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                    <text>July 15, 1987
Turan M. Itil, M.D.
HZI Research
150 White Plains Road

Tarrytown,‘ New York 10591
Dear Turan,
I would be,» pleased to serve on the Advisory Board for Research and
Development of the H21 Research Center for a period of three years.

My best regards.

Sincerely yours,

Max Fink, Md).

Professor of Psychiatry

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                    <text>link

15, 1987

Mr. Keith A. Greathouse
Sandoz Pharmaceuticals

Route 10
East Hanover, New Jersey 07936
Dear Mr. Greathouse,
i am not aware of. a pharmaco-EEG bioequivaience study for thioridezine.

it is possible that Professor itil of the New York Medical College in Valhalla
carried out such a study. Our own studies have been dedicated to a range of other
psychoactive substances, and i enclose recent summaries of our experience.

Peter lrwin was a leader in these projects in my laboratory. He joined the
Sande: professional staff about five years ago and is in your East Hanover facility.
Should you went direct information on our experience, i am confident that he is
able to answer your questions with as much security as lcould.
These studies were done with single channel EEG processing. in the past
year, we set up two EEG laboratories with multi-ieed EEG recording systems with
simultaneous processing of It to 16 channels of EEG in real time.
Thank you for your inquiry.

Sincerely yours,

Max Fink, Md).

Professor of Psychiatry

cc: Peter lrwin

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                    <text>ww—w-r ~‘nm'.

-Wm

wa—z—vnqmr

July 25,

19 87

Dr. Stanley Lee

Box 12A

Department of Psychiatry
Downstate Medical Center

Brooklyn, New York 11203
Dear Dr. Lee,

am pleased to support the appointment of Dr. Thomas Craig as Professor
of Psychiatry in your Department. [have known of Tom‘s work for many years, and
have worked with him at Stony Brook from 1983 to his leaving earlier this year.
1

At Stony Brook, he has been responsible for the residency training program,
the ambulatory care services, and the acting clinical director for the in-patient
service at University Hospital. He has been an active administrative officer, as
chairman or member of numerous departmental and medical school committees.
he has also
While he has carried these burdens -- and he has carried them well
maintained his research projects and continued to present and publish the results of
his studies.

-

Tom is an excellent researcher with special skills in epidemiology and
in psychotherapy and psychopharmacology. And, he is a fine administrator, with skills in organization and in
interpersonal relations. He is an excellent supervisor and a superb consultant. He is
well liked by the residents and the staff. Indeed, since he has announced that he is

statistics. He is a fine clinician, with skills

leaving, there has been general consternation among the faculty, the nursing staff,
and the residents.
We were sorry to see him leave. I heartily endorse his appointment as

professor of psychiatry.

Sincerely yours,

Max Fink, MD.

Professor of Psychiatry

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                    <text>aura—vW—Te

u

w
v

w-vm—w—qu—wp—

January 6, 1987
Michael Alan Taylor, M.D.

-‘

r

Professor a: Chairman

UHS/Chicago Medical School
3333 Green Bay Road
North Chicago, IL 60064

Dear Mickey,

'

I am pleased to submit this letter recommending the promotion of
CONRAD SWARTZ, M.D., Ph.D. to the rank of Professor of Psychiatry. I have
known Connie for about four years, since his association with Dick Abrams in your
department in their research in ECT. My relationship has been chieﬂy as an editor
-- in reviewing Connie's submissions to CONVULSIVE THERAPY, and to other
psychiatric journals; and in his responses to my requests for reviews of the work of
others. i have observed his presentation of papers at national meetings, and have
read many of his papers. in addition, when he and Dick sought to develop a better
ECT device, I was consulted and carried out some early assessments of the
THYMATRON. When i wished to make a videotape to inform patients and their
families about ECT for consent purposes, both he and Dick were helpful in
developing the concept and the final tape. Finally, Connie sent me a copy of his
_&lt;_:_._y_., and I have read it.

Connie is clearly one of the best trained, intelligent, and innovative
researchers in ECT today. As a graduate of the University of Iowa training
programs, he has all the hallmarks of a hard-headed scientist, with a keen reliance
on data. He has shown the ability to combine his mathematical and engineering
skills with those of the physician, and has contributed to our understanding of the
ECT process, to neuroendocrine tests, and to lithium. therapy as well. His studies of
prolactin release and the formulation of a mathematical model to estimate the
amount released under different interventions provides the best estimate of central
responses to seizures. Indeed, the demonstration that the amount of prolactin
released by seizures is influenced by electrode placement, current type, and
current dose provides an excellent index of the strength of the stimulus in ECT
which should be useful in further studies of the ECT process. His recent suggestion
for a better way to monitor lithium therapy is innovative and promises to be useful.
The application of his models to the TRH test seems also to be a useful advance.
He has an unusual breadth of interest; his studies go beyond ECT,
statistics and mathematical
encompassing
models,
pharmacokinetics,
neuroendocrine tests, and alcoholism. Connie has achieved an unusual national
reputation for independent research with a firm mathematical and statistical base.

�Conrad Swartz, M.D., PM).

Page 2

He lectures and writes well although his style is

intelligent
investigator.

and

rather prolix. He

is highly

innovative, and is clearly a self-starter and independent

It is a pleasure to recommend Connie's promotion to full Professor. 1 am
confident that he will continue to be productive and innovative and am always
delighted to see one of his manuscripts or reports.
My best regards.

Sincerely yours”
Max Fink, MD.
Professor of Psychiatry

�</text>
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                    <text>January 22, 1987
Mr. Luz Marquez de la

Plata

Corporacion de Television Universidad Catolica de Chile
(Canal 13)
Ines Matte Urrejola # 0848
Santiago, Chile
1-

Dear Mr. de la Plata,
I

Thank you for the kind invitation to participate in the TV series "World 88".
will do my best to cooperate.

First. we no longer speak of shock therapy -- that phrase actually refers to
'insulin shock therapy' .- a treatment that no longer is used in the Western world.
instead, we speak of ‘convulsive therapy' or the specific, ‘eiectroconvulsive

therapy'.
'

We have Cooperated with TV reporters on this same subject, and indeed,

produced a set of videotapes for students and for patients and their families, in
which we presented views of patients, before and after their treatment, as well as
a treatment session. It should be possible to do so again.

am of the opinion that the best presentation is not
made of patients after treatment, nor of patients before treatment, nor of
different patients at different stages of the treatment; rather, the same patients
should be presented while ill, and after the course of therapy. Such a presentation
would require your interviewer and camera crew to come to the University on at
least two occasions, about four to six weeks apart.
From this experience,

I

four to six patients any morning, so that it should be
possible to present two or three patients before treatment at one visit; and the
same patients some weeks later.
We ordinarily

treat

The American Psychiatric Association meetings will be held in Chicago
from May 7 to 15, and i shall be away much of that trime. Again, 1 shall be away
the last week in June.
Thank you again for your interest.

Sincerely yours,
Max Fink, MD.

Professor of Psychiatry

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                    <text>February 18, 1987
Philip L. Bonnet, M.D.
114 West Franklin Avenue, Suite K-l
Pennington, New Jersey 0853‘;
Dear Dr. Bonnet,

It is not clear from your letter how i can be of assistance in the
understanding of your interesting case. The symptom of fatigue and obsessive
compulsive symptoms, in the absence of physical justification as in recurrent
hypoglycemia or a muscle wasting disorder, may reﬂect persistent depression.
The descriptions of prior courses oi ECT andthe cinguiotomy are too
scanty to determine their adequacy or their effects.
We would be glad to have the patient seen at our center, following receipt
of a more detailed history. Evaluations maybe done as an out-patient or as an inpatient, depending on the patient’s needs. Appointment can be made with my
secretary at 516-14“ 2929.

Or, you may consider consultation with my former co-worker Dr. Donald F.
Klein at the Psychiatric Institute. He has made a study of patients with unusual
syndromes of depression.
-

Thank you for the inquiry.

Sincerely yours,

Max Fink, M.D.
_

Professor of Psychiatry

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                    <text>'!’h

"m...

February 20, 1987

Wmuuwlwmm'wmww,

Paul 3. Poppers, Md).
Professor 6: Chairman
Department of Anesthesiology

at Stony Brook
Long Island, New York H791;

SUNY

Dear Paul,
1 am pleased to submit this letter endorsing the promotion of KENNETH
FREESE, MD. to the rank of Clinical Associate Professor of Anesthesiology.
1 first met Ken when he delivered anesthesia for the ECT service in 193$.
At the time, we were studying the relations between seizure duration and outcome.
Ken was particularly remonsive to our needs for Controlled anesthesia. Later, when
i decided to edit the journal Convulsive Therapy, I raised questions with him, which
he answered with good documentation. One response led to the report "Can

patients safely undergo electroconvulsive therapy while receiving monoamine
oxidase inhibitors?", which 1 published in 1985.

A

v"

w—rryu—n-vvv

um—w-

Wu‘mmvH—m

"‘WVHWv—rtwm'w

Aww‘zmv‘w—‘m

Last year, i invited him to discuss the relations between anesthesiologists
and electrotherapists in the American Psychiatric Association training course on
*1 ECT in Washington. His presentation was authoritative and stimulating; the
students loved it. His success led us to invite him to present again in May this year
in Chicago.
Since he took over the chair at the Nassau County Medical Center, we have
met occasionally, to discuss our common interests. He has maintained his interest
and enthusiasm for this special application of modern anesthesia.
Ken is a most engaging, enthusiastic, responsible, and competent physician.
He is an excellent student and teacher. He aroused in his residents (and in mine) an
interest in anesthesia, and encouraged their understanding of the physiology of the
processes. His administrative skills are excellent, and are reflected in his being
selected to take over the arduous position at NCMC. I am pleased to recommend
his promotion, and do so with enthusiasm.
Sincerely yours,

Max Fink, MD.
Professor of Psychiatry"

'

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                    <text>February 24, 1987
David A. Casey, M.D.
Department of Psychiatry 5: Behavioral Science
University of Louisville School of Medicine
Norton Psychiatric Clinic

P.O. Box 35070
Louisville, Kentucky ll0232

Dear Dr. Norton,
We have not published a case report of the use of ECT in patients with

NMS. Our experience, however, led one of my associates

at Stony Brook, Lawrence
Greenberg, to write a letter which we published (Convul. Therapy 2: 61-62, 1986).
A copy is enclosed for your information.
There have been a few case reports of the use of ECT in NMS, and a few
reviews of NMS as a syndrome, but no comparative study has been brought to my
attention. I enclose a copy of the citations in our files with regard to NMS and
ECT; it may be of use in your report.
I also enclose copies of our information for authors and a publication
which
release
must accompany all reports submitted for publication.

Thank you for your interest. I look ofrward to reading your report.
Sincerely yours,
Max Fink, MD.

Editor

P.S. If Dr. Denber still is a regular visitor to your facility, please give him my

regards.

»

�</text>
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                  <elementText elementTextId="104244">
                    <text>"a,

A?

k.

w

'—‘&lt;\-

«

’xﬁwaésc'.Irﬂ'J—urrrr

v

u.¥am',

,—,\.r,-.x:-:;;-.,w

frmmmn,gt.r =V~-—-——r,— 1-".i

H

,

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,,

1,

.

,

,,

‘

imp _,,,___,,,

V

.,_..;V(‘.,.,m

7. ﬂag “w
7

”5?“,TFVR, ,TW‘L‘LN

March 31, 1987

Robert Martz, M.D.

Group Director- CNS Diseases
Du Pont - Medical Products Department
Wilmington, Delaware 19898
Dear Dr. Martz,
I thought that I had sent a copy of our response to the FDA regarding 1ND
21,821 to you, but I may not have.

in response to a request from the FDA in June, 1986, I noted our failure to
EEG or the behavior of our psychiatric patients during the course of
convulsive therapy by doses of naioxone up to 20 mg. As our findings were
consistent with other reports, we discontinued the study. We have not published the
results of our experience. The remaining supplies of naloxone were outdated and

affect the

destroyed.

Copies of our formal notiﬁcation of the FDA and their reply are enclosed.
Thank you very much for your cooperation and assistance in the study.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

_

4“

..

,

..

.

.

�</text>
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                    <text>April 17, 1987
Sandoz Foundation for Gerontological Research
Regional Committee for North America
P.O. Box 10
East Hanover, New Jersey 07936

Gentlemen:
i would be grateful for an application for support for a research project
under the auspices of the Foundation. Please send to:

Dr. Max Fink
SUNY at Stony Brook
P.O. Box #57
St. James, New York 11780
Thank you.

Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

�</text>
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,.

7

.,,~.,

v.
—

r

.w—,.myw&lt;v—.

v-w-mw-—,-..,.

zrwmn-v.-qprw

.
.

r

an-w—w—w;

"av-Wm:

January 26, 1986
Joan M. Blaies, R.N.
Director, Mental Health Nursing

Waukesha Memorial Hospital
725 American Avenue
Waukesha, Wisconsin 53186
Dear Ms. Balies,

You are, of course, free to use the model consent form form my book, and

to modify it as you may need. i am pleased that it may serve a useful purpose. The
issue of consent in psychiatric therapies remains complex; it was a central issue at
the 1985 NIH sponored ConsenSus Conference on Electroconvuisive Therapy.

that the patient and the family have been given
sufficient information about the ECT process, which remains a surgical type
procedure in psychiatry? One answer is the diligence of the psychiatric staff in
How is one to assure

explaining the procedures, and in the training and experience of the therapists. But
since guidelines for therapists are not established, nor for consent procedures, we
have come up with another solution, that of an informational videotape. 0n the
invitation of Somatics Inc., producers of the THYMATRON, l participated in
making two videotapes, one for patients and their families and the second for
therapists. These may be of interest to you and your associates and I have asked
Somatics to send you a description.
'

WVWPWWMWV

Good luck in your work.
wrwvu—m

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>W”
l
E

E

January 28, 1986

Mr. Harry Wassall

Petroconsultants S.A.

5345 S.W. 92 Street
Miami, Florida
Dear Mr. Wassall,

Convulsive therapy (ECT) is, by reputation, not popular in Switzerland ever
since the leading psychiatrist, Professor Paul Kielholz of Basie made it known that
he could successfully treat all his patients without its use. However, he is retiring,
and there may be a relaxation of attitudes.

cannot refer you to anyone in Geneva, but can suggest some excellent
clinicians in that small country:
I

Professor Jules Angst, Psychiatrische Universitatsklinik Zurich, Postfach

68, CH-8029, Zurich.
#025.

Dr. Markus Gastpar, Psychiatric Clinic, Wilhelm-Klein-Strasse 27, Basel
Dr. J. Fleischauer, Cantonal Clinic of Psychiatry, CH-49l5, St. Urban/LU.

Each of these men are internationally known as skilled in the treatment of patients
with depressive disorders.

addition, the dean of clinicians in the treatment of depressive illnesses is
Dr. Roland Kuhn (Psychiatric Clinic, CH—8596 Munsterlingen). He may be retired
by, now, but if he will see your employee, I think she would be in good hands.
In

Good luck.
Sincerely yours,

Max Fink, MD.
Professor of Psychiatry

,

�</text>
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                    <text>February

1, 1986

Michael Miller, MD.
Apt SE
515 West 110 Street
New York City 10025
Dear Michael,
The enclosed report is quite good. A larger sample, or more observations
per patient would have provided definitive data for the profession. As it is, the
report supports the continued use of atropine for ECT in the patients with clear

evidence of cardiovascular disease.

1. If you wish to have the article considered by CONVULSIVE THERAPY, then the
citation style should be that of Raven Press. A copy of the guidelines to authors is
enclosed. In general, we have found that the citation style we use is best in the
preparation of a manuscript. As you have already discovered, the numeric style is
difficult to alter by addition or subtraction of a citation; and it is difficult to find
citations, especially in articles with long citation lists.

2. Pg 4: Note the discrepancy in your use of 0.8 mg atropine and the stated
recommendation of the APA of 0.1+ mg. Explain or leave the APA guide out.
3. Pg 7: The section on the criteria for cardiac arrhythmia is a bit muddled. If your
article is intended for a psychiatric audience, this paragraph needs clarification.

Pg. 9: Tl-iis section is quite muddled. Read it to a non-physician, and if it can be
clearly understood, then you have hit the right level of complexity.
1+.

5. Pg 10: Same as 4 above.
6. Page

ll:

All of this paragraph can be safely forgotten, as can most of the next.

7. The alternate anticholinergic treatment is glycopyrrolate; there is a literature
for this use, and it should be included in your discussion. See reference list.
Since your findings seem to differ for the two medically identified groups
of patients, cardiovascular disease and none, why not present your data in this
framework? Also, if you can arrive at a recommendation for the usage of atropine,
you should do so, clearly.
Thank you for the opportunity to read this report.
Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>February 24, 1986
Henry Murphree, M.D.

Department of Psychiatry
Rutgers Medical School
Piscataway, New Jersey 08854
Dear Henry,

have received a note from Helen Pettinati regarding my willingness to act
as referee for the departmental consideration of her promotion. 1 would be
delighted to do so . i first read Helen's work a few years ago, and have since come
to know her and her co~workers quite well, and admire their professionalism and
excellent work. When 1 took on the position of editor of CONVULSIVE THERAPY, I
invited her to join the editorial board; she has since been most helpful. Let me
know what I can do.
1

---—v

—,

qua-"w...

v—wm-

'"T’r

,-.

my

.Ww"

My

best regards.

_

Sincerely yours,

,

7%?

'7vvrw-wv

wn—n—rrw

Max Fink, M.D.

Professor of Psychiatry

WW»

m—v

r.wmr

wnn

w,

Ip—vrrrvn‘

.,
WV

W

—.

‘mvw

.

van

v.

er~

MW

�</text>
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                    <text>February 25, 1986
Mr. Steve Moore
FDA Center for Drugs and Biologics (HFn—ZSO)
5600 Fishers Lane
Rockville, Maryland 20857
‘

Dear Mr. Moore,
1 became aware of the FDA Bioequivalence
Workshop to consider the
in vivo testing of pharmaceuticals on May 7-9, in reading the PMA
of
design
Newsletter of February, 1986 (page 6). i have been testing psychotropics for their
effects, on brain function using quantitative EEG measures for many years, and
have carried out a numbq of bioequivalency studies. Lately, i was asked by the
physicians at Hottmann La Roche Laboratories to consult on the issues of
bioequivalence of generic formulations of diazepam with Valium. it is my
understanding that these data led to a request by Hoffmann La Roche to the FDA
to consider quantitative pheromone-EEG measures in the development of guidelines
for bioequivalency of psychotropic drugs.
’

Will these questions be part of the discussion and presentation
meetings? Would your ofﬁce send me a copy of the program?

Many thanks.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

at the

May

�</text>
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                    <text>we:

-

w‘, Fwy—.7

a“. ”pr—W...“

March 11, 1986
Samuel Gershon, MD.

Professor dc Chairman
Department of Psychiatry
Wayne State University dc Lafayette Clinic
951 East Lafayette
Detroit, Michigan lt8202
Dear Sam,
Thank you for sharing the very interesting protocol on haloperidol and ECS.
It is quite detailed and should answer the questions handsomely. Let me know if
there is anything that I can do to assist Dr. Galloway. We are particularly adept at
searching the literature and in identifying sources to answer technical questions
(about ECS) as they may arise.

Martha and I would be delighted to meet you and/or Lisl in New York. You
can reach us most evenings at our home (516 862-6651) or our apartment in Great
Neck (516 466-2307).
My best regards.

Sincerely yours,

Max Fink, MOD.

�</text>
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                    <text>WWW—m;

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January

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1, 1986

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Editor- OP ED Page

New York Times
Times Square, New York 10036
Sir:

r-‘v-NWWW'WWWWVW

The opinion piece by Sergei Batrovin on December 31 was of special
interest as it described the administration of "sulfazine shocks a torturous type
of 'treatment', prohibited in the West, that puts the patient into coma, then causes
convulsions and many hours of unbearable pain."
——

w.

w-w—

wry?

sought to identify the compound 'sulfazine' and a search of various
sources elicited no clear identification. A search of the International
Pharmaceutical Abstracts found one citation to a sulfonamide derivative, and it is
unlikely that such a compound has the effects cited by the author.
I

would be grateful for a clarification. 1 am unaware of any substance that
produces the effects cited; nor am Iaware of any interdicted treatment which may
do so. The closest is the use of high doses of insulin for a treatment known as
insulin coma. Such a treatment was widely used and was replaced by
pharmacotherapy. I am not aware of any prohibition or prescription in any Western
country, nor am i aware of any instance of 'many hours of unbearable pain' in this
i

treatment.
Is

it possible that the author is exercising a high degree of hyperbole?

Thank you for any help in this interesting matter.
Sincerely yours,

Max Fink, MD.

Professor of Psychiatry

um

mac

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1—-

v

W?“"""m Wm: MF~Wm

-

f

E

March 1, 1986

i

E

i

i

I

r

E

E

E

i

i

i

l

5

Bernard J. Carroll, M.D., Ph.D.
Department of Psychiatry
Duke University Medical Center
Durham, North Carolina 27705
Dear Barney,
i am pleased to write this letter in support of the recommendation for
tenure appointment for Richard Weiner, M.D., Ph.D. 1 have known Rich Weiner for
more than nine years, becoming first acquainted with his work when he was a
consultant to the APA Task Force on Electroconvulsive Therapy and when he
appliedvfor VA Merit Review support. Later, we worked together on developing a
collaborative ECT study for NlMH, and more recently, he has been helpful in the
development of the new journal, CONVULSIVE THERAPY. I am well acquainted
with his research projects and writings; have attended many of his presentations;
and have had the beneﬁt of his advice.
In the past decade, he has established himself as a major researcher in
electroconvulsive therapy. He (and the research group at Columbia University) seek
to tease out the relationships between stimulus parameters and electrode location,
with efficacy, cognitive, and EEG effects of two current types (brief pulse and sine
wave) and two electrode locations (unilateral, bilateral). His work is methodical,
detailed, with significant attention to the parameters of the treatment. His
training in electrical engineering may have been instrumental in the selection of
his research interests and in the type of work that he has done. He has also
presented useful case reports, and he has often been invited to summarize the
present status of ECT in textbooks and conferences.

He has been the chairman of a special task force on electroconvulsive

WV

«-

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WWW—”1‘

therapy devices for the American Psychiatric Association. He has attended and
participated in almost every major ECT conference in the past few years.

Rich is a careful, methodical, rigorous worker. He speaks slowly and
deliberately, and he is always 'thoughful. His research publications are well
documented, and they are accepted as standards in the field. it is a pleasure to

recommend him for tenure.
My

best regards.
Sincerely yours,

mW-mmwm

Max Fink, M.D.

Professor of Psychiatry

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                    <text>March 20, 1986
Howard W, Fisher, M.D.
lO

Sandcastle Court

Pueblo, CO 81001
Dear Dr. Fisher,

In reply to your earlier letter to the APA in June, 1985, I
suggested you
obtain counsel to advise you as how best to proceed. I am still of the same
opinion:

"Your letter to the APA was forwarded to me for comment. You are quite
right that there has been an active anti-ECT lobby in this country, best exemplified
by the media atention to Peter Breggin and the repeated showing of "One Flew
Over the Cuckoo's Nest" and other anti-psychiatry films; by the legal issues in
California and Vermont; and by the willingness of many psychiatric leaders to
argue that ‘after all, we all know that ECT is abused'. It is not clear what can be
done in one instance such as yours, other than by the usual legal maneuvers. To
that end, the legal firm that is defending your malpractice actions
should be
acquainted with those of us in the APA who have served as consultants in defending
the actions of our members. Your lawyers should be given the names of the
following knowledgeable consultants:
Richard Abrams, Chicago Medical School, North Chicago, IL
Gary Aden, San Diego, CA
Fred Frankel, Beth Israel Hospital, Boston, MA
Sidney Malitz, Columbia University, New York, NY
Trevor Price, University of Pennsylvania, PA
Iver Small, University of Indiana, Indianapolis, IN
Richard Weiner, Duke University, Durham, NC
"These men are active fellows of the APA and have ably defended legal issues on
behalf of other members with difficulties similar to your own.
-

&lt;y—wxvv—wrv-o

s—urvw-wxaq-v-u

"As you already have discovered, the APA lacks a central
agency to help
our members with ECT problems, despite the fact that the Task Force in 1978recommended a continuing committee to attend to such matters. You
wish to
write a letter reminding the present president, Dr. Nadelson and may
the medical
director, Melvin Sabshin, of this deficiency."

Sincerely yours,

”who-w

w

w'w'v

u
w-

r

,.
-wnr.

-.-

WM.

W'wI-ml“"r'

v“

....,.

Mr

“Vm'vwvw'urr

Max Fink, MD.
Professor of Psychiatry

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                    <text>r_.——-

»

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.

nim’mm": ism-'- WW“ rl—IWP‘P w'mww'mxww‘ Wmaww-r—r-wum—vww

1:"v *-»-’-’

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v

March 24, 1986
vm-:’.-.—_.m-.,

Henry B. Murphree, M.D.
"‘Wlw-Jw,

Department of Psychiatry
Rutgers Medical School
Piscataway, New Jersey 0885“
Dear Henry,

am writing this letter in support of the promotion of Dr. Helen M.
Pettinati to the rank of Adjunct Associate Professor at the Rutgers Medical
School. I have known Helen for a few years, first becoming acquainted with her
studies of ECT when she reported assessments of the differential effects of
electrode location on the efficacy and side-effects of ECT, and the lack of effect
of dexamethasone on ECT induced cognitive impairment.
I

Her work has been excellent. She has carried out careful and well designed
parametric studies. The reports reflect meticulous attention to case selection,
treatment, and statistical assessment. [liked her work sufficiently, that when l was
inviting scientists as associate editors of the new journal, CONVULSIVE
THERAPY, I invited her and am pleased that she has joined the Board.
She is an excellent reviewer, and recently she organized and reported an
assessment of the characteristics of two new ECT instruments (CONVULSIVE
THERAPY _2_: #3-54, 1986). I think the evaluation is fair and very useful. She also

has reported an interesting meta-analysis of the studies of unilateral and bilateral
ECT.

She is a delightful person, and apparently well liked by her co—workers. She
lectures well. It is a pleasure to recommend her promotion.
My regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

wags—aw

-

Nun—u: u-u

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                    <text>February 12, 1986
Robert Millman, M.D.
Department of Psychiatry

New York Hospital Medical Center
525 East 68

Street

New York City 10021
Dear Bob,
I am writing with regard to the
story, "Psychiatrists Challenge FDA" which
appeared this month in Psychiatric Times. If the story represents your views, then I
support the questions which you raise with the FDA. Our interest is not with regard
to the bioequivalence of generics for thioridazine, but a similar question regarding
diazepam.

Last year, my former co-worker Turan Itil assessed the CNS patterns of
and some generic formulations of diazepam, finding differences in
quantitative EEG measures. I was asked by physicians at Hoffmann-La Roche to
review his data. I was impressed that his findings were probably real. They require
replication, of course. When the petition was made to the FDA for an elaboration
of the regulations, to include the requirement that similar studies be done for
generics to demonstrate CNS bioequivalence, the FDA answers given were, as you
noted, vague and indefinite; the petition was denied; and manufacturers of generic
formulations of diazepam were licensed to market their products.
Valium

Since Itil's methods are very advanced, we have decided to tool up to
replicate his studies. Our interest is not in the legal issues or in the methodology,
but in applying his methods to other problems. Nevertheless, I am upset that the
FDA gave so little credence to these data.
I recently published a
summary of my EEG experiences with different
formulations of psychoactive compounds (Integrative Psychiatry 2(Supplement):
125-195, 1985). In it I note some clinical experiences, similar to those reported by
others, which could have resulted from variations in dosage, perhaps occasioned by
differences in formulations.
I
encourage your efforts in getting the FDA to provide meaningful
guidelines and recording requirements for generic formulations of psychoactive
substances. Let me know if I can be of any help.

My

regards.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

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                    <text>April

ll,

1986

Mr. A. J. Roccograndi
Sonnenreich 6c Roccograndi P.C.
Watergate 600 Suite 720
600 New Hampshire Avenue, N.W.
Washington, D.C. 20037
Dear Mr. Roccograndi,
Dr. Robert Millman sent me a 'copy of your letter of March 21 regarding
the petition to the FDA on bioequivalence. i had written to Dr. Miliman of my
interest in this topic and my concerns that the acceptance of bioequivalence for
psychoactive substances on the basis of in vitro tests was inadequate since their
penetration of the blood brain barrier was an important characteristic of their
actions. My opinion is based on numerous studies of the CNS effects of
psychoactive substances as reflected in quantitative EEG measures.
7

should like to encourage the petition to the FDA to review the
requirements for demonstrating bioequivalence of psychoactive drugs. My
experience was cited by the Hottmann La Roche petition to the FDA for a review
of bioequivalency standards with specific regard to diazepam (Valium). The work
was cited in support of the data developed by Professor [til of the New York
Medical College. 1 enclose a copy of my letter to Bob Millman, as well as a recent
report in which 1 reviewed my expereinces with this problem. You may, of course,
cite the article if it seems helpful.
1

Good luck in your

efforts.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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                    <text>.«

.A-

“air

....

March 18, 1986
lrl Extein, M.D.
Fair Oaks Hospital at Boca/Delray
5440 Linton Boulevard
Delray Beach, Florida 33445-6512
Dear Irl,
Thank you for the invitation to contribute to the APA volume 'Treatment
of Tricyclic Resistant Depression'. I will try to get the chapter to you before the
stated deadline of July 25, 1986. l have examined my earlier chapter, and lbelieve
that i can rewrite it with new data and updates on the literature, in a fashion that
should satisfy the managers of both volumes.
Would it not be useful to present some of the evidence for the use of EC!”
at the Washington APA session as well? The evidence for the efficacy of ECT is as
compelling (or more so) than the evidence for the other maneuvers cited in the

program. I have to be at another session at the same time, where I am the
discussant, but could probably make an appearance at your session for a stated
time; or, send one of my associates (Dr. Lawrence Greenberg) with an appropriate
short presentation. From the list of presentations, a comment after Preskorn's
report, citing the most recent report by Glassman, would seem to be appropriate.
Let me know if this is feasible.

«Wu-vy—

My

regards.

W

w

)&lt;

wr-r.

Sincerely yours,

Wuuz~w~vw.mr

.
nu.-

-

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Max Fink, M.D.

Professor of Psychiatry

�</text>
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7

,.

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v

April 22, 1986

Shervert Frazier, M.D.
Director, National Institute of Mental Health
Bethesda, Maryland 20205
Dear Sherv,

it was good to hear your optimistic talk at the Arbour Conference in
and
to dicuss ECT issues.
Boston,
The NIH sponsored Consensus Conference on Electrconvulsive Therapy
concluded that while the treatment was controversial, its continued use and study
was indicated. The panel recommended further research, particularly a survey of
the practice of ECT in this country, both as a follow-up of the 1976 survey of the
American Psychiatric Association and with the techniques which were so successful
in the 1980 British survey by Pippard and Eliam. They also recommended special
attention and study of ECT in patients with schizophrenia and mania.
I am writing to enquire whether any office or officer of the National
Institute of Mental Health is following-up on these recommendations. is the
institute preparing any proposal for a survey? Or, any specific efforts at research
into the mechanism of action?

Convuisive therapy will remain controversial so long as our information as
its
to
usage and mode of action remain scanty. Your encouragement of research,
both within the intramural and extramural research programs, is sorely needed.

Separately, I have written to Dr. Regier as you suggested.
My

best regards.
Sincerely yours,

”-1"

»—_.......

.

.w—F'q

-r-m—ww

w

r—v—v-l-wvw

Max Fink, MD.

Professor of Psychiatry

«we

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                    <text>April 22, 1986
Daryl Regier, MD.
National Institute of Mental Health
Bethesda, Maryland 20205

i.

Dear Dr. Regier,

E
l

Dr. Shervert Frazier suggested that I visit with you the next time lam in
Washington with regard to ongoing programs of research into convulsive therapy at
NIMH. l was enquiring as to any follow-up 01 the recommendations of the NIH
sponsored Consensus Conference on Electroconvulsive Therapy held in June, 1985.

E

i
E
‘
,

~1w"...u

”7.,

Dr. Frazier indicated that any efforts in any special direction at NlMH
required educated and dedicated manpower, willing and able to maneuver through
the administrative thickets of the present administration. I recently undertook the
launching of the new journal CONVULSIVE THERAPY, published by Raven Press,
and i believe that my plate is quite full. However, i am eligible for a University
sabbatical in 1987 or 1988, and if there is a mechanism whereby a program in ECT
could be encouraged, I would like to consider it.

a“

.7,“

.w,-;mw_

shall be in Washington for the Society of Biological Psychiatry and APA
meetings in May. My calendar is free on Monday morning, May 12 until i p.m. if
you will be at the sessions that morning, or are free for lunch, I would be pleased to
meet you. I could also come to Bethesda if that suits you better.
I

~T-r

m_
-

wry.

Thank you for your consideration.

wwwwn-w-v-

r
;.
a

71.1m—

Sincerely yours,

,3

“1.1,.”

N,

3v!

"

"'

”WW-W'W

“ﬁrm-w:w1wt'WW‘mmmwmmW“V-m'

«iriv'lﬂ

"rr'ﬁmr'rv

4/.

,./F(,
I

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{/4 ﬂ/‘f

W5
.w

Max Fink, M.D.

?é 4’0 23,4215”

,

15’

'41:,Miég;
"9”

Professor of Psychiatry

�</text>
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                    <text>April 22, 1986
David Dunner, MJ).
President, American Psychopathological Association
Harborview Medical Center
325 9th Avenue

Seattle, Washington 9810!;
Dear Dave,

Congratulations on your new office at the APPA! The meetings in New
York last month were quite good, and I learned much, and enjoyed meeting our
friends from the Midwest and the West. I look forward to the 1987 meetings as
well.
One issue prompts this letter, and it is to suggest that subscription to the
journal be part of each member‘s participation and included in the annual dues.
COMPREHENSIVE PSYCHIATRY was founded by. Fritz Freyhan, and in its
early days, it was clearly a preferred vehicle for novel contributions by members of
the Association. It became the official organ of the Association, and sought to
publish information about the members and the programs.

It was also the practice, beginning under the leadership of Paul Hoch and
Joe Zubin, to publish the proceedings as an annual monograph. On a number of
occasions, the Council considered subscription to the annual volumes, as well as to
the journal, as part of the annual dues and membership. But such costs would not be
bourne by the members, especially since the annual volumes were priced at varying
levels by the different publishers. It seems to me that subscription to the journal
usually failed of support because of the junction of the two issues.

Perhaps it is time to again address the journal subscription as a
membership feature of the annual dues, separate from other issues. No scientific
journal is able to survive on advertising alone, and it must depend on its readers for
support. If we wish to continue to support COMPREHENSIVE PSYCHIATRY as a
vehicle of the APPA, perhaps the membership should be polled as to its willingness
to subscribe, probably at a preferred rate, as part of the annual dues?
Thank you for your consideration, and my best regards.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>1—1

WVWFVW

'iu—r'.

“ﬁrm—w

v
v

AFWW,-w

V

April 24, 1986

Richard I. Shader, MD.
Department of Psychiatry
Tufts University School of Mediocine
171

Harrison Avenue

Box l007
Boston, MA 02111

Dear Dick,
A few weks ago, l was consulted on the question of hepatotoxicity to
phenelzine. After a literature survey, in which 1 found no examples to justify an

association, 1 re-read the PDR package insert, to find that there are assertions of
risk. in some texts, risks are described for the class of compounds, usually including
iproniazid as well as phenelzine and tranylcypromine. i did find many reports of
toxicity to iproniazid, and I wonder if the package insert description is not a
spillover, 'guiit by association', from the chemical similarity of the two

compounds?
I

would like to pose a question to your experts for the Journal:

What is the degree of risk of hepatotoxicity for depressed patients
receiving phenelzine therapy? Is the risk sufficient to require that we modify the
written advice (as to diet and risks) we regularly give our patients before we

institute this therapy?

Thanks for your help. My best regards.
Sincerely yours,

Max Fink, MD.

Professor of Psychiatry

�</text>
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                    <text>June 26, 1986
Helen Pettinati, Ph.D.
Department of Research

Carrier Clinic

Belle Mead, New Jersey 08502
Dear Helen,

‘W’wt

‘WIV'VIWv-WJ1.W

.‘

m

"Vtml‘i'

Thank you for the copy of your letter to Mr. Chyung regarding an
assessment of the new Medcraft 8-25. 1 am delighted that you and your associates
will be undertaking such a review, and look forward to publishing it.
I have made good use of the MECTA/THYMATRON comparison, and it has
allowed me to answer questions about instrumentation by referral.

Would you consider a comparison with the ElCo'l' instrument, which Mr.
Schick states will be available ‘very shortly'?
My

best regards to you , Stephani and Ken.
Sincerely yours,
Max Fink, MD.

Editor

�</text>
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                    <text>June 30, 1986
Charles B. Schaﬂer, MD.
and Linda C. Schaﬂer, M.D.
711 University Avenue
Sacramento, California 95825
Dear Linda and Charles,
It was a pleasure having you visit with us this past week. This note is to
conﬁrm that you attended three ECT treatment sessions on June 23, 25 and 27;
observed and participated in the treatment of at least 10 patients; made rounds on
our in-patient unit; and spent more than six hours in discussion with my associates,
Drs. Greenberg and Gujavarty our research nurse, Mrs. Carasiti, and our attending
anesthesiologist. Discussions included reviews 01 present treatment practices,
indications, consent procedures, anesthesia, monitoring, complications and their
management, and the features of three of the ECT instruments (Thymatron,
MECTA, Medcraft).
I

trust the experience was useful. Good luck in your work.
Sincerely yours,

Max Fink, MD.
Professor of Psychiatry

�</text>
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                    <text>July 5, 1986
David W. Swanson, MD.
Section on Psychiatry
Mayo Clinic
200 First St., S.W.
Rochester, MN 55905
Dear Dr. Swanson,
I

read your interesting report on the Soviet viewpoint on paranoid disorder

latest issue of the American Journal of Psychiatry with much interest. I was
particularly struck by your comment that 'in the best controlled (treatment) study,
in the

computer-assisted multidiscriminate analysis of the EEG was used to monitor
pharmacotherapy'. The author was cited as Alimkhanov, and the citation indicates
that the original article was in Russian.
1 have been
using quantitative EEG recordings to assess pharmacotherapy
for many years, and l have been unaware of this author. 1 would like to read this
report. Was it translated for your use, and is such a translation available? 1 would
be glad to defray the costs of duplication.

Thank you for your help.
Sincerely yours,
Max Fink, M. D.

Professor of Psychiatry

�</text>
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                    <text>July 29, 1986
Dargut Kemali, M. D.

Instituto di Psicologia Medica e Psichiatria
University of Naples
Piazza Miragiia, 2

80138 Naples ITALY
Dear Dargut,

With regard to the proposed VIII international symposium on Clinical
Neurophysiological Aspects of Psychopathological Conditions, I regret that my
associates and I do not have new data which would be suitable for presentation at
the next meeting. We recently set up a new laboratory based on the H21 brain
mapping system (developed by Turan Itil) and we are studying the CNS changes
occurring in patients receiving convulsive therapy. If we are successful in our
findings, we will be happy to present our data at the next symposium.
Good luck in your work. My best regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>August 11, 1986
Norman Endler, Ph.D.

Department of Psychology

York University
Keele Street
Downsview, Toronto Canada M33 1P3

l#700

Dear Norman,
From your card, sent from Downsview, I assume that» you have completed
sabbatical
studies in Italy. I would be interested in hearing what you learned
your
about the origins of ECT.

Regretfully, in answer to your request, I did not get reprints of the
editorial, so send you a xerox copy in its stead. I was impressed with the efforts
which went into the report and overall, see it (and the Consensus Conference) as
public reviews which, when done fairly, are useful in supporting our present usage.
The material for the final number of CONVULSIVE THERAPY for this year
was sent to the publisher on Saturday; and we already have some fine articles for
the first numbers of next year.
‘

You may be interested in an argument against ECT just published by the
Irish curmudgeon Peter Skrabanek in the Irish Medical Journal (79:157-165, 1986).
He has wit and a talent in writing which may make him a more formidable

opponent to ECT than Breggin or Friedberg.
My

regards.
Sincerely yours,

Max Fink, M. D.

Professor of Psychiatry

�</text>
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                    <text>September 16, 1986
Gian Carlo Salmoiraghi, M.D., Ph.D.
Hahnemann University
230 North Broad Street
Philadelphia, PA 19102
Dear Dr. Salmoiraghi,

.
..
—

awn—vvmnmv.

”7w.”

—-r--w

i am pleased to submit this letter of recommendation on behalf of
Professor Michael A. Taylor, whom [have known for almost two decades, and who
is being considered for the chairmanship of your Mental Health Sciences
Department. I first met Mickey when he was a resident at New York Medical
College. Among a group of outstanding students, he was already an independent
thinker and careful worker. He designed and carried out research for which he was
awarded the prestigious A.E.Bennett award of the Sosiety of Biological Psychiatry.
After a tour in the U.S. Navy, where he also published important clinical research
studies, he returned to join our faculty at Stony Brook.
He took over a standard state hospital ward and within a year, it was an
outstanding study and research unit. He was rapidly promoted to Associate
Professor and then was invited to Chicago, where he became Professor and

Chairman.

MWWWWl-uwul.

in research, Mickey is an outstanding clinician and phenomenologist. He
and his associate, Richard Abrams have led a re-assessment of the genetic and
familial contributions to clinical phenomenology; the classification of
schizophrenia and catatonia; and the neuropsychoiogical consequences of subtle
brain damage, both generalized and localized. Their independent thinking and databased studies are outstanding.
in teaching, his texts are excellent. Both his Neuropsvchiatric Mental
Status Examination and General Hospital Pgghiatgy are innovative and important
texts, widely used in teaching psychiatric residents. He is an oustanding lecturer.

As for his administrative abilities, these are also excellent. i watched the

Wyw—w-w.

development of the teaching unit at the Central lslip Psychiatric Center. 1 have
visited the units in Chicago. And, lam amazed by the continued productivity of his
students and associates.
can think of few psychiatrists in the U.S. who match Mickey's talents as a
clinician, researcher, and teacher, and i recommend him heartily for the
chairmanship. it will be a pleasure to have him closer to New York.
i

.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

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                    <text>September 16, 1986
Walter Sannita, M.D.
Laboratory of Neurophysiology

Universita
le Benedetto XV

V.

l-l6l32 Genoa, Italy

Dear Walter,
Martha and

had looked forward to your visit; we regret that it was a
family tragedy that kept you from us.
I

would very much like to see you in the fall. My son is planning a
wedding celebration the weekend of November 21-23; and we will probably be
away for the Thanksgiving holiday period of November 27—30 as well. But we should
be in New York from December 1 until December 8, when lam scheduled to attend
the ACNP meetings in Washington, D.C.
We

The ACNP meetings are followed by meetings of the CINP in San Juan,
Puerto Rico December lit-l7 and iam scheduled to be in San Juan on Saturday
evening, December 13. Turan ltil is organizing a session on £86 imaging in San
Juan for Sunday, December '14 at the Caribe Hilton in San Juan. If
you and Titty
would like to attend, lam sure he will be an excellent host.
Would you come to New York the first week in December? Best would be
end of that week, and we can socialize on Saturday, December 6 in New
the
near
York City if you like. Or, would you like to include a visit to Washington, D.C.
as
well, for the next week?
'

Let me know what is best for you.

My

best regards.
Sincerely yours,
Max Fink, MD.

Professor of Psychiatry

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                    <text>September 23, 1986
John Straumanls, M.D.
Department of Psychiatry
Louisiana State University Medical Center
PO Box 33932
Shreveport, Louisiana 71130
Dear John.
am writing this letter of recommendation on behalf of Dr. Fred Struve
who is considering an appointment in your department. 1 have known Fred and his
work for more than two decades, since he assumed responsibility for the EEG
research programs at Hillside Hospital. When I left Hillside Hospital in 1962,
Donald Klein assumed responsibility for the Department of Research and appointed
Fred in 1966 as associate, and in 1968, as Director of EEG at the hospital.
1

Fred was trained by Fred and Erna Gibbs in Chicago. and developed skills
and interest in EEG topography in relation to behavior. in numerous studies, he
sought to relate EEG patterns to emotional disorders, and his work on the BMitten, ill and ﬂ, and dysrhythmia patterns to suicide ideation, tardive dyskinesia,
and schizophrenia are among the most secure in our field. He has an established
track record with NIH grant committees, and an extensive publication history.

it 1977, he was appointed Associate Professor in this Department at Stony
Brook, and in 1983, he became Professor at Eastern Virginia Medical School.
am pleased to heartily support his application for appointment as
Professor at LSU; he is a capable and innovative researcher, and an established
teacher. He is eminently capable of developing research using the new topographic,
multi—lead EEG analytic systems.
1

Good luck in your work

at

LSU. My regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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TW'

September 25, 1986
Nathan B. Epstein, M.D.

Department of Psychiatry
Brown University

Providence, R102912
Dear Dr. Epstein,
I am writing with regard to the consideration being given to the promotion
of Barry Fogel MD. to the ram of Associate Professor. 1 have known Dr. Fogel for
about three years through his interest in the problems of the elderly and the
development of a medical/surgical psychiatric unit. For his fellowship in geriatrics,
Barry consulted me with regard to the collection and analysis of the data of the
ECT treated cases.

h

our association, I found him knowledgeable and enthusiastic. He is well
read and has a historical and political perspective on the treatments of the elderly.
His experience in treating patients in the medical/surgical unit has given him a
unique will and the assurance to manage these difficult cases well.
i am unable to assess his teaching skills, as Ihave not had an opportunity to
observe him in a lecture or conference situation.
His skill as a clinician and his scholarship are important assets and

encourage an enthusiastic recommendation for his promotion. i believe that his
record would be considered favorably in this Department, and with that in mind, i
heartily endorse the favorable consideration of his application.
Sincerely yours,

Professor of Psychiatry

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                    <text>October 3, 1986
Louis A. Wienckowski, Ph.D.
5911 Holland Road
Rockvilie, Maryland 20851
Dear Lou,
Enclosed is my full C.V., as you requested.
What is not cited in this record is the extensive interaction with fellow
scientists. Much credit must be given to my co—workers and students, notably
Robert L. Kahn, Ph.D., Max Pollack, Ph.D., Donald F. Klein, M.D., Joseph Jaffe,
M.D., Turan M. itil, M.D., Donald M. Shapiro, D.Sc., Richard Abrams, M.D.,
Michael A. Taylor, M.D., Alfred M. Freedman, M.D., Rhea Dornbush, Ph.D., and

Jan Volavka, M. 0., Ph. D. among many others. I am particularly proud that many of
these co—workers are independent investigators of national and international
renown.

Good luck in your work. I
My

trust Iwill get a chance to see the final product.

regards.
Sincerely yours,

Max Fink, MD.

Professor of Psychiatry

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                    <text>‘

October 3, i986

Dr. Brice Corder
College of Liberal Arts, $5107
Arizona State University
Tempe, Arizona 85287

Reid Rick D'Alli
Dear Dr. Carder,

lam pleased to write this letter in support of the application by Mr. Rick
D'Alli for admission to medical school. i first met Rick as a friend to my son, Dr.
Jonathan Fink of the ASU Department of Geology. Rick was a science editor for
KABT-TV in Tempe.
'

in 1984, he was asked to develop a science report on depressive illness and
its treatment, and he asked for my help. He knew that both in my practice and
research at this University, lhad an interest in the treatment of depressed patients
with drugs and convulsive therapy. hltially i demurred. Such requests are fairly
frequent, and my experience with TV and other media reporters has been uniformly
unfavorable; too many reporters approached treatment for its sensationalism and in
a desire to present a balanced' view of a 'controversial' topic, shaded their
questions so as to be unfavorable to an effective treatment. i suggested that Rick
read some articles first and call me back if he was still interested.

short while later, he called again and asked questions in a knowledgeable
and friendly manner, ensuring my interest and support. He developed a program,
agreeing to come to New York to film an interview with me and the treatment of
patients. When the report was produced, he sent me a copy. I was surprised by the
quality of the tape, the balance in the interviews, and the excellence of the
presentation. Some months later, he called to say that a segment of the tape was
accepted by the MacNeil/Lehrer News Hour. That viewing was national, and soon
thereafter, i understand that the videotape was given a national award for
A

excellence.

u.—

v,—u-...—~wv»...._.

W'I'ww'T—um'a—v

-

‘mu-WWN-wmw-

qr-

We began to use a copy of the MacNeil/Lehrer version of the tape in
educating our patients and their families about depression and its treatment, and
found it most helpful. in 1985, [was asked by another scientist whether [would like
to make a new tape, specifically for the education of psychiatric trainees as well
as patients and their relatives. 1 agreed and called on Rick to produce two
videotapes. “mesa were made and have since been distributed widely. The reviews
have been most salutary.

�arm-«A.».m:

Re: Rick D’Aiii

My

Page 2

During this time, Rick talked to me about his wish to enter medical school.

first reaction, as a member of the Admissions Committee of this University,

was to dissuade him, on the grounds of his age and the long time since he had been
a 'student'. He applied, nevertheless, without sucCess. But in his interviews at Stony
Brook, he was given high marks. The principal question was his ability to return to

the classroom.

i understand

‘

'

that he has attended classes this past year, updating his pre-

medical requirements with excellent grades. His MCAT scores have improved.
-w‘

um

'W'M’n“'w'

i believe that Rick is sincere in his desire to become a physician. While I
would see him combining his medical skills with those he has in communication, and
hoping he would continue to interpret our science to the laity, it is more likely that
he will seek a clinical career.

.&lt;-'\w-—-'r'-"

_.

.

.7“...

vy-

m.-¢—.v_.—.‘-.

—~

-..,.uw.......m....~mrm

v.
-

Rick is a delightful human being. He is warm, friendly, considerate, and
intelligent. He put my patients, many of whom were quite ill, at ease, and obtained
their Cooperation for a project which was of little direct benefit to them. He
grasped medical terms and concepts quickly; and did not seek to direct the
presentation of complex material by his prejudices; rather, he encouraged us, the
professional and the patients, to speak openly.
He has broad interests in literature, science, music, and the arts. His wife
is mature and on two occasions, discussed the impact of Rick's schooling on their

lives.

I

found her most supportive of his aim to become a physician.

Rick is more mature than most of our candidates. But his maturity is an
i believe he is sincere in his desire to practice medicine, and i heartily
endorse his wish. i recommend his admission to medical school with much

asset.

enthusiasm.

Sincerely yours,

.mr-u—W-nm

my...“

Max Fink, M. D.

Professor of Psychiatry
Attending Psychiatrist
University Hospital

,

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                    <text>~W-v-v

.V

TIN-7m

W

..

VW‘an-u

my"

October 9, 1986
Gordon C. Miller, M.D.
Sacred Heart General Hospital
1255 Hilyard Street
PO Box 10905
Eugene, Oregon 97MO
Dear Dr. Miller,
am pleased to submit this note in support of the application of Dr. Paul
Helms for hospital privileges at Sacred Heart General Hospital. Iworked with Paul
during the past few years while he was an attending psychiatrist on the in—patient
service at University Hospital.
I

He is a well trained and experienced psychiatrist. His evaluations of
patients and recommendations for treatment were excellent. He is well able to
identify patients in need of electroconvulsive therapy. On a number of occasions,

when lwas absent from the University, he took over the ECT unit and treated the
roster of patients with skill and without mishap. i believe that he is capable of
treating in-patients with all the disciplines that we have available, and heartily
recommend him for such privileges.
Sincerely yours,

Max Fink, M.D.

Attending Psychiatrist

�</text>
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                    <text>October 9, 1986
Prakash N. Desai, M. D.
iilinois Psychiatric Society
20 North Michigan Avenue
Suite 700
Chicago, Il 60602
Dear Dr. Desai,

lam pleased to submit this letter of recommendation for Fellowship in the
American Psychiatric Association on behalf of Professor Michael A. Taylor, whom i
have known for almost two decades. 1 first met Mickey when he was a resident at
New York Medical College. Among a group of outstanding students, he was already
an independent thinker and careful worker. He designed and carried out research
for which he was awarded the prestigious A.E.Bennett award of the Sosiety of
Biological Psychiatry. After a tour in the 0.5. Navy, where he also published
important clinical research studies, he returned to join our faculty at Stony Brook.
He took over a standard

state hospital ward and within a year, it was an
outstanding study and research unit. He was rapidly promoted to Associate
Professor and then was invited to Chicago, where he became Professor and
Chairman.

h

research, he is an outstanding clinician and phenomenologist. He and his
associate, Richard Abrams have led a reassessment of the genetic and familial
contributions to clinical phenomenology; the classification of schizophrenia and
catatonia; and the neuropsychological consequences of subtle brain damage, both
generalized and iocalized. Their independent thinking and data-based studies are
outstanding.
in teaching, his texts are excellent. Both his Neurgpgychiatric Mental
Status Examination and General ﬁgspital Psychiaﬂ are innovative and important
texts, widely used in teaching psychiatric residents. He is an oustandlng lecturer.
As for his administrative abilities, these

are also excellent. i watched the
of
the
development
teaching unit at the Central Islip Psychiatric Center. 1 have
visited the units in Chicago. And, lam amazed by the continued productivity of his
students and associates.

lean think of few psychiatrists in the [1.5. who match Mickey's talents as a
clinician, researcher, and teacher, and i recommend him heartin for fellowship.
Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

�</text>
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                    <text>n

E

October 9, 1986

i
5

I

[

i

TO:

Fritz Henn, M.D., Ph.D.

FROM: Max Fink, MD.

Subject: Promotion of Emmeline Edwards, Ph. D. to Assistant Professor

E

E

i
i

i
E

i
E

E

i

i
i

I am puzzled by this request for advice as to promotion to a rank of
Assistant Professor of a scientist in the Institute. It has been my understanding
that the recommendation to this rank did not require Departmental consensus,
particularly for appointments in the Institute with the 'research' modification of
title. Or, is the proposal lierally correct, that Dr. Edwards is being proposed for
promotion to an ‘unmodified' appointment in the Department?

It a Departmental consensus is required, it would be helpful to distribute
of
copies her gig, preferably with letters "from referees who know and can evaluate
her work in relation to that of others with her academic credentials. May we also
have recommendations from our own faculty, such as Nisson Schechter and Bob
Hitzeman, who may be expected to understand her contributions?

,1 .v...r,,.

�</text>
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    <fileContainer>
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                    <text>...

..
.A

__,m

October 10, i986

vvww

my"...

-:w.—.e.‘,..._

Herbert Pardes, M. D.
Department of Psychiatry
College of Physicians at Surgeons of Columbia University

722 West 168 Street
New York City 10032
w-wwrvv—mwm-u—

vaw—v-p—

,y—"v—n

WWW-W.

-w——m~——.

VIN—rvvv'

,
..,,,

wwa‘vnr'www

-

m

Dear Herb,

it is a pleasure to endorse the recommendation for promotion to the rank
of Associate Professor of Clinical Psychology (Psychiatry) for DR. HAROLD
SACKEIM. I first met Harold about five or six years ago, when he was first
planning his studies with Sid Malitz in convulsive therapy. He sought my advice and
l was impressed first with his knowleae and that the proposed program was a good
one. Later, when he and Sid proposed a conference on ECT at the New York
Academy of Sciences, 1 was consulted. in the past year, we have collaborated in
editing the new journal CONVULSIVE THERAPY. Finally, ihave worked with him
at numerous conferences on ECT.

(Sw-

Harold is intense, dynamic, and ambitious. He came to the field of
convulsive therapy just a few years ago, and already has made his mark as a leader
in the quality and quantity of his studies. He has proposed ingenious hypotheses of
the mode of action of BCT, and has stimulated considerable work and debate. He is
clearly one of the nation‘s outstanding researchers in this esoteric and
-

controversial topic.

He is an excellent

lecturer; has handled himself well

in public debate, even

fending off the challenges of hostile reporters with considerable skill.

addition to his contributions in EC'l‘, he has done innovative research in
perception and his contributions are the basis for considerable ongoing study.
In

in his knowledge, drive, and skill, he is outstanding and

recommend his promotion with enthusiasm and without reservation.
My

iam pleased to

best regards.
Sincerely yours,
Max First, MD.
Professor of Psychiatry

»-

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                    <text>-

October 11, 1986

.“W—Wr

Alexander Gralnick, M.D.
High Point Hospital
Port Chester, New York 1057 3

~

Dear Al,

ﬁwvvm—m-Nwmwww—mx—wmrww

Thank you for the fine old reprints. I very much enjoyed reading the article

on meningioma, as this remains an active topic of research and argument.

Mark Altschule‘s recall of the milieu vs shock therapy controversy hinges
on an assumption that he makes that modern 'shock therapy' has as poor a
clinical efficacy as the swing therapies of old. He is probably correct in his
estimate of insulin coma, but incorrect in the modern use of convuslive therapy.
With the introduction of psychotropic drugs, it was pomible to develop a strategy
of treating the severe mentally ill with the most effective intervention for their
syndrome —and, as you well know, the efficacy of ECT in patients with sevre
depressions and catatonia remains unmatched by all other therapies, including
milieu and psychotherapy.

-

wvr-zuu—w»

continue to look for old articles and books from the inception of the
'modern' shock therapy era, and I will be grateful for any other books or articles
you may find in your archives or shelves.
I

,

My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

'

P.S. Irecently wanted to use Metrazol in a patient with a very high seizure
threshold, only to find that it has been withdrawn from the market by the FDA.
After some travail, I filed the appropriate papers and now have an IND for
Metrazole research. In a trip to Hungary this summer, I found that Metrazol was
still in use in their mental hospitals, precisely for the cases for which I wish to use
it. (With anesthesia, however.)

�</text>
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                    <text>October 20, 1986
Alan J. Gelenberg, M.D.

Psychiatrist-dn-Chief

The Arbour
49 Robinwood Avenue
Jamaica Plain, MA 02130
Dear Alan,
A friend who attended the recent Harvard course in psychOpharmacology
shared the syllabus with me, when he told me of how he pleased he was with the
course. in reading some of the sections, 1 came acrm your notes regarding NMS
and was surprised to find that you included ECT among the less accepted
treatments for this dborder.

treating

It is my understanding that ECT has been used, apparently successfully, in
NMS. It is usual that ECT k a treatment of last resort, so that it is not

unexpected that there has been me death emaciated with its use (as you note). But
there have also been successes. In a recent extensive review (Pearlman, C. ,1. 9132'
257—273, 1986) the author gives nine citations to favorable
Psychogharm
outcomes and two to unfavorable (page 268). In the table, ECT is cited as useful in
10 cases, negative in one, and equivocal in two. In the uncontrolled reports cited to
date, ECT is as useful as other suggested interventions.
_6_:

Harvard students deserve the best data.
My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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                    <text>.4

‘2‘.

October 28, 1986
Dr. Heinrich Sauer

Psychiatrhcbe Universitltsklinlk
Vow-8m 4
6900 Heidelberg
Federal Republic of Germany
Dear Dr. Sauer,
In your

cite a report by C. Ernst
1396-1405, 1982. attempted to obtain thk article from

abstract for the

1986 CINP meeting, you

in Schweiz. Arzteztg. :49:
our library, and have been unable to do no.

I

Would it be possible for you to send me a copy of the

complete citation?

article and the

Many thanks. My regards.

Sincerely yours,

Max Pink, M.D.

Profemor of Psychiatry

�</text>
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                    <text>October 30, 1986
Richard D. Weiner, M.D., Ph.D.

Psychiatric Service

VA Medical Center
508 Fulton Street

Durham, North Carolina 27705

Dear Rich,
SCIMATE has three major programs— Searcher, Manager, and Editor. We do
not use the Searcher; the Manager is the main operating system for data entry and
retrieval; and the Editor h the special program for extracting citations in styles
for different journals. The Manager is the main program, and I enclose a
description of it; as well as an article about the Editor.
My files are divided into blocks of 1000 citations each. I searched the most
recent files for WEINER and part of the output is enclosed so that you can see the
style of the records. The main advantage of SCIMATE is that one need not identify
descriptor terms; all terms in any record may be the basis for a search since the
strategy is a string search throughout all the records; no thesaurus is created.

If you or one of your amelates wish to visit, we would be pleased to
demonstrate our system, and make copies of the files for your use.
The SCIMATE hotiine number is 800 523 4092.
My

regards.
Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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              <elementText elementTextId="64783">
                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                  <elementText elementTextId="107093">
                    <text>fire}?

November 10, 1988
Donald F. Klein, M.D.
New York State Psychiatric Institute
722 West 168 Street
New York City 10032
Dear Don,

received the note from Robert Clampitt and agree to being listed on the
NAFDI referral list. The emphasB on psychopharmaeology is well defined, but it is
not clear, from the limited material sent me, what the attitude of members of the
Foundation toward ECT may be.
I

If, in addition to fund-raising for research, the aim is to educate the
families and patients as to all available therapies, perhaps attention shouiqnbe paid
to the role of 801‘. All too often, referrals to our center initially refuse ECT when
it is deemed useful, usually because their physicians or families are antagonistic.
Good luck in this educational

effort.

My

best regards.

Sincerely yours,
Max Fink, M.D.

Profeuor of Psychiatry

�</text>
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            <elementTextContainer>
              <elementText elementTextId="64772">
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          <element elementId="48">
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              <elementText elementTextId="64773">
                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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            <elementTextContainer>
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                    <text>October 30, 1986
Bernard Let-er, M.D.

Jerusalem Mental Health Center
PO Box 140

Jerusalem, Israel
"

.1

(u-Biubv‘éi-sié

.

Deer Bent,

,

We would be pleased to have Baruch Staph-a visit with us on December 5.

Stony Brook h rather far out on Long Island and it would be difficult to get
here by train from Queens by 8:30 a.m., in time to work with us in the treatment
room. There are other options. When he arrives in New York, have him call me at
my offlee in the morning (516- 444 2929) or at my home in the late afternoon or
evening (518- 862 6651). If there is a problem in reaching me, he should eat my
secretary to call Larry Greenberg, my woclate, and he will be able to make the
arrangements. It would be preferable for him to come out Thursday evening, if that
is possible, and join us for dinner.
Have a good trip to the 0.8. My best regards.

Sincerely yours,

Professor of Psychiatry

�</text>
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          </element>
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                    <text>November 14, 1986
Norman Endler, Ph.D.
Department of Psychology
York University
4760 Keele Street
Downsview, Toronto Canada M3J 1P3
Dear Norman,
Enclosed is a copy of the recommendations regarding electrode placement
Abrams
and myself.
by
The best citation for the consensus conference report is:
1985.

Consensus Conference. Electroconvulsive therapy. JAMA 153: 103-108,
,

Your note implies that you have obtained the necessary support for the
Depression Conference in Toronto in October 1987. I would appreciate a note as to

the dates.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>November 20, 1986
John Kane, M.D.

Director of Research
Hillside Hospital

P.0.

Box 38

Glen Oaks, New York 11004
Dear John,
Enclosed are the two reports of our studies of clozapine, both published in
1979. I was not satisfied that we had done an adequate analysis of clozapine's EEG
profile. I considered it an important study; first, because the compound was being
reported as successful as an antipsychotic, and secondly, because if its
antipsychotic activity is proven, and its EEG profile is outside that of established
antipsychotic substances, it would deserve a place as a unique prototypic substance
in EEG classification schemata, the head of a new class. Gil Honigfeld was unable
to accommodate my furtha' studies, but they should still be done.
I also enclose a copy of Morihisa's review of the EEG data in schizophrenic
patients. The review ignores most of the earlier BEG material, but it reﬂects the
more recent studies well.
My

regards.
Sincerely yours,
Max Fink, MJ).
Professor of Psychiatry

�</text>
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                    <text>December 19, 1986
Robert Michels, M.D.
Department of Psychiatry
New York Hospital- Cornell Medical Center
525 East 86 Street
New York City 10021
'

Dear Bob,
1

am pleased to write in support of the promotion of Henry J. Lefkowits,

M.D. to the rank of Clinical Associate Professor of Psychiatry.

first met Hank during his residency at Hillside Hospital. He was an
enthusiastic student, who participated actively in our clinical research. projects. He
was interested in studies of staff attitudes toward the somatic therapies,
particularly to the introduction of psychoactive drugs and the continued use of
insulin coma. He was an assessor in our insulin comaochlorpromazine random
assignment study (which sounded the death knell of insulin coma), and a principal
investigator of our studies of flurothyl (helping us define the efficacy and safety of
this chemical induction of seizures).
1

.

After cornpleting his training at Hillside, he went into private practice in
Westchester County where he developed a good following. He continued his clinical
teaching. From time to time, he has asked my advice in the management of
patients and my recollection is that the patients had been treated well. The records
were uniformly excellent.
He is thoughtful, sincere, honest, dedicated, and responsible. He is a fine
clinician, with excellent skills in diagnosis and treatment. He has a modest
research record, and a good teaching record. it would be a pleasure to endorse his
promotion at this University, and i am delighted to recommend his promotion at
Cornell, as well deserved.
My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>December 20, 1986
Walter Sannita, M.D.
Laboratory of Neurophysiology

Universita
V. le Benedetto XV
1-16132 Genoa, Italy
Dear Walter,

What has happened? I expected to see you last month in New York, and
then last week in San Juan. I am disappointed. I trust all is well in Genoa, and that
you may still make a trip West soon.

The recommendation for your appointment at this University has been
approved by various committees and is now before the final APT committee
(Appointments, Promotions 6t Tenure). The recommendation for appointment was
made for December, 1986; we anticipate no difficulty.
Guido gave a good overview of your EEG and blood ﬂow work in a session
Monte
Buchsbaum on brain mapping techniques at the CINP in San Juan. We
by
run
showed some very early figures from the Itll system, of patients treated with EC!"

and with isoﬂurane.

Our engineer, John Pavel, has built a new special purpose device which
does online FFT analysis of four EEG channels for monitoring anesthesia and drug
effects. The system is much less expensive than any demonstrated in Santa
Margherita, and I an anxious to show it to you. It may be a good device for you to

try.

pleased.

CONVULSIVE THERAPY has completed its second year of issue. I am so

At this holisay season, Martha joins me in wishing you and Titty and your
daughters, good health and happiness in the coming year.
My best regards.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>it!

January 22, 1985
Max Hamilton, MD.

Psychiatry Annexe
University of Leeds School of Medicine
30 Clarendon Road
Leeds L52 9N2

England

Dear Max,

Martha and I, as well as many of my patients, enjoyed your visit this past
week-end. After you left, 1 completed the review of the meeting, and sent it on to
the publisher. Vol I No. l is now complete. Thank you for your help. I enclose a
draft for your information.
Thank you also for the updated copy of SCHIZOPHRENIA. It remains a
valuable contribution to our limited knowledge about this dread disorder. In reading
the section on treatment, I am disappointed with the short shrift given ECT. The
young man you met on my service, Mr. White, clearly suffers from this disorder.
The remarkable change in his behavior was not achieved with any drug
combination, and when ECT was proposed, as a 'last-ditch effort', his family
demurred for more than two months. Now they are delighted, and even if the
improvement is transient, and allows him to be home for only a few weeks, it still
remains a miracle to them.
I

have taken the liberty of writing to your publisher.

My

best regards, and my thanks for your help in CONVULSIVE THERAPY.

Sincerely yours,
Max Fink, M.D.

�</text>
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                    <text>,w,

3.“

art,

imvw

T
m.“

'1’v/V")r&lt;n

——-

January 23, 1985

w‘wuvv-r—v

,

new

.vwm—

Walter Knopp, MD.
Department of Psychiatry
Ohio State University

ll73 West 12 Street
Columbus, Ohio l432l0--1228

Dear Dr. Knapp,
I attended the ECT conference and prepared a summary of the
proceedings, for publication in the News and Notes section of the new journal,
CONVULSIVE THERAPY. Volume 1 number 1 is at the publisher's and will appear
in March. I enclose a pre—publication draft of that summary for your use, as well
as a copy of my report.

Sincerely yours,

Max Fink, MD.

Editor

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                    <text>January 25, 1985
Alexander Gralnick, M.D.
High Point Hospital
Port Chester, New York 10573
Dear Alex,
Thank you for the many reprints that you have sent me, and especially for
the report of the experiences of EC!" by a practicing psychiatrist. I have used this
report, on occasion, to help families with their decision-making.
Sid Malitz organized a fine 3—day meeting on ECT in New York City last

week. The discussions were lively, and even representatives of the angry public
were given a chance to ventilate. This meeting, and the forthcoming consensus
conference organized by NIH, indicate that ECT, unfortunately, remains alive in
America. I say 'unfortunately', because its very existence after 51 years reflects
our lack of progress in developing better treatments for major depressions.
When last we met, you said that you were making a film of your ECT (and
insulin '2) experiences. When the weather is better, perhaps we should view it
together ?

The papers for the first issue of CONVULSIVE THERAPY are at the
publishers, and it should appear in March. I held a meeting of the Board of Editors
and they seemed quite enthusiastic.
My

best regards.
Sincerely yours,

Max Fink, M.D.

�</text>
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                    <text>January 25, l985
Dear Harold,
It was kind of you to ask about old psychiatric books.
following:

I

am looking for the

Meduna, Ladislaus von. Die Konvulsionstherapie der Schizophrenie. Carl Marhold
Verlagsbuchhandlung, Halle a. 5., 1937, 121 pp.

Wagner-Jauregg, Julius. Fieber- und Infektionstherapie. Ausgewahlte Beitrage
1887—1935. Verlag ﬂlr Medizin, Weidmann 6: Co., Wien, Leipzig, Bern. 1936,
299 pp.

Wagner-Jauregg, Julius. Lebenserinnerungen. Herausgegeben und erganzt von L.
Schbnbauer und M. Jantsch. Springer-Verlag, Wien, 1950, 187 pp.
Sakel, M. Neue Behandlungsmethode der Schizophrenic. Perles, \Vien, 1935.
These books are out-of-print and are among the bed-rock documents of the somatic

therapies era.

ECT is having a resurgence of interest. 1 am told that one article on ECT
appeared in a Boston newspaper science section on January 114 and another is
scheduled to appear either this week or next. There will also be an article in the
local papers, reflecting the recent meetings in New York.
All seems well here. We did miss you during the New Year's celebrations
Alice
and
at
Marty's. it was fun, and the weather was reasonable.
My best regards and my thanks for your kind

efforts.

�</text>
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                    <text>January 27, 1985
Petr Skrabanek, Ph. D.
Department of Community Health
University of Dublin
196 Pearse Street
Dublin 2, Ireland

Dear Dr. Skrabanek,
It was kind of you to send me a reprint of your arguments on the
biochemistry of schizophrenia. As before, I enjoyed your review. I have little faith
in the present biochemical or animal models of mental disorders, but they seem
necessary steps in our learning. Both Horrobin and Ackernecht reflected my
appreciation of the problems.
I had already cut out your note in Lancet on "Holy Dread" which
found delightful.

I

also

you will see from the letterhead, I have succumbed to temptation and
the
invitation of the publisher of Raven Press, Alan Edelson, to edit a
accepted
journal CONVULSIVE THERAPY, which is a quarterly, with the first issue to
appear in March. While most of the space will be dedicated to refereed research
reports, there is room for innovation. ECT has just passed its 5lst birthday, and its
very persistence is a challenge to our understanding. For almost three decades,
research interest lagged, but lately there has been a re-awakening. In 1978,
Timothy Crow challenged the belief that a seizure was necessary to the outcome
and thereby launched six or more studies in Britain. While most observers now
accept that either the seizure or something accompanying the seizure is necessary
for maximal antidepressant effects, Tim still believes that good nursing care will
do as well. There are other beliefs which are as contested, not the least of which is
the range of theories of the antidepressant efficacy of ECT. The two principal
(‘serious') theories are those of Grahame-Smith, Costain, Green, and Modigh on the
neurohumoral theory; and Ottosson and myself on the neuroendocrine.
As.

I do not know how much experience you have with the ECT
process, nor
whether it is a feature of your University landscape. But should you wish to tackle
the ECT beliefs, consider a contribution to this new journal.

My best regards.

Sincerely yours,
Max Fink, M.D.
Editor

�</text>
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                    <text>January 26,

19 35

Morton F. Reiser, M.D.
Department of Psychiatry
Yale University School of Medicine

25 Park

Street

New Haven, CT 06519
Dear Mort,
I

am pleased to write this letter strongly endorsing the promotion of

DENNIS CHARNEY, Md). to the rank of Associate Professor of Psychiatry. I have

known of his work since his important reports with Nelson on delusional depression.
As I hold an IND for research studies with mianserin, I have also cooperated with
him in making the substance available to him, and in providing the FDA backup for
his studies. And, I have come to know him from his presentations at the APA and
ACNP.
His studies of delusional depression have been useful in defining the

characteristics of patients (with delusions) who do not respond as anticipated to
tricyclic drugs, and for whom other treatments are required. His subsequent work

with clonidlne, yohimbine, mianserin, haltrexone, and most recently, the trials of
lithium and antidepressants in the treatment of refractory depressions are
innovative, thoughtful, and logically derived from monoaminergic theories of
antidepressant drug actions. His studies are well designed, and on the occasions
when I have had the opportunity to review them prior to publication, have had no
difficulty in recommending their publication.
Dennis is clearly one of the outstanding students of depressive disorders,
with a keen grasp of modern theories and research design. My only regret is that he
has not (as yet) shown an interest in convulsive therapy, for I am confident that he
would make important contributions to ow understanding of that therapy which
remains the most effective treatment of delusional depression.
My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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mm.--.-..m-w1

March 9, 1985
Mr. Peter Irwin
Medical Research Department
Sandoz Inc.
Hanover, New Jersey
Dear Peter,
I read the article by Glassman
st 31. and react much as you did. There is
as much evidence that drowsiness was the active component in the effects on
craving as that a specific biochemical process was responsible. But it seems
difficult to attack the conclusions based on these data alone. I seem to recall that
our subjects, given clonidine, also had a significant degree of drowsiness, as did our
subjects when given higher doses of diazepam and bromazepam. Also, the time
course of our experience would be applicable.

In order to do justice to a critique of this report, I think we would have to

extract some of our own data, see if they are relevant, and make a more

compelling case than your argument. The dependence on the PDR does not have
much cachet; indeed, it is not considered a relable source of scientific information,
being seen as a negotiated average of sentiments between legal partisans from
industry and less-than-competent administrative bureaucrats. Such an argument
may have place in the board-rooms of industry or the law courts, but hardly in
SCIENCE.
am so busy with convulsive therapy, that Glassman's peccadillos and the
pseudo-science of SCIENCE influence me little.
I

The historical paper which I wrote for IPEG in memory of Bente has been
published. I enclose a copy for your bulletin-board.
The IBM 1800 is acting up again, and i am getting desparate to end it all,
either by decapitating the machine and chucking all the work, or by replacing it
with the H21 IBM-AT based system. I am visiting HZI next week to see if there is
some fire where there has been nil-smoke for so long.
Meanwhile, Itil has convinced Hoffmann-La Roche that he can distinguish
three
formulations of Valium; they have petitioned the FDA to change the
among

rules on generics and look-alikes by requiring pharmacodynamic equivalence as well
as pharmacokinetic and chemical dissolution equivalence. The petition went in two
weeks ago; you can read all about it in the pink sheets. if the FDA is convinced and
changes the regulations, industry will need our pharmaco-EEG studies as much as
they needed the sleep-EEG studies when the FDA accepted such studies as
evidence of soporific activity. If the FDA acts favorably, I will get my new AT
system; and you could go into business for yourself with little investment.
Keep the faith. My best regards.
Sincerely yours,
“it

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                    <text>w-

March 14, 1985
Dear Gerry,
Thank you for your note about answering public inquiries.

accordingly.

it

I

will act

Please accept this copy of Feynman's book, with my compliments. Ifound
that l have sent a few out to some friends.

so delightful,

also enclose a newsletter sent me by Arnold Mandell. For the past 20
years, Arnold Mandell has sought the Rosetta Stone to psychiatry in mathematical
models of brain function. i have always found him obscure and confused, and he has
always presented himself as a California guru. His messages have left me
unimpressed. But he has been named to every prestigious award, including a
MacArthur brilliant scholar, so I have had to temper my reactions with the
admonitionJhat my lack of appreciation is probably a fault of mine. After all, he
could not total all the awards committees, or could he? As a founding fellow of the
American College of Neuropsychopharmacology —- a self proclaimed select group
of neuroscientists -- i receive his broadsides periodically.
A

Perhaps these equations have meaning for you.
My

best regards.
Sincerely yours,

‘-

�</text>
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                    <text>w-u

.

v

v

.---..

.~

_

v—vr

“rm.“

«7

‘7‘

w-r-‘?:"

arm

wm-hamwnnhc‘m

.:

.

March 14, 1985

Richard Weiner, M.D., Ph.D.
Department of Psychiatry

V.A. Hospital

Duke University Medical Center
Durham, North Carolina 27705
Dear Rich,
Each year, second year students at Stony Brook are given a
course on
Neuroscience, with some input from psychiatry. i am scheduled to give three
lectures on "EEG and Psychiatry" on April BO/May 1-2. The students will have had
lectures on CT, PET, and NMR scanning. I usually present ﬁgures from our
pharmaco—EEG‘ program and always a few slides about the slow wave
changes

induced by ECT.

i would like very much to show them examples of the
same EEG changes
with ECT using the multi-lead display which you are now collecting. Would
it be
possible to supply me, at my cost, with slides of a pre-ECT, post ECT 6 to 9, and
any other example of a display from your work?

Many thanks and my best regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

fl"?

-

'

Wﬂmn‘rﬂn‘""¥

arm

M:1¢“"V"‘

"(m-NIP

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                    <text>March 15, 1985
Alan Gelenberg, NLD.
Department of Psychiatry
Massachusetts General Hospital
Boston, MAssachusetts 02114
Dear Alan,
The citation you requested is:
Fink, M. CONVULSIVE THERAPY: Theory and Practice. Raven Press,
New York, 306 pp., 1979. (Unfortunately, the text is now out of print; when and if I
get to a re-write, it will be revised and updated, probably in 1987.)
Your other quesry is unclear, for articles about ECT for practitioners and
psychiatrists, but I carried out a small search in my files, and some that came to
mind, are listed on the attached review.
The first issue of CONVULSIVE THERAPY is at the printers and should be
on your desk by the end of the month. I have sent in most of the articles for the
second issue this week.
I

look forward to seeing you in June. My regards.
Sincerely yours,
Max Fink, MD.

Editor

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A.

“—7“.._..

May it, 1985
v—w...___W—w~—W~—.mwmewp

Barry Lebowitz, Ph.D.
National institute of Mental Health
Parklawn Building, Room llC-OB5600 Fishers Lane
Rockville, MD 20857
Dear Dr. Lebowitz,
i am writing with regard to the application for support of studies of
convulsive therapy (ECT) in the elderly, submitted by Dr. Barry 5. Pogel of the
Rhode island Hospital.

Dr. Fogel has consulted with me regarding his research program, and has
asked that 1 continue to act as a consultant, to respond to his requests for advice
and to meet with him up to four times each year to review the progress in his
studies. 1 am pleased to accept his invitation, and agree to work with him during
the study period.
’

i am particularly pleased to encourage these studies. In 1981, i
particpated in a symposium organized by Ed Faun on problems of psychiatric
treatments in the elderly. in reviewing the literature, 1 was impressed by how much
work needed to be done.‘P The studies proposed by Dr. Fogel are clearly needed.

Sincerely yours,
Max Fink, Md).

Professor of Psychiatry
*Fink, M. ECT in the elderly. in: C. Eisdorferand W. E. Faun (Eds.): Treatment 91
Psychopathology it; the Aging. Springer Publishing Co., New York, Chap. 7, 97111, 1982.

K’

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May 4, 1985

Barry 5. Fogel, M.D.

Director, Inpatient Psychiatry
Departments of Psychiatry and Neurology

Rhode Island Hospital

Providence, RI 02902
Dear Barry,

Thank you for the opportunity to review your protocol. It is interesting
and ambitious, and it is about the ambition reflected in many studies that I
anticipate the most criticism.
am pleased to work with you in developing these studies, and include the
necessary letter of agreement. For the curriculum vitae, I have marked up a copy
of the historical pages from my record and given you some of the more recent
citations which may be relevant to this application. These can be used to make up
the appropriate historical page in the application.
1

also include two reports that may be of particuir interest -- one by
Regestein and Reich that is in press in the second issue of CONVULSIVE
THERAPY; and one by Dr. Dubovsky that reviewed for Hosp 95 Commun Psych. i
presume the report is accepted; the copy is from my files, but it may not be cited
as yet.
1

Also, the most recent issue of JAMA (May 3, 1985; pg 2525-2529) has an
excellent article on the effects of ECT on ECG and serum cardiac enzyme levels
by Dec, Stern and Welch which must be cited in your application.
I have some specific comments on the protocol, and append these in
an
informal note. I hope these are helpful.

My

regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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                    <text>May 4, 1985
TO:

Dr. Fricchione

FROM: M. Fink

Subject: Grand Rounds, 1985-1986
I recently became acquainted with Barry Fogel of Brown University. He is
a bright young man with much to say. It may interest you to invite him to describe
his experiences with med/psych issues. A copy of his 91 is attached.

�</text>
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                    <text>May 5, 1-935

Michael E. Miller, MD.
515 W. 110 Street
New York City 10025

Dear Michael,
I have discussed your letter of May 1 with Dr. Henn, the
Department
Chairman. We are pleased that you are interested in working with us after your
residency is complete in June, 1986. As I discussed during your visit, it is difficult
to make a definite committment so long in advance, but we will be able to do so in
October. We will ask that you visit us, and meet the relevant members of the
faculty early in October, when we will be able to discuss the assignments and
openings for July, 1986. We will orange that you meet Dr. G. Fricchione (C at L),
Tom Craig (CPD), and Dr. Henn at that time.

Arthur Gabriel gave a good overview of the medical aspects of ECT at the
sessions
held a few weeks ago at the Carrier Clinic. He must be impressed
teaching
with your data as he quoted the findings as encouraging him to now use atmpine in
his treatments. How is the paper coming?
Went.

You should have a good experience

at Columbia. Let me know

My best regards.

Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

how it

�</text>
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                    <text>Wm

m

w...

June 3,

u. a

.m

.w—V

19 85

Howard W, Fisher, MD.
10

Sandcastle Court

Pueblo, CO 81001
Dear Dr. Fisher,

Your letter to the APA was forwarded to me for comment. You are quite
right that there has been an active anti-ECT lobby in this country, best exemplified
by the media atention to Peter Breggin and the repeated showing of "One Flew
Over the Cuckoo's Nest" and other anti-psychiatry films; by the legal issues in
California and Vermont; and by the willingness of many psychiatric leaders to
argue that 'after all, we all know that ECT is abused'. It is not clear what can be
done in one instance such as yours, other than by the usual legal maneuvers. To
that end, the legal firm that is defending your malpractice actions should be
acquainted with those of us in the APA who have served as consultants in defending
the actions of our members. Your lawyers should be given the names of the
following knowledgeable consultants:
Richard Abrams, Chicago Medical School, North Chicago, IL
Gary Aden, San Diego, CA
Fred Frankel, Beth Israel Hospital, Boston, MA
Sidney Malitz, Columbia University, New York, NY
Trevor Price, University of Pennsylvania, PA
Iver Small, University of Indiana, Indianapolis, IN
Richard Weiner, Duke University, Durham, NC
These men are active fellows of the APA and have ably defended legal issues on
behalf of other members with difficulties similar to your own.
As you already have discovered, the APA lacks a central agency to help
members
with ECT problems, despite the fact that the Task Force in I978
our
recommended a continuing committee to attend to such matters. You may wish to
write a letter reminding the present president, Dr. Nadelson and the medical
director, Melvin Sabshin, of this deficiency.

Finally, there will be an NIH supported Consensus Conference on ECT in
Bethesda June 10-12. There is some hope that the conference will conclude with a
supporting document, similar to the APA Task Force report of I978. You may wish
to attend these sessions, as they are open to the public, and they may encourage
you not to despair.
Sincerely yours,

Max Fink, MD.

Professor of Psychiatry

�</text>
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                    <text>4_

.

.

VV‘qnt'V‘V-n'

June

‘1,

1985

Alfred Bertagnoll, M.D.
Catholic Medical Center
100 McGregor Street
Manchester, NH 03102
Dear Dr. Bertagnoll,
Dr. T. Meehan was a staff psychiatrist at the V.A. Hospital in Northport a
few years ago. During that time, ECT was administered at the V.A. under the
general supervision of consultants from the Department of Psychiatry of SUNY at
Stony Brook. Before Dr. Meehan joined the staff, my associate Dr. Richard Abrams
had set up the unit, and after he left, I supervised it.
During Dr. Meehan's service at the V.A., he carried out treatments in this
and
was considered sufficiently adept that he continued to treat patients for a
unit,
I
time. cannot recall a time when I observed his treatments.
To the best of my recollection, Dr. Meehan did not have any formal
in
training convulsive therapy at this University. The 'training' was passed on from

one therapist to the next. Nor can I recall the length of time that he 'ran' the ECT
unit, since such assignment was the responsibility of the clinical director, Dr.
Robert Derman.
As you well know, there is no formal accrediting process for ECT in the
United States. It was a recommendation of the American Psychiatric Association
Task Force that a continuing committee on ECT be established at the APA, to
develop guidelines for training; but the leaders of the APA have seen fit not to
create such a committee since the report was accepted in 1978. in this climate,
judgement as to Dr. Meehan's credentials must be based on your own criteria.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>August 5, 1985
Dr. Bracegirdle
Keeper of the Wellcome Museum

Science Museum

Exhibition Road
London SW7 2DD
England
Dear Dr. Bracegirdle,

I hesitate to write the following, as it may appear presumptuous to
you,
but in a recent visit to the Wellcome Museum, I was struck by an apparent error in
the panel #T32. As I have recently written a history of convulsive therapy, and
published an autobiography of Ladislas Mcduna, I decided I would present my views
of the history.

The panel states that "In the 1930's, Manfred Sakel treated schiz0phrenia
by producing convulsions by injecting insulin. This in turn was replaced by . . ." The

treatment‘s origin was more likely in the work of Ladislas Meduna.

Manfred Sake! developed insulin coma therapy, and ardently maintained

that the induction of seizures, which occasionally occurred, was a complication to

be avoided. He presented his ideas in Vienna in January, 1933. In January, 1934 the
Hungarian neuropsychiatrht, Ladblas Meduna introduced camphor injections with
the intent of developing seizures, in the belief of a biological antagonism between
epilepsy and schimphrenia.
These two protagonists met at a meeting of the Swiss Psychiatric Society

in Mﬂnsingen in 1937. They differed in their views as to what was the essence of

-

each therapy
coma and the death of 'sick' brain cells in insulin therapy; and
seizures in Metrazol therapy. (In later years, Sakel emigrated to New York, and
asserted that seizures in insulin coma may have some beneficial effects.)

I enclose a copy of a historical review for your use. A more detailed
exposition of the Meduna story is to be found in the first two issues of the new
journal, CONVULSIVE THERAPY, in which Meduna's previously unpublished
autobiography is published. This biography was written about 1954. Other sources
can be found in citation 35 in the enclosed reprint.

I very much enjoyed my visit to the museum.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                  <elementText elementTextId="104189">
                    <text>”xv-’1
s.

i.

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v

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August 18, 1985
John Lehmann, Ph.D.
Department of Neuroscience

Ciba-Geigy Corporation
Summit, New Jersey 07901
Dear Dr. Lehmann,

This letter is in response to your inquiry regarding the availability of a
post-doctoral candidate in EEG to develop spectral analyses for drug effects in
animals. i regret that i have no candidate to recommend from my laboratory.
If you are willing to import an overseas scientist, you may wish to write to
Dr. Walter Sannita (Laboratory of Neurophysiology, Osp. San Martino, v. ie
Benedetto XV, 1-16132 Genoa, Italy). I understand that he has a number of
associates, one of whom may be interested in a two year opportunity in the U.S.
.

Also, the best man from my laboratory in the past decade has been Mr.
Peter Irwin (201-386 8683). He is an excellent scientist and understands drug
effects, frequency analysis, and EEG very well. A few years ago, he left to work in
Sandoz in Basie with Dr. M. Matecjek (who heads the Sandoz quantitative EEG
laboratory). After a few years, he wished to return to the U.S., but Sandoz had no
EEG laboratory here, so he has been working in clinical pharmacology. if you are
truly seeking for 'the right candidate to be the driving force and run the project'
you may consider him. His salary may be a problem, as he left us at more than
$#0,000/year (and well worth it).
Finally, there is a new organization, recently formed in Europe to bring
scientists interested in drug effects and EEG together. Meetings are held every two
the next will be in Genoa in July, l986. The IPEG - (International
years
Pharmaco-EEG Group) includes both clinical and animal pharmacologists, and drug
effects in animals and man are discussed. You may wish to write to the President
of the group, Dr. Johann Kugler (Nussbaumstrasse 7, D-SOOO Munich 2, Germany)
for further information.

-

w

~mv'—

Good luck.

vw—

-.-

-

WWw-w

m

mﬂww-

Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

'

rum

�</text>
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                    <text>October 23,

19811L

Emerick Friedman, M.D.

219 S. Manning Boulevard

Albany, N.Y. 12208

Dear Emerick,
Your letter of October 3 piqued my curiosity. i re-read the copy of
.Meduna's autobiography, and found that he described meeting with you in the text.
Describing his visits to the United States and other countries of the Western
Hemisphere in 1939, Meduna writes:
"In New York we met Emerick Friedman, an American psychiatrist of
Hungarian parentage, with whom i had been in previous scientific correspondence,
and in collaboration with whom i had published a paper. He took us in his car to
Boston where' we saw how the Metrazol treatment was given in this country and I

recited one of my memorized English speeches of which

word."

I

understood hardly a

l have decided to publish this autobiography, probably divided in two
issues of the new journal CONVULSIVE THERAPY which I am now editing. The
first issue should reach you in March/April. If there are comments that you would
like to add at that time, I would be pleased to consider them.
.

My

regards.
Sincerely yours,

Max Fink, M.D.

�</text>
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                    <text>Department of Psychiatry and Behavioral Science
Health Sciences Center
State University of New York at Stony Brook
Stony Brook, New York 11794-8101
telephone: (516) 444-2990

’—

StonyBrook

/

ﬂ

2

September 30, 1985
Alfred M. Freedman, M.D.
Department of Psychiatry
New York Medical College
Valhalla, New York 10595
Dear Al,
Thank you for your kind invitation to join the distinguished Board of
Editors of Integrative Psychiatry. I am pleased to accept your invitation, and look
forward to supporting the aims of the journal.
My

best regards.
Since ly yours,

/

Max ' ,M.D.
P essor of Psychiatry

�</text>
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                    <text>-~v-'—

-~wv.—wyrv-va"—-‘T"

Air—r...-

.7...

”mm...

«up—”WY

October 3, 1985
“a-“y—qwzw“

_,....

"“V""-'""‘-“"’”"‘

Ms. Carolyn White
John Wiley dc Sons
Baffins Lane, Chichester
Sussex P019 lUD
England

Dear Ms. White,
W'yrrwiw’w’vvr’r"

I regret that I do not consider myself qualified to assess a textbook
on
neurotransmitters, as you requested in your letter of September 24.

If you are looking for a knowledgeable U.S. reviewer, you may wish to
consider Dr. Fritz Henn, the chairman of this Department, who can be reached at
the same address.

uw

W

ww—mwwq'

..

Sincerely yours,
"w

'
Urn

'—

v—w-

,

“wt-m

wow—myr-

w»

a”;

mwrn-mmmlwm,

wmw'

rm

-wwmww-qumwwwwngm

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>October 3,

19 85

S. Rohmel-Brosze
IPEG
AFB Armimitteliorschung in Berlin
,

Kurfﬁrstendamm 21?

D-1000 Berlin 15
Germany

Dear Ms. Rohmel-Brosze,

Enclosed are the addresses that you recently requested.

Sincerely yours,

Max Fink, M.D.

�W.—~xmﬁ—m

.

,

‘

_

Richard A. Roemer, Ph. D.

Philadelphia Psychiatric Center

Ford Road 6: Monument Avenue
Philadelphia, PA 19131
John Straumanis, Ph. D.

Philadelphia Psychiatric Center

Ford Road 6: Monument Avenue

Philadelphia, PA 19131

-

E. Roy John, Ph.D.
Department of Psychiatry
New York University Medical Center
500 First Avenue
New York City 10016

Richard Weiner, M.D., Ph.D.
Department of Psychiatry

V.A. Hospital

Durham, North Carolina 27705

Janice R. Stevens, M.D.

A. White Building, NIMH
St. Elizabeth's Hospital
Washington, D.C. 20032
W.

Pierre Flor-Henry, M.D.
Alberta Hospital

Box 307

Edmonton, Alberta T53

Canada

2117

Richard Abrams,"M.D.
Department of Psychiatry
Chicago Medical School
3333 Green Bay Road
No. Chicago, lllinois 6006‘:

Kenneth Lifshitz, M.D.
Nathan S. Kline Research Center
Rockland Psychiatric Center
Orangeburg, New York
Dennis Staton, M.D.

V.A. Hospital

Fargo, North Dakota

�</text>
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.

1...,"7.

:
..._,

_

~—

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.

v———-s-m—w—--..«

—-

vr':

wry-wv—p—mwv

W.V"M\'"-r-w‘llxmﬁr"v1&gt;wﬁﬁ"rl’

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October 24, 1985‘
Dean Debra Gillers
Committee on Admissions
SUNY at Stony Brook
Dear Debra,
I am pleased to recommend Richard E. D'Alli for admission to our next
medical school class. Despite his unique record, or because of it, I recommend him
most highly. He will be an outstanding student, and with his skills in communication
and his mastery of the media, he can become a unique asset to our profession.

Rick is a friend to my son, a geologist at Arizona State University. At the
end of 1983, Rick was commissioned to do a medical series on depressive disorders
and their treatment, a commission based on some brouhaha in the community. He
asked my advice and after dividing the therapy issues into three major therapies, I
agreed to help him with the section on convulsive therapy. I did so with much
trepidation, because my experience with other reporters was unfavorable; their
desire to emphasize the dramatic, to titillate the readers with anti-medical
statements, usually resulted in a hostile report which presented physicians as asses.
l deferred my agreement, and suggested that Rick read some articles before calling
me back. When he did call, some days later, his questions showed that he had read
and understood the material. His questions were non-hostile. We disCussed a script
and I recommended some advocates and critics. Suffice it to say, he did his
homework so well, that the final report, four sessions of 12 minutes each, was
excellent, receiving numerous commendations and repeated showings.
It is a fair statement of the medical and social issues in the controversy
about convulsive therapy, so fair that we have adopted it as a standard
presentation to our patients and their families as part of our consent process for
electroconvulsive therapy at University Hospital. (Call Mrs. Irene Carasiti on lON
to arrange a viewing.)

“may

.v

"‘ww

Since then, I commissioned him to make two training videotapes on ECT,
one dedicated to families and a second for students, and these are being completed
now.
It was during these interactions that Rick shared his interest in a medical
career with me. I was puzzled by his desire to change his career, and spent hours in
discussion. I am convinced that his career change is occasioned by his acquaintance
with medical projects, his ease with physicians and patients, and his desire to
dedicate his time to work with patients and to be part of the excitement that he
has seen in medicine.

�,,

v

7

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7—

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1-:

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Richard D'Alli

..,,.V

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Page 2

Rick is a warm, enthusiastic, friendly human being, with a pleasant laugh
and a pleasing sense of humor. He is sincere and thoroughly honest. He has done his
work well, and he is reliable. He recently married and his wife is a trained social
worker who is most encouraging of his career change. My son, who has known him
for more than four years, has told me of many interactions with Rick and Arlene
which support my recommendation.

_,

”w",—

.
A

At age 38, Rick is older than most candidates. But he has matured well,
and he is an outstanding candidate. I have no question regarding his ability to
dedicatehimself to the work and to complete the course of studies with better
than average grades. 1 have no hesitation in recommending him for admission to our
next class, as a candidate who will be a class leader, and who has much to offer our
profession, especially as a teacher and communicator.

-';-WV~WVWWWWWv

Sincerely yours,
—r

wan,

——v-«v

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mu

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“anqu-y

war:

war

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Hw—IF'“V‘1)V'&lt;-r

.-

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“w“

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WW.&lt;-r-‘l"'."'rv&lt;r

mnvw

:w'wAVXvWV'm'WW-wvw'z‘wvwvv-WV

Wn'

W‘ww-me’ﬁmﬁﬁ-w'mcv‘

wwrxxo-uw-m

rv

Max Fink, M.D.

Professor of Psychiatry

�</text>
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..wr.wm'—__,ww

..

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November 18, 1985

Richard Abrams, M.D.
Department of Psychiatry

Chicago Medical School

3333 Green Bay Road

North Chicago, IL 60064
Dear Dick,

have received the enclosed invitation, at the suggestion of Arnold
Friedhoff. Before proceeding with the intent of cooperating, I need your advice as
to how such a presentation would impinge on our present agreement. It is my
impression that it is not a conflict.
I

My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

.

�</text>
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                    <text>Department of Psychiatry and Behavioral Science
Health Sciences Center
State University of New York at Stony Brook
Stony Brook, New York 11794-8101
telephone: (516) 444-2990

StonyBrook
November 21, 1985
Mr. Robert Wilbur
125 West 96 Street
New York City 10025

Dear Mr. Wilbur,
Thank you for the invitation to participate in the videotape programs on
biological psychiatry. I regret that I am unable to accept your invitation.
The leading research center in convulsive therapy in New York is at the
York
State Psychiatric Institute. You may wish to call on Dr. Sidney Malitz or
New
Dr. Harold Sackeim for assiStance. Others with exemplary technical skills are Dr.
John Mann at the Payne Whitney Clinic of the New York Hospital, Dr. Richard
Weiner at the V.A. Hospital in Durham, North Carolina, and Drs. Richard Abrams
and Michael Taylor at the Chicago Medical School in North Chicago. Each of these
are well known researchers with extensive NIMH support for their efforts.
V

Good luck in your

efforts.
Sincerely yours,

Wan.

Max Fink, M.D.

Professor of Psychiatry

cc: Arnold Friedhoff, M.D.

�</text>
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                    <text>.s
u

.—.

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“emu”... ».-Ww-vvvw—w~mr._._.w._._._.

V

.

V——-——v»r~ -.__——v

-

—.—7mm—-—.ym.-nim

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~ «may»...7-.“

,3,

November 21, 1985
Fred H. Frankel, M.B.Ch.B., D.P.M.
Department of Psychiatry
Beth Israel Hospital
330 Brookline Avenue
Boston, MA 02215
Dear Fred,
Your question regarding the two available brief-pulse ECT instruments is
timely. The MECTA Corporation has developed four new models, three as computer
based modiﬁcations of their Model D, and a fourth smaller and simpler version
without EEG monitoring. Somatics Inc. has developed one new instrument, the
Thymatron.
To obtain a review of these instruments,

commissioned Helen Pettinati
and her associates at the Carrier Clinic to do an 'lnstrument Review", in the
fashion of a book review or a Consumer's Report for CONVULSIVE THERAPY. The
review was requested in May; and she delivered it to me this past week-end. It will
be published in the March, l986 number of CONVULSIVE THERAPY.
1

They find the two instruments comparable, although they give some extra
plus marks for the Thymatron. I agreed 9.0.3 to make the review available until it is
published, but Helen will share her conclusions with you, if you direct a question to
her. (Helen Pettinati, Ph.D., Carrier Clinic, Belle Mead, NJ 08502).

-.-—-&lt;

.

V,

m.”

.,

-w~=1-,—.w..mmv—.f

Our own experience is limited to the Thymatron, which we have had since
March. We find its use easy and the delivery of currents reliable. The instrument
has a single control for selecting current characteristics. There is an auditory EEG
monitor, which is simple and effective, although the chirping and warbling rhythm
has made some listeners uncomfortable (like the beeper warning on a car). Yet it is
an effective index to a seizure and to seizure duration. The manual was written by
Richard Abrams, and it has useful information for a user, especially for one with
limited experience with the role of different currents and electrode placements.

rm”

'w-rwvv-ywvww.‘

umw-er,

«vw‘w

v

WW~

We have not had the new MECTA instruments for use, although one is on
order and should be delivered in December. I have seen them demonstrated,
however, at two shows (in Dallas and Philadelphia). The new models overcome some
of the objections to the earlier model, in that the upper range of energy is more
suitable to our practice, and its use should be associated with fewer missed

�w'”1".-IFW~".'

:mvg—vmr—v—w—u

van-ATM" ,,

v

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.er.m-r mmywww_“»w_m a...

.w

Dr. Fred Frankel

.l

V

_

Page 2

seizures than the earlier model. The printed numeric record of stimulus parameters
is probably a useful record of the patient's treatment. The paper recorded EEG is
useful for researchers (although its quality is not much better than the earlier
version, so serious researchers like Weiner, Sackeim, and I will continue to depend
on recorders with better resolution for serious research work).
models.

in pricing, the Thymatron is less expensive than the upper range MECT A
__

Treatments at Stony Brook are given by a senior Fellow and the residents,
under my su rvision. They have three instruments available (Thymatron, MECTAD, Medcraft and they preferentially use the Thymatron. Perhaps because it is the
newest.
am unable to give a categorical recommendation since I have not had the
opportunity to personally assess the new MECTA models. Ask Helen for her
experience, since it is based on a direct experience with the new models.
I

The fourth number of CONVULSIVE THERAPY will be shipped in the first
week in December; I am working on the March, 1986 number. Would you believe
that a whole year has gone by since we began this exercise?
know.

Good luck in developing your unit. If there is anything else

Ican do, let me

My best regards.
‘

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry
P.S. lam working on two videotapes on ECT. One is designed as an explanation for
patients and their families, intended to facilitate the consent process. The second
is designed as a teaching tape for resident psychiatrists. Both will be marketed by
Somatics Inc., and will be announced in January. Look for them; they may be

useful.

..

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Department of Psychiatry and Behavioral Science
Health Sciences Center
State University of New York at Stony Brook
Stony Brook, New York 11794-8101
telephone: (516) 444-2990

StonyBrook
November 21, 1985
Mr. John S. Purvis
Div. Neuropharmacological Drug Products
FDA
Rockville, Maryland 20857

Dear Mr. Purvis,
reply to your inquiry of November 5, 1985 regarding the status of our
ongoing studies of mianserin, please be advised that we continue to have two
patients who are receiving mianserin. The study is continuing.
In

There have been no reportable untoward effects observed in this study.

mW
Sincerelyyurs,
Max Fink, M.D.

Professor of Psychiatry

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                    <text>November 22, 1985

Kurt R. Hoffmann, M.D.
Boehringer ingelheim, Ltd.
90 East Ridge
P.O. Box 368
Ridgefield, CT 06877
Dear Kurt,

it was a pleasant surprise to receive a gift of holiday wine. In past years,
these vintages have been excellent, and i have come to reserve them for dinner
with my special friends. Thank you for your thoughtfulness.
During the past year, I have put aside my work with pharmaco—EEG and
devoted most of my time to editing a new scientific journal, CONVULSIVE
THERAPY. i received the invitation to organize the journal in July, 198% agreed in
September; and the ﬁrst issue was mailed in mid-April, 1985. Succeeding numbers
appeared in July and September and the fourth will be mailed the first week in
December. We are on a good schedule now, and i think the journal will be accepted.

it has been much work, but i have enjoyed it. From time to time, i regret
not working with our volunteers and with the EEG graphs, but that work continues
in the hands of others.
i trust the year has been a good one for you. My thanks again, and my best
wishes for a healthy and a happy 1986. My best regards to Penny.

Sincerely yours,

Max Fink, MD.

Professor of Psychiatry

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                    <text>November 22, l9 85
Penny Bowers, M.D.
Boehringer lngelheim, Ltd.
90 East Ridge
P.O. Box 368
Ridgefield, CT 06877
Dear Penny,
i received a gift of holiday wine with Kurt Hoffmann's card, and I
immediately thought, "Another year has gone by, and how is Penny?" It was kind to

- these bottles have been superior, and
special friends during the holiday season.

send the wine

I

usually share them with

As I wrote to Kurt, during the past year, I have put aside my work with
pharmaco-EEG and devoted most of my time to editing the new scientific journal,
CONVULSIVE THERAPY. I received the invitation to organize the journal in July,
1984 at the CINP meetings in Florence; agreed in September; and the first issue

was mailed in mid-April, I985. Succeeding numbers appeared in July and September
and the fourth will be mailed the first week in December. We are on a good
schedule now, and I think the journal has been accepted.
have enjoyed the work, and especially the challenge of working with
authors to improve their manuscripts. Some reports are hardly decipherable, and in
many, the English is horrid. From time to time, however, I regret not working with
volunteers and with the EEG graphs, but that work continues in the hands of others.
Turan has been busy with Hoffmann-La Roche, helping them with their problem
with Valium and generic diazepam. Twice, he invited me to his presentations in
Nutley,and I had to admit that his data are compelling —- there are differences in
time course of EEG effects for different formulations. To confirm his findings, I
wrote a protocol for them, and I am awaiting their approval.
I

trust the year has been a good one for you.
wishes for a healthy and a happy 1986.
I

My

thanks again, and my best

.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>“ﬁve.” .w... 7w, W, _”.,.....~

“W'mmwmn—

77“

.. ., .V..,-.-.v.—-:-u-n

rwwmwvww.

December 30, 1985
Samuel Gershon, MJ).

Professor 6t Chairman
Department of Psychiatry
Wayne State University 6c Lafayette Clinic
951 East Lafayette
Detroit, Michigan #8202
Dear Sam,

It was fun being with you and Lisl in Maui. We trust your visits to Australia
were as pleasant as the days in Hawaii. Let's get together when next you spend
some days with Bernard in New York.
I did attend the session at which Bob Friedel presented his data on the
greater efficacy of the combination of thiothixene and ECT than thiothixene alone
in 'therapy-resistant' schizophrenic patients. The first question was asked by
Seymour Katy and Bob answered that a possible mechanism of action was greater

penetrance of thiothixene because ECT induces a reduction in the integrity of the
blood-brain barrier.
'

The principal studies of blood brain barrier and seizures are cited in the
i enclose. The principal scientist
behind recent studies is Thomas Bolwig, M.D.(Psychochemistry Institute,
Rigshospitalet, 9, Blegdamsvej, DK-2100 Copenhagen, Denmark). He is an old
friend and lam confident that he will answer any inquiries directly.

attached list and in the three abstracts which

Following your suggestion, I would be very much interested in a well
designed and controlled examination of this hypothesis in animals. The findings are
clearly publishable, and CONVULSIVE THERAPY is clearly interested in the
findings.
My best wishes for the continued success of the Lafayette Clinic, and my
best regards.

Sincerely yours,

Max Fink, M.D.

�</text>
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                    <text>,

rmW.~—-m.

“W‘Fw—nswmh—u

..

-

m——-W

“mmmmm“
,

-

,
.m—u-wwmw—p—«vm—v—w

w

...‘mm.mv—u-—.y

w»-

.

..

_

mm, mm.

... “fume. V7,-.. ._...

December 30, 1985
Thomas Bolwig, M.D.

Psychochemistry institute
Rigshospitalet

9, Biegdamsvej
DK-ZlOO Copenhagen
Denmark
Dear Tom,

At the recent ACNP meetings in Maui, Martha and I had a most pleasant
time with Ole. He seemed to be enjoying himself (when he wasn't politicing for the
CINP or the WPA or the August meeting in Copenhagen).
-

As he had in Philadelphia, Robert Friedel presented a report on the greater
efficacy of the combination of ECT with thiothixene than thiothixene alone in

'therapy-resistant' schizophrenic cases. He reported on nine cases, eight of whom
recovered with the combination, and one who was much improved.

In the discuSsion, Seymour Kety asked what possible mechanism could
Friedel suggest for the greater efficacy; and he presented the view that ECT (and
ECS) produces greater permeability of the blood brain barrier, thereby allowing
greater levels of thiothixene in the brain tissues, for greater efficacy.

had discussed this theory with Sam Gershon, who quickly suggested that
this theory was eminently testable in animal studies. i put together a package of
citations from your summary in the Handbook of Biological Psychiatry, my book,
and that of Stanley Rapaport (Blood-Brain Barrier in Physiology and Medicine), as
well as a citation list for him. He may be able to undertake such a study.
1

Perhaps you have already done such a study? If yes, have I missed it? Are
the data available? If not, perhaps you or one of your associates would be able to
undertake a systematic study? If Bob Friedel's idea gets any play at all, there will
be a rash of trials of the same suggestion, and it would be nice for CONVULSIVE
THERAPY to have a definitive article on this possible mechanism.
Have you organized or will you organize an ECT session for the August

WPA meetings in Copenhagen?

My best wishes for a happy and healthy 1986!

Sincerely yours,
Max Fink, M.D.

.

�</text>
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                    <text>March 4, 198‘!
Dr. M. Shafique

Department of Psychiatry
Khyber Teaching Hospital

Peshawar, Pakistan

Dear Professor Shafique,
Thank you for your kind invitation to participate in the Fifth International
Conference of the Pakistan Psychiatric Society in December. it was kind of Dr.
Stevens to suggest my name, and while I would be pleased to visit with you, I do not
know how it can be arranged. We lack the funds to make such a trip feasible.
As Dr. Stevens may have told you, I have been active in two programs for
more than 20 years -— an understanding of the effects of psychotropic drugs and
psychiatric treatments on the quantitative EEG, and the mode of action of
convulsive therapy, particularly in the relief of mood disorders. If a trip could be
arranged, I am able to describe our present usage and understanding of the mode of
action of convulsive therapy (Convulsive Therapy: Theory and Practice); and on
another occasion, describe the theory of association of EEG and behavior which has
been helpful in our management of psychiatric patients with psychotropic drugs
(EEG and Human Psychopharmacoiogy: Present Practice).
My

regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>April 12, 1984
33 Electronics Components Ltd.
Medical Products Division
South Nelson Industrial Estate

Cramlington
Northumberland N523 9QA
Great Britain
Gentlemen:

I have read your advertisement of a new advanced ECT system, as
described in the March 1984 issue of the British Journal of Psychiatry. I should like
a copy of the specifications and quotations for delivery, both for London and for
New York. 13 the instrument sold in the U.S., and by whom ? Can it be supplied for
110 volt AC currents in use here ?

Thank you for your advice.
Sincerely yours,

Professor of Psychiatry

�</text>
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                    <text>April 16, 1984

Jeffrey Lieberman, M.D.
Department of Psychiatry
Lil-Hillside Medical Center

75-59 263 Street
Glen Oaks, New York 1100‘}
Dear Jeffrey,
It was kind of you to give me a copy of "Blue Jolts'. I am collecting books
about convulsive therapy, and l have been seeking this book for a few months,

without success.

'

Enclosed is a copy of my book on ECT. There is a chapter on a “theory' of
its mode of antidepressant action. A year later, after some consultations with Jan—
Otto Ottosson, we decided to put this theory forth in a more structured fashion.
One of my associates, Yiannis Papakostas did a ﬁne job with an initial study of the
DST in ECT. Both reprints are enclosed. The Papakostas' findings have been
supported by some additional studies since 1981, and I believe them to be
essentially correct today.
Hence, my interest in neuroendocrine studies. We are collecting CSF and
blood samples in patients undergoing ECT, with two taps for each patient. The
samples will be assayed for different peptides, and perhaps we will find some
support for these ideas.

Before I left Hillside, John said that you were in charge of neuroscience
seminars held each month in the Department. If you will send me a notice, I will do
my best to attend those that I can.
My

regards.
Sincerely yours,
Max Fink, MD.

Professor of Psychiatry

�</text>
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                    <text>of Psychiatry and Behavioral Science
Sciences
Helm
Center
37'. -:c University ofNL-w York
at Stony Brook
D’i‘f‘zlll‘llllL’PA

3‘ “n1;

Book. New York 11794-8101

Iéienhone: (516) 444-2990

StonyBrook

April 24, 1984

Israel Hanin,

Ph.D.

Professor of Psychiatry,

Pharmacology and Psychology

University of Pittsburgh
3811 O'Hara

Pittsburgh,

Street

PA

15213

Dear Dr. Hanin:
I

am

Thank you for the invitation to
unable to accept your invitation.
Good luck

visit

in China in October,

in your fine work.
Sincerely,

Max

Mcmjp

Fink, M.D.

Professor of Psychiatry

�</text>
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May 14, I984

Robert M. Chalfin, MD.
Department of Psychiatry

Long Island Jewish - Hillside Medical Center
P.O. Box 38
Glen Oaks, New York 1100#
Dear Dr. Chalﬁn,
I received your survey, attempted to complete it, but was unable to do so.
The survey seems based on Hillside Hospital residents as practitioners, office
primarily, and with a decided bias toward psychological therapies.

My own career in academic medicine owes much to Hillside -- to the
opportunity given me to develop a research program based on clinical experimental
studies with the random assignment of patients. The Board of Directors, Dr. Israel
Strauss, the hospital Founder, and the Medical Director, Joseph S.A. Miller, gave
me much support. In part the support was financial, but much more valuable was
the encouragement to undertake the best studies possible.
I completed the psychodynamic training at the William Alanson White
Institute while a resident and supervisor at Hillside, but I must admit that the
teaching and practice paled with the advent of psychotropic drugs in l95#, and I
gladly put the practice aside.
I do not know how many. other residents went on to an academic
career,
but it would be helpful if the survey sought these out, and identified the
contributions of their Hillside experience to it.

Good luck in you study. I would be pleased to receive a copy of the report
when it is completed.
‘

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>May 22, 19814

i

Dr. P.J. Fell

Swalcliffe Lea,
Nr. Banbury

Oxfordshire OX5
Great Britain

QTQ

Dear Peter,
What a lovely address for a new home! There is something about the
British use of language that is delightful, and nowhere is it better seen than in your

addresses.

Since reading your book, I made a search of other literature, and came
across the book, "Using Computers in Clinical Practice: Psychotherapy and Mental
Health Applications", edited by Marc D. Schwartz (Haworth Press, New York, 1984,
510 pp.). It promises much, but there is little in it that is meaty
except for
examples of machine scoring of simple psychological tests. They do refer to
computer aided diagnostic schedules for clinical psychiatrists, but these are still
complex and require main frame type machines for the programs as now written.
From time to time, the BMJ presents book reviews of non-medical books.
One such recent review (BMJ @1095, 7 April 1984) touts John Collee's Kingsley's
Touch, as an outstanding first novel by a young physician, 3 medical mystery. The
book is published by Allen Lane (6.95 Pds) and is unavilable through our booksellers.
If you read a copy and find it as delightful as Michael O'Donnell
says it is, could
you send me a copy and I will reimburse you ?
Good luck in your new home. My best regards.
-

'

Sincerely yours,

'v‘w'

‘~'Wr‘-rw‘ﬂawm=h"rv

.»
«4‘

Max Fink, M.D.

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1w.v‘~rrhnmr.‘~£—I

A-

v.

May 23, 1984

Joel E. Dimsdale, M.D.
Department of Psychiatry
Massachusetts General Hospital
Fruit Street
Boston, Massachusetts 02114
Dear Joel,
I am pleased to enclose some reprints of our quantitative EEG studies. We
have not published our studies with antihypertensive drugs, although we have
completed assays of propranolol, l-penbutolol (Betapressin), and azepexole. I will be
presenting these findings at the CINP meetings in Florence at the end of June, but
have not yet written the paper.

In the meanwhile, the techniques are clearly sensitive to the CNS effects
of these substances. Each affects brain function at doses which are clinically
relevant, and do so in normotensive male volunteers. Preliminary reports of studies
in progress in elderly hypertensives define CNS effects which are strongly sedative
in type. These have been done by Kleindienst at Hoechst (Frankfurt), Matecjek and
Irwin at Sandoz (Basie), and Herrmann (Berlin). I anticipate that they will be
presenting their findings this year as well.
My

regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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                    <text>May 23, 1984

Steven G. Potkin, MD.
Department of Psychiatry
National Institute of Mental Health
5600 Fishers Lane
Rockville, Maryland 20857
Dear Dr. Potkin,
was interested in your presentation at the Society of Biological
Los Angeles on the continued use of insulin coma in China. My own
in
Psychiatry
l

contribution to the insulin coma story was to carry out a random assignment,
insulin coma gs chlorpromazine study at Hillside Hospital in New York in 19571958. This was published under the title "Comparative Study of Chlorpromazine and
Insulin Coma in the Therapy of Psychosis ( JAMA _l_§_6_: 1806—1850, 1958).
The enclosed Chinese paper reports on 2,858 cases of psychoses treated
with ECT, and send it on, as requested. If you can translate the data tables, I would
be most interested in the findings. The citation list of ﬁve papers is for reports
between 1950 and 1960 only. Do they not get any Western books or journals? Is
that a reason for the continued use of insulin coma?

thanks for an interesting paper. I would be grateful to receive any
reports that may come from your experience with insulin coma (and ECT, should
My

you get back there again.)
My regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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                    <text>July 13, 1984

Prof. Henri Loo
Faculte de Medecine de Paris-Cochin
100-102, Rue de la Sante
75674 Paris Cedex 14
France
Dear Prof. Loo,
Thank you for your kind remarks in your letter of July 3. I enclose a draft
of my report to the CINP -- but you should be aware that this is a reading copy and
lacks the tables, figures, and references which a properly completed paper would
include. You may use it for your outline, but I must ask that you not quote it

directly.

I suggest that you obtain a copy of my 1979 book, CONVULSIVE
THERAPY: THEORY and PRACTICE, published by Raven Press. There has been
much progress since then, and I enclose additional reports which supplement my
book.

You may be pleased to know that I will edit a new journal, CONVULSIVE
THERAPY, to be published by Raven Press, which will appear early in 1985. Should
you or your associates have reports which may be suitable for such a journal, I
would be pleased to receive them.
My regards and best wishes for the success of your

efforts.

Sincerely yours,

Max Fink, MD.

Professor of Psychiatry

�</text>
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                    <text>September 11, 1984
Jonathan A. Hill, Bookseller

470 West End Avenue
New York, N.Y. 10024

Dear Mr. Hill
I

have read your advertisement in a recent issue of JAMA. I am interested

in obtaining copies of the following psychiatric books, and would appreciate your

quotation.

Meduna, Ladislaus von. Die Konvulsionstherapie der Schizophrenic. Carl Marhoid
Verlagsbuchhandlung, Halle a. 5., 1937, 121 pp.

Wagner-Jauregg, Julius. Fieber- und lniektionstherapie. Ausgewﬂhlte Beitrage
1887-4935. Verlag ﬂir Medizin, Weidmann 6: Co., Wien, Leipzig, Bern. 1936,
299 pp.

Wagner-Jauregg, Julius. Lebenserinnerungen. Herausgegeben und erganzt von L.
Schdnbauer und M. Jantsch. Springer-Verlag, Wien, 1950, 187 pp.
Sakel, M. Neue Behandlungsmethode der Schizophrenie. Perles, Wien, 1935.
If there are questions, I can be reached
Hospital, (516) Milt-2929, most afternoons.

at my office at University

Thank you for your assistance.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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�</text>
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                    <text>.v,...,.v-&lt;,.

..,.,,.

.

A

.

.W

.

W‘s-WH‘FHI'VL'.

September 17,

1981}

Wu

"rr'"

David N. Pfohl, MD.
Associate Medical Director
Biomedical Products Department

DuPont
Wilmington, Delaware 19898
Dear Dr. Pfohl,

i am in receipt of your letters of July 5 and August 14 regarding the
unusual experiences reported in patients receiving high doses of naltrexone. Please
be advised that I have not prescribed naltrexone for a number of years, and that I
have no supplies on hand. I do not recall any similar adverse experiences.
HTWWGMWWY'W'w-WW""

My regards.

Sincerely yours,
rm”,

2-,»

wam~

’(W'ﬂl‘bv'ml'Fﬁ

"

"'r'

as”:

w

Max Fink, MD.
Professor of Psychiatry

�</text>
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                    <text>November 24,

19814

David B. Friedman, MD.
20 Park Avenue
New York City 10016
Dear David,
What a lovely note; my thanks for your kind comments. There are days
when the work seems so much of the same, that I wonder why I don't retire and
follow the sun. But then there are notes like yours and all the work seems
worthwhile again.
My connection with ECT is largely the accident of my residency

experience at Hillside, where I was asked to take over the unit since I had some
years experience in neurology at Bellevue at the time I came to Hillside. It also
helped that other residents were disinterested and I was willing. But the experience
has been productive. My book in l979 was well received (it is out-of-print) and the
publisher asked me this summer whether I would edit a new journal. 1 agreed to
work on CONVULSIVE THERAPY
a new quarterly journal that you should see
aims
It
of
in
the
stimulate more research into ECT with the
to
late
more
spring.
aim of improving the training and treatment procedures first, but ultimately to
finding a better treatment for major depressive disorders. If you liked the parts of
the Meduna history which related to his autobiography, I decided (once I had the
authority) to publish the whole autobiography in a few issues of CONVULSIVE
THERAPY. I hope you will find the sections as interesting as I did.
——

family is maturing in fine style. My son is a geologist at Arizona State
his own home, and a 'significant other'. My older daughter has just
has
University,
her
doctorate
at Duke in cellular biology and is a post—doc at Yale. The
completed
M.S. at Florida in Gainesville and is on her way to a
her
has
completed
youngest
in
doctorate
zoology-- chiefly the predation of insects by birds. My work at Stony
Brook is rewarding, although our resident candidates are a rather sorry lot and
much of my time seems wasted. But there is a continuing research program and the
medical students are brighter each year. It is a joy to teach them.
My

family.

So, my thanks for your kind comments. I

My

trust all is well with you and your
best wishes for happy holidays and a healthy 1985.
Sincerely yours,

�</text>
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                    <text>December 10, 1984
Louis Jolyon West, M.D.
Department of Psychiatry
UCLA School of Medicine
760 Westwood Plaza
Los Angeles, California 90024
Dear Joly,
I

am pleased to submit this letter of reference on behalf of ROBERT

HUGH GERNER, M.D. who is being considered for promotion to the rank of
Associate Professor in Residence ill. My experience with Bob Gerner is largely
through his writings. On an occasion, a few years ago, I visited him at UCLA to

consult him with regard to our ongoing studies with des-Tyr-gamma-endorphin;and
lately I have consulted him with regard to our CSF studies. He also presented a
Grand Rounds in our Department of Psychiatry this month.

the twelve years that he has been publishing scientific articles, he has
established an outstanding record in clinical and experimental psychiatry. He is an
acknowledged leader in questions of changes in the CSF of psychiatric patients
during the course of their illness. He has done some of the best individual studies of
the behavioral effects of beta~endorphin. His contributions to the ECT literature
have been original, so much so that when I was making up a panel of assessors for a
new scientific journal, CONVULSIVE THERAPY, I invited him to be a member of
the editorial board.
In

There is a long list of co—workers as co-authors of his publications. He is a
friendly and popular psychiatrist, with a pleasant personality. In his presentations,
he is relaxed and exhibits a detailed knowledge of his subject matter. 1 estimate
that he is a good teacher.
He is one of the bright young men of biological psychiatry, with
established skills in research, writing, and teaching. While I can assume that he

must be a good clinician from the quality of the clinical research reports, I am
unable to assess this aspect of his career directly. When our new chairman was
looking for some bright talent to invite to Stony Brook, our committee agreed that
Bob Garner's record was outstanding; hence, his visit to us this month.
’

am pleased to recommend his promotion to Associate Professor without
hesitation. He clearly meets the criteria for academic excellence for such a title
at this University.
I

My

best regards.
Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

�</text>
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                    <text>December 19, 1984
w

......r

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&lt;1

.-

Judy Wurtman, Ph.D.
E25-604

Massachusetts Institute of Technology
Cambridge. MA 02139
Dear Judy,

y——.-.,War-—-uw_v-—'-u

n-

It was a pleasure having dimer with you and Dick in San Juan last week.
The tan is fading rapidly, and despite my best efforts to tell my co-workers that it
came from sitting too close to the slide projectors, they are not persuaded.

.

A reprint from our experience with fenfluramine is enclosed. The work
was initially done at the Missouri Institute of Psychiatry in 1964-65, and replicated
in 1965—66. 1 hesitated publishing it, until we had some clinical experience (open
trials in obese subjects seeking a weight reduction regime) and had confirmed the
compound's sedative qualities.

it was this study that convinced us that the pharmaco—EEG model had
merit in man, yielding information that was independent of animal trials, more
relevant and reliable with regard to clinical projections and experience. It is this
model that has been so useful in defining the clinical profiles of doxepin, mianserin,
flutroline, and some antihistaminics, antihypertensives, and hormonal agents with
greater accuracy and reliability than the animal pharmacology.
This model is well accepted in EurOpe, where many of the large
pharmaceutical companies have 'in-house' pharmaco-EEG laboratories; and where
numerous 'contract-laboratories' do the work for the smaller firms. The Europeans
have founded an "International Pharmaco-EEG Group" which now holds biennial
meetings (similar to the CINP). in this country, only Turan ltil at the New York
Medical College and I are active researchers in this field. If you are interested in
obtaining a more accurate appraisal of enantiomers or congeners of fenfluramine,
the pharmaco-EEG model can yield useful projections as to a compound's CNS
activity, its classification, dose-response range, and behavioral effects.
My

I also enclose some more recent summaries of work from my laboratory.
best regards.

Sincerely yours,

Professor of Psychiatry

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                    <text>u...

.-

J

wwwnwwur...

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“WWWE,”

December 21,

‘,
.m

_

"wr'

«wan-av

.

meuM':

m’:

198%

Prof. Dr. P. Netter
Fachbereich Psychologie

Justus-Liebig—Universitat Giessen

Otto Behaghel-Strasse 10
0-6300 Giessen

W.

Germany

r-

ww-

Dear Prof. Netter,
Thank you for your kind invitation to write a review of the usefulness of
pharmaco—EEG studies to predict clinical pharmacologic activity of drugs. While I

am interested in writing such a paper, I regret that lam unable to carry out such a
mission in the near future. I have just accepted the responsibility to edit a new
journal, CONVUSLIVE THERAPY, with its first issue due to appear in March 1985.

There are others who are known to you who can carry out such a mission
admirably, notably Dr. Turan [til at the New York Medical College, Dr. Milan
Matecjek of Sandoz (Basle), or Dr. Walter Sannita of Genoa.
If you do not get a satisfactory response by the summer, try me again.
My best regards.

Sincerely yours,
Max Fink, MD.

Professor of Psychiatry

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mvvr-wvu

_.,.....,

vn-

'—‘l—I.—"'

-mw

-

.—w—.A

-

Vurz'H-I

December 23, 1984
Ross Baldessarini, M.D.
Mailman Laboratories
McLean Hospital
115 Mill

Street

Belmont, Massachusetts 02178
Dear Ross,
Thank you very much for your prompt reply to my request for more
information about your DST reviews. The reports are very useful, and I will send
you a copy of my review for Peter Loosen when it is done in January.
When Yannis Papakostas worked at Stony Brook and reported that failure
of the DST to normalize was associated with a poor clinical outcome, 1 was

diffident, but encouraged him to publish his finding. Since then, the number of
reports has increased, and while the diagnostic usefulness of the DST remains in
question, i am more than ever impressed that the continued presence of abnormal
cortisol measures is a poor prognostic sign -- one that we ignore rarely, often
increasing our treatment, or at the least, increasing our vigilance of the patient's
course. Your reports support this impression.

Your summaries combine the data for antidepressant drugs and ECT. The
efficacy of ECT and drug therapies differ, often markedly, with ECT usually
superior to that of drug therapies. It may be a fruitful exercise to extract the ECT
data from the other antidepressant therapies, to assess the relationships between
DST findings and the ECT process.
As you may know, i have accepted the responsibility to edit a new journal,
CONVULSIVE THERAPY, to be published by Raven Press, with the first issue to
appear in March. Should you undertake such a study, I would be pleased to have an
opportunity to consider it for this new journal.
My

best wishes for a happy and productive 1985.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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                    <text>June 13, 1983
Robert J. Campbell, M.D.

Editor—in-Chief
Psychiatric News

American Psychiatric Association
MOO K

Street, N.W.

Washington, D.C. 20005
Dear Bob,

There is an error in the June 3 issue of Psychiatric News (page 214) which
embarrasses me, and I am writing to ask that a correction be published. The story
on GP's education is captioned "Physicians" and near the end of the article states:
"The discussant of these two papers—Max Fink, M.D. of the State University of
I did not discuss these
New York at Stony Brook- took exceptions ..."
I
and
was not present at that session. have no public opinions on the
presentations,
matters quoted.
Perhaps the reporter meant my namesake, Paul Fink of Philadelphia.
Could your executive editor check the original story and publish a correction ?
Many thanks.

Sincerely yours,

Max Fink, MD.
Professor of Psychiatry

�</text>
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