In a previous post I mentioned a British GP (general practitioner) who had given his patients more than 10,000 electroconvulsive treatments over a twenty year period. Which twenty years? Richard Woodland’s use of ECT came to prominence in 1984, when the GP’s magazine Pulse (13 October) published a long article about him. But it looks as if by that time he had given up his practice, although he was still trying to interest other GPs in his ideas about ECT. The first letter to the medical press he wrote about his use of ECT dates from 1957, so I imagine that the twenty year period covers a time from the 1950s to the 1970s.
The people to whom Woodland gave ECT were not psychiatric patients; they were people attending his GP’s practice. Some of them were diagnosed as depressed, but he also used ECT as a treatment for a wide range of physical ailments, including colitis, mouth ulcers and rheumatoid arthritis.
Woodland studied medicine at Cambridge University and Westminster Hospital, London. During World War II he was a lieutenant in the Royal Naval Volunteer Reserve. After a short spell as a GP in Port Talbot and Wittering he departed for Canada. Was it in Canada that he acquired an enthusiasm for ECT? I don’t know, but on his return he set up a practice in Paignton, Devon, and it was here that he began to use ECT on his patients, and write the occasional letter to the medical press about his use and opinions of ECT.
In 1957 he joined in a discussion about endogenous depression on the letters page of the British Medical Journal, writing:
“I am continually surprised at the prejudice and suspicion with which convulsive therapy is regarded by the vast majority of the medical profession. The only reason and excuse I am able to conjecture to account for this most tragic and lamentable attitude is the unfortunate outcome of cases inadequately treated by this method.”
He went on to suggest that between 7 and 12 treatments were needed to get good results in the treatment of depression, and took issue with another correspondent who had suggested that ECT was a “traumatic operation”.
“To me it would appear that in E.C.T. we have a therapeutic weapon of a stature ranking with that of the organic arsenticals, penicillin, and cortisone.”
He ended his letter by saying that he didn’t consider consent as necessary when treating depressed patients.
“Finally, I would plead again for the use of E.C.T. in the home. Sensitive, depressed patients are far more readily and pleasantly treated in their own beds, when it is usually unnecessary for them or anyone but a close relative to know the nature of the treatment being given.”
Six years later, in another letter to the British Medical Journal, he was writing that he had given 8,000 treatments and planned to continue. In 1984 he wrote two letters to the Journal of the Royal Society of Medicine (May and December) in which he described people he had treated with ECT some 20 years previously. One letter was about a patient with mouth ulcers:
“I recall the case of a young, attractive woman whose mouth had been continuously full of aphthous ulcers for 7 years…. I have used ECT to treat may other disorders, including ulcerative colitis, with some success. Above all, cases of rheumatoid arthritis were almost invariably cured or greatly benefited.”
The other letter was about the treatment of a man with colitis. Again Woodland claimed good results for ECT.
Perhaps it was the correspondence in the Journal of the Royal Society of Medicine that prompted Pulse to publish a lengthy article about Woodland. The article begins:
“The doctor who was last week accused of indiscriminate use of electroconvulsive therapy has spoken out about his research and treatments. Dr Richard Woodland has rejected suggestions, made at a recent research meeting, that he conducted ‘unethical’ trials and says that calls for stricter control of GP research would limit basic freedoms to practise medicine.”
In the interview Woodland described how he got a diploma in anaesthetics and gave ECT to patients in their homes:
“My NHS practice was on a council estate and I pottered round with my nurse and oxygen cylinders going to people’s homes, rendering them unconscious and leaving about 20 minutes later… I took an awful lot of trouble.”
The article said that Woodland’s decision to leave Paignton in 1968 was due to fact that other GPs had disapproved of his use of ECT and “virtually ostracized” him. “We came up to London where we found less hostility” he was quoted as saying. We? Was someone else involved? The article didn’t say. At the time of the article Woodland, described as a former GP, was working as a medical officer at Heathrow airport.
GP Paul Hewish was quoted as saying that Woodland had been trying to involve other GPs in his work for many years:
“But he has not had much success basically because no one else would touch it with a barge-pole.”