Vignettes from Psychiatric Training, 1945-1951

When I graduated from the Johns Hopkins School of Medicine in June 1945, I went almost directly to a nine-month rotating internship at the University of Iowa Hospital, with the plan of returning to Hopkins for a residency in psychiatry. Iowa City was and is today an outstanding medical center. The relaxed atmosphere not only allowed me to grow personally, but gave time for the assimilation of knowledge from a fine group of professors and a wide diversity of patients brought in by ambulance from the four corners of the state.

My father proudly deposited me and my belongings at the institution from which his brother Myron had graduated in medicine in l903. On a wing close by the wards, an apartment had been constructed for the women interns who, because of the war, had appeared on the scene for the first time. Would I ever adjust to these strange quarters amidst the smells, the bustle, the repeated "Calling Dr. So-and-So" of hospital activity? I settled into a tiny room with its hospital bed and a curtained swinging half-door which provided little privacy. The suite of rooms felt so "clinical," so different from the Hen House where the women medical students at Hopkins had created a home in a row house adjacent to the hospital. I missed my friends, I missed Baltimore itself. To keep myself company, in my spare moments, I began to read Marcel Proust's Remembrance of Things Past. My heart constricted and tears rose to my eyes as he recalled the touch of his grandmother's enfolding arms. I shared his joy in the sparkling sea reflecting in the mirror of his armoire, and the lights that danced around the bedroom wall. I wrote my parents: "So many times he will elaborate on an unusual idea which had crossed my mind at one time but left me inarticulate."

Our little apartment became more interesting when a young woman doctor from Bombay blew in on a breath of perfumed air. At times I was astounded that someone from the other side of the world could be so much like me. The next moment she was an unfathomable mystery. Her movements were quick—alas, sometimes too quick. One day in the operating room she discarded the gauze that contained radon seeds removed from the cervix of a patient. By the time they were missed, the waste had been emptied into the Iowa River. Two divers from the hydraulic engineering school retrieved the radon from the murky bottom by means of a Geiger counter.

Our apartment hummed with life: Kamal chanting and dancing with bells around her ankles, Helen crocheting, and me busy at the sewing machine. On the Victrola, Dorothy Maynor sang from Louise as she trembled deliciously in her love. We were happy in the home we had created.

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My first service at Iowa was in a building across from the hospital, known as "Psycho." I was put right to work giving the intravenous injections of curare to patients who were receiving electric shock treatment. The patients—immobilized by the medicine, which relaxed their muscles so the convulsion did not break their bones—were frightened as the nurse rubbed a conducting ointment into their temples, inserted a padded tongue blade between their teeth, and held the electrodes in place. The blue flash, the convulsion, a pause to be sure the patient had resumed breathing—and a very limp patient was rolled out to make room for the next. At first I was horrified: it all seemed so medieval. But when the memory confusion gradually cleared after the course of therapy was complete, often the depression had been cut short. I came to the conclusion that the psychiatry department at Hopkins could make more use of electroconvulsive therapy (ECT).

The shock therapies, sodium amytal interviews, and use of hypnosis were techniques new to me. With the...