This Date in UCSF History: Dubious Therapy


This story was originally published in Synapse - The UCSF student newspaper on December 17, 1971. 

The chronicle of rehabilitation practices in California penal institutions has often been grim. Only 20 years ago, for instance, psychiatry in prisons consisted primarily of punitive or disciplinary practices.
Therapy generally included: electric shock, insulin shock, fever treatments, hydrotherapy and amytal and pentothal interviews.
Presently, shock treatment is out of vogue, considered as “aversive therapy.”
However, in its place at the Vacaville Prison's planned adjustment center opening shortly, is a drug that is a questionable improvement-the drug Anectine (succinylcholine).
The drug paralyzes all voluntary muscles for about 60 seconds and makes it impossible for an individual to use his lungs.
While a prisoner is thus paralyzed, the therapist tells him that the next time he feels an impulse to smash or attack, he will remember the sensation.
According to Dr. Arthur Nugent, chief psychiatrist at Vacaville, “the sensation is of suffocating and drowning.
The patient feels as if he is on the brink of death.” (“LA Times,” Sept. 9, 1970).
Taking advantage of resources
The California' Department of Corrections (DOC), at a cost ofs7ooo per man, places perpetrators of violent behavior in similar “adjustment centers.”
These centers were originally conceived as places where “men would be allowed to take complete advantage of the educational, vocational, medical and psychiatric resources of the prison system,” stated the “Sacramento Bee” (Feb. 9,1970).
The reality is far different. The afore-mentioned “medical and psychiatric resources” comprise, instead, “pseudo-medical torture” according to Dr. Edward Opton, psychologist.
After attending a recent DOC-sponsored conference in Davis, Dr. Opton revealed the DOC plans to open the new Vacaville “super-adjustment center” where men would be sent from prisons around the state for “psychiatric and psychological assessment.”
Most of the doctors at the conference were unwilling to discuss the therapeutic practices that will be put into effect at the new center.
However, one doctor did proffer his opinion. Dr. Opton quoted (“Berkeley Barb,” Dec. 2, 1971) Dr. Bach-y-Rita, half-time research psychiatrist for the DOC and half-time for Langley Porter.
“I'd try drug therapy first. Then I'd use implanted electrodes.”
The psychiatrist was convinced that violence-prone inmates suffer from “temporal lobe epilepsy” and advised the sticking of long needles into the temporal lobe section of the brain to locate the epilepsy and kill that area of the brain.
“Sort of a mini-lobot-omy is what he was talking about,” explained Dr. Opton.
Other therapeutic practices currently underway at Atascadero State Hospital for drug and sex offenders and in other California prisons include: a method of shock with electric prods for “curing” catatonic schizophrenics and the Errorless Extinction of Penile Responses for treatment of sex offenders.
The latter therapy consists of giving a shock to the penis if it becomes erect at an erotic picture.
Dr. Opton remarked upon the similarity of such “therapeutic” practices to the tortures used in Vietnam to secure information from enemy soldiers.
Medical care in the local penal institutions is similarly often inadequate. Gwen Scott, 4th year UCmedical student, is currently working on a project visiting the women's section of the city jail for a course in ambulatory and community medicine.
“This project,” explained Gwen, “was initiated by Marie Felton (U.C. 71, SFGH intern) and was continued last quarter by Betty Pfefferbaum, also a 4th year student.
At the beginning of any rotation, a committee of four people, Dr. Bob Brenman, Dr. Ken Barnes, Joanne Donsky and myself went to the city jail to obtain permission for access to the jail.”
Permission was granted and since then, Gwen has frequently accompanied the prison doctor on his rounds. Inmates are brought into a small treatment room with a nurse and a police medical officer in attendance.
“Most of the male prisoners come in for treatment of penile discharges. The patients are treated with antibiotics on clinical grounds alone.
“All those persons arrested for prostitution,” she continued, “are put into quarantine. To my knowledge, before they are released from jail, they are given a blood test for syphilis (VDRL) and injections of penicillin. They may or may not be given a pelvic exam and cervical culture for gonorrhea.”
On one particular occasion, Gwen saw a girl who had had surgery for a broken jaw just prior to being picked up on a felony charge.
The girl, at that time, indicated to Gwen that she could not open her mouth and maintained that she had not been given anything to eat which she could take through a straw during the 18 hours she had been there.
Some of the “jaw stabilizers” had broken and she stated that she had received no pain medications although she was allegedly in pain.
When Gwen indicated to the medical officer that the girl should be taken to the clinic for repair of the broken stabilizers, the officer explained the difficulties involved for the police officers.
When an individual charged with a felony has to be taken to the hospital, the person requires a 24-hour guard.
Upon another occasion, Gwen noticed a woman who had a badly infected toe at the site of a skin graft. The dressing had not been changed and the woman stated she had no facilities available to her to soak the toe.
Gwen commented upon the appearance of the “dormitory cells.”
“As has been similarly observed in penal institutions across the country, prisoners tell of thin mattresses, no sheets and thin woolen blankets for cover. They complain that the cells are cold and the food is not nutritious.”
She also remarked that the striking feature of the jail is the pervasive boredom.
“Women are daily taken to a large enclosed recreation area with a cement floor and five picnic tables. No radio, television, newspapers or magazines and only two or three paperbacks are present in the room.”
The San Francisco city jail and the California state penal institutions offer testimony to the many failings of the California Department of Corrections.
It is encouraging that Gwen and a few other individuals have expressed their concern with improving the present conditions of medical care and rehabilitation practices in these institutions.