In the middle of the kitchen table in Ted Chabasinski's apartment is a stack of papers and press clippings held down by a book called "Organizing, Organizing, Organizing." The title is an appropriate centerpiece to his table, even to his current life.
Chabasinski is the man responsible for organizing Measure T. On Nov. 2, 62 percent of those voting in Berkeley turned out in favor of Measure T and banned electroshock therapy in their city.
By American standards the initiative was a radical one. Even by Berkeley standards it was unique. For what is believed to be the first time, citizens found a specific medical treatment on the ballot. They voted against the psychiatric establishment, against authority.
"The essence of the doctors' campaign against us was to say, 'We're DOCTORS, how can you tell us what to do? You're too ignorant to tell us what to do,'" says Chabasinski with more than a hint of pleasure at their comeuppance.
Chabasinski, 45, who works now "off and on" in day care, has good cause for his personal grievance. He didn't learn about shock treatment by watching "One Flew Over the Cuckoo's Nest." At age six, he says, he was institutionalized and given electroconvulsive treatment (ECT). "It took three people to hold me down." He wasn't released for 10 years. He hasn't forgotten for nearly 30 years.
In some ways, Chabasinski is right. This is a battle over control of treatment, technology, a battle about expertise, professionals and people. The campaign against ECT is not unlike the campaigns against nuclear plants or nuclear waste disposal or a dozen other referenda.
This year in particular, voters have been encouraged to think for themselves instead of following "expert opinion." There is nothing unusual about that. The underlying bias of democracy is that nothing is too complex for citizens to decide.
As Alan Stone, a psychiatrist and Harvard law professor, puts it, "There has been for the last 10 years what I think is a wonderful questioning of authority." Yet at some point questioning turns into wholesale suspicion, and suspicion about expertise turns into the confidence of know-nothings. "There is an exaggerated fear of psychiatrists, that they have these science-fiction treatments or they're doing things totally horrible," ponders Stone. "My sense is that the public is not well informed about treatment. It's hard to be well informed about treatment."
In fact, in the years since "Cuckoo's Nest" was written, the years since Chabasinski's childhood was brutalized, the treatment of ECT has changed into a more benign procedure. Under controlled conditions it carries fewer risks or side effects. Ironically, California already had one of the most stringent laws regulating ECT and protecting patients' rights.
Psychiatrist Loren Roth, a University of Pittsburgh professor and chair of the American Psychiatric Association's Commission on Judicial Action says, "Nobody likes the idea of electricity in the brain. I'm aware of the public fear, the potential and past misuse. But in terms of changing severely depressed, mute, catatonic people at a life-threatening risk it can be a most dramatic, impressive treatment."
But whether out of arrogance or ambivalence, psychiatrists were late and reluctant to enter the Berkeley political fray. They were an easy, unpopular target, but not the only target.
The Berkeley case, suggests Roth, is one of a series in which we face conflicting rights: the right of a patient to have a beneficial treatment versus the right to be protected from a harmful treatment. The right of an individual to contract with a doctor for any procedure versus the right of the public to regulate procedures.
We have seen these rights conflict before in attempts by some to limit access to abortion and by others to legitimize laetrile. We have seen the dramas acted out in legislatures and regulatory agencies and courtrooms. Now, Berkeley has played it out at the ballot box in one broad brush stroke -- an all-out ban.
This time I think the people of Berkeley misplaced their mistrust. The victory is likely to be a short one. The APA and the Northern California Psychiatric Society announced this week that they will challenge the ban. The controversy will go on.
We are, simply put, ambivalent toward science, medicine, technology. In need, we reach out for the quick fix, the newest pharmaceutical hope. In skepticism, we hold back for fear of being misled, zapped. This is not a problem that we can allay by adopting some new democratic bedside manner. We can't cure it with prescriptions by ballot box.