He had always been a small man with wizened lines, a moguled nose that sloped over a deep philtrum and two ears that flew like flags on the sides of his head. Looking at Marcos has always been a study of human terrain. For someone with so much activity and exchange with just being seen by others, it was an apparent contrast to how disconnected he remained emotionally. Brain illness had harmed Marcos. It was as if he had been scooped out in places.
Marcos and I had worked together for ten years in psychotropic and psychotherapeutic remedies with only partial treatment responses that curved up toward an imagined healthy baseline on currents of hope. His improvements however, never reached where he would call himself, “well,” and too soon they drifted down despite our cumulative efforts.
About that time, I had returned from Duke University for an update in training on electroconvulsive therapy, (ECT,) and had just opened up a new outpatient ECT surgery treatment center. When Marcos and I discussed this as a new option, (new for our living location,) he wanted it without contest.
The evidence for efficacy as compared with the side-effect profile in ECT is dramatic. When I tell patients about it, ECT might sound too good. However, it has been around for so long that it celebrates itself. Marcos wanted in.
It has been a year already since we started ECT together but I still remember the way he leaned back in his chair that day in my office, animated almost for a change. His scrubber eye brows were like punctuation marks around his eyes. “Yes. I want it.”
Marcos has not been able to taper down ECT at this point in his treatment to less than one treatment every two weeks. He and his wife argue for it. We have tried many times to taper down but every time we do, his symptoms come back. He and his wife ask me separately and together, “Why doctor? What is the point of decreasing treatments? I do not understand? When they work so well and we are not having any problems from them, why are we trying to reduce them?” So, for now, he maintains one ECT treatment every two weeks.
His wife tells me he is better than he was on their wedding day. She has never known him to be doing this well and they both think he is closer to whatever that baseline is for brain health he has always thought he was never going to get. More connected with her, their sex life is having a run. More connected with their kids, everyone feels like he has become a giver and the kids grades are even getting better. By taking, Marcos became more of a giver; taking time, courage, emotional energy, even a ride there and from ECT, Marcos took and then was able to give.
Marcos is reading everything he can get his hands on about ECT; personal biographies, scientific articles, he has become his own advocate. He could not read before ECT. His concentration was too poor. Now, with improved focus and attention, he perceives his memory is better. Marcos believes he is interesting because he is interested in himself. He is more aware of how others see him and smiles back when he catches the looks he gets just by wearing that face.
ECT is not a cure, but it is a treatment option. It leads to brain healing, quality of life and improved connections.
Questions: Have you struggled with quality of life? How do you describe quality of life? Please tell us your story.
Self-Care Tip: Consider changing treatment paradigms to improve brain health.
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