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                  <text>April 13, 1997
Mrs. Katherine Graham
The Washington Post
1150 15th Street NW.
Washington DC 20071
Dear Mrs. Graham,
Reading the story of Mr. Philip Graham’s death in your Personal History
is a sad reminder that even the best educated in America do not get the best medical care.

The tragedy reﬂects the failure of the early recognition of manic depressive illness, the
failure to use available medications, and what is most egregious, the failure to use
electroshock. While much has been learned since, the beneﬁts of electroshock, including
its use against suicide, were clearly well known in the profession at the time of the
tragedy.
Why write now? Because your tragedy is still repeated in America. It is
one thing to have a fatal illness for which no remedy has been devised; it is another to
have an available remedy and not use it because of professional bias and incompetence,
encouraged by the bias of the press and the media.

Electroshock, as you hint [pg 329], is different today than what was
available a quarter century ago. But the negative attitudes to electroshock expressed by
your husband’s physicians are as prevalent today. The legislature of the State of Texas is
considering a bill to abolish the use of electroshock in the state; it already has regulations
that proscribe its use in persons under the age of 16. A starting point could well be the
enclosed memorandum from Texas.
The bias against the use of ECT is largely engrained among mental health
professionals and managed care companies where ECT is seen as a ‘last-resort’ therapy -—
to be used only after all other possible treatments have been tried and failed. Dependence
of oft-repeated ineffective trials encourage suicide and death.

�Mrs. Katherine Graham

Page 2

Perhaps you can turn the powerful searchlight of the Washington Post on
national
bias
and hostility against the use of an effective and safe treatment for severe
our
depressive illnesses. Sadly, few of the active psychiatrists at NIMH have experience with
electroshock. The only two names that come to mind are Dr. Richard Wyatt and Dr.
Matthew Rudorfer; the ﬁrst has an academic knowledge but little clinical experience; the
second a limited clinical experience. But they are knowledgeable.
Thank you for writing such an interesting story and for expressing so
clearly the tragic effects of professional bias against an effective intervention.
Sincerely yours,
Max Fink, M.D.

�</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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