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A lesson learned

Madison Hospital

Lessons from Everyday Life By Theodore Lewis

Bridgman, MI—My first job in a hospital was a summer position at Madison Hospital. Back then it was a full-service faith-based community hospital in Madison, Tennessee, a suburb of Nashville.

]I was hired as an "attendant” on the men's side of an inpatient psychiatric unit that specialized in the convulsive therapies of electroconvulsive therapy (where a seizure is induced with electric currents in the brain) and insulin shock/coma therapy (where a patient is put into a coma with large amounts of insulin.)

The psych unit of Madison Hospital at that time was in a separate building from the main hospital. I wasn't involved with the insulin and electric shock therapies. However, I did have the opportunity to observe these therapies in process. This was one of the most excruciatingly difficult things I have ever witnessed. The sight of a human being intentionally induced into a seizure from electric shock, or a coma from a large dose of insulin, is something I never want to see again

The utilization of insulin shock/coma therapy was generally discontinued in the industry by the end of the 70s.

One of our patients, John, was undergoing insulin shock/coma therapy. He was a large hulk of a man, and rarely spoke a word. Although his large physical features were intimidating, I felt totally safe around John. When the movie "One Flew Over the Cuckoo's Nest" came out, I immediately thought of John, whose stature, mannerisms, and behavior matched closely with Chief Bromden, the large Native American in the movie who would appear to be deaf and mute.

What I had heard about John from one of the staff was that he was a brilliant scientist, but his wife had convinced their psychiatrist that John was a paranoid schizophrenic.


In any event, he had been admitted for treatment of his "disease" which included insulin shock/coma therapy. John's wife would come to visit him every couple of weeks. She would talk to him non-stop, but I never heard him say one word to her while she was there.

While John had intimidating physical features, he appeared to me to be a sensitive and caring soul who wouldn't hurt a flea. When I would take him for supper (I worked the 3 to 11 shift), he typically would give me a smile and a couple of encouraging words to let me know he appreciated any small act of kindness toward him.

The head nurse/manager of our psych unit was a wonderful man. Mr. Newman had a psych nursing background and was a positive leader for the staff on the unit. One night about 8 p.m., Mr. Newman needed to make a trip over to the main hospital. Mr. Newman and I were the only staff members on the unit at that time. Before he left, he instructed me to stay inside the locked nursing station, and not leave that area while he was running his errand.

As Mr. Newman went out through the locked door that could only be opened with a special staff key, a bell in the unit rang, indicating that the locked door had been opened.

Not long after Mr. Newman's departure, John came to the nursing station and knocked politely on the locked glass door. I opened the door slightly and asked John what he needed. He told me his room's air conditioning unit wasn't working and he wondered if I could help. Ignoring Mr. Newman's instructions, I left the secure nursing station and walked down the hallway toward John's room. I entered his room and went over toward the window air conditioner, which was on the opposite side of the room from the doorway.

After putting my hand on the vents pumping out cold air, I turned around saying "John, the air conditioning is working just fine."


John closed the door and said matter-of-factly, "Give me the key." I swallowed hard and couldn't get a word out.

"Give me the key," John said again as he took a step toward me.

John's voice was firm and unwavering. Gone were the positive vibes I had previously felt from him.

I knew instantly I was in trouble.

Not only had I failed to follow the instructions of my supervisor, but I was also about to be overwhelmed by a large physical force I couldn't come close to matching. The likely outcome was an elopement that I would be responsible for.

For a moment my mind froze, and I couldn't muster any response.

Then, John took another step toward me, this one larger and more pronounced. "Give me the key!" he said, this time with urgency and determination in his voice.

I had to do something. The only thing I could think of was just to start talking.

I began to tick off every reason I could think of, why I shouldn't give him the key: I would get in trouble. He wouldn't go far. He would get in trouble. Then, after three or four minutes of my ramblings, the bell rang. At that point, both John and I knew his attempt at taking the key was over.

I have never felt such relief in all my life, and I scurried past John to get back to the nursing station before Mr. Newman arrived there.

As Mr. Newman came into the station and sat down, he asked: "How did things go while I was gone?"

After I blurted out the whole story of what had happened, we both agreed that this would be a lesson I would never forget.

Theodore Lewis is the former CEO of Guam Memorial Hospital and has a healthcare consulting business in Bridgman, MI. He is collecting stories about lessons learned in life and can be reached at

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