"There's a whole group of people who will keep it alive...It's so easy to feel his passion," says Dr. Georgios Petrides, one of Fink's younger proteges. "The results are so dramatic. Our challenge is to use ECT to understand mental illness." But if the psychiatrist has not succeeded in changing the reputation of ECT in the decades since he delivered the first volts to a patient in 1952, Fink's battle will be even more difficult now. The next generation of devices to treat mental illness is already on the horizon, a series of magnets that deliver a different form of electrical current. These devices don't need to target the whole brain. The energy is directed locally, and there's no anesthesia, no side effects.

The developers of these new systems-called transcranial magnetic stimulation or TMS-say that these energy sources are backed by science, and are much safer.

"We are beginning to understand depression and there will be a host of new ways to get into the brain to help people," said Dr. Mark S. George, a psychiatrist at the Medical University of South Carolina.

"ECT got a terrible reputation and it is still struggling to get beyond that," George said. "TMS is totally new and non-invasive. It can be done when people are awake, even reading." "I am betting that we don't need a seizure to treat serious depression," said George. With TMS, patients sit in a chair while doctors deliver magnetized energy over the frontal lobe, directly above the area scientists suspect is involved in depression. The magnets are pulsed on and off for 20 minutes. To patients, it feels like being tapped on the head with a large eraser. By the second week of daily treatment, patients report they are beginning to feel better.

George's latest study of 30 patients-all of whom suffered symptoms of major depression for more than two years-proves the power of the magnetic energy on the brain. Those who received TMS had a 45 percent drop on depression test scores after two weeks, compared to 20 percent of those in a placebo test.

TMS and other modern-day brain devices are wending their way through the federal device regulatory process.

Meanwhile, says Fink, "ECT is alive and well."

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