WILTIMS #114: Now you CME, now you don't

This evening I attended a showing of Dr. Kildare's Strange Case (1940) put on by my school as part of a continuing medical education (CME) series. CME requirements are credits that doctors are required to amass throughout their careers to maintain their licensure. CMEs can be everything from classes, to research conferences, to (apparently) educational movie nights. After the showing there was a panel-led discussion of the movie and medical issues it presented.

Of particular interest was the use of insulin shock therapy to treat a patient with schizophrenia. This was a positively medieval treatment used from around 1935 to 1960, to little proven effect. In the words of one of the panelists, "the reason insulin shock therapy was perceived as working on schizophrenic patients was that, for the first time, someone was actually trying to kill the patient."

The bizarre idea was to put the patient into a hypoglycemic coma and see if she or he is better when you wake them back up (if you can wake them back up). This only seems humane compared to the alternative treatments of electroshock therapy and lobotomy. Amusingly, electroshock is still in use as a last line intervention, although using much more compassionate methods.

I think my favorite quote from the movie was from the chief nurse: "Nurses are just like husbands. You can abuse them, insult them, work 'em to death, jump all over 'em. They'll take it. But give 'em a bad cup of coffee and you got a revolution on your hands."

TIL: Adenosine deaminase deficiency is the cause of ~15% of severe combined immunodeficiency (SCID), the disease made famous by the "bubble boy."