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                    <text>August l7, 19 88
Alan Edelson, Ph.D.
Raven Press
1185 Avenue of the Americas
New York City 10036
Dear Alan,
The enclosed letter speaks for itself.
Alfred Freedman has been a remarkable leader in American and world
psychiatry- thoughtful, liberal, productive. It was his vision that launched the
Comprehensive Textbook of Psychiatry and its many offshoots. He launched this
journal, and although it has not made a big impact, its issues are among the most
thoughtful in our profession. The closest relative in my ken is the Behavioral 6c
Brain Sciences (Cambridge University Press) edited by Steven Harnad of Princeton.
Alfred is retiring, but remains active and enthusiastic. He probably needs a
project to keep his interests high during his retirment, and the journal may be a
useful vehicle.
I know that some exploration has been done by Raven
Press, and perhaps
the issue is moot. Nevertheless, lam bringing it to your attention again. Alfred is a
connection to the 'political' leaders (vis a vis the 'scientific') of the world of
psychiatry. That may be of some merit.

My best regards.

Sincerely yours,
Max Fink, MD.

Editor

P.S.
Martha and I very much enjoyed your visit. Carol's suggestion led us to get
the electrician in and, among other changes, the face plate for the light switches
is
level. And, I did not get to Munich after all; my mother fell and fractured her hip;
the surgery and hospitalization kept me here. She is progressing nicely now, but the
timing was inopportune.

�</text>
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                    <text>-

‘rw-w-v

”W'WW‘I"

August 23, 1988
Murray Wexler, Ph.D.
Department of Psychiatry 6: Behavioral Sciences
University of Southern California School of Medicine
LAC/USC Medical Center
1934 Hospital Place
Los Angeles, CA 90033
Dear Dr. Wexier,
i am pleased to submit this letter in support of the promotion of Dr.
BARRY A. KRAMER to the rank of Associate Professor of Psychiatry. I have
known Barry since his tenure at Hillside Hospital when he was interested in

electroconvulsive therapy and we developed a collaborative research protocol. He

left for California in i9 82, as we were completing our protocol, and we sought to
develop the project at USC but that was not feasible. We have collaborated on a
number of reports since then. His survey of the usage of ECT in California is an

important historical and social document, often quoted. He also carried out a
survey of the use of ECT as a maintenance treatment, and published a fine report
last year. He participated in a number of programs with me at national society
meetings.
Barry is a well trained psychiatrist, with a keen appreciation of the role of
ECT in clinical practice. He has made significant contributions to convulsive
therapy research and his publications are well regarded.

recognize Barry as a dedicated, responsible, and excellent clinician. He is
friendly, interested, and enthusiastic about his work. He is a dedicated parent.
Barry is an established clinical teacher. His presentations are clear and well
thought out.
I

He clearly meets the standards for promotion at this University, and i
would heartily endorse his promotion.
As for the question of tenure at this University, it is not possible to make
such a judgement since tenure is reserved for full-time faculty. if Barry were a
faculty member on a full-time basis, I believe we would recommend his promotion
with tenure, although there may be a question regarding the absence of laboratory
investigations in an aspect of neuroscience in his record. Such evidence seems now
to be the standard in our department.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

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                    <text>——-——-—-—m

«n

vumvm

w-wnv

—.,
&lt;

'7

-vm'Fw—uu—n

"v.1..-

W

September 6, 1988

.vmm

w.

m,

a“nun...”

_N—v'y-W

Leon Grunhaus, M.D.
Department of Psychiatry
University of Michigan Hospitals,
D9702, Box, Oil 8
Ann Arbor, Michigan #8109-0118
Dear Leon,
Thank you for sharing your videotape with us. My nurse, Mrs. Caraslti and I
viewed it together. We famd it a fine presentation of case material and the ECT
treatment process. We found no portion to criticize. The overall effect is clearly a
positive one. I have asked Mrs. Carasiti to use the tape instead of our own for the
next few teaching sessions and I will let you know it the patients or their families
have any feedback.
1
am delighted that another tape now exists and 1 encourage you to make it
available
as
to users in other centers as Somatics has made my tapes. I! it does
become available, please let Richard Weiner know so that he can include it among
the list of available teaching materials in the forthcoming APA Task Force report.

Your letter to Harold was enclosed with the tape and lam returning it to
that
you so
you can address the special requests to him again.
My best regards.

Sincerely yours,

Max Fink, MD.
Professor of Psychiatry

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                    <text>September 6, 1988
Joseph Jaffe, NH).
New York State Psychiatric Institute
722 West 168 Street
New York City 10032
Dear Joe,
vu, all over again! Yes, I do remember our little diagnostic
experiments, and I must say that our experience has inﬂuenced me all my life. In
our Hillside days, we learned that diagnosis was not particularly useful when we
were asked to treat patients, since from time to time, the obviously 'wrong'
treatment seems to have been useful. Our random assignment imipramine,
chlorpromazine and placebo studies laid the groundwork for the studies of
imipramine in phobic disorders, for example.
De}_a_'

In the 19703, when the APA committee under Bob Spitzer was devising the
Chinese
menu diagnostic scheme, I argued for consideration of biological
present
(at the time, mainly the sedation threshold and the nascent neuroendocrine tests)
and treatment results as cutting tools, arguing that the main advances in syphilis
came about only after the Wasserman test was devised. Such views were
disregarded as 'premature'.

From time to time I am asked to consult on complex cases, and usually I
discard the diagnoses presented in favor of any diagnosis for which a treatment
exists. A few weeks ago, I was sent a 25 year old man, ostensibly with
schizophrenia (2 consultants agreed), with the statement that BC!" was clearly
useless in schizophrenia and therefore neither psychiatrist would treat the boy.
This despite the record that 4 years earlier he had responded well, albeit for 13
months! We have since treated him and he is doing nicely.
.

Another case is that of a 56 year old confused and apathetic woman who
was diagnosed as Alzheimer disease, confirmed by a neurologist, and again by a
second opinion; consigned to a nursing home for 5 years. She was referred to
University Hospital because of a medical condition. When she was on our medical
service, our consulting team thought she was depressed. She was referred to our
team, and we could not agree on a psychiatric diagnosis; but since the diagnosis of
Alzheimer disease was untreatable, we suggested to the husband that since she
looked depressed there was the option of a course of ECT, which could make her a
little worse for a while, but if it worked . . . It did, and she has now been at her
own home for more than 3 years. (When she returned home, she could not believe
that her daughters were her own, for she had the Rip van Winkle syndrome,
believing that her daughters were five years younger.)

�Dr. Joseph Jaffe

Page 2

Another more recent case is that of a 25 year old married mother with a
history of lupus erythematosus, admitted in manic excitement, treated with
haloperidol, and seen the next day in a catatonic state. Internists believed she had
lupus cerebritis with epilepsy continua, and they tried various voodoo treatments
including high doses of antiepileptic medications; the psychiatrist laid on the
benzodiazeplnes (he feared antipsychotics as neurotoxic). The patient was
incidentally presented to my ECT training class and after some discussion, I argued
that ECT was the preferred treatment regardless of her diagnosis (lupus cerebritis
or NMS or epilepsia continua) since her main symptom was catatonia. Four weeks
later she was finally sent for ECT when her catatonia became the aggressive
variety and she required continuous restraints. Four weeks of ECT, and she is now
home, alert and well.

-

0! course, not all such agnostic diagnoses work as well as these did; but it
only takes one such diagnosis every so often to convince me that our present
disgnostic schemes in psychiatry, especially the Chinese menu approach of your
institute, is Rorschach testing in real life; and that more is in the eye of the
beholder than in the face of the object, despite the professional belief in their

objectivity.

_

'

'

Yes, i remember those experiments very well, and often tell my students
about them. Perhaps we should do the experiment over and publish the results in
the American Journal of Psychiatry? (Under pseudonyms, of course.)
Thanks for the very pleasant reminder. My best regards.
Sincerely yours,

Max‘ Fink, MJ).

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                    <text>.m wwwmm—r—u-w «v.0u-r-xn—‘w-a-m-W-~k'“~ﬁfww.mr1wwmr&lt;uﬂ«' r w‘v “~-vu‘--'mw'wwarutrv" w .w-rmmr --y—.w._.,..
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September 9, 1988

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.

var-v

m

Larry Koran, M.D.
Department of Psychiatry
Stanford University Medical Center
Stanford, CA 94305

1!

‘

Dear Larry,

it was kind of you to write and to give me the news of your work. I enjoyed
much.
it very
I continue on service on the inpatient unit at University Hospital six
months a year with two residents and two medical students during their rotations;
run the ECT service (which is ﬂourishing); and do some research in EEG, as before.
My main work is in editing CONVULSIVE THERAPY, a challenge which 1 accepted
in 1984 and which has kept me busy since.

Our Department has changed markedly under Fritz Henn. We are a
neuroscience center, with good relationships with the V.A. and with the State
services. So much so, that we are planning a new 250 bed psychiatric research
hospital adjoining University Hospital. Planning and architectural drawing funds
have been approved. I have put in my bid to run a neuropsychiatry unit when that
center opens, but we will surely have a large medical/surgical psychiatric unit, as
well as research units for dementia, schizophrenia, and affective disorders.
Meanwhile, Mort Miller‘s successor, Tom Craig left to head a unit in New
and
we are seeking a new Director for the CPD programs. Do you have an
Jersey,
interest to get back into academic research? The position would be good if you

were interested.

Thank you again for your kind words and the reminder that sometimes good
deeds are rewarded in one's lifetime.
My best regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>September 9, i9 88
Robert Shaw, M.D.

1542 Leroy Avenue
Berkeley, CA 94708

Dear Bob,
It was such a nice note; thank you.

have had occasion to recall your insulin coma/ chlorpromazine study.
have argued that it was one of the most important studies at Hillside as it
rang the death knell, in an academic and research sense, for insulin coma therapy.
The study uniortunately is not well known, despite its publication‘in JAMA, since
few of the present practitioners even recall that insulin coma existed.
I

Indeed,

I

Hillside remains an active part of the SUNY clinical campus structure and
our students rotate through there for their third year rotation. Their residency
continues to have a good reputation, and their research is excellent. Don Klein
succeeded me as Research Director, then went on to Columbia University. John
Kane, his student headed the research for the past decade and has a clinical
research center in schizophrenia. He was juSt promoted to be the medical director
of Hillside and chairman of the Division of Psychiatry of LIJH. He should be able to

continue its research interest.

I continue on service on the in-patient unit at University Hospital six
months a year with two residents and two medical students during their rotations;
run the ECT service (which is flourishing); and continue research in EEG, as before.
My main work is in editing CONVULSIVE THERAPY, a challenge which I accepted
in 198‘! and which has kept me busy since. It is a quarterly journal, now completing
its fourth year of publication.

It was kind to have a reminder of our work together; my best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>p‘

October 25, 1988
C. w. Erwin, M.D.
Duke University Medical Center
Durham, North Carolina 27710
Dear Dr. Erwin,
I

am pleased to submit this letter in support of the promotion of Dr. C.

EDWARD COFFEY to the rank of Associate Professor (Psychiatry). 1 have known
Ed for about three years, initially through his research writings in convulsive
therapy, then as a contributor and reviewer for CONVULSIVE THERAPY, and
lately as a member of the journal's Editorial Board. I have observed Ed present
‘

reports at many meetings, and have read many of his reports, not only those
submitted to our journal, but to many other journals as well.

Ed is a well trained neurologist and psychiatrist, one of a few young
academic psychiatrists who has completed formal neurologic training. While it was
customaryfor trainees in my generation with an interest in an academic career to
complete neurologic training, it is (unfortunately) much less common today, and
such experience has contributed materially to Ed's writings and teaching. He
clearly has the opportunity to become a leader in the rediscovered discipline of

‘neuropsychiatry'.

When I read his c.v., i discovered that he was a Rhodes Scholar. It did not
surprise me, for despite his youth 1 already thought of him as an acknowledged
expert in ECT and brain imaging, to name two aspects of his research interest.
Ed has published more than 35 good scientific articles on MRI scans, EC‘l’,
and neuropsychiatric topics. His studies of the effects of caffeine in lengthening
seizure duration in ECT are the main citations in an active field. Lately, he has
focussed on MRI imaging in elderly depressives, and I believe he is making useful
contributions to that preliminary and complex literature.
He is among a small band of young, articulate, and enthusiastic researchers
in clinical psychiatry. I recognize him as a dedicated and responsible researcher
and excellent clinician. He is friendly, warm, genteel, interested, and enthusiastic
about his work. He lectures well, and responds to questions with a relaxed and
softspoken demeanor. He is an established independent researcher and teacher. He

meets the standards for promotion at this University and I recommend him for
promotion with much enthusiasm and without reservation. I also would support a
recommendation for tenure.
Sincerely you rs,
Max Fink, M.D.

Professor of Psychiatry

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                    <text>4.

r,_v«--.y-

,_

.

October 25, 1988
Louis Jolyon West, MD.
Department of Psychiatry
UCLA School of Medicine
760 Westwood Plaza
Los Angeles, CA 90024

Dear Jolly,
am pleased to submit this letter in support of the promotion of Dr. I
LEWIS BAXTER to the rank of Associate Professor in Residence I at UCLA. have
known Lew for about four years, initially through his research writings, and more
Two years
recently as a contributor and reviewer for CONVULSIVE. THERAPY.
showed
and
me
host
Lew
was
UCLA,
I
my
ago, when was a visiting lecturer at
I
his
interests.
shared
and
his
ceaworkiers,
to
through his laboratory, introduced me
also have seen the ECT videotape which he produced for his research and teaching.
I

Lew is a well trained psychiatrist, with skills and interests in
psychopharmacology and brain imaging. He has published more than 30 good
scientiﬁc articles on a wide range of topics ~— PET scans, neuroleptic malignant
syndrome, ECT, and clinical psychopharmacology. Lately, he seems tois have
iocussed on imaging studies as his particular interest, and i believe he making
useful contributions to that preliminary and complex literature.
He is among a small band of young, articulate, and enthusiastic researchers
in clinical psychiatry. In late 1986, when Fritz Henn sought a candidate to head our

him Lew's
imaging programs in conjunction with Brookhaven Laboratories, i sent
of
Reimann
Washington
Eric
(like
Lew,
do
that
today),
(and
c.v. for i thought then
brain
imaging.
in
{17,15 a leader psychiatric

recognize Lew as a dedicated and responsible researcher and excellent
clinician. He is friendly, interested, and enthusiastic about his work. He lectures
is
well, and responds to questions with a relaxed and non-hostile demeanor. He an
established independent researcher and teacher. He meets the standards for
promotion at this University and I recommend him for promotion with much
enthusiasm and without reservation.
I

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

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                    <text>w

“Wm

www.—

W

-r»—--—-n—-—-m-————

1W,

”a."

October 25, 1988

-..”W...

W...”

”mm

aw

.w.

w

Walter Sannita, M.D.
Laboratory for Neurophysiology
Universita
V. le Benedetto XV
1-16132 GENOA, Italy
.Dear Walter,

.W

,
1W..W

W“

r—

.7,

Awmm

van-Ur

Martha and I were delighted to hear that you escaped from Japan intact,
without the benefits of octopus tea. It was a good meeting, and I am still relishing
the many fine recollections.
‘

.

i received the application of your young M.D., and gave it to our new
Director of Residency Training, Gregory Friccione, who agreed to write a personal
letter regarding the application process. I hope it was helpful.

Meanwhile I am back at work after a hectic week in the Netherlands,
where I lectured on ECT at seven universities in five days -- yes 7 in 5 days. It was
fun and i am just about recovered.
No word from our friends at Sigma Tau, although Milt Kletzkin called for a
report of our meeting. 1 gave him the glowing one that I had prepared and he
seemed rather pleased. Invited me to lunch in New York, soon.
My

best regards.

UWWWWWT'J-n

.

Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

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                    <text>October 26, 1988
Alfred M. Freedman, M.D.
Department of Psychiatry

New York Medical College

Westchester Medical Center
Valhalla, New York 10595
Dear Al,
The advertisement1n the March issue of the British Journal of Psychiatry
caught my eye; hence my note to you about an article on ECT. Perhaps the editor
moved the article to a later issue.
was sorry to hear that the recommendation for the McAlpin did not
materialize; we should try again.
I

Meanwhile, I have kept up with Lothar's progress and plan to see him
tomorrow, as I am coming to New York after a month's travelling. Turan and I
presented our work at the international Pharmaco-EEG meetings in Kobe, Japan.
He did well and he has many loyal students who attended the sesssions reliably and
enthusiastically. My own impression (it was my first trip to Japan) was that I had
never seen such a fine organization nor were my questions answered so quickly and
so well in more than 35 years of attending national and international meetings. Our
hosts were most solicitous and the meetings were quite good. Martha and l
travelled about, from Kobe to Osaka/Kyoto/Nara by trains, finding them prompt,
efficient and generally clean. Language was no problem, and we thoroughly enjoyed

ourselves.

lam sorry to have missed the program in New York. My trip to the
Netherlands (seven lectures at seven universities in five days) was an educational
success, mainly because I learned much about the politics of medical care in a
socialized society. It was enough to turn one into a confirmed reactionary.
As for Australia,

I

you anyway for your help.
My

do not see myself getting there in the near future; thank

best to Marcia.
Sincerely yours,

Max Fink, MD.
Professor of Psychiatry

�</text>
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                    <text>October 29, 1988
Alexander Gralnick, M.D.
Upper King Street
Rye Brook, New York 10573
Dear Alex,
Good for you! Your article in yesterday's New York Times expressed what
we feel, ashamed and uneasy, on hearing and seeing the anti-liberal, NO—NOTHING,
anti-American attitudes of Mr. Bush and his accomplices. i did think the American
people were stupid when they elected Mr. Reagan, and when they did it again, it
was a disaster. But the blatant anti-liberal, anti—black, pro-Redneck, flag-waving,

anti-abortion, and anti-environmental blandishments of the Republicans far
exceeds even the excesses of the sleazy government which Mr. Reagan brought to
Washington.

Your article is important and you are to be congratulated, and thanked, by
all of us 'liberals' who see the U.S. Constitution as the main hope of mankind in this
crazy world.
Keep it up. My best regards.
Sincerely you rs,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>October 29, 1988
Alan J. Gelenberg, M.D.
THE ARBOUR
49 Robinwood Avenue

Jamaica Plain,

MA

02130

Dear Alan,
The Therapy Resistance Conference was most interesting and clearly a
successful and important occasion. The topic deserves the study that it is now
getting. Perhaps I over-reacted to the Post slides, but is it not a reflection on our
practice when a leader of what is presumably the most prestigious, expensive, and
over-funded psychiatric research venture in the [1.5. unashamedly tells a public
audience that he subjects his patients to one experimental regimen after another,
month after month, year after year, without prior attempts at an effective
treatment? is that not a sign of hubris? I cannot imagine a similar scenario at The

Arbour or

at University

Hospital (or at McLean, or Payne Whitney, or the many

other fine clinical/ research centers in the U.S.)
In any case, the
My

article by Kroessler is enclosed.

best regards.
Sincerely you rs,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>November 4, 1988
Norman Endler, Ph.D.
Department of Psychology
York University
l‘700 Keele Street
North York, Ontario, Canada M33 1P3
Dear Norman,
Yes, the meetings-in Philadelphia were quite good, and much better than
had heped for. It was indeed a celebration, despite the protesters, who seem to
have made their greater mark on the press, and seemingly little on the

I

participants.
you.

Yes, I have received a copy of ECT: The Myths and the Realities; thank

reported earlier this year, I am committeed to so many projects that I
can hardly get to my clinical work; but I will, do what I can to contribute the
requested chapter.
As

1

a

My

best regards.
Sincerely yours,

Max Fink, MD.
Professor of Psychiatry

�May 26, 1988

C. Douglas McCann, Ph.D.
and Norman Endler, Ph.D.
Department of Psychology
York University
’4700 Keele Street
North York, Ontario, Canada M33 1P3
Dear Dr. McCann and Norman,
While Iseem to be committeed to so many projects that I can hardly see
the top of my desk, 1 will do what i can to contribute the requested chapter later
this summer.
What is not clear to me is the intended audience. The chapter titles are too
diverse to be of interest to the practicing psychiatrist or psychologist; and too
unfocussed to be attractive to the research/academic type. Students of
psychology? Laity? Please advise.
Thank you for your consideration.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>November 27, 1988
Sidney Malitz, M.D.
New York State Psychiatric Institute
722 West 168th Street
New York, New York 10032
Dear Sid,

It was kind of you to nominate me for membership in the Royal College of
Psychiatrists. Alan Miller was pleased to endorce the nomination and the papers
went off promptly on Wednesday.
My

best regards.
Sincerely you rs,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                    <text>December 21, 1988
ml—m'vr

,-

ﬂaw”

w».

www—r—r—,~

GretaKoinig, M.D.
Psychiatrische Universitéitsklinik
Allgemeines Krankenhaus der Stadt Wien
Wilhringer Gurtel 18-20
1090 VIENNA
AUSTRIA

Dear Greta,
What a pleasant surprise to receive your informative letter and greetings.
have regularly received news from Vienna from our young Ph.D. scientist (who
seems to be doing very well in his laboratory work, and his social life).
We

Protocol: Dr. Gangadhar has been a regular contributor to CONVULSIVE
THERAPY and he had informed me that he was planning to study in Vienna. I read
the proposal and it is consistent with our present knowledge and experience. There
are a few points that you may wish to consider.
A study focussed on a defined course of 6 ECT argues that about 1/3 or
of
the subjects will be inadequately treated at that measurement. Whatever
more
benefits ECT may provide, may yet develop with more treatment. it may be better
science to design the study so that that the ratings of depression reach an arbitrary
(though low) value as the time at which the prolactin measures are re-examined.

Prolactin release is influenced by electrode placement, amount of energy
(threshold or supra-threshold), type of current (sinusoidal or brief—pulse), and sex
and age of the subject. One problem with the Siemens Konvulsator is that it
delivers variable amounts of energy. Some attention should be paid to these
variables in the design of the study.
While the study is of temporal

interest, a more illuminating study of
dopaminergic phenemona in ECT might be one of patients with parkinson disease
and depression. Suggest that Dr. Gangadhar read CONVULSIVE THERAPY g: 321327 (Fochtmann) and 3: 189—191 (Fink).
Hypothesis: As for the other questions, I enclose a copy of a report which I
have just sent to the journal Neuropsychopharmacology, and’which is under
editorial review. It is the latest version of the neuroendocrine hypothesis of ECT.

.

"W

wwwt‘

�Dr. Greta Koinig

December 21, 1988

Training: We do not have a formal ECT training program for our
psychiatric residents. in the first year, they receive lectures on affective disorders
and the treatments available; about 3 hours are devoted to ECT. In their second
year, while on the in-patient service, they spend two months on the 'ECT Team',
managing every case referred for ECT. On average,’they manage about 8-12 cases.
ECT is also discussed in the weekly attending case rounds.

Finally, selected residents may do research in ECT duing their elective
period (fourth year) for periods up to six months. We average one resident each
year.

in addition, we have organized a formal hands-on' training in ECT. A
description is enclosed. The next course is sceduled for the week of March 6, 1989.

lPAAE: The details of the lPAAE are enclosed. (The society is changing its
name to The Association for Convulsive Therapy (ACTH.
ECT DATABASE: Citation searches for tapics in ECT are available to
subscribers and contributors to CONVULSIVE THERAPY, by request addressed to
my office. There is no formal citation list that is made up periodically; each issue
of CONVULSIVE THERAPY contains the citations included in the database in the

previous quarter.

There are numerous ways to reach me. Using the University BITNET
system, my address'is MFINKQSBCCMAIL.BITNET. For FAX, my temporary
number is 516- 862 8604 (although this will change in about a month). My home

number is 516-862 6651.

i am delighted that there is a resurgence in interest in ECT in Vienna. i
have been gratified by the continuing acceptance of ECT and CONVULSIVE
THERAPY; its portrayal as a reasonable treatment; the greater investment in
training and improved facilities; and the greater attendance and interest in ECT at
conferences and meetings. The main thrust today is no longer the acceptance of
ECT, nor its indications, nor the technical details of currents and electrode
placements, but in its mode of action. Hopefully, this interest will improve our
understanding of both the treatment and the pathOphysiology of affective

disorders.
1989.

i trust these responses are helpful. 'iy best wishes for a happy and healthy

Sincerley yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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              <elementText elementTextId="65733">
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            </elementTextContainer>
          </element>
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    <fileContainer>
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                    <text>”it 3"

yu—a-v.

a—u—w

April 7, 1988

Charles Kellner, M.D.
Department of Psychiatry
Medical University of South Carolina

l

i
E

i

l

171

i

Ashley Avenue

Charleston, SC

29‘325

Dear Dr. Kellner,
We would be pleased to assist you in the development of both research and
clinical skills in convulsive therapy, and agree to supervise your education at
University Hospital at Stony Brook for a period that is mutually satisfactory.
in response to the prevailing need for education in ECT practices, we have
developed a five-day, 'hands-on' ECT course. Our first class of four psychiatrists
and two nurses went through the course in February, and we have scheduled a
second course the week of May 16. A description of the course is enclosed. The fee
for psychiatrists is $1,500.
,

»

On occasion, we have had fellows attend our service for periods of up to
two months, and would be willing to do so again. in addition to our active ECT
teaching and treatment programs, our research programs in ECT include:

ECT and Antipsychotic drugs in Patients with Positive-Symptom Psychosis
(Schizophrenia).
Comparison of etomidate and methohexital anesthesia: Inﬂuence on seizure
'

'

,

duration.
Pentylenetetrazol vs Caffeine in Altering Seizure Duration.
Electrophysiology of seizures: Comparison of Brief pulse, Sinusoidal
currents, and Pentylenetetrazol enhanced seizures.
Relations between Neuropsychological changes and the duration of
isoelectric EEG period after seizures.
Effect of ECS and antipsychotic drugs on blood brain barrier.
Effect of ECS on brain catecholamines in animals with learned
helplessness.

Finally, wt edit the journal CONVULSIVE THERAPY and manage the
CONVULSIVE THERAPY DATABASE from these offices.
Good luck in your program.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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April l7, 19 88
Michael A. Taylor, MI).

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Professor 6c Chairman
Department of Psychiatry

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3333 Green Bay Road
North Chicago, Illinois 60061:

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Dear Mickey,
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was pleased to send the enclosed to the Search Committee of the
University of Vermont. I have been there twice, about six and two years ago. It is a
good campus, and seemed to have well qualified students. I was not impressed with
the research interest, since my hosts impressed me that they were busy earning
their salaries through their practice plan. But if anyone can shake the
establishment and raise the academic sights, I am sure that you can.
I

When I was a boy, I camped often on Lake George, and canoed Champlain.
Indeed, was camping on Lake George on June 6, 19M (ID-Day) and can still recall
I

the thrill of our fishing the next few days, with the optimism that the war would

now soon come to an end. In the early 1970s, we usually rented a camp for a month
on Raquette Lake. You will surely like the fishing in the Adirondack streams and

lakes.

’

I

do hope that you get the position if that is what you want.

Is there anything else lcan do for NNérBN? lam not too surprised that the
reviewers didn't accept the pharmaco-EEG article. The question, whether there is
anything more than noise in the waking EEG, remains an interesting one,
particularly since the technical issues of recording and analysis have been solved so
handsomely. Now that the ECT issues are fairly cut and dried, I have decided to
take time off the second half of the year and write a book on Brain and Behavior:
Pharmaco-EEG Revisited. I will emphasize theory, much as I did with Convulsive
Therapy. If Iam successful, we should be able to get reviewers of NNchN to look
at the article with a fresh eye a year hence.

My best regards.

Sincerely yours,
Max Fink, MD.

Professor of Psychiatry

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April 18, 1933
Norman R. Alpert, Ph.D.
Chairman, Search Comm. for Psychiatry
Dept. Physiology 6: Biophysics

Given Building
University of Vermont School of Medicine
Burlington, VT 05305
Dear Dr. Alpert,

lam pleased to submit this letter of recommendation on behalf of
Professor Michael A. Taylor, who is being considered for the position of chairman
of the Department of Psychiatry. He is ably qualified and fully capable of
accepting the responsibilities outlined in the job description sent to me.
I

have known Mickey Taylor for more than two decades, since his residency

training at the New York Medical College. Among a group of excellent students, he

was outstanding, an independent thinker, and a careful worker. Taking an idea from
a single report from Michigan, he examined the incidence of male and female
offspring born to psychotic mothers in the State hospitals in New York, mothers
who were psychotic at the time of conception. He. found a higher incidence of
female infants born to such mothers.'He then examined the impact that medication
may have had on the gender advantage for female infants. Such innovative studies
were awarded the prestigious A.E.Bennett award of the Society of Biological
Psychiatry.
«v-

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,

After a tour in the U.S. Navy, where he also published clinical research
studies, he returned to join our faculty at Stony Brook. He took over a routine state
hospital ward without a single distinguishing or redeeming feature. Within a year, it
became an outstanding study and research unit, indeed, the premier unit of the
many at the hospital. He was rapidly promoted to Associate Professor and was
under consideration for promotion to Professor when he was invited to the chair in
Chicago where he became Professor and Chairman.
in research, Mickey is an outstanding clinician and phenomemlogist. 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 neuropsychological 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 Neuropsychiatric Mental
Status Examination and General Hospital Psychiatry are innovative and important
texts, widely used in teaching psychiatric residents. He is an outstanding lecturer.

-

�Michael A. Taylor, MD.

University of Vermont

Page 2

Based on his record of contributions in neuroscience and neuropsychology,
he was invited to become the founding editor of a new scientific journal,
"Neuropsychology, Neuropsychiatry and Behavioral Neurology”, published by Raven
Press of New York.
His administrative abilities are also excellent. i watched the development

of the teaching unit at the Central lsiip Psychiatric Center. I have visited his units
in Chicago, where he not only has developed a productive Department of
Psychiatry, but established such fine relationships with the Department of
Psychology that i believe he has been acting chairman for an interim period. And, I
am 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. Mickey is an avid fisherman, and lam conﬁdent that the waters of
Lake Champlain and the many lakes of the Adirondack Mountains will be a positive
attraction. i hope that you can attract a man of his experience and talent. Good
1

luck.

-

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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                    <text>genufﬂ...‘

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...,” “usurp—...". ..-

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mar .. -...—,—.v«-~i.m.,_.»---_-nn, “2...“. mm; :.

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April 23, 1988
...T.,..—‘.v.‘

A

Dr. John Waterhouse
Department of Psychiatry
Western General Hospital
Edinburgh EHQ ZXU
United Kingdom
Dear Dr. Waterhouse,
I

Your letter of November 25 arrived (inexplicably) at the end of March, and
it
sent through the Department Chairman to the professorial faculty. While we

would be pleased to have you participate in one of our many research or teaching

programs, present State regulations regarding appointments of outside faculty
preclude our providing an appointment which has clinical (therefore reimbursable)
service as the basis for an appointment and support.
The strictures which apply to a State facility do not ordinarily apply to a
private hospital or university. You may wish to write to the two principal
psychiatric academic centers in New York City, Dr. Herbert Pardes at Columbia
University (722 West 168 Street, New York City 10032) or Dr. Gerald Klerman at
the Cornell Medical College (Payne Whitney Clinic, 525 East 168 Street, New York

City 10021).

‘My regards to Professor Hamilton.

Regrettably,

Professor of Psychiatry

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.

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.41

203.7 lop“?
April 30, 1988
Dr. John W. Goethe
and Dr. Martin R. Ford
Institute for Living
t$00 Washington Street
Hartford, CT 06106
Dear Dr. Goethe and Dr. Ford,
1
was so sorry the weather did not hold for your flight on Thursday. I very
much understand the frustrations of being at the airport and getting weather
reports every 15 minutes, only to decide that the trip had to be cancelled. It is then
that instrument rating looks so good.

had searched the ECT Database for citations to EEG and culled the
attached list as those that seemed most relevant. Interest in EEG studies has reawakened as we have become more interested in the definition of an 'adequate’ or
i

'therapeutic' seizure.

Two other topics have surfaced. Are focal or lateralized post-ECT findings
related to treatment outcome; and do focal or asymmetric records predict a good

or a bad outcome with treatment.

There is an international association, not well known in this country, that
meets every two years to discuss quantitative EEG and psychopharmacology. They
occasionally have papers on ECT, but the main benefit of the group is their interest
in the problems of quantification. Your 1986 report in Biological Psychiatry is
clearly within the interest of the group. The IPEG (International Pharmaco-EEG
Group) meets later this year (September 28-October 1) in Kobe, Japan.

Please re-schedule your trip. Weather in May is always better; I did my
New York to San Francisco flight in a Cessna 172 in May.
My regards.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�We”. w (. ”TAM.

V

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.V.

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v.» ;

March

mam“

II,

,_,,

i

“WW. .5.“

,

4~._‘-.‘V._‘r~r~p-.~‘rr‘ w~&gt;1m~ um

1988

John W. Goethe, M.D.
Director of Clinical Research
Institute of Living
‘‘00 Washington Street
Hartford, CT 06106
Dear Dr. Goethe,
I

would be pleased to have you visit our laboratories in April.

at the University most of the month except for April ll; to 20.

I

expect to be

The EEG recordings are mostly done on Thursdays, and a visit on that day
would permit us to demonstrate the ongoing work.
I can be reached most mornings at 516-444 2929; and most late afternoons
516-862
6651. The best time is from 11 a.m. to noon, after I have completed
at
rounds.
morning
'

The University is 60 miles east of New York City on the North Shore of
Long Island (Long Island Expressway, Exit 62). The best entry by air is to Long
Island MacArthur Airport (20 minutes) or LaGuardia Airport (1.2 hours). If you

drive, the Bridgeport/Port Jefferson Ferry brings you about
University.

15

minutes from the

Come for lunch and we can have the afternoon together.
I

look forward to your visit.
Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

-

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                    <text>V’""' "aw."

.—

.

H.

w.

mm.

WWW—mnp—m—w,

,

“ﬂy,“

run.“ WW

-w—nrv—

Wawv'r

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Ma...

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«J. "Yarn—«w

7

,

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r.-.

we.“

m,

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w,"

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w,

-

.

May 25, 1988

Michael A. Taylor, M.D.
Department of Psychiatry
Chicago Medical School
North Chicago, IL 60064
Dear Mickey,
am delighted with the list of papers accepted for the first issue of
NNPchN; and i will review the Hales 6r Yudofsky book in early June. i just read the
enclosed review in JAMA of another book that may interest our readers; perhaps
you should consider it for NNPGIBN.
I

Meanwhile, Al Freedman's rattling of the cages at the Society of Biological
Psychiatry was successful, and Martha and I had a most pleasant occasion. We sat
with Oliver Sacks (who gave a special lecture on "lmpulse") who is: l) delightful in
a peculiar, idiosyncratic way; 2)looks very much like his cousin, Abba Eban; and 3)
seems to be a much better writer and poet than neurologist. (I tried to get him to
talk about anosognosia, exosomesthesia, aphasia, and the retardation of
parkinsonism, but what he said was mostly poetry.) Still, a most delightful man.
My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>E

May 30, 1988

David Kroessler, MD.
Department of Psychiatry
Rhode Island Hospital

Providence, RI 02903
Dear David,

Last month you enquired about support for continued research in ECT. At
the APA meetings, I became acquainted with the NARSAD program. This looks like
an appropriate place for you, with Barry's support, to obtain funds for your
research.
Good luck.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�April 7, 1988
David Kroessler, M.D.

Department of Psychiatry

Rhode Island Hospital
Providence, RI 02903
Dear David,

I know of no special foundation grants in electroconvulsive therapy. From
time to time, we have been able to get special funding for a seminar or a
colloquium at a meeting from some of the ECT companies or a few small
foundations. But felloewship money sufficient to allow someone like yourself to
develop an academic career has generally come from the National Institute of
Mental Health.
'

There has been an announcement of a new career fellowship program for
medical graduates who have less than five years of post-residency experience. You
may qualify and should consider applying. One applicant called me and asked
whether I would agree to having him study here for a training period of one to two
months, and I agreed. If you wish to arrange such a training program, I will do what
I can to make the arrangements at those centers that may be of interest to you.
As for project grants, these come exclusively from NIMH. There is a
fund
at Veterans Administration hospitals which allows investigators to get
special
funds
($25,000) and then to apply through a special VA funding program.
start-up

The work here is going well. We have started a five-day CME 'hands-on'
training program in ECT. The first class went through in February; we are
scheduling the second for the week of May 16. Our research projects are running
well and we have a steady output of papers. Larry has taken over the ln-patient
service; Krish Gujavarty is moving to the V.A. I append a list of our active ECT
projects for your information.
Tell Barry that I included a review of his book (which I like very much) in
the next issue of CONVULSIVE THERAPY. My best regards.
Sincerely yours,

Professor of Psychiatry

�</text>
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                    <text>June

1, 1988

Dominick P. Purpura, M.D., Dean
Albert Einstein College of Medicine
1300 Morris Park Avenue

Bronx, New York 10461
Dear Dr. Purpura,

I am puzzled by your letter of May 31, asking for an additional assessment
of Dr. Gregory Asnis' qualifications. 1 will do what Team. The request is to 'expound
on how much time and originality he contributed to these articles . . '.

Dr. Asnis came to my laboratory fresh out of his residency at the Mount
Sinai Hospital, where he had undertaken independent case material studies,
sufficient to receive the annual award for the best 'resident' presentation.
Our first published study (his {I 5) was a survey of the use of ECT in
metropolitan hospitals. The study was undertaken at my request. Sue Saferstein
was a third year medical student, and Greg Asnis was her supervisor in the study.
The commission came from the APA Task Force on Electroconvulsive Therapy. My
recollection is that I developed the design of the study; Greg and Sue Saferstein
carried it out, and wrote the initial reports; and that I edited the final report. I do
not think that Greg was interested in ECT thereafter.
The second study (his #9) was an outgrowth of an interest in abnormal
motor movements. Both Ed Sachar and Herb Meltzer had shown that active
antipsychotic drugs elevated serum prolactin. I cannot recall whether the idea of a
study came from Greg or another of our team, but my main contribution was to
develop the relationship with Ed Sachar, obtain his agreement to undertake the
assays, and make one trip to Columbia University to meet Mrs. Halpern, the
technician who carried out the assays. Greg left Stony Brook after the samples
were collected and the patient' status defined. The report was written at Columbia
University, and I received a penultimate copy for my advice. Ido not recall making
a contribution to the analyses, nor do I know what processing went on at Columbia
University.
Greg's experience at Stony Brook was marked by our unsuccessful attempt
to organize a research unit at Central lslip Psychiatric Center. I was given that
mission by Stanley Yolles, and it was a frustrating and unhappy experience.
Because we could not provide a satisfactory site for research, I urged Greg to go to
Ed Sachar (and I moved my research to the V.A.). That is one reason why his two
years with us appears so unproductive in his record.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

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                    <text>June 3,

19 88

V. N.

Bagadia, M.D.
Broadway Building, 2nd Floor
Matunga
Bombay #00 019
India
Dear Professor Bagadia,
Yes, I believe that our readership would be very interested in a survey of
the use of ECT in India. There is a dearth of good data on ECT usage, and much
argument, whether usage is increasing or decreasing, whether the indications are
changing, and whether consideration is being given to the effects of electrode
placements, current type, dosage, frequency of seizures, seizure durations
monitoring, and other technical details. I enclose a copyright release which should
be signed to accompany the article.
The article "Reevaluation of ECT ~6: Right Tempemparietal vs Bitemporal
Electrode Placement in Schizophrenia", is scheduled to appear in the third issue of
CONVULSIVE THERAPY, in September this year.
I

look forward to hearing from you. My best regards.
Sincerely yours,

Max Fink, M.D.
Editor

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                    <text>“'r'wwn'w" MF’ WW~w——,nu

-..v

v

~

,

IF:

,

v—w

rmw—mwuuf

-

-—m-wm"l‘v-—lwv-L’-‘V"V.

May 30, 1988

Alfred M. Freedman, MD.
Professor 5: Chairman
Department of Psychiatry
New York Medical College
Valhalla, New York 10595
Dear Al,
Enclosed is a copy of your nomination for the 1988 McAlpin Award.

it may be helpful if another letter is sent. If you will suggest names of
leaders outside the Department who may also send a letter, i will contact them. I
think of Leon Eisenberg as a long-standing friend, or Milton Greenblatt. Have your
secretary call me at 516—3“ 2929 so that icon do what needs to be done, before
the end of June.
My best regards.

Sincerely yours,

Max Fink, MD.
Professor of Psychiatry
.

.

»
WW»;

Ww— vu't—u'r -‘ - . -1“

�</text>
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                    <text>June 3, 1988
Alan Stone, M.D.
Harvard Law School
Langdell Hall,
Cambridge, MA 02138
Dear Alan,
Thank you for agreeing to support the nomination of Al Freedman for the
National Mental Health Association McAlpin Award. I enclose copies of the award
announcement, Al's 'short' biography, and my letter of nomination.
have submitted all the requested documentation, including the curriculum
vitae, photograph, etc. It would be helpful if you would write a suitable endorsing
letter, which should-Fe sent to the McAlpin Award Panel in Alexandria, Virginia.
I

I

have also asked Leon Eisenberg to send a letter of nomination.

My best regards.

Sincerely yours,

Professor of Psychiatry

�</text>
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                    <text>June 1, 1988
Leon Eisenberg, M.D.
Department of Social Medicine
Harvard Medical School

25 Shattuck Street
Boston, MA 02115

Dear Leon,
Thank you for agreeing to support the nomination of Al Freedman for the
National Mental Health Association McAlpin Award. [enclose copies of the award
announcement, Al‘s 'short' biography, and my letter of nomination.
have submitted all the requested documentation, including the curriculum
vitae, photograph, egg. it would be helpful if you would write a suitable endorsing
letter, which should be sent to the McAlpin Award Panel in Alexandria, Virginia.
i

Note that the award includes a medal and $5,000. The least that we should
be able to extract from Alfred and Marcia is a dinner at our favorite restaurant.
Since last we met, I have continued supporting the proper use of ECT, by
my research, editing the journal CONVULSIVE THERAPY, and training clinicians
who seem, in increasing numbers, to seek direct experience with this complex

treatment.

My best regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>May 30, 19 88

McAipin Award Panel
National Mental Health Association
1021 Prince Street
Alexandria, VA 22314-2971
Dear Panelists:

lam pleased to nominate Professor Alfred

M. Freedman for the 19 88

McAlpin Mental Health Research Achievement Award. Few psychiatrists have done
as much for the education and training of psychiatric professionals, have
encouraged such useful and important academic research, and have provided
leadership for the nation’s major scientific societies as has Dr. Freedman. His
formal academic curriculum vitae is attached, but I would like to highlight a few
aspects of his record which encourage me to make this nomination.

Formally, Dr. Freedman was certified in psychiatry and psychoanalysis
his
after
graduation from the University of Minnesota Medical School in 1942. He
assumed the chairmanship of the Department of Psychiatry at the New York
Medical College in 1960, and created an outstanding research and teaching center.
His major contributions in academic research are in the treatment of opiate
dependence with narcotic antagonists and long-acting opioids; and in his studies of
the effects of psychoactive substances on brain functions.

joined him as a member of the faculty of the New York Medical College
in 1966. At the time, opioid addiction had surfaced as a national problem. Few
psychiatrists were willing to undertake the treatment of those afflicted with drug
addiction, yet he established the first municipal hospital treatment unit for drug
dependence. He supported two separate research programs in addiction, one based
on sociological models (under Richard Brotman) and another, based on biological
models of narcotic antagonism. His program developed the merits of naloxone,
cyclazocine, and naltrexone as treatments for opiate dependence; and broadened
the applications of methadone and ievo—acetyimethadyl as narcotic substitutes. He
encouraged the collaborative study of chronic hashish users in Athens; and began
studies of the central effects of cocaine, when cocaine use was a rare and
i

occasional dependence.

addition to developing a Department and teaching programs for medical
students and residents, and encouraging the research studies, he found time to edit
the definitive Comprehensive Textbook of Psychiatry, which is now used worldwide. ile also founded and edits the journal integrative Psychiatry.
In

�Nomination of Alfred M. Freedman, MJ).

Page 2

in his residency training programs, he recognized the special needs of

women physicians, and he developed the first post~graduate training program for
women psychiatrists. lie established a Day-Hospital program for the severe
mentally ill; and has always maintained relationships with many community
hospitals for the education of their personnel. (i believe that the present program is
affiliated with 14 community hospitals).
in his support of the studies of
is not well known in this
which
pharmaco-electroencephaiography, a discipline
And
in his willingness in 1968 to
and
Japan.
country, but well established in Europe
when
the treatment was outside
support studies of convulsive therapy -- at a time
the main stream of psychiatric practice and research. That encouragement led his
student, Richard Abrams and myself, to become international leaders and authors
in ECT.
The diversity of his

interests is to be seen

His reputation in research led to his election as President of

the American

College of Psychopharmacoiogy 0972), President of the American
Psychopathological Association (1971). in 1973, he was elecred President of the
American Psychiatric Association.

Dr. Freedman has an enviable record of participation and interest in
international psychiatry. He invited leaders from foreign countries to visit the
Department and lecture, in the Goldman lecture series that began in the early
19605. He has been an active member of international psychiatric associations and
is well known as lecturer, teacher, and friend throughout the psychiatric world, not
only in Western countries, but in many developing countries as well.
Al has received many awards and much recognition for his leadership,
humanity, and support of academic principles in research and teaching. He is a
warm, friendly, and encouraging man, with friends throughout the world. His wife,
Marcia is a Professor at Columbia University, and both their sons have enviable

academic records.

Considering the long list of outstanding recipients of the McAlpin Award,
am proud to recommend your consideration to add his name to this list. i have
discussed this nomination with him, and he has agreed to be considered for the
award, and to attend the symposium in Los Angeies in September. His current
address and telephone numbers are listed in his 9.x;
Thank you for your consideration.
Sincerely yours,
(V‘ax

Fink,

649,-).

Professor of Psychiatry

1

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_......_.,..,,,_.A_

June 2“, 1988

,_..V

.

w...

John M. Kane, MD.
Department of Psychiatry
Long Island Jewish Medical Center
75-59 263 Street
Glen Oaks, New York llOOQ

is...

V
V,

.,,

1
T
m

V'mﬁ'm—VV'WM-rwr‘

Dear John,
w:

Congratulations on your appointment as Chairman of Psychiatry at LIJH. It
is a particular pleasure to know that the hospital has sought a researcher as its

leader, and to join with other graduates of Hillside‘s training programs in wishing
you a fruitful tenure of leadership.

,

It was 30 years ago that Israel Strauss, Joseph S. A. Miller, and the Medical
Board of Hillside Hospital endorsed their research aims by creating a full time
position of Research Director. When Don Klein and my co-workers in the
Department of Experimental Psychiatry (that was the fashionable term in those
days, much like Division of Neuroscience would be today) wrote a review of our
activities for the Journal 9__f the Hillside Hospital in l96l, we not only looked back
at our accomplishments, but sought to direct the Board's eyes forward by calling
for a 200 bed clinical research center. We saw something specialin Hillside.
Perhaps it was ambitious, but we were encouraged by the dramatic gains of the
psychopharmacologic drug revolution, the nation was in an expansive mood (preViet-Nam, pre-Kennedy/Johnson),and we thought the cure of mental illness was in
our grasp.
In the interim decades, the leadership of the hospital seemed too concerned
with fiscal and operational matters to fully utilize its outstanding research
opportunities. Your success in building on Don's programs has given you the unique
opportunity to realize even more of the potential in Hillside's patients, staff, and
history. it is a fine opportunity, and the staff at Long Island Jewish Hospital and
the community it serves are to be congratulated in their selection.

My congatulations on your appointment; and my best regards.

Sincerely yours,
Max Fink, MD.

Professor of Psychiatry

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-&lt;

‘//4' 7 a; {1/9

’(0)

4/4, -223 éBﬁZ “W
wv—m-wm‘nmwwwv—V-v—w‘W.

.

June 25, 1988
Norman Endler, PM).
Department of Psychology
York University
4700 Keele Street
North York, Ontario M33 1P3
Canada
Dear Norman,
Enclosed is a draft of 3 Forward for your new book. in acknowledging Dr.
Persad's contribution, iassumed it was to assure the details of the treatment,
indications, and risks, and iso noted on page 3. if that is incorrect, or you wish me
to include a different statement, please let me know.

Let me know if there is something that you wish changed. 1 will be at my
office this week, but will be away from July 3 to 12 in England.

it is a pleasure to make this small contribution to the success of the book.
When it is published, ask Ms. Stillman to send me an additional copy for review, and
i will ask one of the members of the Editorial Board of CONVULSIVE THERAPY to

review it promptly. (indeed, if she will send an unbound copy of the page proofs,
and we get a review by the end of August, we may get it into the December issue.)
My

best regards and my best wishes for the success of this effort.
Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

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“—4..

-

-v.—

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i

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q.

‘1nyle

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-,-.~mn

w» w

V-v"“~—'-4W

Michael Faumann, MD.
25824 Dundee Road
Huntington Woods, Ml 48070
”Dear Mike,

Enclosed is our ﬁle copy of SCIMATE and two diskettes.
The diskettes contain the BACKUP files for our ﬁle ECT 87. (Get them by
RESTORE.) The second diskette also contains three copied ﬁles- TNAMEFILDAT,
TEMPLATEDAT, AND FNAMEFIL. DAT. When you install SCIMATE, you will find
that the template files contain the standard templates given out by 15!. Copy my
three ﬁles over the Scimate templates; this will conform the templates for ECT87.

Return the manual and original diskettes when you have made your copies.
Good luck. If you have any questions, 516-“th 2929. My regards.

Sincerely yours,

”um...

w~—v—

m

January 2, l9 88

é‘

E

,

Max Fink, MD.

Professor of Psychiatry

‘Vu‘mWs-s

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                    <text>gs—v—r-w m—vm

,0... mum» m" 7-

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:

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-

January 28, 1988
Mrs. Edward M. Bigler
#0 Doubling Road
Greenwich, CT 06380

Dear Mrs. Bigler,
Thank you for your request that I participate in the Phil Donahue show.
Beginning with the appearance of the New Yorker article by Berton Rouche
"As Empty as Eve' in 1974, and my subsequent work with the APA Task Force on

Electroconvulsive Therapy, 1 have actively assessed the merits and limitations of
the ECT process. What may have been a debate in the 19703, as to the merits of
the treatment, has been resolved by the many assessments by individuals and
international commissions and committees, culminating in the 1985 NIH Consensus
Conference. The question of ECT efficacy is resolved. Until a more effective and
safer treatment for the serious mentally ill is devised and tested, ECT remains a
useful and needed treatment. That is not a matter of public debate, either by the
Phil Donahues or the Opreh Winfreys of the entertainment world.
Indeed, the acceptance by laymen that there is a 'debate‘ on efficacy and
into the hands of the anti-psychiatry lobby. There is no more reason
plays
safety
for a debate by the laity on TV or radio of the merits of ECT than it would be
reasonable for a debate on the merits of insulin in diabetes or penicillin in
neurosyphilis or any other technical medical therapy.

In the face of the anti-psychiatry lobby, there is a need for public
education, but in proper fora. For that reason, my associates and I were responsive
to the requests by Susan Squire for an opportunity to meet treated patients before
she wrote the November 22, 1987 article in the New York Times Magazine; and
why we have been cooperative with the PBS/BBC producers of the series MIND, to
appear later this year.
We continue to seek to improve the delivery of mental health services, and
my present missions support this aim for ECT. I wrote my review of ECT in 1979,
launched the journal CONVULSIVE THERAPY in 1985, and have developed a
training program in ECT at SUNY at Stony Brook in the past year.

But I will not cooperate with a 'show', surely not one of the kind produced

by Phil Donahue under the guise of a 'debate‘ or a 'balanced‘ presentation. But if I
can help you present the facts of EC‘I‘ history and present practice in educational

venues, please call on me. I enclose articles that may be of interest, as well as a
description of CONVULSIVE THERAPY.
Sincerely yours,

cc: Donald Klein, M.D.

Max Fink, M.D.

�</text>
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                    <text>February 8, 1988
Librarian

Smithtown Public Library
1 North
Country Road
Smithtown, New York 11787
Dear Sir:
As a subscriber to the library, 1 was surprised to see the volume: "ElectroShock: Its Brain Disabling Effects" by Peter Breggin among the new books. The
book was published in 1979.

Peter Breggin has taken the position that the treatment is both ineffective
and dangerous. His position is considered idiosyncratic. The treatment is used
widely throughout the world, and is available to patients in this county at
University Hospital as well as private and public psychiatric hospitals.
Patients and families who may be considering the treatment are likely to
look to your resources for advice and help. It is unfortunate that this volume may
be considered timely, when in fact, it is out-dated. in 1985, the NIH held a
Consensus Development Conference on this topic. Peter Breggin was one of many
witnesses. The Consensus commission did not accept his views of the treatment and

recommended its continued use.

Alternatively, the library may consider making the book "Electroconvulsive
Therapy" published by the American Psychiatric Association (1400 K Street, N.W.,
Washington D.C. 20005) equally available. That report appeared in 1978.
I enclose a copy of the Consensus Conference
statement. Perhaps it would
be a service to your readers to append the report to Peter Breggin's book?

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>a
«a:

j-ryup

..

"s-‘ww

--7

January 28, i9 88
‘

Mark Abramowicz, M.D.
The Medical Letter
New Rochelle, NY

Dear Dr. Abramowicz,
i am disappointed with present methods of psychoactive drug evaluation.
The debacles in assessment which are cited in the article on fluoxetine are
matched by the over-investment in the use of benzodiazepines as antidepressants.
The present methods of contract assessment in out-patients, with inadequate
monitoring of the case material or the 'blindness' of the assessors; the inflation of
rating scale data to suggest that individuals can be working with Hamilton
Depression Scores above 22; the very high fees paid assessor groups (up to
$2500/patient); the failure to consider the likelihood that practitioners do know
when the patients begin a new medication and therefore know when to inflate and
deflate scores; and the lack of placebo controls all serve to make modern
assessments of efficacy of antidepressant and anti-anxiety agents highly suspicious.

-

While I have not worked with this compound, 1 would still caution readers
more strongly -- " Until effective in-patient trials of fluoxetine against placebo

and active antidepressants are published in indeprendent review journals, the
responsible physician will use these compounds only in patients properly cautioned
that the results are tenuous and that the treatment must be seen as experimental."
Thank you for sending me the Medical Letter. The reports remain

invaluable.

mw’W'V-l"

Sincerely yours,

w

'

no

Max Fink, M.D.

Professor of Psychiatry
wmv-mmn-W'IWW'dW-IW

"I“lwu'ﬂ‘x-u'fwhz

'r-""WF'WIW

M1?!

"""mel

n

any-M

P.S. Much has changed in the treatment of severely depressed patients with
electroconculsive therapy. Perhaps it is time for the readers of the The Medical
Letter to read about the efficacy and safety of this treatment.
J

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                    <text>February 2, 1988
Ralph A. O'Connell, M.D.

St. Vincent's Hospital

144 West 12 Street
New York City 10011

Dear Tony,
Thank you for the invitation to attend the meeting of the Editorial Board
of Comprehensive Psychiatry. lam pleased to accept.
Shall we try again to get the APPA to accept subscriptions to

the annual dues?

My regards.
,

.u-

Sincerely yours,

,.

«I.

v

,
We

am...

.
mm.

,...

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.
.._.

..

“A.

“up...”

mu“.

Max Fink, M.D.

Professor of Psychiatry

Q as part of

�</text>
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                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                    <text>'7 ‘JW-mw'ﬂ-r-ww-

.

--r~:~~--~~v*

vra "'V"-’~-w"W-‘I-S-Wrr2'rwm"war/1W

um“.

«5:.

-

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no

...., .7.‘.w-—'-...w

February 19, 1988
Ms. Michelle Trudeau

c/o Steve Potkin, MD.

Department of Psychiatry
UCIMC

City Drive 5., Route 88
Orange, CA 92668
101

Dear Ms. Trudeau,
We treat ECT patients at University Hospital on Monday, Wednesday and
Friday mornings at 0800. You may wish to come the afternoon before and meet the
patients and their relatives (visiting hours are from 2 to 4 p.m.). Patients are
usually cooperative for interviews. We recently entertained the BBC/PBS crew for
the series “MIND", and they filmed patient interviews and treatment sequenceswith patient and family consent, of course.

The campus is 55 miles from mid-Manhattan, due east on Long Island. It is
best to come into Long Island MacArthur (lslip) airport, if that is feasible; it is a
short taxi ride to our community. If you come to JFK or LAG, Winston Limousine
service (800 942 l+222) or Colonial Taxi (800 832 7878) generally give the best ﬂat
rate service to our area. It you plan to stay over, the best accommodations are at
the Three Village Inn (516 751 0555) in Stony" Brook. There is one *** restaurant in
our village (Mirabelle).
The next issue of CONVULSIVE THERAPY is celebrating the 50th
anniversary of the introduction of ECT. Among the articles is a translation of the
eye-witness account of the first ECT treatments by Ferdinando Accornero, an
active participant in the research studies at the University of Rome. The article
was published in Italian in 1950; I have had it translated and I enclose a copy of the
proof. (The account is veriﬁed by another participant in the research in Rome,
Lothar Kalinowsky of New York.)
I

look forward to your visit to Stony Brook. My regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

.

.

wrwqm-wr

.‘

�</text>
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              <elementText elementTextId="65517">
                <text>1987 </text>
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                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                    <text>February 21,

19 88

Michael A, Faumann, Ph.D., M.D.

Arisoft Systems

25 824 Dundee Road
Huntington Woods, MI 48070

Dear Michael,
Thank you very much for sending me a copy of BOOK PRO PLUS, and for
translating one of my SCIMATE ﬁles to the BOOK PRO format. I have used the
system, following your suggestions.

It is a useful system for citation retrieval, and easy to learn. I was able to
use the search strategy and to enter new citations. In each activity, the program
performed well.
After some thought, i find that I cannot adopt the system .for my use;
mainly because my investment in SCIMATE is so great, making it uneconomic for
me to convert all my files to the new system.
I

am returning the material sent me, with my thanks. My best regards.
Sincerely yours,

Max Fink, MD.
Professor of Psychiatry

�</text>
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                    <text>February 23, 1988

Stanley Ibmhauser, Ph.D.

NIEI, Inc.

P.0. Box 4633
Bay Terrace, New York 11360
Dear Dr. Konmauser,

Wipt

for
invitation to admit a
EEG
of
with
imagijg
nulti-lead
experience
our
describing
mblication
psychiatric patients. Our work has progressed slowly, and I regret
that we are not in a position to present any useful information at
imam you for the

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>n.

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December 14, 1987
Ross Baldessarini, M.D.
Mailman Research Center
McLean Hospital

il5 Mill Street

Belmont, MA 02178
Dear Ross,
The letter by Lieber in the American Journal of Psychiatry seems to have
been a spontaneous letter, not submitted in response to an article in the Journal. It
looks like an old-fashioned testimonial. For my part, it argues for a complex
polypharmacy whose worth is not known but whose risks are formidable.
i have written to Morry Lipton as

attached; and am sending you a copy as
one of the two established psychopharmacologistson the Editorial Board. Should
the Journal not publish a disclaimer noting that the recommended methodology is
not substantiated either by published studies or established practice?
in the past few years, i have been asked by lawyers to review the records
of patients treated by polypharmacy;patients who have had significant damage

(including two cases of death) which could be ascribed to such practice. One well
established practitioner gave up his practice when faced with charges of abuse of
practice largely due to polypharmacy. Should we not respond to the Lieber letter?
My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

..,,,».~.—....V

,,

1“. ,H".

cw

mm

.

.

�</text>
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                    <text>December 14, 1987
Herbert Y. Meltzer, MD.
Department of Psychiatry
Case Western Reserve University School of Medicine
2040 Abington Road

Cleveland, Ohio

#14122

Dear Herb,
The letter by Lieber in the American Journal of Psychiatry seems to have
been a spontaneous letter, not submitted in response to an article in the Journal. It
looks like an old-fashioned testimonial. For my part, it argues for a complex
polypharmacy whose worth is not known but whose risks are formidable.

have written to Morry Lipton as attached; and am sending you a copy as
one of the two established psychopharmacologistson the Editorial Board. Should
the Journal not publish a disclaimer noting that the recommended methodology is
.‘LOE substantiated either by published studies or established practice?
I

In the past few years, I have been asked by lawyers to review the records
of patients treated by polypharmacy; patients who have had significant damage

(including two cases of death) which could be ascribed to such practice. One well
established practitioner gave up his practice when faced with charges of abuse of
practice largely due to polypharmacy. Should We not respond to the Lieber letter?
This is another small annoyance, like the arguments of Johnstone and
Crow, which we heard in San Juan.
My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>»-

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December 1’4, 1987
Morris A. Lipton, M. D.
Deputy Editor, American Journal 93 Psychiatry
1400 K

Street, N. W.

Washington, D.C. 20005
Dear Morry,

It was a pleasure to talk with you in San Juan. On my return, I read the
letter by Lieber on the "Treatment of Rapid Cycling Bipolar Patients"in the latest
issue of the 5.13. The letter recommends complex polypharmacy as a treatment of
therapy resistant depression. But the letter gives no data as to patient characteristics, history, in-patient or out-patient status, assessment of efficacy of
treatments, trials with established treatments, Egg. The letter seems to be a
throwback to the old—fashioned testimonial which modern psychopharmacology
eschews.

letter is published in the Journal, it suggests that the practice has
review
standards of the Journal and the Association. Do spontaneous
met peer
in response to an article'in the Journal, meet the peersubmitted
letters, not
review standards of Journal articles? Was this letter reviewed by any of the
acknowledged psychopharmacologistsof the Board of Editors? If yes, is there a
message in the letter that our attitude to polypharmacy should change?
As the

if no, would you consider soliciting letters to argue against the adoption of
the Lieber recommendations until they have met established standards of study for
efficacy and safety?

a fact of practice, as we often read in the
which
records
come our way, polypharmacy is not generally condoned
malpractice
by our experience or by our science. is the publication of this letter not a
regrettable mis-step?
While polypharmacy is

My best regards.

Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

�</text>
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                    <text>mq:"u 5"“ "‘.1m‘-I‘qm§&lt;vvm

Wr-Vx-I"'IV' -—-

"vault—'7-

_-

m'RF—"r-Fy'

arm-N.

.

1." m’,‘ vmv

.

raunwmw—q-v

yer

February

"M.

8,

w-rm‘

\w‘n-«m’ﬂ .,

“Juan-vvgg-‘r'v-

-

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quwv-

1988

John C. Nemiah, M.D.

Editor, American Journal of Psychiatry
1400 K

Street, N.W.

Washington, D.C. 20005
Dear John,
Thank you for your and Morrie‘s replies on the Arnold Lieber letter. i am
satisfied that suitable review requirements have been met and that the difference
in opinion is just that..
While lam not likely to advocate or use the treatments described, I also
am not in a position to present data on the risks or benefits of such a complex
regimen. It would not raise the level of discourse to state that such treatment
remain unproven, so i shall not send a response.
I am grateful that you and Morrie have taken the time to answer my query.
Thank you and my best regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

.

mum

van-”m.

~

_

�</text>
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                    <text>March 26, 19 88

Professor Paul J. Poppers, M.D.
Department of Anesthesiology

at Stony Brook
Long Island, New York 1.1794

SUNY

Dear Paul,
I am pleased to submit this letter in support of the promotion of Dr.
FARROKH R. MENEKSHA from the rank of Clinical Assistant Professor of
Anesthesiology to Clinical Associate Professor. 1 have worked often with him in the
ECT treatment unit. I first met him during his residency training, and since then he
has frequently been the attending anesthesiologist for our treatments. It may be
useful at this point to indicate that our ECT facility is a tertiary care center, with
many high-risk patients sent to us from other treatment facilities for this complex

treatment.

He is a dedicated and responsible clinician, well trained with a sincere

interest in our patients. He shows good clinical judgement, relates well to patients,
and is well liked by the psychiatric staff. Regardless of the medical and anesthesia

complexity of the case, he has been deliberate, careful, and reasoned in our
collaboration. He has a knowledge of a wide range of interventions, and l have yet
to see him upset by a case.

He is well versed in the anesthesia literature and discusses the treatment
with assurance. His knowledge of anesthesiology appears excellent, and he likes to
teach. He is comfortable teaching both anesthesia and psychiatric residents and

students.

Farrokh has been interested in our research studies, and he has been most
cooperative regardless of the delays which our tests and requests imposed on the
clinical process.
Finally, Farrokh is friendly, relaxed, interested, and enthusiastic about our
work. Given encouragement, I believe he will expand his research accomplishments.
He is a valuable member of the clinical staff, and lam delighted to recommend his

promotion to associate professorial rank.

This letter may be shared with him.
Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>August 3, 1987
Jovan Simeon, M.D.
27 Davidson Drive
Ottawa, Ontario K13 6L7

Canada

Dear Jovan,
Thank you for the reprints and for the advance notice of the article by
Barry Martin. There seems to be some continuing activity in Canada in ECT, both
clinically and in research, and it is good to read of these things as they appear.
Gabe Carlson has taken a firm hand of the child psychiatry service, opening
the in-patient unit, and in encouraging the residents to work with her. Two of them
are taking a fourth year child psychiatry elective and they enquired as to the
feasibility of following the course of. methylphenidate therapy in ADD children
with QEEG measures. lam pleased to cooperate with them, but asked that they do
a literature review first. Considering the long standing interest in this topic, 1 was
surprised by the dearth of reports. Yours are of some help. We will proceed, in any
case.
i will send the Annals back by separate mail. My best regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

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                    <text>i

v

,
m

August 20, 1987
Dr. Allan Scott
Department of Psychiatry

Royal Edinburgh Hospital
Morningside Park
Edinburgh EH10 5HF
United Kingdom
Dear Dr. Scott,

"'Ivn

"tum-WI

‘T'V‘WVLWFNTW""W"’VW_"F!""=V"

(Following your call, we made reservations for you and your wife at the
Three Village inn in Stony Brook, N.Y. for late arrival on Saturday, September 19,
and departure on Tuesday, September 22. The room is a double, with one bed. The
charge is $75 to $95/night, depending on the location. (Inn: 516-751 0555).

Kennedy Airport is about 55 miles from Stony Brook. The principal
connection is by airport limousine. If you let us know your flight number and arrival
time, we can arrange for either Winston Limousine (516-589-3938)or Colonial Taxi
(516-589 7878 or 800-645 7878) to pick you up. if we arrange a limousine, you will
call the appropriate number on arrival and they will tell you where to find the car.
The rate is about $35. Do not take a regular taxi —- the meter rate is excessive. if
you are in trouble, call us from the airport (516- $2 6651).

V1"'WI""'~“"N"WVW

~
-

mw-cw-ﬂ-wv'w—v

‘

We plan to be at home (about 7 miles from the Inn) that week-end, as I am
'on call' at University Hospital. You will be welcome to join us Sunday afternoon or
evening, according to your jet-lag. i will plan to pick you up at the inn on Monday
morning at 0715; I will be treating patients with ECT at 0800 that morning, and
making patient rounds later in the morning. You are welcome to join in. After
rounds, approximately noon, 1 will be free to work with you.

Stony Brook, and the associated villages of Setauket and Old Field, are
quaint Old English villages, with a strong association with Long island Sound. There
are museums and old houses in the villages. A neighboring village is Port Jefferson,
which is a major port. A trip East along the North Fork will bring you to the
wineries and farms. A trip to the south will bring you to the Hamptons and Montauk
-- the ‘in' communities for the yuppies, the rich, and the famous around here. Or,
directly south is Fire Island and Jones Beach -- among the finest beaches in the
world. Bring bathing suits and boating shoes.
Have a good trip West.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�.
.
m...“

_.-

February 9, 1987
&lt;w..-,,.W——w«

—.,

W—wrv

vv'Vll‘F'r'mr'v-W»

Dr. Allan Scott.
Department of Psychiatry
Royal Edinburgh Hospital
Morningside Park
Edinburgh EHlO 5H1”
United Kingdom
Dear Dr. Scott,

at Stony Brook later this year.
end
the first Monday in September. A visit anytime
Summer holidays traditionally
after mid-September should be convenient.
We will be pleased to have you visit us

I

University Hospital is about 60 miles from mid-Manhattan. it is usually
more convenient to stay at one of our local inns; the Three Village inn (Main
Street, Stony Brook, New York 11790) is most favored.
Our present interest is in two projects -- the efﬁcacy of ECT in therapy
resistant psychosis with an associated study of prolactin metabolism; and the
el-ectrophysioiogy o1 induced seizures. For the latter, we are re-examining the
relationship between the seizure EEG’and the efficacy of seizures; and between the
inter-seizure EEG and clinical outcome. We have completed a study of DST and
outcome in ECT, with disappointing results.
‘

.Your studies of ECT are indeed of interest to us, and i look forward to
reading the results of your studies. As you may know, i launched the journal
CONVULSIVE THERAPY in 1985. We are in our third year and i am quite pleased
with the quality of the material which we are receiving. You may wish to consider
the journal for the publication of reports from your studies.
Oswald.

We look forward to welcoming you in New York. My best regards
I

Sincerely yours,

Max Fink, M.D.

.

Professor of Psychiatry

to [an

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                    <text>ww~vww

.qu.x.v~—w———r_,._:

P—"vmd‘: -w;,r-l.mw~

u

rnwwm

.

—

-..

.7..-x~—.—»—,-mw»m

a...“

September 1a, 1987

’

Prof. Anthony Clare
Department of Psychological Medicine
St. Bartholomew‘s Hospital Medical College
West Smithﬁeld, London E. C. 1
England

,

Dear Tony,
Following your letter of August 28, we will expect you to give a lecture at.
the University on November 10 on the topic "Depressive Disorder in Primary Care".
We have made arrangements for you to stay at the Three Village Inn in
Stony Brook on the night of November 9. When you are in the States, would you call
my secretary, Mrs. Carolyn Paul (516 MM 2929) and she will clue you in to getting

to Stony Brook and the lm from local airports. it would be best to fly into the Long
Island Macarthur (lslip) airport rather than LaGuardia, Kennedy, or Newark
airports.
you come before dinner on Monday evening, i will arrange to have some
associates meet you and your wife for dinner.
it!

We look forward to your visit.

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

cc: G. Carlson

.

.

. .

..

"var—V

�July 31, 1937
Prof. Anthony Clare
Department of Psychological Medicine
St. Bartholomew's Hospital Medical College
West Smithfield, London E. C. 1
England

Dear Tony,
Thank you for your advice in the matter of the Wesner and Winokur article.
Another assessor is equally unenthusiastic and we will probably return it to the
authors with your advice when I get the advice of a third.
It was good to hear that you would be visiting New York this Fall. Our
Department has weekly 'Grand Rounds' for invited speakers on Tuesday mornings.
The dates you made available, October 30 and November 10 includes two Tuesdaysthe first is Election Day and an annual State holiday; the second date, November 10
is provisionally open for you.
The presentations are in a main auditorium, with about 40-50 members of
the staff present. Duration is usually one hour with discussion up to U6 hours. This
is usually followed by an informal lunch with the psychiatric residents. Some
clinicians also make informal rounds, either before or after the presentation, on
one of the psychiatric services, either seeing a number of cases in walk-rounds or a
single case presentation.
I would be pleased to be your host. We can arrange for your stay at the
University, and we usually provide an honorarium of $250.

Let me know if these arrangements are agreeable, and select a topic of
your present interest. While the main thrust of the Department is clearly in
neuroscience, there is a nascent interest in the more psychosocial aspects of

clinical practice as well.
I

look forward to your visit.

Sincerely yours,

cc: G. Carlson

/

Max Fink, M.D.

Editor

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                    <text>September 15, 1987
Nathan Epstein, M.D.
Chairman, Department of Psychiatry
Brown University
c/o Butler Hospital
3&amp;5 Blackstone Boulevard
Providence, RJ. 02906
Dear Dr. Epstein,

Ref: DAVID KROESSLER, M.D.

It is a pleasure to submit this letter of reference on behalf of Dr. David
Kroessler who is being considered for an initial appointment in the Department of
Psychiatry at Brown University.
met David when he was in his residency training program" at University
Hospital at Stony Brook in 1984-1986. Early in his program, i was his supervisor
during his PGY-Z year on the impatient service at University Hospital. David
showed a keen interest in his patients, and stood out as one who was willing to read
original articles when these were considered during our rounds. An interest in the
treatment of delusional depression led to his study of the literature and the writing
of an excellent review article, which was published in the first year of publication
of CONVULSIVE THERAPY.
1

in his senior year, he was chief resident and carried out his assignments
well. He became interested in an academic career and applied for a position with
Barry Fogel in your Department. David and Barry have developed a series of
innovative research protocols, which they have discussed with me.
David is a warm, enthusiastic, dependable, andinter’ested young physician.
He is well liked by his peers, by the staff, and the patients. He seeks and academic
career and iam pleased to endorse his quest and recommend his appointment to
your Department.
My regards.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>Viv—W‘w‘w-v

October i9,

&lt;7..-

19 87

Tn.

ma.

'Wuw

"

'

vw-rrr".

va

"-Im“w'

ww'mwu-w-

-.-

"K‘Fv'vv-g—W-

Stanley H. Kornhauser, Ph.D.
National Institute of Eiectromedical Information, Inc.
P.O. Box #633
Bay Terrace, New York 11360-4633
Dear Dr. Kornhauser,
Thank you for the invitation to join in membership of the National Institute
of Electromedicai» Information, Inc. I regret that Iam unable to join another
organization, as my time for participation in new ventures is severely limited.
My

best wishes on the continued success of your organization.
Sincerely yours,

Max Fink, MD.

Professor of Psychiatry

�</text>
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              <elementText elementTextId="65403">
                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                    <text>..

v

,

W. .--_~...~.,_..;.:‘_y..

~1D~WHYW‘$~—.'wnr',r-

"kn—r- :

w;m.w.v

1

:uv

n

»v..-r—-_-

-m...

"vw—r

m".

rumm— -.——.'—‘.~,..-u

~‘»x.vu.l‘-—(‘r .»..~_.r

October '19, 1937
Ms. Christa Brandt

587 Echo Valley Road
Salinas, CA 93907
Dear Ms. Brandt,

._

Your request for information regarding the psychiatric phenomenon of
multiple personalities was sent to me for reply. This organization tocusses its
research interests on biological treatments in psychiatry, and we have little
experience with the problem of multiple personalities.
Our recollection is that the classic study "Three Faces of Eve" was written
by fellow biological psychiatrists Corbett Thigpen and Hervey Cleckley of Georgia.
The book was published in 1957 by McGraw Hill and should be in your library. I
commend it to you.
Good luck in your studies.
Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

.-_

_,—-mwp~ws

�</text>
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                    <text>October 26, 1987
Ms. Karen Tkach

Excerpta Medica
PO Box 1126

1000 BC Amsterdam

The Netherlands
Dear Ms. Tkach,

am chagrined to have received your kind letter regarding the article
requested by Professor Hamilton for Psychiatry i_n the §_Q_'_§.
I

When Professor Hamilton was a guest in my home in early September, we
spoke of many things, including my concerns with psychiatric classification systems
as well as my interest in coanisive therapy. We discussed a guest article on
convulsive therapy, and I offered to write one whenever he asked. When he called a
few weeks ago, it was to ask for an article on DSM-HI and the classification
dilemma. I said that I would lookinto it, ”and do what i could. After a week, i wrote
to say that I was not prepared to write such an article in the time limit he
suggested. I recommended that he'consider an invitation to one of my students,
Professor Michael Alan Taylor of the UHS/Chicago Medical School.

Professor Taylor, and his associate Professor Richard Abrams, have
published systematic studies of psychiatric diagnostic systems. He has carried out
surveys of actual usage of the system, and has first-hand information on its
limitations. He is well qualified for the task set by Professor Hamilton.
Professor Taylor can be reached at 3333 Green Bay Road, North Chicago,
IL 60064 (312-578 3330), should Professor Hamilton wish to invite his participation.
Should you wish a commentary on aspects of the ECT process, I will be
pleased to write one for Psychiatry in the .3895. Again, my thanks for your kind
,

invitation.

,

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>December 13, 1987
Herbert Pardes, M.D.
Department of Psychiatry
Columbia University College of Physicians
722 West 168 Street
New York City 10032

dt

Surgeons

Dear Herb,

Iam pleased to write this letter in support of the promotion of Dr. Sukdeb
Mukherjee to the rank of Associate Professor of Clinical Psychiatry (Annual) in
your Department. I have known of his work since his EEG studies with Dr. Turan
Itil at the New York Medical College during his residency training. Lately, I have
become better acquainted with the reports of his studies of electroconvulsive
therapy with Drs. Sidney Malitz and Harold Sackeim, and his collaboration with
members of our faculty in neuropsychiatric studies.
Dr. Mukherjee is experienced in psychiatry and neurology, and has
developed special skills in electrophysiology. His major contributions are in the
description of the effects of psychoactive treatments, both drugs and EC’I‘, on
brain function and behavior. In developing these skills, he is clearly in the new
mainstream of 'neuropsychiatry' in clinical psychiatry.
He has a very extensive publication record which reflects a lengthy
research interest. His work is generally shared with many others and he is well
liked. However, it is difficult to discern the area of individual expertise which may
become his main research interest; a development which may be needed for him to
establish professorial independence.
am unable to comment on his skills as a treating psychiatrist, nor as a
teacher, as I have not had the opportunity to assess these aspects of his work. He
has established a firm foundation for his research, and when he identifies an area
of individual expertise, I anticipate that he will extend his important contributions.
1

‘

His record is robust and quite sufficient to support his promotion to the
recommended rank. His academic career will continue to be productive, and I
recommend his promotion with confidence.
'

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>December 21, 1987
Jay Amsterdam, M.D.
Depression Research Unit
Hospital of the University of Pennsylvania
36th 6: Spruce Streets
Philadelphia, PA 19104—4283
Dear Jay,
When you called on Friday, you' seemed surprised that many Europeans
knew of your plans to develop a conference on the treatment of therapy-resistant
depression. Reading the latest Bulletin of the Royal College of Psychiatrists should
clarity the mystery “.- one of your co~workers or consultants has let the cat out of
the bag.
My regards.

Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                  <elementText elementTextId="104264">
                    <text>m»»-m. w,

“ﬂag"...-

w—r, .

7’.»

m7..-

awn—e"

"aw—.7.

7~ru¢mmnmﬂwra

"are".

._‘..w.._..._

,

.

December 22, 1987
Francis A. Gagliardi, M.D.
177-30 Wexford Terrace
Jamaica, New York 11'132
Dear Frank,
A

enclosed.

formal summary of our experience with Mr. DOMINICK CHINDAMO is

At the time of his discharge from the hospital, we were not assured that
the relief that ECT had afforded him would persist, and encouraged him to
continue on tricyclic antidepressant medication. His daughter called me a few
weeks after his discharge, relating that he had some recurrence of symptoms. I
encouraged continuation of medication, but failing that, offered to see him again
for further ECT at University Hospital if his physicians thought it would be useful.
My

best regards.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>Of

College

Physicians

C?

Surgeons of Columbia University

DEPARTMENT OF PSYCHIATRY
Donald F. Klein, M.D.

‘

New York, N. Y. 10032
722 West 168th Street
(212) 960-2307

Professor of Psychiatry

December 22, 1987

Mrs. Edward

M.

Bigler

Doubling Road
Greenwich, CT @6830
40

Dear Mrs.

Bigler:

Delighted to hear that Tom is doing so well.
With regard to the panel on the Phil Donahue Show, I would be pleased
to join it. However, I must point out that I am not really a
national expert on ECT but rather on medication. My old boss, Max
Fink, M.D., who is Professor of Psychiatry at State University of New

at Stony Brook, is an international authority on ECT and
I think he would be an excellent person for
your panel.
York

extremely well spoken.

has recently told me that he has seen a number of patients
somewhat like your son who have an atypical schizophrenia where
had worked in the face of substantial drug resistance.
He

Cordially,
”,7

/I/

/7

‘1’

0K/wxfx
Donald F.

Klein,

dcd
bcc:

Max
"'

Fink
.3

M.D.

ECT

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                    <text>December 26,

19 87

Frederick H. Kasten, Ph.D.
Department of Anatomy
Louisiana State University Medical Center
1100 Florida Avenue
New Orleans, Louisiana 70119
Dear Dr. Kasten,
i recall Leo Alexander well; he was an active, outspoken, and critical
member of the audience at many of the meetings of the Society of Biological
Psychiatry and Electroshock Research Association that iattended. i did not know
him personally, and i can recall no direct interaction with him.
He wrote the textbook TREATMENT OF MENTAL DISORDER which was
published in 1953 by $1.8. Saunders, Phildelphia. In it, he has extensive sections on

convulsive therapy, as well as the psychotherapies. Reading the index today, one
gets the impression that he was trying to resolve the dilemma of the success. and
risks of the somatic therapies with the elegance and greater acceptance (especially
in Boston) of the psychodynamic model. He does notsucceed in balancing these
antithetic attitudes well.
Leo Alexander was a practitioner seeking to make the best of an impossible
of
test allegiance. His textbook is idiosyncratic and limited; it contrasts rather
poorly with other texts published at the same time (see Kalinowsky and Hoch or
Sargant and Slater).
The APA Task Force report on Electroconvulsive Therapy is report #14,
published in 1978. It should be available in your library, or from the APA in
Washington, D.C. l was a member of the panel, and contributed to, but did not

write the report.

_-

i met Reuben Reiter back in the 19505 when I was interested in ECT
devices. 1 used one of his devices for a while but thought his instruments were
poorly designed. They are no longer in active use. i was told a few years ago that
he had died, but have no further information.

i

trust these comments are helpful.
Sincerely yours,

Max Fink, Md).

Professor of Psychiatry

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                    <text>May 20, 1987

Samuel Barondes, MD.
Department of Psychiatry
University of California, San Francisco
401 Parnassus Avenue
San Francisco, CA
~

‘

9“”

Dear Dr. Barondes,
At your request, I am writing this letter regarding the promotion of Dr.
Edward Merrin to the rank of Associate Professor. I do not know Dr. Merrin, and“
was not acquainted with his writings before reviewing the publications sent to me.
I am impressed with the quality and sophistication of Dr. Merrin's research
studies using quantitative. EEG methods. His choice of problem (laterality in
schizophrenia) is timely and important; the methods used (power spectral analysis,
unlinked reference leads, medication controls) are reasonable; and the quality of
the reports excellent. The latter are clearly written, and Dr. Merrin uses good
statistical and data processing procedures.

These studies are important and they reflect an interest that should
continue to be productive in the forseeable future. It is difficult to assess the
importance of these studies in the field, since there is much activity and little that
has been conclusive. These studies of laterality are well done and must be
considered in any further studies of the problem. And, as a young investigator, I
believe that these reports are of high quality, comparing most favorably with other
reports in the field. For example, he has not made the glaring errors of Duffy, E.
Roy John, and Morihsa, who failed to control for handedness, drug use, and
electrode montage in their conclusions (which have since had to be retracted.)
Dr. Merrin’s clinical reports are also well written and useful. I am unable to
assess the studies of saccadic eye movements, since I am not conversant with the
theory of these studies.
_
i have examined his list of Departmental, V.A., and University teaching
responsibilities, and these seem consistent with his rank. I am, of course, unable to
assess their quality.

To the extent of this review, I am impressed with Dr. Merrin's reports and
output, and would have no difficulty in endorsing a recommendation for his
promotion to the rank of Associate Professor at this University. I am comfortable
in making the same recommendation for the University of California, and
recommend Dr. Merrin's promotionwithout reservation.

Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

'

‘

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E

l

i

‘

l

May 23,. 19 87

Mr. John S. Purvis
Division of Neuropharmacological Drug Products
Food 6: Drug Administration

Rockville, MD 20 857
Dear Mr. Purvis,

E

E

S

The studies of ORG 3770 (6-azamianserin) under IND ”.915 were
completed. The results were published in 1982 (Psychopharmacology 78:44-48).
We were the only investigators under this IND.
We no longer have supplies of

6-mmianserin.
Sincerely yours,
Max Fink, MD.
Professor of Psychiatry

�</text>
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                    <text>May 23, 1987

Alfred M. Freedman, M.D.

IPMS

Department of Psychiatry
New York Medical College

Valhalla, New York 10595
Dear Al,

am unclear about the mission of the new International Association
for the integration of Psychiatry and the Medical Sciences (IPMS), I am pleased to
work with you on this project.
While

1

In the latest number of CONVULSIVE THERAPY, I have written an
editorial about the increasing interest by neurologists in behavior and of
psychiatrists in brain function, with the re-emergence of neuropsychiatry (under
the code-name of Behavioral Neurology). Indeed, it was only yesterday that 1
proposed the development of such a journal to Alan Edelson at Raven Press and
recommended that he consider inviting Michael Taylor to develop such a project.
‘

Perhaps we are responding to similar awarenesses, with a slightly different
emphasis.
in any case, I look forward to hearing more about the forthcoming meeting
in New York of IPMA.
‘

My best regards.

Sincerely yours,

Max Fink, MD.
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 1794—8101
telephone: (516) 444-2990
1

StonyBrook
May

S. Reddy Pasem, M.D.
1301 River Oaks Drive

Colonial Heights,

VA

26, 1987

23834

Dear Dr. Pasem:
Thank you

for your inquiry.

I

will not

be

available to

course until October. I think your needs can well be
served by the program at Duke University.
Duke University has just announced its programs in ECT.
I
enclose an announcement and suggest that you contact Dr. Coffey
directly. If that does not work out please get in touch with me
after the summer.
supervise

a

Sincerely yours,
Max

Encl.

C.

M.D.

Professor of Psychiatry

MF:cjp

cc:

W

Fink,

Edward

Coffey,

M.D.

�</text>
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                    <text>May 28, 1987

Dr. H. Babikian
Department of Psychiatry
New York Medical College
Westchester Medical Center
Valhalla, New York 10595
Dear Hrair,
For a course in convulsive therapy for the residents, we propose three
sessions, each of take hours.
.

1. Seminar: History; Indications; Clinical Issues in treatment; Risks and
Side-effects; Maintenance therapies.

Videotape: Information for Professionals.
2. Technical issues in Treatment: Electrode Placement; currents;
anesthesia; high risk cases, instruments; seizure duration monitoring.

Consent. information for patients and relatives.
7 Videotape #2— Information for Patients and Families
3.,

Review.

Clinical Case Seminar:

Question Period; Case presentations by the residents from your wards; and

The first and third sessions will be by myself; for the second, my associate, Dr.
Greenberg will talk about the technical issues; and our nurse, Mrs. Irene Carasiti,
who teaches patients and families about ECT, answers their questions, and obtains
consent, will discuss these aspects of the treatment.
We will provide reprints from the literature as well as a reading list for
the latter well in advance of the course so that the materials
reproduction;
your
can be made available for the students.

if this sequence is helpful, we can set aside the time and discuss the
honoraria involved.
'

My regards.

'

Sincerely yours,
Max

seamen.

Professor of Psychiatry

�</text>
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                    <text>‘.,,_...

Ww-y.w~.m

June 3, I9 87
Conrad Swartz, M.D., Ph.D.

Department of Psychiatry

UHS/‘i'he Chicago Medical School
3333 Green Bay Road
North Chicago, ll. 6006!;

Dear Connie,
Thank you for sending me the videotape of your unusual interview on the
demasculinizing and cardiac effects of chronic alcohol use. To the long list of other
reasons which I have dutifully expressed to the students about the hazards of
alcohol use, lcan now add these data. The argument that alcohol use contributes to
myocardial infarction is another compelling one for the anti-alcohol lobby.
Two decades ago, similar questions about demasculinizing effects were
raised about cannabis use, mainly by Gabriel Nahas. l have often wondered whether

these reports have merit. Is there any data on cannabis use and myocardial
infarction? A question to Costas Stefanis at the University of Athens may
encourage a parallel study in chronic cannabis users.
am so glad that I am not an alcohol user, and when
your ﬁndings, she was also pleased.
I

I

told Martha about

'

Keep up the good work. My best regards.
Sincerely yours,
Max Fink, M.D.

Professor of Psychiatry

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                    <text>May 23, 19 87
'Mr. Henry Feiwel
850 Park Avenue
New York City 10021

Dear Henry and Maria,
At the recent APA meetings in Chicago, I was introduced to a psychiatrist
from Lima, Peru. Recalling that Dr. Honario Delgado, a previous Professor, had
displayed the art of his patients, I enquired what may have happened to the
collection. 1 was told that it is maintained as a permanent museum under the
direction of:
-

Dr. Grover Mori
Victor Larco Herrera Hospital
Pabellon #2
Lima 27 - Magdalena

Peru.

It was not clear whether they had a catalog, but part of the collection had been
exhibited in Paris some years ago.
It may be of interest to enquire as to the state of the
collection, so
written to Dr. Mori.

I

have

am delighted that you will be on the Island this summer. We are
completing the refurbishing of our pool-side apartment, and it should be ready for
visitors in a few weeks -- as soon as we can get the air-conditioning installed.
I

My best regards.

Sincerely yours,

Max

-

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                    <text>June 30, 1987
Greta Koinig, M.D.

Allgemeines Krankenhaus der Stadt Wien
Psychiatrische Universitﬁtsklinik
wahringer Gartel 18-20
1090 WIEN
AUSTRIA

Dear Greta,
Because flights to Kennedy Airport are so irregular, it is not feasible to
meet arriving passengers. When you have cleared customs, find the telephones for
suburban limousine services, and pick up the telephone which is labelled "Long
Island Limousine Service” or "Winston Limousine Service (Long Island)". Tell the
operator that you wish to go to Stony Brook (Railroad Station). When you know
what time you will be arriving at Stony Brook, let me know and we will pick you up
at the station. (Or call from the station; we will be about 15 minutes away.)
Or, call me before making limousine arrangements and 1 will explain again.
at work (516 MW 2929) or at home in the late

i can be reached most days
afternoons (516 862 6651).

We will make arrangements for your stay.
My

regards to Gerhard.
Sincerely yours,

Max Fink, M.D.

Professor of Psychiatry

�April 25, 1937

Greta Kolnig, M.D.

Allgemoines Krankenhaus der Stadt Wlen

Psychiatrlsche Universltlltsklinik
wantinger Gurtel 18-20
1090 WHEN
AUSTRIA

Dear Greta,
We should be in New York dorlng much of July. While I will not be ‘on
service', I will be able to have you meet my associatos and work with us on July 13.
I

will arrange some accommodations.

When your plans are finalized, let me know. I can be reached most days at
work (516 #44 2929) or at home in the late afternoons (516 862 6651).
My regards to Gerhard.

Sincerely yours,

Max Fink, MD.

Professor of Psychiatry

�</text>
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                    <text>. ~,W.',-W-n‘wa.._ ,___,._..._

_

s
,...

we.

WA.

July 15, 1987
Professor Fritz Henn, Ph.D., MD.
Department of Psychiatry 6: Behavioral Science

SUNY at Stony Brook
Long Island, New York 11794

Dear Fritz,

lam pleased to submit this letter in support of the promotion of Dr.
Krishnareddy Gujavarty from the rank of Clinical Assistant Professor of Psychiatry
to Clinical Associate Professor of Psychiatry. I have worked closely with Dr.
Gujavarty for more than four years, as a collaborator on research projects, as a
team-mate in both the in-patient unit at lO-North and the Affective Disorders
Clinic in the CPD, and as a fellow teacher and member of the Department.
I have come to know his professional work very well. He is a dedicated and
responsible clinician, well trained (in our own resdiency training program, I might
add), with a sincere interest in our patients. He shows good clinical judgement,
relates well to patients and their families, and is very well liked by our co-workers.
He reads the literature avidly, and often presents the latest clinical findings in our
case conferences. He has accepted additional assignments within the Department,
including the medical management of the cases in the Sleep Disorders Program
when it was headed by Drs. Mitler and Baker, scientists without clinical

certification.

His knowledge of clinical psychiatry is excellent, and he likes to teach. In
addition to the supervision of residents, for many years he has taught psychopharmacology to each rotation of third year clerks. Each year, he has accepted the
repsonsibility for presentations in our Grand Rounds program.

He has accepted numerous departmental administrative assignments with
enthusiasm; the latest is his appointment as acting clinical director for the inpatient unit at University Hospital -- a position which he is carrying out with elan.
In his research work, he has made independent observations and reports in
sleep physiology and convulsive therapy. At present, he is principal investigator in
drug therapy studies.

�His greatest strengths are in clinical care and the teaching of medical
students and residents. in his research, he has been slow to identify an area of
expertise, although his recent sleep studies show considerable promise of achieving
wider recognition.

lam delighted to recommend his promotion to associate protessorial rank.
He is a dedicated, reliable, and loyal member of our staff and we have come to
depend on him for his clinical and teaching skills.
This

letter may be shared with Krish.
Sincerely yours,
Max Fink, MD.

Professor of Psychiatry

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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

�</text>
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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

�</text>
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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

�</text>
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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

�</text>
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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

�</text>
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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"

'

�</text>
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                <text>Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York).</text>
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                  <elementText elementTextId="104245">
                    <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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                    <text>"a,

A?

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«

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7

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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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                    <text>~
,.

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

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WV

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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

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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;

_

....W~w.,.m, .w

.7

(W,

‘

._.

.

.

..-.,.__n_. my-

W

W

January

w...

1, 1986

”mm

my.

w“.

ww—u-

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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                    <text>WW“.—

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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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

�</text>
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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

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....,.

Mr

“Vm'vwvw'urr

Max Fink, MD.
Professor of Psychiatry

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                    <text>r_.——-

»

rwv—v'

.

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

1:"v *-»-’-’

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,

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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

�</text>
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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

�</text>
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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.-

-

w,._.,v_w..'

Max Fink, M.D.

Professor of Psychiatry

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                    <text>&gt;

7

,.

....r_mw.,mw is

..

._..

v” -. .mu—l-

..

—,

w.

a—v

-.

l.“"‘

.-.-...-v

i”

u.-

&lt;.

—

”.1er

vrtmr"

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_
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wry.

Thank you for your consideration.

wwwwn-w-v-

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Sincerely yours,

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Max Fink, M.D.

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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

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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

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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

�</text>
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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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"WWW“..‘WWWv—F-wnn

-—

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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