Intended for healthcare professionals


The acme of efficiency

BMJ 2004; 328 doi: (Published 29 April 2004) Cite this as: BMJ 2004;328:1050
  1. Alan Gibson, retired consultant psychiatrist
  1. Woking

    In 1955 I was a registrar in a large mental hospital in the north of England. Most of the bedswere in the old buildings, which had remained largely unchanged for nearly 100 years. There was also a modern building in the grounds, to which new patients were admitted. If these patients needed electroconvulsive therapy, they were anaesthetised and given a muscle relaxant. Electroconvulsive therapy was also widely used in the chronic wards, where it was the consequence of disturbed behaviour. There, it was given “straight”—that is, without anaesthetic or relaxant. This policy was defended by the view …

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