"SouthPointe Hospital is kidnapping my mother!" Steve Vance shouted into a pay phone.
It was May 2000. Vance had dialed 911 from the hospital lobby in a frantic effort to keep doctors from giving his mother, Kathleen Garrett, another round of electroshock therapy.
Vance, of St. Louis, couldn't stop the treatment. But he helped propel an effort in Missouri to regulate shock therapy, a procedure that most psychiatrists believe is a vital tool in treating severe depression and other mental illnesses.
The campaign is part of a national movement led by the Church of Scientology and fought in legislatures across the nation. It also has drawn support from a network of people who call themselves shock "survivors."
Psychiatrists are resisting -- but quietly, not wishing to draw more attention to a procedure that has been stigmatized in popular books and movies. And they don't relish a fight with Scientologists, who compare psychiatrists to Nazis, picket at psychiatric conferences and have been known to sue some of their critics.
Scientologists oppose psychiatry because it conflicts with their own philosophy of spiritual self-help. They argue that shock therapy can be coercive and harmful, that it doesn't work and that no one knows how often it's performed.
But psychiatrists believe there's little to debate. Over the years, shock therapy has become as routine as an appendectomy.
And while those involved in psychiatry have been celebrating their successes quietly, the Scientologists and others opposed to shock therapy have been turning up the volume, using people like Garrett to dramatize their message. They got a bill passed in Texas in 1993 and have gathered momentum in Missouri, Illinois and other states.
Many Missouri legislators said during the last session that they were unaware that shock therapy was still in use. And they were appalled by some of the stories they were hearing.
To this day, an aura of mystery surrounds electroshock. No one is quite sure why it works, but the procedure effectively readjusts a patient's brain chemistry - like hitting the reset button on a computer.
A double-dose of bad publicity in the 1970s nearly led to the elimination of shock therapy. First, U.S. Sen. Thomas F. Eagleton, a vice presidential candidate in 1972, revealed that he had undergone shock treatments in the 1960s.
That belated revelation led to his removal from the Democratic ticket, led by George McGovern. Then in 1975, Jack Nicholson starred in "One Flew Over the Cuckoo's Nest," one of the most popular movies of the decade. The movie, based on Ken Kesey's novel of the same name, showed electroshock used as a means of punishment and control.
Many states, including Missouri and Illinois, instituted reforms. Missouri banned the procedure in 1980 on the mentally retarded, minors and anyone else who refused it - unless there's a court order. Illinois began regulating shock therapy in 1979 with similar rules.
In 1980, with a new wave of antidepressant drugs, about only 33,000 people nationwide got shock treatments, according to the American Psychiatric Association. But shock treatments have tripled since. Experts say about 100,000 people a year nationwide get them.
They say that shock treatments today are nearly painless with the use of anesthesia and that there are no long-term side effects. "It is in some cases absolutely life-saving," says Dr. Garry Vickar, president of the Eastern Missouri Psychiatric Society.
But decades later, she still battled depression. The last year had found her worrying obsessively about money, her health, germs. She scrubbed her hands so much the skin turned raw. She would lie in bed all day. Her medications weren't helping.
In May of last year, she called a mental health hot line to talk to a friendly voice. She said she didn't feel like living, that she would jump out of her ninth-floor window. The service called for an ambulance, which took her to SouthPointe Hospital, 2639 Miami Street.
When doctors told Vance they were going to give his mother electroshock treatments, it brought back unpleasant memories. He remembered visiting his mother in the hospital as a teen and thinking then that she looked like a zombie.
After Vance made his desperate but futile 911 call, he went to St. Louis Circuit Court to prevent the treatments and to take his mother home. His mother took the stand:
"Do you want to be given electroshock therapy?" her lawyer asked.
"No," Garrett said.
"Could you tell the court why you don't want to receive it?"
"Because I'm afraid I might become senile."
Her psychiatrist, Dr. Rick Mofsen, told the judge that Garrett was suicidal and that he had tried treating her first with medication. The judge approved up to a dozen shocks and sent her back to the hospital for 21 days.
She would have a seizure that lasted about 30 seconds. About 20 minutes later, Garrett would wake up, a bit disoriented. Hospital records show that after the fourth treatment, she told nurses the shocks were helping. She was discharged five days later.
"It's not the greatest treatment," Mofsen said in an interview recently. "It's not fun. If there's a simple pill you could take, it would be wonderful."
Although psychiatrists praise the effectiveness of shock therapy, it isn't always a cure. A few months after Garrett was released from the hospital, she fell back into depression.
In August of last year, she called the hot line again and wound up back at SouthPointe. According to hospital records, she was sobbing, and flailing her arms and legs. Hospital records show that her son protested to nurses that she acts like that "for attention."
Garrett didn't try to fight the treatments this time. She signed a consent form at SouthPointe in shaky handwriting (which she doesn't remember) and was scheduled for up to 10 rounds of shock treatments.
Vance had lost hope for getting his mother out of the hospital - until he bumped into a group called the Citizens Commission on Human Rights about two weeks later.
He found the organization at the Missouri Black Expo, a showcase for black-owned business and other services. The people at the Citizens Commission booth were wearing anti-psychiatry T-shirts and passing out pamphlets. One of their brochures shows a harnessed man clenching his teeth as lightning bolts shoot from his temples.
Vance had never heard of the Citizens Commission, which the Church of Scientology helped form in 1969 to ferret out psychiatric abuse. But he thought the organization might be able to help his mother, and he enlisted its help.
The group got in touch with Juli Lawrence of Belleville. A leading foe of shock therapy, Lawrence published a report about Garrett's case on her Web site, started an international e-mail drive and contacted local news outlets. About a week later, the hospital released Garrett.
The Citizens Commission claimed victory, but doctors say the timing was fortuitous. Garrett had been in the hospital for nearly a month. "She responded very nicely" to the shock treatments, says Mofsen, the psychiatrist.
In April, Garrett and Vance joined about 20 shock-therapy opponents at the hearing. They spent 90 minutes sharing their stories of forced treatments. The bill would have required doctors to report the age and race of people who get shock treatments, who pays for it and the side effects. Doct ors who don't comply would face up to six months in jail or a $10,000 fine.
The state doesn't collect the data now, although hospitals keep a tally of how many people were admitted for shock treatments - 1,477 in 1999. That number excludes treatments at state or private mental health centers, jails, or procedures at doctors' offices.
In Texas, the Citizens Commission got an identical bill passed in 1993, and the information gleaned from the reporting requirement has led to stronger efforts to restrict the procedure. Illinois passed the reporting law in 1997 and made it harder to use shock treatments on minors two years later. But in Missouri, lobbyists for the psychiatrists weren't too concerned.
The bill's sponsor, state Rep. Harold Selby, D-Cedar Hill, isn't taken very seriously in Jefferson City. He doesn't accept campaign contributions, takes up causes that garner little support and provides an ear to people with unorthodox views on everything from UFOs to HMOs.
When it was time for the psychiatrists to give their side at the hearing, a couple of lobbyists took 10 minutes, mostly complaining to lawmakers that the bill would require too much paperwork.
The only psychiatrist who testified, Dr. Joe Parks, the medical director at the Department of Mental Health, doesn't perform shock treatments. He said the bill unfairly singled out the procedure while more risky ones like heart transplants don't face as much scrutiny.
The lobbyists assumed the issue would wither away. But committee members seemed impressed with the testimony. One legislator on the panel who supported the bill, Rep. Roy Holand, R-Springfield, is an orthopedic surgeon. He said it's healthy for doctors to defend seemingly outdated practices from time to time. Three weeks after the hearing, on April 26, the committee approved the measure.
But with less than a month left in the legislative session - too little time for such a controversial measure to move through the system - the lobbyists figured the bill would die anyway.
Even so, Selby gave lobbyists a brief scare just days before the session ended when he attached his proposal to another bill. That bill was passed, but Selby's amendment was eliminated along with several others in the final hours of the session.
Selby plans to push the legislation next year, and the activists continue drawing attention to the issue.
Meanwhile, the caginess of those in the medical field only piques Selby's interest more: "They don't want us to know those numbers," he says. Since the hearing in April, Garrett has moved into a new apartment and is doing well, going out to eat with friends and socializing more.
Garrett doesn't remember getting the shock treatments last year, but says: "They really didn't benefit me." Vance credits his mother's turnaround to a psychologist and a new psychiatrist who doesn't favor shock therapy.
He's convinced the shock treatments did nothing but harm for his mother. He asks, "If it was really going to help, don't you think we'd all be in line for them?"