Evening star., 1949-05-24

pEElIlAl pIONSOlitn-
The case may come TO trial late
this year or. early in 1850.
therapy was not as successful as
had been hoped. Over this initial
five weeks period. the weight
gained was approximately five
pounds of the % which he had
lost. Several additional members
Of the psychiatric staff at Bethesda
provided a supporting staff for
administrative measures. A con-
tinuous watch was maintained
with the patient at all times and
one of two specially trained res
idents was available in the next
room during nights throughout
the course Of treatment.
The course of Mr.. Forrestal' Is
recovery. as is usual in such cases
was not steadily upward. but grad
ually upward in wave-like ad-
vance. A tendency to increased
depression toward the end of the
week was early noted. All ordi-
nary precautions were taken as
the patient improved. BY May
it was felt that continued i'm
provement required the lessening
of restrictions. Accordingly. priv
ileges were gradually extended to
the patient with full awareness py
the phychiatrist as a portion OF
treatment.
Daily Interviews Eased.
BY May IA. improvement had
reached a point where I felt that
daily interviews were not essential
and that I could make plans to
leave the city about May l8. Mrs
Forrestal left Washington with my
knowledge and approval on May
II and sailed for Europe the fol-
lowing day. On my advice. Mr.
Michael Forrestal returned to his
work In Paris on May IS. In my
last interview with Mr.. Forrestal
on the morning Of May Is. found
him somewhat better than on the
corresponding day of the preceding
week end felt that barring any un-
forseen incident he would be able
to carry along during my absence
from the city. ! also felt at that
time he was nearing the end OF. his
illness and that the next 30 days
should see him ready 70 leave the
hospital.
II further recognized the we'll
known psychiatric fact that the
next 80 days would constitute the
most dangerous period of the ILL
ness as far as suicide Was! Eon-
cerned. inasmuch as suicidal pre-
occupations had to be present and
at the same time privileges had to
be extended to the patient to allow
his full recovery. felt that the
assumption Of responsibility must
rest on my shoulders and not be
shared with the family or with
other naval authorities.
There was a history Of an al
legged suicide attempt obtained by
DR.. Menninger which is said to
have occurred on the night before
the patient was seen by him. Al
no time during his residence in the
Naval Hospital had Mr.. Forrestal
made q suicidal gesture or q sui
cidal attempt. His feelings OF
hopelessness and possible suicide
had been q matter of frank dis
cussion between the two Of us
throughout the. course Of the
therapy.
Sudden Fit Of Dependency.
''The facts surrounding the de-
tails Of the actual suicide are
being investigated by a special
board. Psychiatrically. 1t is my
opinion that Mr.. Forrestal was
seized with a sudden fit of de-
lspondency In the evening and
early morning of May %. This is
extremely common in all depres-
sions Of the severity of which he
suffered.
Suicide is the mortality rate OF
therapeutic psychiatry. The Navy
has not and does not subscribe
to the view that psychiatric pa
tients should be thrown in q
dungeon. It Is our belief that
calculated risks Of therapy must
be accepted for the practice Of
modern psychiatry.
In Mr.. Forrestal's case this
belief made the extension Of his
activities imperative. had per.
sonally encouraged him to leave
his room and to visit about the
floor. This increased socializa-
tion was considered essential te
his recovery.
1T is needless to add that
am deeply regretful Of the un-
fortunate outcome In Mr.. Forrcs-
tails case"