest Baylor Scott & White Lakeway Baylor Scott & White Marble Falls Baylor Scott & White Round Rock Baylor Scott & White Taylor Cedar Park Regional Medical Center Christus Santa Rosa Hospital San Marcos St. David's North Austin Medical Center St. David's Medical Center St. David's Georgetown Hospital This article originally appeared on Austin American-Statesman: Most U.S. hospital ERs are not prepared to treat children, study finds
