The Patient Was…

The patient was in her twenties, a lovely young woman and a friend of the family. On a weekend when her usual medical care was not available, she was seen in the Emergency Department (ED) of a large and well-known hospital. She had fever, back pain, and weakness; testing revealed evidence of a serious infection of her urinary tract. The ED physician prescribed an antibiotic with known side-effects of both kidney damage and hearing loss, and the amount prescribed was well over the customary dosage of the drug.

The patient developed both kidney damage and hearing loss as a result of the toxic overdose of the medication.

She had been a heavy cigarette smoker before her illness, and despite warnings about the dangers of smoking now with her compromised health, she was unable to quit.

As a cardiologist, I had particular interest in smoking cessation because of the known adverse effects of smoking on the cardiovascular system. Although the toxic effects of cigarettes on some body organs do not go away even when people stop smoking, the effects on the heart are considered largely reversible if people give up tobacco.

I was disappointed in the results of most of the recommended methods to stop smoking. Even in the few instances where I had seen them work, people often reverted to their former habit after a period of abstinence. As a result, I was always looking for better ways to help people stop using tobacco products.

A psychiatrist, with whom I had done some research in trying to control irregularities of heart rhythm in people with so-called arrhythmias (disorders of the heart beat), was an expert in hypnosis. He had developed a technique using hypnosis to help people stop smoking, a technique different from usual attempts to use hypnosis for smoking cessation.

While the customary use of hypnosis to stop smoking involved what might be called negative reinforcement, where subjects were told cigarettes were bad, or that they tasted terrible, or would injure them, the different technique employed positive reinforcement. It focused on respecting and protecting one’s body.

I decided to try to learn the technique of inducing hypnosis and use it for the limited purpose of getting people to give up cigarettes. (I have subsequently used the technique of inducing hypnosis in other urgent situations.)

Having thought I mastered the technique of hypnotic induction and the positive reinforcement messages of smoking cessation, I thought I would try it on the patient. As she was a family friend, my wife and I agreed that she could come to our home for the session.

My wife left the room when we began the “treatment.” The patient sat comfortably on the couch, and I proceeded to give her the instructions for entering a “hypnotic trance.” This was the first time I had actually tried it on a subject, and it worked so smoothly I was amazed. Once she was in a hypnotic state, I gave her the positive messages about protecting and respecting her body and so on; the actual “script” is a long one and takes a while to go through the whole thing.

When I was through with all the messaging, I gave the patient the simple instructions to wake up from the state of hypnosis.

She did not wake up!

I wasn’t upset at first; I thought I just hadn’t done it correctly, so I went through the simple instructions again. Again, nothing happened.

After a third attempt with no response, my wife came in silently just to see where we were in the whole exercise.

“I can’t wake her up,” I said, quietly.

“What do you mean you can’t wake her up?”

I repeated, “I cannot wake her up.”

“Don’t fool around,” my wife said. “This isn’t funny!”

“I’m not fooling,“ I said.

“Well, is she going to spend the rest of her life on our couch? What do we do?”

I said, “I remember that I asked the guy who taught me this technique what to do if a patient ever didn’t wake up. He said they fall into a natural sleep and eventually wake up normally.”

“How long,” asked my wife.

“I don’t know, I replied, “We just have to sit here and wait.”

So we did.

But as I kept thinking about what I had done, it suddenly came to me. When
I gave her the instructions to enter the state of hypnosis, I had spoken loudly knowing that she had a hearing deficit. But once she entered the hypnotic state, I dropped my voice and everything that followed was spoken in a very soft tone. She had heard nothing!

Now, in a loud voice, almost yelling, I repeated the simple instructions to awaken from the state of hypnosis. Sne promptly woke up, reached for and lit a cigarette, and leaned back, smiling.

I had never been so happy to see a patient light up.