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It’s said that the further you get from where they know you the more respect you get. And so it seems.
Before discussing the “flaw in the system,” in the next chapter, I would like to tell you of some experiences I’ve had with PHT abroad, and of an unusual relationship that developed between the Dreyfus Medical Foundation and the Institute for Experimental Medicine in Leningrad.
My first trip abroad, on the subject of PHT, was to England in 1965. Soon after Dr. Turner joined the Foundation, he and I went to Chichester, England, to visit a friend of his, Dr. Lionel Haward. At the Graylingwell Hospital in Chichester, Dr. Haward introduced us to a group of his colleagues. We all sat at a large round table and for an hour I described my experiences with PHT. When I finished, to my surprise, they applauded. I know it was just English good manners but it gave me a nice feeling.
As a result of our trip, Dr. Haward did a series of five controlled studies on PHT. (See The Broad Range of Clinical Use of PHT.) They were excellent studies, three of them unusual in that they were influenced by his background as a pilot. In simulated air control tests, he demonstrated with students and experienced pilots that PHT was significantly effective in delaying fatigue and accompanying errors. Haward made the point that it’s an unusual substance that can calm without sedation and also effect a return of energy and improvement in concentration.
Dr. Rodolfo Paoletti, scientific director of the Institute of Pharmacology at the University of Milan, a friend of Dr. Bogoch’s, frequently visited our office when in New York. On several occasions I talked to him about PHT. During one of the times Dr. Paoletti said, “Why don’t you come over to Milan and talk about PHT at a meeting of the Giovanni Lorenzini Foundation?” He suggested a date four months in the future and I accepted. A week before the meeting I found out what I had let myself in for. I was not to be one of many speakers, but the only speaker, before a large group of physicians. I had talked at formal medical meetings before, but only as one of the speakers. This was different.
At the meeting in Milan there were about 120 physicians. Dr. Paoletti gave me a kind introduction, put me on the podium with a microphone attached to me, and told me to speak in my normal way—a UN-type device would see that it came out in Italian. I was close to stage fright, but after I got started it was all right. I talked for an hour and twenty minutes, and apparently it went well because I got a letter from Dr. Paoletti saying, “From the comments I heard afterward you certainly caught everyone’s attention,” and he invited me to come back the next year.
After the meeting a number of physicians came up to say hello, and I learned that PHT was already being used for purposes other than epilepsy. One physician, G. A. Bozza, who seemed an especially kind man, talked to me about his use of PHT with retarded children, a use I was not familiar with. A few months later he sent me his paper, “Normalization of intellectual development in the slightly brain-damaged, retarded child.” (Presented at the Italian National Conference of Child Neuropsychology, 1971.)
One day in October 1972, Dr. Bogoch phoned and said he was coming to the office with a Russian doctor he thought I’d like to meet, and that we might have lunch. The doctor was in New York for an International Brain Sciences Conference, of which Dr. Bogoch was chairman. At eleven o’clock that morning Dr. Bogoch arrived in the office with Dr. Natasha Bechtereva. Sam had not overdescribed Dr. Bechtereva when he referred to her as a Russian doctor. Dr. Bechtereva had the most impressive credentials of anyone I’ve met in the medical profession. At that time Dr. Bechtereva was chairman of the Commission on Public Health of the USSR. She was also Director of the Institute for Experimental Medicine, formerly the Pavlov Institute, a group of seven large hospitals in Leningrad. Dr. Bechtereva was the first woman to become Director of the Institute and she was Chief of its neurophysiological branch.
I remember our meeting clearly. Dr. Bechtereva, Dr. Bogoch, and I sat in chairs at a window overlooking New York Harbor. I had intended to talk about PHT for half an hour or so and, if Dr. Bechtereva showed interest, give her a copy of The Broad Range of Use of Phenytoin. When lunch arrived at one o’clock I was surprised to find that I’d been talking for two hours. Dr. Bechtereva hadn’t said a thing, but the patience with which she had listened and something in her remarkable eyes had kept me going. When I had finished Dr. Bechtereva spoke for the first time. She said, “What you say seems too good to be true but it’s not illogical, and I can find out to my own satisfaction. In our Institute we have sensitive electrical equipment that can test PHT. Would you be kind enough to send us a supply of your brand of phenytoin? If our tests should disagree with what you say I wouldn’t want you to think it’s because our brand is different from yours.” That made sense, and I said we would send the Dilantin. After many difficulties, the Dilantin arrived in Leningrad. Several months later I received a letter from Dr. Bechtereva (mail in those days took about a month—now it’s not so rapid). Dr. Bechtereva’s electrical instruments had not been disappointed. From the letter:
“Thank you very much for the prospect of Dilantin and the Dilantin itself. The Dilantin—really a most peculiar medicine. I am advising it to more and more people. I simply can’t resist doing it—you know how one feels. And so, step by step, Dilantin is used for nonepileptic purposes, not only in Leningrad but in Moscow and Kiev as well.”
Dr. Bechtereva has a refreshing way of putting things. In a later letter she said, “People use Dilantin much more, though it met the normal prejudice determined by the engram fixed in each doctor’s memory: Dilantin Þ epilepsy.” Apparently we don’t have a monopoly on this engram. A few months after Dr. Bechtereva started work with PHT, she invited Dr. Bogoch and me to visit the Institute in Leningrad, at our convenience. We accepted. Having heard too much about the Russian winters we selected June for the visit. Four of us made the trip—Dr. Bogoch and his wife Dr. Elenore Bogoch, and Joan Personette, my former wife, and I.
We stayed in Leningrad for a week at the Hotel Astoria, a very old hotel, like the Ritz in Paris, but otherwise dissimilar. But the people were nice, which is the most important thing. When we had time we saw the sights, the beautiful cathedrals and the extraordinary Hermitage, and we walked around Leningrad as we pleased. The days were long. We were near the land of the midnight sun, and it got dark at 11 p.m. and light at 2 a.m. It seemed strange reading by daylight at 10 p.m. in a park across from the Astoria. Dr. Bechtereva’s hospitality was reminiscent of our best Southern hospitality. We had a delicious dinner at her home with her family, were taken out to dinner by her, and thoughtfully left to ourselves. The food in the restaurants was good, if you like garlic, which I don’t. On one occasion, out to dinner with Dr. Bechtereva, I was trying to finesse my way around the meat and Natasha said, “My dear Jack, you suffer so much.” A keen observer.
The first day we were in Leningrad, Dr. Bechtereva took the Drs. Bogoch and me to one of the seven hospitals and introduced us to key members of her staff. Later we went through other hospitals, getting to meet many doctors. I was surprised that so many of the doctors were women until I was told that seventy percent of physicians in Russia are women. The second day we were there, Dr. Bechtereva introduced us to three patients who’d had dramatic benefits from PHT. Each had a different disorder. The patient I remember best was a woman who’d had severe headaches for many years and had to be hospitalized periodically. This time she had taken Dilantin for a few days and was on her way home. She explained, through an interpreter, that the pain in her head would get so bad she’d sit absolutely still and if anyone came near her it would make her furious. While she was explaining this in Russian, she was smiling happily, as though she were talking about someone else. The next day Dr. Bechtereva called a meeting and Dr. Bogoch and I had the opportunity to talk about PHT to eighty physicians. I talked for about two hours. That was like talking one hour because translation was not simultaneous. Then Dr. Bogoch discussed the basic mechanisms of action. Several of the Institute’s physicians also addressed the group. I was told that they had given favorable reports on PHT.
The day before we left, Dr. Bechtereva and I were alone for a few moments and I brought up what I considered a delicate subject. I told her that I was most impressed with the work the Institute had done. I said our Foundation had funded numerous studies on PHT, some outside the U.S.A., and, if proper, we would be happy to do it here. Natasha set me at ease. She said she appreciated my asking but that her Institute was well financed by the government. However, we might consider a “joint cooperative effort.” She said such a possibility was provided for in the recent meeting between President Nixon and Premier Brezhnev.
I thought this a fine idea and asked how we should proceed. Dr. Bechtereva said since we had introduced the PHT idea it would be best if we initiated the matter through our Department of Health to their Ministry of Health. We discussed it. Our thought was that we’d exchange ideas and information by mail, and would periodically visit each other. It was agreed that when I got back to New York I would introduce the matter to our Department of Health. I won’t bore you with details. The mills of government grind slowly all over the world. But in 1976, a formal approval was given for a “joint cooperative effort” between the Institute for Experimental Medicine and the Dreyfus Medical Foundation. I have been told that this is the only venture of its sort between a Russian and an American institution.
Before closing I’d like to say that Natasha Bechtereva is one of the most remarkable persons I’ve ever met, and I thank her for her help.
Next Section: A Flaw in the System
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