A Legacy of Shattered Lives - Psychiatrist Was Neither Healer Nor Hero

A Legacy of Shattered Lives
Psychiatrist Was Neither Healer Nor Hero

By Christine Hahn
Special to Freedom

An investigation supported by the Fund for Investigative Journalism, Washington, D.C.

Madeleine was rolled into the operating room on a gurney and prepared for surgery, her head shaven. A local anaesthetic was applied to a portion of her scalp. The surgeon cut away a flap of skin and drilled a hole through her skull. Wielding a spatula-type instrument, he made several sweeping incisions through her brain, slicing all the way to the back of her skull. While the surgeon worked, psychiatrist Ewen Cameron stood over the young woman, plying her with questions until he was assured the surgeon had achieved the desired result. When Madeleine stared vacuously and could only grunt in response, the “surgery” ended. Madeleine lived the rest of her life an automaton in the confines of an insane asylum.

Madeleine Smith, a 28-year-old newscaster, was just one casualty of the ghoulish experiments conducted in the 1950s and early 1960s under Ewen Cameron at McGill University’s Allan Memorial Institute.

The experiments were part of the infamous “MK ULTRA” program conducted under the aegis of the U.S. Central Intelligence Agency in the 1950s and 1960s, exposed in media and United States Congressional hearings in the 1970s. Patients were brutalized and maimed with drugs, shocks and lobotomies as Cameron sought a means to “depattern” and “re-program” the human mind. Canadian survivors still able to seek reparation finally obtained some compensation from the U.S. government in 1999.

Virtually all accounts of this dark chapter in our history have named Cameron, who died in 1967, as the main culprit responsible for such vicious treatment of patients in the country’s mental wards.

But evidence has existed all along that human psychiatric experiments were far from isolated, whether funded by intelligence agencies or not, and that the mindset that sanctioned them was pervasive in Canadian psychiatry—even decades after they occurred.

“It wasn’t a criminal experiment using people as guinea pigs,” Heinz Lehmann, a psychiatric colleague of Cameron’s, said in a 1984 Montreal Gazette account of his contemporary’s efforts. Lehmann taught at McGill and became the Allan Memorial Institute’s clinical director in 1958, a position he held until 1971. “It was a heroic, very aggressive treatment based on a certain theory which proved to be wrong.”

The treatment Cameron’s patients received was no secret to Lehmann. “I knew ... and I didn’t approve,” he said. “But not for moral reasons. I didn’t believe in his theory.”

Lehmann, instead, had his own theories—and performed his own experiments, at times with fatal results.

Behind the Façade

Hailed as one of the leading lights of Canadian medicine, Lehmann has been described as a Montrealer who shaped the course of modern psychiatry. He is credited as the first in North America to use so-called antipsychotic drugs on his patients, taking treatment of mental illness beyond the destruction or removal of brain tissue as with psychosurgery or electric and insulin shocks.

The drug said to have made this radical change possible was chlorpromazine, sold under the names Largactil in Canada and Thorazine in the United States.

The German-born Lehmann, who moved to Montreal in 1937, is credited with introducing the use of the drug on psychiatric patients in 1953.

By 1955, chlorpromazine was being used in every major psychiatric institution in Canada and the United States.

Lehmann went on to receive virtually every significant Canadian and U.S. medical and psychiatric award for his work. They included, in 1957, the Annual Award of Merit from the Canadian Mental Health Association and the Albert Lasker Award from the American Public Health Association. In 1976, he received the Order of Canada—the country’s highest civilian honor.

Yet, while Lehmann was lionized in psychiatric circles for supposed dedication to his patients, investigation reveals that several of them suffered horrific deaths during his experiments. Evidence also shows that Lehmann routinely ignored patients’ rights, medical ethics and drug side effects, and while hailed as a hero, this “doctor” did not even hold a valid medical license in Quebec for the 26 years during which most of his work was done.

Further, documents obtained from the Canadian government reveal that Lehmann’s use of chlorpromazine—known as a neuroleptic (“nerve-seizing”) drug—on psychiatric patients was, in fact, illegal. In the 1950s, the drug was permitted for use as a sleep aid and was not licensed as a neuroleptic in Canada until the early 1960s.

Harming with Impunity

Documents obtained by the Citizens Commission on Human Rights (CCHR) Canada disclose that Lehmann conducted hundreds of human experiments from the late 1930s to the early 1970s. Between 1955 and 1973 alone he conducted 330—the equivalent of a new experiment every three weeks.

Before his work with chlorpromazine, he was involved in lobotomizing, shocking and otherwise invading subjects with various poisons and drugs.

“Our two major therapies were insulin-induced hypoglycemic coma and electroconvulsive shock therapies (ECT) for schizophrenia and affective disorders,” Lehmann wrote. “Paraldehyde and the barbiturates were about our only means to quell agitation and violence in addition to physical seclusion and restraint.... 70 to 80 per cent of patients relapsed.... The treatments were very invasive, cumbersome and often dangerous.”

The latter admission apparently lacked compunction; according to his records, Lehmann neither scaled back his treatment nor sought less harmful methods.

The psychiatrist casually recounts “carrying pure nitrous oxide by inhalation to the point where there was complete loss of consciousness,” injecting “sulphur oil which was painful and caused a fever” and injecting turpentine into the abdominal muscles of a patient to create an abscess to see whether a “strong fever” produced by an infection might drive out a severe pre-existing illness.

Lehmann also administered carbon dioxide to patients, an excruciating “treatment”. Lehmann, however, recounted these tests in an eerily cheerful manner: “It should be noted that the carbon dioxide treatment was so aversive that one chronically mute patient promised he would speak if he would be spared another treatment!”

When his experiments had fatal results, there were no consequences for Lehmann, who operated with impunity upon the faceless, nameless inmates of Quebec’s mental institutions between the 1940s and 1960s.

“You Have to Take Certain Chances”

The official record states that Lehmann introduced chlorpromazine in Montreal in May 1953 while working at Verdun Protestant Hospital (since named Douglas Hospital).

Lehmann and a colleague, Gorman Hanrahan, published an article in 1954 advocating the psychiatric use of chlorpromazine after the drug had been tested on 74 patients. They wrote of the results that spawned their enthusiasm for the drug:

“Patients receiving the drug become lethargic. Manic patients often will not object to rest and patients who present management problems become tractable. Assaultive and interfering behavior ceases almost entirely. The patients under treatment display a lack of spontaneous interest in the environment.... They tend to remain silent and immobile when left alone and to reply to questions in a slow monotone.... Some patients dislike the treatment and complain of their drowsiness and weakness. Some state they feel ‘washed out’ as after an exhausting illness, a complaint which is indeed in keeping with their appearance.”

Lehmann knew the extreme and sometimes deadly effects of the drug, even describing it himself as a “pharmacological substitute for lobotomy.” Despite extensive evidence accumulated in the 1950s and early 1960s of its dangers, he did not slacken his pace.

In 1965, for example, he conducted a study entitled “Skin Pigmentation, a Rare Side Effect of Chlorpromazine” after patients at Verdun developed “slate-blue pigmentation of the face and forearms” from chlorpromazine. He experimented with 15 patients, concluding that a “greyish-brownish-bluish skin discoloration” is found in patients who have received the drug in high dosages for a considerable length of time.

Black and white photos accompanying the study are vivid and disturbing, showing a patient with severe skin discoloration described in the study as a “complexity of violet, grey, brown, blue and yellow.”

In a 1967 study, Lehmann and colleagues experimented on 38 patients, administering doses ranging from 200 to a staggering 3,200 milligrams.

Lehmann later told the Montreal Gazette that he gave up to “five or six times the usual dose” of chlorpromazine, explaining, “you have to take certain chances.... I was lucky my treatment worked out,” he said, “but I was anxious during the first few weeks.”

Deaths From Drug Reactions

Not so lucky were three of Lehmann’s subjects. After being given large amounts of chlorpromazine, they died of “fecal impaction”, as the drug destroyed their body’s ability to have normal bowel movements. The Gazette article made no mention of the deaths.

As reported in an article in the Canadian Medical Association Journal, one patient, a 51-year-old woman, “vomited feces, went into shock and died. Autopsy revealed acute colitis and peritonitis, secondary to a large tumor-like fecal mass in the rectum.”

Two others suffered abdominal cramps, went into shock and died. Five other patients developed severe obstruction of the intestines and acute bowel pain.

Bob Dobson-Smith, president of the Citizens Commission on Human Rights Canada, toured more than 70 major psychiatric facilities in Canada in 1972 and 1973 in an early phase of his organization’s long-standing campaign to expose and eradicate abuses in the field of mental health. During those tours, he met thousands of patients suffering from severe illnesses, including tardive dyskinesia, after being on chlorpromazine.

He recalls listening to a show during that time on CBC radio on which Lehmann and a psychiatric survivor were guests.

“This patient said that she had been on chlorpromazine and was now unable to walk,” said Dobson-Smith. “Instead of suggesting she decrease the dosage, Lehmann recommended it be doubled to produce a ‘therapeutic dosage.’”

Similarly, other documents show that when one of Lehmann’s patients failed to respond during one experiment with the drug—funded by the U.S. Department of Health, Education and Welfare—Lehmann increased the dose several times above what was recommended in the literature. Other patients began to develop jaundice and symptoms of Parkinson’s disease during the course of his experiments.

Helpless Obedience

Peter Breggin, psychiatrist, author and founder of the Center for the Study of Psychiatry and Psychology in Bethesda, Maryland, compared Lehmann’s experiments to those conducted by Nazi-era psychiatrists in Germany. He said chlorpromazine was never intended to treat mental illness, but rather to disable patients so they would not “cause trouble.”

“In many ways, these drugs can accomplish in a few doses what took years for the Nazis to do to put people in a state of helpless obedience,” said Breggin, who trained at Harvard and is widely consulted as an expert on psychiatric drugs. “Within one year, most patients in most mental hospitals were on these drugs because they were so effective at suppressing rebellion.”

Just so much can be blamed on the archaic methods and bad conditions prevailing in the field of mental health at the time Heinz Lehmann undertook his experiments.

Most of his experiments were conducted after passage of the Nuremberg Code in 1947, the most important document in the history of the ethics of medical research and the first of its kind to ensure the rights of research subjects. Its provisions include full consent—also meaning patients should have legal capacity to give consent—and prohibition or termination of experiments where reason exists to believe that death or disabling injury will occur.

The adverse effects of chlorpromazine were documented in psychiatric literature well before Lehmann began killing patients with the drug, said Breggin. These included a study published in July 1952 by French researchers Jean Delay and Pierre Deniker as well as studies by Rhone-Poulenc, the drug’s manufacturer.

Andrew Scull, a professor at the University of California at San Diego who has studied Lehmann’s work, said Lehmann’s studies violated every basic tenet of medical ethics, even for that period.

“This was being done right at the same time as the Nuremberg Trials,” he said of Lehmann’s early chlorpromazine experiments. “It’s hard to accept the protestations of ‘We didn’t know any better.’ The point is, they did.”

Scull said the “science” behind the experiments wasn’t science at all.

“The methodology he used was they gave a bunch of patients the drug and said, ‘We looked at them before and after and they were clearly better after the drug.’”

If you have an aggressive patient who, post-lobotomy, sits in an apathetic heap, “does that constitute improvement?” asks Scull.

Immortalized by Pharmaceutical Money

Lehmann became an international psychiatric icon after his 1953 chlorpromazine “breakthrough”. Claims that chlorpromazine “improved” treatment gave psychiatry legitimacy, said Scull, and it opened the door to a multibillion-dollar partnership between psychiatry and the pharmaceutical industry.

The National Institute of Mental Health in Washington, D.C., offered to support Lehmann’s research and gave him a seat on its selection committee to award grants. As an indication of his stature, in 1963, while the U.S. was cutting back on research grants awarded outside the country, Lehmann received one for $100,000—a considerable sum of money by today’s standards, let alone at the time. Lehmann also became one of the longest-serving members on the U.S. government’s Advisory Committee on Psychopharmacology, which investigates and reports on all developments in drugs for use in mental health.

Money seemed to flow endlessly to Lehmann, despite the nature of his experiments—and also despite his questionable medical credentials.

Documents obtained from the Quebec government reveal that from the time of his arrival in Canada in 1937 until 1963, Heinz Lehmann was never licensed to practice medicine, but operated under a “temporary permit” granted to him as a professor at McGill University.

This was apparently credentials enough for the psychiatric community even though a check with the College of Physicians and Surgeons of Quebec reveals that no official or valid “temporary permits” to practice medicine have ever existed in Canada.

Silent Partners

In the two and a half decades since exposure of the infamous psychiatric “mind-control” experiments of the 1950s and 1960s, only Lehmann’s colleague Ewen Cameron would bear close scrutiny, due to his prominent role in the MK ULTRA program.

“The Canadian Psychiatric Association has put out some disinformation that has been pretty well ‘bought’ by the Canadian public,” said psychiatrist Colin Ross, author of Bluebird: Deliberate Creation of Multiple Personality by Psychiatrists, in an interview on radio station CKLN in Toronto. “That is that Ewen Cameron was just an isolated incident, it happened a long time ago back in the ‘50s... there were sort of different ethical standards back then.

“Well, that’s not true because that research completely violated the ethical standards of the time, but also it wasn’t an isolated incident.”

Cameron was not the only one receiving intelligence funding, at McGill and at other locations. Documents have revealed, for example, that Raymond Prince was funded at McGill through an MK ULTRA subproject. Others received funding through Canada’s Defense Research Board.

Cameron’s MK ULTRA money ultimately came from the U.S. Department of Health, Education and Welfare and the U.S. Department of Defense; the funds were channeled by the CIA through a front group known as the Human Ecology Fund.

Lehmann’s work was financed largely by hundreds of thousands of dollars in overt grants from the same U.S. government departments. He also received money from Canada’s Defense Research Board.

Virtually every patient treated by Cameron under MK ULTRA was administered chlorpromazine, as revealed in declassified CIA records from the Library of Congress in Washington, D.C.

Washington, D.C., lawyer James Turner, who represented the Canadian victims of Cameron’s experiments in their successful civil lawsuit against the CIA, finds it significant that chlorpromazine was not on the CIA’s list of drugs it was testing at that time. He said the omission raises the distinct possibility that Cameron had a silent partner in Lehmann.

Lehmann and Cameron were associates and, as Lehmann recounted in an article he wrote, after Cameron established the Department of Psychiatry at McGill University in the late 1940s, he “gave me opportunities to do undergraduate and postgraduate teaching.”

Lehmann continued his affiliation with McGill for decades, moving up to clinical director and associate professor of psychiatry in 1958, and becoming chairman of the psychiatry department in 1971. In his twilight years, he took the position of assistant professor in 1979, and professor emeritus in 1981. Lehmann died in April 1999, immortalized in North American medical history.

Certainly enough evidence exists concerning Lehmann’s ties to Ewen Cameron and his inhumane actions toward patients to raise serious questions, said psychiatric survivor and activist, Don Weitz.

Weitz, founder of People Against Coercive Treatment (PACT), said Lehmann was no healer or human rights advocate.

“Lehmann was a drug pusher, shock promoter and torturer—just as psychiatrist Ewen Cameron was. We now know that Lehmann forcibly drugged hundreds of psychiatric patients with high-risk, experimental drugs such as chlorpromazine which he knew or ought to have known would cause serious harm including brain damage.”

Learning the Truth

Yet other questions remain unanswered about the nature and extent of human experimentation in Canada. Some relate to evidence that chlorpromazine—the drug Heinz Lehmann was credited with discovering in 1953 for use on mental patients—was being used on Quebec’s orphans in psychiatric facilities as early as 1947 (see accompanying story).

Today, Dobson-Smith said, whether or not the work of Lehmann and others was conducted for secret intelligence purposes is not so much the point. “Why they did it makes no difference in the lives of the patients who suffered. The most important thing now is that remaining survivors and their families learn the truth and are recompensed. It is the only way Canada can close this chapter of her history with some sense of honor left intact.

“The psychiatrists and others knew what was going on,” he said. “Any ‘lone gunman’ theory doesn’t hold up.” Dobson-Smith points out that the psychiatric community at the time in Quebec was very small—records from the office of the Quebec Ombudsman show only 15 psychiatrists licensed to practice in 1950, making the scenario of any psychiatrist working in isolation a “virtual impossibility.”

“And what about the profession as a whole? To this day, psychiatrists condone and excuse the activities of these prominent members, and for the most part they have carried on in the same vein, drugging, shocking and cutting up patients, always claiming that the treatment is ‘better’ now, more ‘modern’. And always reporting that more and more people are mentally ill,” he said. “It points up that this is an ineffectual, uncaring and frequently destructive industry with a highly questionable moral compass.”

In a media interview in his late life in which he discussed his years of experiments, Lehmann was to say, “I didn’t ask the patients, I didn’t ask the relatives ... I certainly didn’t have to ask the government which I would have to do now.... I did what I thought was right.”

In doing what they thought was right, Lehmann, Cameron and others like them, once pillars of the Canadian psychiatric community, operated above the law and left a legacy of shattered lives.

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