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A Soft Voice in a Deaf Ear
The time had come to tell the story to the medical profession. I had seen seven persons benefit from PHT, the electrical thoughts had been checked out and were not implausible, and there was the medical support of the Goodman & Gilman excerpt.
Now that the time had come, I didn’t know how to proceed. I had always assumed that if I had enough evidence I would just “turn it over to the medical profession.” That would be no problem, I thought. Now, faced with turning it over, I realized there was no “receiving department” in the medical profession—and I didn’t know where to go. Dr. Silbermann and I discussed this problem at length and finally came up with what seemed a sensible plan. Max, an associate professor at Columbia Presbyterian, was a personal friend of Dean H. Houston Merritt. This was the Merritt of Putnam and Merritt who had discovered that PHT was useful for epilepsy. What could be more logical than to bring the story to Dr. Merritt and Presbyterian Hospital?
At Max’s suggestion we invited Dr. Merritt to have dinner at my home. Dr. Merritt accepted and brought with him Dr. Lawrence C. Kolb, chief of Psychiatric Research at Presbyterian. Since this was the first opportunity I’d had to present the PHT story in some detail, I was anxious to have other physicians present, and I invited my family physician, Dr. Alfred Steiner, and Dr. Ernest Klarch, a psychiatrist, whom Max had consulted in one of the seven cases. Also at dinner was my friend Sol. He had come from Miami so that the physicians could hear about PHT from a person other than myself.
Sol and I related our experiences with PHT. Then I told the physicians about the other five cases, and reported my observations of the medicine’s effects on anger, fear, and the turned-on mind. They didn’t express skepticism, but I think that the story, coming from a layman, was hard for them to believe. I was glad I could conclude with the quote from the respected medical source, Goodman & Gilman. To repeat: “Salutary effects of PHT on personality, memory, mood, cooperativeness, emotional stability, amenability to discipline, etc., are also observed, sometimes independently of seizure control.” Dr. Merritt appeared surprised by this excerpt from Goodman & Gilman. He said he hadn’t heard of it but hoped it was true. Then he suggested that maybe Presbyterian could do a study. Dr. Kolb agreed and said it could be arranged.
I couldn’t let Dr. Merritt get away without asking him about possible side effects of PHT. He said that PHT had been in use for about twenty years, and a good record of safety had been established. There were side effects but they were rarely serious. He said PHT was nonhabit-forming, and unlike many other substances it was not sedative in therapeutic doses. This was good news and I thanked Dr. Merritt. At the end of the meeting Dr. Kolb said he would be in touch with me.
Postscript to the dinner. When I’d invited Dr. Steiner and Dr. Klarch, appreciating their time was valuable, I said they could bill me for it. Dr. Steiner didn’t send a bill. Dr. Klarch (fictitious name) sent a bill for $500. This seemed high. His only contribution to the meeting had been “Please pass the butter.”
A few days after the meeting, Dr. Kolb phoned and told me he had arranged for Dr. Sidney Malitz to conduct the study. Dr. Malitz and I had dinner, and I repeated the PHT story. He said he was surprised to hear such a plausible story from a layman; he hadn’t expected it. Apparently Dr. Kolb hadn’t told him much about our discussion. Dr. Malitz told me that he would set up two studies and I could fund them for $5,000 each. I said the matter was so urgent that I’d prefer to give $10,000 for each study, and this was agreed upon. I told Dr. Malitz I would appreciate it if he would keep me in close touch with how things were going. I didn’t ask how the studies would be conducted; it didn’t seem proper. But I had the feeling that much of my responsibility to PHT was now in the hands of professionals.
Alas. Week after week went by without my hearing from Dr. Malitz and a head of steam built up in me. When I finally called him after three months, I regret that I said, “Why the hell haven’t I heard from you? You know how important this is.” I don’t think Sidney liked this opening remark and I can’t say I blame him. He explained that the patients he had selected for the study were used to getting medicine three times a day, and since I’d only suggested 100 mg of Dilantin (one capsule) he was wondering if Parke-Davis could make it in smaller dosages, so it could be given three times a day. This excuse was so lame it needed crutches. Apparently Sidney had so little faith in PHT that he didn’t think it could help unless the patients were psychologically influenced, and he hadn’t even tried it. Further, if he’d looked into it, he would have found that Parke-Davis already made it in smaller dosages—a breakable 50 mg Infatab, a 30 mg capsule, and a liquid. After explaining to Dr. Malitz the different forms Dilantin came in, I expressed the hope that the study would now move forward.
Four more long months went by. I called Dr. Malitz again and this time, in the quietest way, asked him how things were going. He told me the study hadn’t gotten started yet because he hadn’t been able to get a placebo from Parke-Davis. I thanked him politely, and hung up with a heavy heart. Maybe Dr. Malitz couldn’t get a placebo from Parke-Davis in seven months, but in those days most drugstores could supply a placebo in forty-eight hours. In a last futile attempt I met with Dr. Kolb. He defended Dr. Malitz and said it was better to proceed slowly and carefully than the other way around. I didn’t even argue with this platitude—it was such nonsense. Seven months had been wasted and I was discouraged. I’d taken what I thought was my best shot and hadn’t got any results at all—not even negative.
Occasionally it may seem to the reader that I’m being critical of others. This is the opposite of my intention; I have too many motes in my own eye. But sometimes things have to be spelled out—otherwise this story would be too hard to believe. Looking back, it’s easy to understand the position Dr. Malitz was in. He had been taught to think of PHT as an anticonvulsant. The idea that it had other uses came from an implausible source, a layman, and that didn’t make it any easier for him. He undoubtedly had other research projects to which he gave priority—and PHT got on a back burner.
On other fronts things had not stood still. I had continued to send friends and acquaintances to doctors for trials with PHT. The effects were prompt and similar to those of the earlier cases. The numbers were mounting up. By now there were about twenty-five cases. In addition, I had a new source of information.
Dr. A. Lester Stepner, of Miami, had treated one of the first six people I’d seen take PHT. He had been so impressed with the results that he tried PHT with other patients. In a letter of April 1965, he summarized the cases of twelve patients he’d treated with PHT. In eleven of the twelve (he was unable to follow up the twelfth) he found PHT effective in treating anxiety, depression, anger, impulsiveness, temper outbursts, and incoherent thinking. Coming at this time, Dr. Stepner’s observations were a big psychological help to me, but they didn’t seem to mean much to Dr. Silbermann and others I spoke to. I was beginning to understand the French phrase ideé fixe.
The evidence was growing, but my confidence that I could convey it to others was shrinking. For months I had been buttonholing any doctor I ran into and informally talking about PHT. I must have spoken to a dozen of them during this period. None of them had heard of PHT being used for anything other than epilepsy. They were all (with one exception) polite, even kind, but they didn’t give me any encouragement. That one doctor looked at me the way a Great Dane looks at a cricket and explained: “Medicine is a complicated matter, and I’d advise you to stick to Wall Street.” Bless his heart.
I called a council of peace with my friends who knew of my interest in PHT. These friends were Dr. Max Silbermann, Dr. Peter Suckling, Yura Arkus-Duntov, and Howard Stein. We met in my office in early 1965 to decide the best way to get our information to the medical profession. For the first half of the meeting, we went over many cases in detail. By this time both Howard and Yura had each seen persons benefit from PHT, and we discussed how consistent our observations were with those reported in Goodman & Gilman.
We tape-recorded the meeting. Reading the transcript brings back those days in a lively way—I can still feel the warmth of my frustrations. There wasn’t a suggestion I would make that Peter, Max, or Yura couldn’t find an objection to. Toward the end I must have worn through my daily supply of PHT because I was hopping up and down with frustration.
The transcript of the meeting remembers better than I do. Here are a few excerpts:
Jack: The problem before us is to awaken the doctors in the country to the potential of Dilantin. We’re not in this for financial reasons, and we’re not in it for glory. It’s almost a crime not to try to get this information to the doctors....We’ve got a lot of cases and we could do a thorough job of writing them up. If Dr. Silbermann would be willing...
Dr. Max S: Jack, that would not be accepted by any medical journal. You could publish that at your own expense, there’s no law against it.
Jack: Why wouldn’t this be accepted by a medical journal?
Dr. Max S: Because. You know the old story. There is no blind control, and no medical journal would accept any drug study unless.…
Dr. Peter S: Unless you have had a computer in on it.
Jack: Max, are you serious? This can’t be so.
Yura and Dr. Max S: Oh, yes this is so.
Jack: Yura, we are talking about research, right? Please listen before you say no. None of these people who took PHT knew each other. As far as they were concerned the study was blind. I asked them to write me letters that included details of their experiences. The same results from PHT are reported over and over again. This reinforces the evidence.
Dr. Peter S: It is not accepted as proof and there’s a devastating word that is applied to it, called anecdotal evidence. It doesn’t go.
Yura: It’s indirect proof.
Jack: Sorry fellows. Nobody in the room is thinking. These individuals wouldn’t know which way to lie if they wanted to. They didn’t know each other.
Dr. Peter S: No, no. It’s not that. This is the way...
Jack: Please. Let’s not move the medical people all the way down to diapers. At least keep them in rompers, okay? I’m saying that if we added the Goodman & Gilman to Dr. Stepner’s observations and the evidence of our twenty-five cases, write it up carefully, it’s got to be received. We won’t say we discovered America or anything like that. You, Dr. Silbermann, have got to make the effort.
Dr. Max S: Well, if we write it up and I publish it under my name and I send it in, no medical journal will accept it.
Jack: All right, Max, then no medical journal will accept it. At least we can send the information to the heads of the hospitals and say, “It would be a sin if we didn’t tell you what we’ve found. Evaluate it on the basis of your own experience and do what you want.” Once we’ve told the heads of fifty hospitals, at least part of it should be off our conscience. Let the nonuse of it rest on other people’s consciences... I don’t care if machines are not involved. I can get machines that will lie like anybody else. Will that help? [I wouldn’t have done that—in those days I was over 80 percent honest.]
Yura: No, Jack. We are talking about the best means to achieve this.
This discussion seems funny now, but it was very real then. I was too near my own suffering and I was impatient to get PHT to others. This impatience stayed with me, but after bumping into enough brick walls and closed minds, I realized it got in the way, and tabled it—with the help of PHT. Without PHT I’d have had an implosion.
For several weeks after the meeting, I thought about what was said. I had argued with my friends at the top of my lungs. But I knew they had my best interests at heart, and I had to pay attention to them because they had experience where I had none.
In the course of business I saw Howard Stein almost every day. Every once in a while Howard would say, “If you want to get anything done, you’ve got to do it yourself.” I didn’t even respond to this remark at first. But about the fourth time I heard it, I said, “Why are you persecuting me with that cliché?” He said, “I’m not using it as a cliché; I mean it.” “How can I do this myself?” I asked. “I don’t have any medical background, and besides I have other dishes to wash, like the Dreyfus Fund and Dreyfus & Co.”
But Howard said, “You’ll see.”
Next Section: Establishing a Medical Foundation
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