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149-451: Located in Gotham City , Arkham Asylum is where Batman's foes who are considered to be mentally ill are brought as patients (other foes are incarcerated at Blackgate Penitentiary ). Although it has had numerous administrators, some comic books have featured Jeremiah Arkham . Inspired by the works of H. P. Lovecraft , and in particular his fictional city of Arkham , Massachusetts, the asylum

298-503: A Nobel Prize but did not receive one. By 1940, the procedure was introduced to both England and the US. In Germany and Austria, it was promoted by Friedrich Meggendorfer . Through the 1940s and 1950s, the use of ECT became widespread. At the time the ECT device was patented and commercialized abroad, the two Italian inventors had competitive tensions that damaged their relationship. In the 1960s, despite

447-555: A nickname for New York City that first became popular in the 19th century; Washington Irving had first attached it to New York in the November 11, 1807, edition of his Salmagundi , a periodical which lampooned New York culture and politics. Irving took the name from the English village of Gotham, Nottinghamshire , which was known for the Wise Men of Gotham story, a legendary incident where

596-475: A stroke ; who have increased intracranial pressure (for instance, due to a solid brain tumor ), or who have severe pulmonary conditions, or who are generally at high risk for receiving anesthesia. In adolescents, ECT is highly efficient for several psychiatric disorders, with few and relatively benign adverse effects. A meta-analysis from 2017 found that the death rate of ECT was around 2.1 per 100,000 procedures. A review from 2011 reported an estimate of

745-462: A Canadian guideline and some experts arguing for using ECT as a first line treatment, ECT is generally used only when one or other treatments have failed, or in emergencies, such as imminent suicide. ECT has also been used in selected cases of depression occurring in the setting of multiple sclerosis , Parkinson's disease , Huntington's chorea , developmental delay , brain arteriovenous malformations , and hydrocephalus . A meta-analysis on

894-529: A Gotham City in 2039, referred to as "Neo-Gotham". Gotham City was first shown in the Arrowverse as part of " Elseworlds ", a 2018 crossover storyline among the shows, which introduced Batwoman , although it had been referred to several times previously. In The Flash episode "Marathon", a map shows Gotham City in place of Chicago, Illinois. Themed lands meant to represent Gotham City have been physically constructed in several different theme parks around

1043-514: A Gotham area resident's hometown as "Gotham Estates, NY ". In the episode "Avatar" , when Bruce Wayne leaves for England, a map shows Gotham City, at the joining of Long Island and the Hudson River. The episode "Fire from Olympus" shows a character's address in a police file indicating that Gotham City is located in New York state. The episode "The Mechanic" , however, implies that Gotham resides in

1192-534: A Norwegian mercenary, before subsequently being taken over by the English; this parallels the history of New York City , which was founded by the Dutch as New Amsterdam before being conquered by England and renamed New York . During the American Revolutionary War , Gotham City was the site of a major battle between American and British forces (paralleling the real-life Battle of Long Island ). This

1341-557: A climate of condemnation, the original Cerletti-Bini ECT apparatus prototype was contended by scientific museums between Italy and the US. The ECT apparatus prototype is now owned and displayed by the Sapienza Museum of the History of Medicine in Rome. In the early 1940s, in an attempt to reduce the memory disturbance and confusion associated with treatment, two modifications were introduced:

1490-471: A closer eye on his foes in the asylum due to his intimate knowledge of the manor's entrances and exits (after sealing off the entrance to the Batcave from the manor). Originally, Arkham Asylum was used only to house genuinely mentally ill patients having no connection to Batman, but over the course of the 1980s, a trend was established in having the majority of Batman's adversaries end up at Arkham. Arkham Asylum

1639-580: A cross between 1930s Manhattan and the "Neo-Tokyo" of Akira . Ling cited " neon-ridden Tokyo and the Machine Age as her influences, describing her Gotham as "like a World's Fair on ecstasy ." When Batman is pursuing Two-Face in Batman Forever , the chase ends at Lady Gotham, the fictional equivalent of the Statue of Liberty . During Mr. Freeze's attempt to freeze Gotham in the film Batman & Robin ,

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1788-614: A four-issue storyline that kicked off the Batman: Shadow of the Bat series. In it, the old Arkham Asylum is destroyed, to be replaced by a new and more modern facility. The story introduces Jeremiah Arkham, the asylum's director and nephew of Amadeus Arkham. In an attempt to discover how criminals, specifically Zsasz, keep escaping, Batman has himself committed to the asylum. Jeremiah uses various methods, such as unleashing many patients on Batman at once, in an attempt to gain psychological insight on

1937-534: A greater risk of memory impairment. Retrograde amnesia is most marked for events occurring in the weeks or months before treatment. Anterograde memory loss usually resolves 2–4 weeks after treatment, whereas retrograde amnesia (which develops gradually after repeated treatments in the initial course) usually takes weeks to months to resolve, and amnesia rarely persist for more than 1 year. Retrograde amnesia after ECT usually affects autobiographical memory, rather than semantic memory . One published review summarizing

2086-514: A half times seizure threshold for bilateral ECT and up to 12 times for unilateral ECT. Below these levels treatment may not be effective in spite of a seizure, while doses massively above threshold level, especially with bilateral ECT, expose patients to the risk of more severe cognitive impairment without additional therapeutic gains. Seizure threshold is determined by trial and error (" dose titration "). Some psychiatrists use dose titration, some still use "fixed dose" (that is, all patients are given

2235-532: A large effect size (high efficacy relative to the mean in terms of the standard deviation ) for ECT versus placebo, and versus antidepressant drugs. Compared with repetitive transcranial magnetic stimulation (rTMS) for people with treatment-resistant major depressive disorder, ECT relieves depression as shown by reducing the score on the Hamilton Rating Scale for Depression by about 15 points, while rTMS reduced it by 9 points. Other estimates regarding

2384-507: A man named Atkins. In the wake of Bane's takeover of the city, a man named Dunch served as mayor, and in the aftermath of the Joker War, anti-vigilante mayoral candidate Christopher Nakano wins election in a landslide. In multiple episodes of the 1960s live-action Batman television series , Batman is seen consulting a transparent lucite map of Gotham, which was actually an inverted map of St. Louis . The live-action TV series Gotham

2533-441: A man obsessed with his own reflection in a series of mirrors in his room; and a woman supposedly so ugly, one glance at her face would cause anyone to become mentally ill. Upon discovering his "special" patients (unharmed from the destruction thanks to their secluded cells), Arkham resolves to rebuild the facility according to his ancestor's vision, but to serve as a literal asylum for mentally ill patients in order to shelter them from

2682-425: A meta-analysis found in terms of efficacy, "a significant superiority of ECT in all comparisons: ECT versus simulated ECT, ECT versus placebo , ECT versus antidepressants in general, ECT versus tricyclics and ECT versus monoamine oxidase inhibitors ." In 2003, The UK ECT Review Group published a systematic review and meta-analysis comparing ECT to placebo and antidepressant drugs. This meta-analysis demonstrated

2831-465: A psychiatric or medical condition (e.g., when illness is characterized by suicidality , psychosis , stupor , marked psychomotor retardation , depressive delusions or hallucinations , or life-threatening physical exhaustion associated with mania)." It has also been used to treat autism in adults with an intellectual disability, yet findings from a systematic review found this an unestablished intervention. For major depressive disorder , despite

2980-483: A regular prison are housed in Arkham. For example, Mr. Freeze is not always depicted as mentally ill, but he requires a strongly refrigerated environment to stay alive; Arkham, with special conditions required for certain patients or inmates being a regularity rather than an exception, is seen by authorities to be an ideal location under certain circumstances. Gotham criminals deemed "criminally insane" or "mentally unfit" by

3129-456: A reporter reports on the asylum's renovation, the Joker poisons her and the crew, stealing the news van to broadcast whenever he wants. He later releases criminally insane patients at Williams Medical Center, who, in a short number of weeks, would have been transferred to Arkham Asylum. In the end, Joker is defeated and he himself is locked behind bars, in a straitjacket at Arkham. The graphic novel

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3278-657: A section themed after Gotham City, including rides based on Batman, the Riddler and the Scarecrow as well as a walk-through attraction called "The Joker's Funhouse." The park and its Gotham City section were designed by Thinkwell Group . DC characters as they appear in both the attractions themselves as well as through live performers feature costumes based on The New 52 comic book relaunch from 2011. The Gotham City section neighbors another section themed after Metropolis , home of Superman . Batman (1989) director Tim Burton wanted

3427-409: A shock to the head produced convulsions in dogs. The idea to use electroshock on humans came to Cerletti when he saw how pigs were given an electric shock before being butchered to put them in an anesthetized state. Cerletti and Bini practiced until they felt they had the right parameters needed to have a successful human trial. Once they started trials on patients, they found that after 10–20 treatments

3576-500: A state of the same name; a prison workshop is shown stamping license plates that read "Gotham: The Dark Deco State" (as a reference to the artistic style of the series). The episode " Harlequinade " states that Gotham City has a population of approximately 10 million people. This figure was also given in the 1960s Batman TV series episode Egg Grows in Gotham, the thirteenth episode of the second season. Batman Beyond (1999–2001) envisions

3725-402: A study purporting to show an absence of cognitive impairment in eight subjects after more than 100 lifetime ECT treatments. Kellner stated "Rather than cause brain damage, there is evidence that ECT may reverse some of the damaging effects of serious psychiatric illness." Two meta-analyses find that ECT is associated with brain matter growth. If steps are taken to decrease potential risks, ECT

3874-465: A timeless alternative to New York and described it as "hell burst through the pavement and grew". The look of Gotham was overseen by production designer Anton Furst , who won an Oscar for supervising the art department. Furst stated Batman was "definitely based in many ways on the worst aspects of New York City" and was inspired by Andreas Feininger 's photographs of 1940s New York. Furst's draftsman Nigel Phelps created numerous charcoal drawings of

4023-468: A visual expression of corruption and greed? That got me thinking about the fascistic architecture employed at world's fairs... That feels corrupt because it's evocative of oppressive bureaucracies and dictatorships... So I looked at a lot of [Third Reich] art and images from world's fairs". To physically make the city seem darker, he designed tall "oppressively overbuilt" cityscape that physically blocked out light. When Joel Schumacher took over directing

4172-600: Is a fictional city in the Eastern United States that serves as the primary city appearing in American comic books published by DC Comics . It is best known as the home of the superhero Batman and his allies and foes . Created by writer Bill Finger and artist Bob Kane , the city was first identified as Batman's place of residence in Batman #4 (December 1940) and has since been the primary setting for stories featuring

4321-481: Is a graphic novel written by Grant Morrison and painted by Dave McKean . It was published by DC in 1989. It made reference to the treatment of several of the patients, such as the attempt to wean Two-Face away from dependence on his coin for decision making, first with a die and then a deck of cards. It once again portrays the asylum as having been taken over by its patients. A Serious House on Serious Earth has been critically acclaimed, having been called "one of

4470-632: Is also Catwoman , Batgirl (Barbara Gordon) , Batgirl (Cassandra Cain) , Signal , Batwing , Batwoman , and Huntress . Other DC characters have also been depicted to be living in Gotham, such as mercenary Tommy Monaghan and renowned demonologist Jason Blood . Within modern DC Universe continuity, Batman is not the first hero in Gotham. Stories featuring Alan Scott , the Golden Age Green Lantern , set before and during World War II depict Scott living in Gotham, and later depictions show him running his Gotham Broadcasting Corporation. Also,

4619-854: Is also featured in other DC Comics publications, apart from the Batman comic book titles. In Alan Moore 's run in Swamp Thing the Floronic Man is detained there and in The Sandman by Neil Gaiman , Doctor Destiny escapes the asylum to wreak havoc on both the real and dream worlds. It has also been featured in varying capacities in a number of DC miniseries events, such as Crisis on Infinite Earths , Identity Crisis , Day of Vengeance and Countdown to Final Crisis , among others. Many DC Comics characters who have been patients at Arkham Asylum are listed below. Arkham Asylum: A Serious House on Serious Earth

Arkham Asylum - Misplaced Pages Continue

4768-402: Is destroyed as part of the villains' assault on Batman, with Bruce Wayne also being declared bankrupt after Wayne Enterprises loses most of its assets following Hush detonating some of Batman's hidden weapons caches around the city. As a result, Wayne Manor is repossessed by the city and turned into the new Arkham Asylum, but Bruce decides to accept the situation on the grounds that he can now keep

4917-402: Is evidence and rationale to support giving low doses of benzodiazepines or otherwise low doses of general anesthetics , which induce sedation but not anesthesia , to patients to reduce adverse effects of ECT. While there are no absolute contraindications for ECT, there is increased risk for patients who have unstable or severe cardiovascular conditions or aneurysms ; who have recently had

5066-404: Is generally accepted to be relatively safe during all trimesters of pregnancy, particularly when compared to pharmacological treatments. Suggested preparation for ECT during pregnancy includes a pelvic examination , discontinuation of nonessential anticholinergic medication, uterine tocodynamometry, intravenous hydration, and administration of a nonparticulate antacid . During ECT, elevation of

5215-407: Is generally acknowledged". For people with autism spectrum disorders who have catatonia, there is little published evidence about the efficacy of ECT. ECT is used to treat people who have severe or prolonged mania ; NICE recommends it only in life-threatening situations or when other treatments have failed and as a second-line treatment for bipolar mania . ECT is widely used worldwide in

5364-415: Is housed there, catatonic since Batman's disappearance, but awakens when the vigilante resumes action. Under the employ of the home is Bartholemew Wolper, a condescending psychologist who treats the Joker humanely, even going so far to arrange for him to appear on a late night talk show, while arguing that Batman himself is responsible for the crimes his enemies commit by encouraging their existence; Wolper

5513-479: Is killed when the Joker uses his lethal gas on the talk show audience. In the sequel The Dark Knight Strikes Again , it is revealed that the patients have taken over and have resorted to cannibalism . Plastic Man is one of the more notable patients in this version of Arkham Asylum. In JLA: The Nail , the Joker-using Kryptonian gauntlets provided by a genetically augmented Jimmy Olsen -breaks into

5662-570: Is listed in some histories as the first appearance of Arkham Asylum. It was also Wein who, in 1985's Who's Who: The Definitive Dictionary of the DC Universe #1, created its current backstory. Arkham Asylum has been demolished or destroyed several times in its history, notably during the events of Batman: The Last Arkham (see below). It is also seriously damaged at the beginning of the Knightfall storyline, when Bane uses stolen munitions to blow up

5811-526: Is located in New Jersey. In The World's Greatest Super Heroes (August 13, 1978) comic strip, a map is shown placing Gotham City in New Jersey and Metropolis in Delaware. World's Finest Comics #259 (November 1979) also confirms that Gotham is in New Jersey. The New Adventures of Superboy #22 (October 1981) and the 1990 Atlas of the DC Universe both show maps of Gotham City in New Jersey and Metropolis in

5960-532: Is locked in Mr. Freeze's cell and loses his nose and his lips to frostbite while trapped in there, coming to resemble his nickname. He was originally referred to as 'Fish' as new inmates commonly are, but is re-dubbed 'The Great White Shark' by himself. The demonic threat is nullified after the sacrifice of several patients, thanks to the joint effort of Etrigan the Demon and White tricking the demons into sending themselves back to

6109-420: Is no defined schedule for maintenance ECT, however it is usually started weekly with intervals extended permissibly with the goal of maintaining remission. When ECT is followed by treatment with antidepressants , about 50% of people relapsed by 12 months following successful initial treatment with ECT, with about 37% relapsing within the first 6 months. About twice as many relapsed with no antidepressants. Most of

Arkham Asylum - Misplaced Pages Continue

6258-590: Is set in Gotham City, was filmed in Chicago . The 2024 series The Penguin is set in Gotham City. Gotham City is featured heavily in Batman: The Animated Series . When describing Gotham City Paul Dini , a writer and director of the show, stated "In my mind, it was sort of like what if the 1939 World's Fair had gone on another 60 years or so". ' In the episode " Joker's Favor ", a driver's license lists

6407-698: Is thought to be the father of convulsive therapy. In 1937, the first international meeting on schizophrenia and convulsive therapy was held in Switzerland by the Swiss psychiatrist Max Müller. The proceedings were published in the American Journal of Psychiatry and, within three years, cardiazol convulsive therapy was being used worldwide. The ECT procedure was first conducted in 1938 by Italian neuro-psychiatrist Ugo Cerletti and rapidly replaced less safe and effective forms of biological treatments in use at

6556-438: Is titled The State of New York vs. Arthur Fleck . Gotham City is the home of Batman , just as Metropolis is home to Superman , and the two heroes often work together in both cities. In comic book depictions, the exact distance between Gotham and Metropolis has varied over the years, with the cities usually being within driving distance of each other. The two cities are sometimes portrayed as twin cities on opposite sides of

6705-474: Is unclear if he did this while reveling in his new power or to try and provoke his old allies into destroying what he had become). As an integral part of the Batman franchise, Arkham Asylum has been featured in other media besides the print comics, including the following: In Batman Begins , Arkham plays a much larger role than the previous films, with Jonathan Crane (also known as the Scarecrow) being either

6854-528: The Batman film series from Tim Burton, Barbara Ling handled the production design for both of Schumacher's films, Batman Forever (1995) and 1997's Batman & Robin . Ling's vision of Gotham City was a luminous and outlandish evocation of modern Expressionism and Constructivism . Its futuristic design, which Washington Post critic Desson Howe felt evoked the 1982 film Blade Runner , were described by Ling in her book, Bigger, Bolder, Brighter: The Production Design of Batman & Robin as

7003-522: The Battle for the Cowl one-shot, Dr. Jeremiah Arkham wanders among the remains of the asylum as he muses on his life. He reveals that he has discovered blueprints created by his uncle, Dr. Amadeus Arkham, for a new Arkham Asylum. He also contemplates the fates of his own nonviolent "special" patients: an artist with almost no facial features who must paint facial expressions onto his almost blank face to express himself;

7152-523: The Delaware Bay , with Gotham in New Jersey and Metropolis in Delaware. The Atlas of the DC Universe from the 1990s places Metropolis in Delaware and Gotham City in New Jersey. New York has also garnered the nickname Metropolis to describe the city in the daytime in popular culture, contrasting with Gotham , sometimes used to describe New York City at night. During the Bronze Age of Comic Books ,

7301-512: The National Institute of Mental Health and National Institutes of Health convened a consensus development conference on ECT and concluded that, while ECT was the most controversial treatment in psychiatry and had significant side-effects, it had been shown to be effective for a narrow range of severe psychiatric disorders. Because of the backlash noted previously, national institutions reviewed past practices and set new standards. In 1978,

7450-473: The Scarecrow as the chief villain, also replacing Jeremiah Arkham with a more nondescript administrator, Dr. Bartholemew who is portrayed as naïve rather than sinister. Arkham Asylum: Living Hell was written by Dan Slott , penciled by Ryan Sook with inks by Sook, Wade Von Grawbadger and Jim Royal. The series was edited by Valerie D'Orazio . Eric Powell created the painted cover art which appeared on both

7599-469: The Tim Burton films' "otherworldly timelessness," incorporating period features such as black-and-white title cards , police airships (although no such thing existed, Timm has stated that he found it to fit the show's style), and a "vintage" color scheme with film noir flourishes. Police airships have since been incorporated into Batman comic books and are a recurring element in Gotham City. Concerning

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7748-405: The demonic element suggested by the title. White, facing charges of massive fraud , pleads insanity to avoid being sent to prison, knowing he can bribe a Gotham jury. The judge sees through White's attempt to avoid prison and has White admitted to Arkham, which White himself had never even heard of up until that point. He soon realizes the horrors of the place and tries to survive. Ultimately, he

7897-573: The raped and mutilated corpses of his wife and daughter in an upstairs room, with Mad Dog's alias carved on Harriet's body. Despite this family tragedy, the Elizabeth Arkham Asylum for the Criminally Insane officially opened that November. With his sanity in tatters, Dr. Arkham designed a floor plan that evoked occult runes, believing that the pattern would drive away the mysterious bat that haunted his dreams. One of its first patients

8046-464: The roaring 20s , and then there's this other really kind of heavy Blade Runner vibe floating around. There are elements of it that are completely contemporary and there are pieces of it that are very old-fashioned...There were a couple of examples of modern technology, but maybe an antiquated version of it, that gave me a little bit of sense that it's certainly not the 50s and the 60s...But it's not high tech and it's not futuristic, by any means." In

8195-447: The "dark and often cursed character" of the city was influenced by the being who now uses the name "Doctor Gotham." In Gotham Underground #2 by Frank Tieri , Tobias Whale claims that 19th century Gotham was run by five rival gangs, until the first "masks" appeared, eventually forming a gang of their own. It is not clear whether these were vigilantes or costumed criminals. Many storylines have added more events to Gotham's history, at

8344-551: The American Psychiatric Association released its first task force report in which new standards for consent were introduced and the use of unilateral electrode placement was recommended. The 1985 NIMH Consensus Conference confirmed the therapeutic role of ECT in certain circumstances. The American Psychiatric Association released its second task force report in 1990 where specific details on the delivery, education, and training of ECT were documented. Finally, in 2001

8493-410: The American Psychiatric Association released its latest task force report. This report emphasizes the importance of informed consent , and the expanded role that the procedure has in modern medicine. By 2017, ECT was routinely covered by insurance companies for providing the "biggest bang for the buck" for otherwise intractable cases of severe mental illness , was receiving favorable media coverage, and

8642-549: The Asylum, erecting a forcefield around it that prevents anyone but Batman, Robin and Batgirl from entering, while forcing the rest of the patients to fight each other for a chance to live as his slave when only one is left standing. Catwoman wins the resulting conflict shortly before Batman breaks into the asylum, but the Joker's gauntlets allow him to capture Batman, forcing him to watch as the Joker brutally tears Robin and Batgirl apart in front of him. Although Catwoman manages to distract

8791-833: The Bat Annual #1 (June 1993) further establishes that Gotham City is in New Jersey. Sal E. Jordan's driver's license in the comic shows his address as "72 Faxcol Dr Gotham City, NJ 12345", although the ZIP Code is actually in Schenectady, New York . The 2016 film Suicide Squad reveals Gotham City to be in the state of New Jersey within the DC Extended Universe . Both 2021's The Batman , and its 2024 TV spinoff The Penguin have Gotham City in New Jersey as can be seen with in-universe drivers licenses. However, 2024's Joker: Folie à Deux places Gotham City in New York as Joker's trial

8940-509: The Clench virus after leaving office. A woman, Marion Grange, became mayor with the backing of Bruce Wayne but was assassinated in Washington, D.C. , while trying to secure federal aid for Gotham after an earthquake. In the wake of No Man's Land , Daniel Danforth Dickerson III served as mayor only to be killed by a sniper, after which he was replaced by David Hull. Seamus McGreevy served as mayor in

9089-518: The Comics , writer Bill Finger , on the naming of the city, said, "Originally I was going to call Gotham City ' Civic City .' Then I tried 'Capital City,' then ' Coast City .' Then I flipped through the New York City phone book and spotted the name 'Gotham Jewelers' and said, 'That's it,' Gotham City. We didn't call it New York because we wanted anybody in any city to identify with it." "Gotham" has been

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9238-516: The Cowl". In Batman #697, it is revealed that Dr. Jeremiah Arkham is the new Black Mask. More is revealed about Dr. Jeremiah Arkham in Detective Comics #864 and #865. The Man Who Laughs is a one-shot prestige format comic book written by Ed Brubaker and illustrated by Doug Mahnke and Patrick Zircher , released in February 2005. The comic reveals some of the asylum's dark history. As

9387-513: The GCPD to turn a blind eye to Batman's activities after Batman saved his daughter. Mayor Hill was in office when the Joker debuted, and a man named Gill was mayor early in Batman's career, as was former police commissioner Grogan. An unnamed bald mayor was killed by a villain known as Midnight. Men named Carfax, Bradley Stokes, Sheppard, Taylor, and Hayes all served as mayor. Mayor Charles Chesterfield

9536-569: The Gates of Gotham, each bearing one of their last names. Edward Elliot became increasingly jealous of the Wayne family's popularity and wealth during this period, jealousy that would spread to his great-great-grandson, Thomas Elliot or Hush. The occult origins of Gotham are further delved into by Peter Milligan 's 1990 story arc "Dark Knight, Dark City", which reveals that some of the Founding Fathers of

9685-577: The Gotham City Police Department is the focus of the series Gotham Central , as well as the mini-series Gordon's Law , Bullock's Law , and Batman: GCPD . The first Gotham mayor depicted in comics was in Detective Comics #68 (October 1942). Theodore Cobblepot, great grandfather of the Penguin , was mayor in the late 19th century. An unnamed mayor ran afoul of the Court of Owls in 1914 and

9834-421: The Joker long enough for Batman to escape and damage his gauntlets, the grief-maddened Batman subsequently beats the Joker to death on the asylum roof before the entire building collapses, apparently killing most of the current patients (although he and Catwoman manage to escape, Batman is only tried for the Joker's death once the immediate crisis is resolved, and the sequel confirms that at least Poison Ivy survived

9983-414: The Joker. Arkham is viewed as a desperate place where patients dwell in terror, much in the same fashion as in A Serious House on Serious Earth , which was also illustrated by McKean. Arkham Reborn is a three-part miniseries written by David Hine and illustrated by Jeremy Haun. It tells the story of the rebuilding of the Asylum after having been destroyed by Black Mask during the events of "Battle for

10132-552: The Metro-Narrows Bridge was depicted as the main route connecting the twin cities of Metropolis and Gotham City. It has been described as being the longest suspension bridge in the world. A map appeared in The New Adventures of Superboy #22 (October 1981), that showed Smallville within driving distance of both Metropolis and Gotham City; Smallville was relocated to Kansas in post-Crisis continuity. A map of

10281-630: The Pinkney structures they had hidden; the editorial purpose behind this was to transform the city depicted in the comics to resemble the designs created by Anton Furst for the 1989 Batman film. Batman Begins features a CGI-augmented version of Chicago while The Dark Knight more directly features Chicago infrastructure and architecture such as Navy Pier . The Dark Knight Rises forgoes Chicago, instead shooting in Pittsburgh, Los Angeles, New York City, Newark, New Jersey, London, and Glasgow. Over

10430-502: The TV series Smallville , Gotham City is mentioned by the character Linda Lake in the episode "Hydro", who jokes she can see Gotham from her view. In "Reunion", one of Oliver Queen's friends mentions having to get back to Gotham. The fifth episode of Young Justice , entitled "Schooled", indicates that Gotham is located in Connecticut , near Bridgeport . The 2019 series Batwoman , which

10579-517: The Underworld. Black Orchid , written by Neil Gaiman and illustrated by Dave McKean , also featured Arkham Asylum. The award-winning graphic novel introduced an updated version of the crimefighter Black Orchid , who dies, is reborn and starts a quest to find her identity. During this she encounters Batman, who directs her to Arkham Asylum, where she meets the Mad Hatter , Poison Ivy , Two-Face and

10728-478: The United States are involved in summoning a bat-demon which becomes trapped beneath old "Gotham Town", its dark influence spreading as Gotham City evolves. A similar trend is followed in 2005's Shadowpact #5 by Bill Willingham , which expands upon Gotham's occult heritage by revealing a being who has slept for 40,000 years beneath the land upon which Gotham City was built. Strega, the being's servant, says that

10877-653: The United States in The Secret Files & Origins Guide to the DC Universe 2000 #1 (March 2000) depicts Metropolis and Gotham City as being somewhere in the Tri-state Area alongside Blüdhaven . Within the DC Extended Universe, the 2016 film Batman v Superman: Dawn of Justice depicts Gotham City as being located across a bay from Metropolis. Gotham City was founded in 1635 by Captain Jon Logerquist,

11026-454: The administrator or a high-ranking doctor at the asylum and using it to conduct sadistic experiments with his fear gas, with his own patients as guinea pigs . He also uses the pipes under the asylum to empty his toxin into the Gotham water supply. Though still on an island separate from Gotham City's mainland, it is surrounded by a slum region known as the Narrows, instead of the dense forestry of

11175-405: The asylum was named after Elizabeth Arkham, the mother of founder Amadeus Arkham . The original name of the asylum was "Arkham Hospital". Its dark history began in the early 1900s when Arkham's mother, having suffered from mental illness most of her life, committed suicide . However, it was later revealed that her son had actually euthanized her and repressed the memory. Amadeus then decided, as

11324-529: The brain, the general physical risks of ECT are similar to those of brief general anesthesia . Immediately following treatment, the most common adverse effects are confusion and transient memory loss. Among treatments for severely depressed pregnant women, ECT is one of the least harmful to the fetus . ECT is often used as an intervention for major depressive disorder , mania , autism , and catatonia . The usual course of ECT involves multiple administrations, typically given two or three times per week until

11473-582: The brain, the general physical risks of ECT are similar to those of brief general anesthesia ; the US Surgeon General 's report says that there are "no absolute health contraindications " to its use. Immediately following treatment, the most common adverse effects are confusion and memory loss. Some patients experience muscle soreness after ECT. Other common adverse effects after ECT include headache, jaw soreness, nausea, vomiting and fatigue. These side effects are transient and respond to treatment. There

11622-558: The buildings and interior sets for the production. Following the death of Furst, Burton tapped Bo Welch to oversee production design for Batman Returns (1992). Burton wanted Welch to re-imagine Gotham, stating " Batman didn't feel big to me – it didn't have the power an old American city has". Welch wanted to expand on the same basic concept for the sequel but moved away from European influences to show more American Art Deco / world's fair elements. When asked what inspired his interpretation of Gotham, Welch stated "[H]ow can I create

11771-512: The character. In most of its incarnations, Gotham is depicted as one of the most crime-ridden cities in the world. Gotham City is traditionally depicted as being located in the U.S. state of New Jersey . Gotham's look and atmosphere were primarily influenced by New York City , but also drew inspiration from Chicago and London . Architect Hugh Ferriss ' designs also influenced the look and emotional feel of Gotham City, particularly in its later depictions. Bill Finger said that he chose

11920-604: The coldest night in November". Batman artist Neal Adams has long believed that Chicago has been the basis for Gotham, stating "one of the things about Chicago is Chicago has alleys (which are virtually nonexistent in New York). Back alleys, that's where Batman fights all the bad guys." The statement "Metropolis is New York by day; Gotham City is New York by night" has been variously attributed to comics creators Frank Miller and John Byrne . In designing Batman: The Animated Series , creators Bruce Timm and Eric Radomski emulated

12069-399: The collapse). In Batman: Crimson Mist , the third part of the trilogy that began with Batman & Dracula: Red Rain , the now-vampiric Batman, corrupted by his thirst for blood, breaks into the asylum and murders all the homicidal patients-including Amygdala , Victor Zsasz and the Mad Hatter -drinking their blood and chopping off their heads to prevent them coming back as vampires (it

12218-422: The comics. When it came to a diversion for the fear gas to infect Gotham's water supply, Ra's al Ghul had his men discharge all the patients at Arkham Asylum to keep the police busy. By the end of the film, it is implied that the Narrows has been rendered uninhabitable. Notably, Victor Zsasz is shown as a high-profile criminal being held in the asylum. The National Institute for Medical Research , Mill Hill, London

12367-436: The concern surrounding its use. However, the methods used to measure memory loss are non-specific, and their application to people with depressive disorders, who have cognitive deficits related to the depression, including problems with memory, may further limit their utility. The acute effects of ECT can include amnesia , both retrograde (for events occurring before the treatment) and anterograde (for events occurring after

12516-526: The court of law generally are treated at Williams Medical Center before being deemed dangerous enough to be sent to Arkham Asylum. Serving as a Gotham City psychiatric hospital, Arkham Asylum has a long and brutal history, beginning when its own architect became mentally unwell and hacked his workers to death with an axe. He was convicted and sentenced to spend the rest of his life in the same asylum he had been building. The one-shot graphic novel Arkham Asylum: A Serious House on Serious Earth establishes that

12665-403: The dose and duration of the stimulation is determined on a per-patient basis. In unilateral ECT, both electrodes are placed on the same side of the patient's head. Unilateral ECT may be used first to minimize side effects such as memory loss. In bilateral ECT, the two electrodes are placed on opposite sides of the head. Usually bitemporal placement is used, whereby the electrodes are placed on

12814-463: The effectiveness of ECT in unipolar and bipolar depression indicated that although patients with unipolar depression and bipolar depression responded to other medical treatments very differently, both groups responded equally well to ECT. Overall remission rate for patients given a round of ECT treatment was 50.9% for those with unipolar depression and 53.2% for those with bipolar depression. Most severely depressed patients respond to ECT. In 2004,

12963-456: The effectiveness of his constant current, brief pulse device ECT. This device eventually largely replaced earlier devices because of the reduction in cognitive side effects, although as of 2012 some ECT clinics still were using sine-wave devices. The 1970s saw the publication of the first American Psychiatric Association (APA) task force report on electroconvulsive therapy (to be followed by further reports in 1990 and 2001). The report endorsed

13112-424: The electric current is passed from one side of the brain to the other, or unilateral, in which the current is solely passed across one hemisphere of the brain. High-dose unilateral ECT has some cognitive advantages compared to moderate-dose bilateral ECT while showing no difference in antidepressant efficacy. As early as the 16th century, agents to induce seizures were used to treat psychiatric conditions. In 1785,

13261-404: The evidence for continuation therapy is with tricyclic antidepressants ; evidence for relapse prevention with newer antidepressants is lacking. Adjunct maintenance ECT paired with cognitive behavioral therapy has also been shown to reduce relapse rates. Maintenance ECT may safely continue indefinitely, with no set maximum treatment interval established. Lithium has also been found to reduce

13410-436: The evolution of Gotham throughout the years, former Batman editor Paul Levitz has stated, "Each guy adds their own vision. That's the fun of comics, rebuilding a city each time". In Batman: Gothic , Gotham Cathedral plays a central role in the story since it is built by Mr. Whisper, the story's antagonist. In a 1992 storyline, a man obsessed with Pinkney's architecture blew up several Gotham buildings in order to reveal

13559-457: The facility and release all the patients. After these events, the asylum is relocated to a large mansion known as "Mercey Mansion". At the beginning of the No Man's Land storyline, the asylum is closed down and all its patients discharged. In this instance, a timer was used to open the doors two minutes before the city is sealed. This is orchestrated by the administrator himself, Dr. Jeremiah Arkham ,

13708-469: The federal government cutting Gotham off from the rest of the United States in the 1999 storyline " No Man's Land ", the city's remaining residents forced to engage in gang warfare, either as active participants or paying for protection from groups ranging from the GCPD to the Penguin, just to stay alive. Eventually, Gotham was rebuilt and returned to the U.S. as part of a campaign mounted by Lex Luthor , who used

13857-468: The finest superhero books to ever grace a bookshelf." IGN ranked it as number four in a list of the 25 greatest Batman graphic novels, behind The Killing Joke , The Dark Knight Returns , and Year One , whilst Forbidden Planet named it number eight in their "50 Best of the Best Graphic Novels" list. Batman: The Last Arkham was written by Alan Grant ; pencils by Norm Breyfogle , originally

14006-420: The following year, but it was not until 1979 that Arkham Asylum completely replaced Arkham Hospital, and the occasional Arkham Sanitarium , as the institution's name. Also in 1979, the move to have the asylum closer to Gotham had begun; that was completed in 1980, when Batman #326 by Len Wein described the asylum's location "deep in the suburbs of Gotham City". It is perhaps for this reason that Batman #326

14155-435: The identities of those she kills; Junkyard Dog, a man obsessed with trash; Doodlebug, an artist who uses blood in his paintings; the hulking bruiser Lunkhead; Death Rattle, a cult leader who speaks to the dead; and Humpty Dumpty , an obese idiot savant obsessed with taking apart and repairing various objects. The driving force is the recent admission of a ruthless investor, Warren "The Great White Shark" White , as well as

14304-419: The long bones. In the 1940s, psychiatrists began to experiment with curare , the muscle-paralysing South American poison, in order to modify the convulsions. The introduction of suxamethonium (succinylcholine), a safer synthetic alternative to curare, in 1951 led to the more widespread use of "modified" ECT. A short-acting anesthetic was usually given in addition to the muscle relaxant in order to spare patients

14453-539: The mid-19th century "Father of Electrotherapy", said its use was integral to a neurological practice. In the second half of the 19th century, such efforts were frequent enough in British asylums as to make it notable. Convulsive therapy was introduced in 1934 by Hungarian neuropsychiatrist Ladislas J. Meduna who, believing mistakenly that schizophrenia and epilepsy were antagonistic disorders, induced seizures first with camphor and then metrazol (cardiazol). Meduna

14602-545: The midst of a criminal conspiracy known as "The Body". An unnamed woman was mayor when Batman returned to Gotham a year after the Infinite Crisis . Sebastian Hady was a corrupt mayor who was eventually killed by the League of Shadows. Councilwoman Muir served as interim mayor when the city was in the grip of a virus that only affected men. Michael Akins , former commissioner of police, was appointed mayor, and later replaced by

14751-455: The mortality rate associated with ECT as less than 1 death per 73,440 treatments. Cognitive impairment sometimes occurs after ECT. The American Psychiatric Association (APA) report in 2001 acknowledges: "In some patients the recovery from retrograde amnesia will be incomplete, and evidence has shown that ECT can result in persistent or permanent memory loss". It is the purported effects of ECT on long-term memory that give rise to much of

14900-419: The name "Gotham", and not New York, so that all readers in any city could identify with it. Locations used as inspiration or filming locations for Gotham City in the live-action Batman films and television series have included St. Louis , Chicago , Pittsburgh , Los Angeles , New York City , Newark , London , Glasgow , Hong Kong , Detroit , and Liverpool . In Jim Steranko 's History of

15049-525: The negative portrayal of ECT in the popular media." The New York Times described the public's negative perception of ECT as being caused mainly by one movie: "For Big Nurse in One Flew Over the Cuckoo's Nest , it was a tool of terror, and, in the public mind, shock therapy has retained the tarnished image given it by Ken Kesey 's novel: dangerous, inhumane and overused". In 1976, Dr. Blatchley demonstrated

15198-498: The nephew of Amadeus Arkham, who had the choice of discharging the patients or watching them all starve or kill each other. In the middle of the story, it is revealed during the Prodigal storyline that Batman has established a hidden base within the sub-basement of the asylum known as the "Northwest Batcave " but it was blown up by Black Mask during the Battle for the Cowl story arc. In

15347-458: The new Black Mask and is a patient in his own asylum. It was also revealed during Arkham Reborn, that as both Dr. Arkham and Black Mask, he had begun to manipulate patients, a plotline that culminated in Detective Comics with Alyce Sinner becoming the new head of the facility, but secretly working with Arkham/Black Mask. It was also revealed that the "special" patients were figments of Arkham's imagination. During Batman Eternal , Arkham Asylum

15496-510: The only living one hardly able to walk and ignorant of the killings. Gordon reaches the grandson of the other, who has taken up the "Made of Wood" killer's mantle. The Dark Knight Returns , written by Frank Miller , takes place about 10 years after Batman "retires." It depicts an " Arkham Home for the Emotionally Troubled ", presumably a renaming of the asylum which occurs as a result of changing attitudes towards mental health. The Joker

15645-640: The original Golden Age Spectre and his sidekick, Percival Popp, live in Gotham City as does Black Canary , Starman, and the Grey Ghost. DC's 2011 reboot of All Star Western takes place in an Old West-styled Gotham. Jonah Hex and Amadeus Arkham are among this version of Gotham's inhabitants. Apart from Gotham's superhero residents, the residents of the city feature in a back-up series in Detective Comics called Tales of Gotham City and in two limited series called Gotham Nights . Additionally,

15794-416: The original series and graphic novel compilation. This six-issue miniseries and the subsequent trade paperback provided an intricate and multi-layered look at Arkham Asylum from several points of view: director Dr. Jeremiah Arkham ; psychiatrist Dr. Anne Carver; the guards, chiefly one Aaron Cash; and the patients. There is a particular focus on previously unknown residents: Jane Doe, a cypher who assumes

15943-513: The outside world. However, when told to be happy with the new development, the artist secretly paints his face white with a hideous grin, reminiscent of the Joker ; it is implied that the "special" patients, as well as Arkham himself, have given in to mental illness. In the Arkham Reborn miniseries, Arkham Asylum is rebuilt and financed by Dr. Arkham. But in Batman #697, Dr. Arkham is revealed to be

16092-406: The patient no longer has symptoms. ECT is administered under anesthesia with a muscle relaxant . ECT can differ in its application in three ways: electrode placement, treatment frequency, and the electrical waveform of the stimulus. These treatment parameters can pose significant differences in both adverse side effects and symptom remission in the treated patient. Placement can be bilateral, where

16241-530: The patient's capacity for informed consent. ECT can cause a lack of blood flow and oxygen to the heart, heart arrhythmia , and "persistent asystole ". A 2019 systematic review and meta-analysis of 82 studies found that the rate of major adverse cardiac events with ECT was 1 in 39 patients or about 1 in 200 to 500 procedures. The risk of death with ECT however is low. If death does occur, cardiovascular complications are considered as causal in about 30% of individuals. The placement of electrodes, as well as

16390-460: The patient's head, resulting in approximately 800 milliamperes of direct current passing between the electrodes, for a duration of 100 milliseconds to 6 seconds, either from temple to temple (bilateral ECT) or from front to back of one side of the head (unilateral ECT). However, only about 1% of the electrical current crosses the bony skull into the brain because skull impedance is about 100 times higher than skin impedance. Aside from effects on

16539-536: The positive publicity of his role to make a successful bid for the position of President of the United States. Suggestions of other Gotham City histories include a founding date of 1820 seen in a city seal in Batman: Return of the Caped Crusaders . Batman writer and editor Dennis O'Neil has said that, figuratively, Batman's Gotham City is akin to "Manhattan below 14th Street at eleven minutes past midnight on

16688-427: The pregnant woman's right hip, external fetal cardiac monitoring, intubation , and avoidance of excessive hyperventilation are recommended. In many instances of active mood disorder during pregnancy, the risks of untreated symptoms may outweigh the risks of ECT. Potential complications of ECT during pregnancy can be minimized by modifications in technique. The use of ECT during pregnancy requires thorough evaluation of

16837-490: The procedure is safe and does not cause brain damage. Dr. Charles Kellner, a prominent ECT researcher and former chief editor of the Journal of ECT , stated in a 2007 interview that, "There are a number of well-designed studies that show ECT does not cause brain damage and numerous reports of patients who have received a large number of treatments over their lifetime and have suffered no significant problems due to ECT." Kellner cites

16986-434: The remodeling. While there, Amadeus Arkham received a call from the police notifying him that Martin "Mad Dog" Hawkins , a serial killer , referred to Amadeus Arkham by Metropolis Penitentiary while at State Psychiatric Hospital, had escaped from prison and sought his considered opinion on the murderer's state of mind. Shortly afterward, Amadeus Arkham returned to his home to find his front door wide open. Inside, he discovered

17135-429: The response rate in treatment resistant depression vary between 60–80%, with a remission rate of 50–60%. In addition to reducing symptoms of depression and inducing relapse, ECT has also been shown to reduce the risk of suicide, improve functional outcomes and quality of life as well as reduce the risk of re-hospitalization. Efficacy does not depend on depression subtype. With regards to treatment resistant schizophrenia,

17284-408: The response rate is 40–70%. There is little agreement on the most appropriate follow-up to ECT for people with major depressive disorder. The initial course of ECT is then transitioned to maintenance ECT, pharmacotherapy or both. When ECT is stopped abruptly, without a bridge to maintenance ECT or medications (usually antidepressants and Lithium ), it is associated with a relapse rate of 84%. There

17433-434: The results of questionnaires about subjective memory loss found that between 29% and 55% of respondents believed they experienced long-lasting or permanent memory changes. In 2000, American psychiatrist Sarah Lisanby and colleagues found that bilateral ECT left patients with more persistently impaired memory of public events as compared to right unilateral ECT. However, bilateral ECT may be more efficacious than unilateral in

17582-402: The results were significant. Patients had much improved. A positive side effect to the treatment was retrograde amnesia . It was because of this side effect that patients could not remember the treatments and had no ill feelings toward it. ECT soon replaced metrazol therapy all over the world because it was cheaper, less frightening and more convenient. Cerletti and Bini were nominated for

17731-399: The risk of relapse, especially in younger patients. ECT is generally a second-line treatment for people with catatonia who do not respond to other treatments, but is a first-line treatment for severe or life-threatening catatonia. There is a plethora of evidence for its efficacy, notwithstanding a lack of randomised controlled trials, such that "the excellent efficacy of ECT in catatonia

17880-478: The same time greatly affecting the city and its people. Perhaps the greatest in effect was a long set of serial storylines, which started with Ra's al Ghul releasing a debilitating virus called the "Clench" during the " Contagion " storyline. As that arc concluded, the city was beginning to recover, only to suffer an earthquake measuring 7.6 on the Richter Scale in the 1998 " Cataclysm " storyline. This resulted in

18029-598: The sole heir to the Arkham estate, to remodel his family home in order to properly treat the mentally ill, so others might not suffer the same fate as his mother. Prior to the period of the hospital's remodeling, Amadeus Arkham treated patients at the State Psychiatric Hospital in Metropolis , where he, his wife Constance and his daughter Harriet had been living for quite some time. Upon his telling his family of his plans, they moved back to his family home to oversee

18178-494: The state of Delaware . Detective Comics #503 (June 1983) includes several references suggesting Gotham City is in New Jersey. A location on the Jersey Shore is described as "20 miles north of Gotham". Within the same issue, Robin and Batgirl drive from a "secret New Jersey airfield" to Gotham City and then drive on the "Hudson County Highway", a reference to the real-life Hudson County in New Jersey. Batman: Shadow of

18327-589: The targeting screen for his giant laser locates it somewhere on the New England shoreline, possibly as far north as Maine . The soundtrack for Batman & Robin features a song named after the city and sung by R. Kelly , later included on international editions of his 1998 double album R. Director Christopher Nolan has stated that Chicago inspired his portrayal of Gotham, and the majority of both Batman Begins (2005) and The Dark Knight (2008) were filmed there. However, Christopher Nolan's Gotham City

18476-568: The temples. Uncommonly bifrontal placement is used; this involves positioning the electrodes on the patient's forehead, roughly above each eye. Unilateral ECT is thought to cause fewer cognitive effects than bilateral treatment, but is less effective unless administered at higher doses. Most patients in the US and almost all in the UK receive bilateral ECT. The electrodes deliver an electrical stimulus. The stimulus levels recommended for ECT are in excess of an individual's seizure threshold: about one and

18625-451: The terrifying feeling of suffocation that can be experienced with muscle relaxants. The steady growth of antidepressant use along with negative depictions of ECT in the mass media led to a marked decline in the use of ECT during the 1950s to the 1970s. The Surgeon General stated there were problems with electroshock therapy in the initial years before anesthesia was routinely given, and that "these now-antiquated practices contributed to

18774-484: The theming elements primarily having been inspired by the Batman films directed by Tim Burton. Both the ride and the Gotham City Backlot opened on March 26, 1994. The Magic Mountain section closed at the end of the park's 2010 season and was later rethemed and rebranded as the "DC Universe," featuring characters and attractions outside of just Batman. It reopened in 2011. Warner Bros. World Abu Dhabi features

18923-687: The therapeutic use of seizure induction was documented in the London Medical and Surgical Journal . As to its earliest antecedents one doctor claims 1744 as the dawn of electricity's therapeutic use, as documented in the first issue of Electricity and Medicine . Treatment and cure of hysterical blindness was documented eleven years later. Benjamin Franklin wrote that an electrostatic machine cured "a woman of hysterical fits." By 1801, James Lind as well as Giovanni Aldini had used galvanism to treat patients with various mental disorders. G.B.C. Duchenne,

19072-542: The time. Cerletti, who had been using electric shocks to produce seizures in animal experiments, and his assistant Lucio Bini at Sapienza University of Rome developed the idea of using electricity as a substitute for metrazol in convulsive therapy and, in 1938, experimented for the first time on a person affected by delusions . It was believed early on that inducing convulsions aided in helping those with severe schizophrenia but later found to be most useful with affective disorders such as depression . Cerletti had noted

19221-571: The treatment of schizophrenia , but in North America and Western Europe it is invariably used only in treatment resistant schizophrenia when symptoms show little response to antipsychotics ; there is comprehensive research evidence for such practice. It is useful in the case of severe exacerbations of catatonic schizophrenia , whether excited or stuporous. There are also case reports of ECT improving persistent psychotic symptoms associated with stimulant-induced psychosis . Aside from effects in

19370-719: The treatment of mood disorders. ECT has not been found to increase the risk of dementia nor cause structural brain damage. Considerable controversy exists over the effects of ECT on brain tissue, although a number of mental health associations—including the APA—have concluded that there is no evidence that ECT causes structural brain damage. A 1999 report by the US Surgeon General states: "The fears that ECT causes gross structural brain pathology have not been supported by decades of methodologically sound research in both humans and animals." Many expert proponents of ECT maintain that

19519-581: The treatment). Memory loss and confusion are more pronounced with bilateral electrode placement rather than unilateral, and with outdated sine-wave rather than brief-pulse currents. The use of either constant or pulsing electrical impulses also varied the memory loss results in patients. Patients who received pulsing electrical impulses, as opposed to a steady flow, seemed to incur less memory loss. The vast majority of modern treatment uses brief pulse currents. A greater number of treatments and higher electrical charges (stimulus charges) have also been associated with

19668-409: The use of ECT in the treatment of depression. The decade also saw criticism of ECT. Specifically, critics pointed to shortcomings such as noted side effects, the procedure being used as a form of abuse, and uneven application of ECT. The use of ECT declined until the 1980s, "when use began to increase amid growing awareness of its benefits and cost-effectiveness for treating severe depression". In 1985,

19817-411: The use of unilateral electrode placement and the replacement of sinusoidal current with brief pulse. It took many years for brief-pulse equipment to be widely adopted. In the 1940s and early 1950s, ECT was usually given in an "unmodified" form, without muscle relaxants, and the seizure resulted in a full-scale convulsion. A rare but serious complication of unmodified ECT was fracture or dislocation of

19966-458: The vigilante. This story makes a few passing references to the events of A Serious House on Serious Earth , such as Amadeus Arkham taping over the mirror, and his journal is shown early in the story. Jeremiah also mentions his relative's descent into mental illness. An episode of Batman: The Animated Series titled "Dreams in Darkness", also about Batman in Arkham, portrays a similar theme, with

20115-491: The village's residents feigned idiocy to prevent a royal visit from John, King of England . Gotham City, like other cities in the DC Universe, has varied in its portrayals over the decades, but the city's location is traditionally depicted as being in the state of New Jersey . In Amazing World of DC Comics #14 (March 1977), writer Mark Gruenwald discusses the history of the Justice League and indicates that Gotham City

20264-536: The world. WB Movie World in Germany featured a Gotham City section that housed Batman Adventure – The Ride , and Six Flags Magic Mountain opened a section called the "Gotham City Backlot" that featured Batman: The Ride . The section featured at Magic Mountain was designed by park designer Kevin Barbee, and alongside the opening of Batman: The Ride coincided with the largest expansion the park had ever undergone in 23 years, with

20413-536: The years, in various Batman-related titles in the chronological DC Comics continuity, the Caped Crusader enlists the help of numerous characters, the first being his trusty sidekick, Robin . Although a singular title, many have donned the mantle over the years. The first being Nightwing , then came Red Hood , Red Robin , Spoiler and finally Batman's son Damian Wayne . In addition to the Robins or former Robins, there

20562-408: Was Mad Dog, whom Amadeus Arkham insisted on treating personally. After treating Mad Dog for six months, Amadeus Arkham strapped him to an electroshock couch, then deliberately and purposefully electrocuted him. The staff treated the death as an accident, but it contributed to Amadeus Arkham's gradual descent into mental illness, which he began to believe was his birthright. Eventually, Amadeus Arkham

20711-427: Was a patient in his own asylum after he tried to kill his stockbroker in 1929 , where he died scratching the words of a binding spell into the walls and floor of his cell with his fingernails and belting out " The Star-Spangled Banner " in a loud voice. In Batman #258, it is named as Arkham Hospital , although it is not clear what kind of hospital it is. Arkham Asylum first appeared in another Dennis O'Neil story

20860-415: Was being provided in regional medical centers. Though ECT use declined with the advent of modern antidepressants, there has been a resurgence of ECT with new modern technologies and techniques. Modern shock voltage is given for a shorter duration of 0.5 milliseconds where conventional brief pulse is 1.5 milliseconds. In a review from 2022 of neuroimaging studies based on a global data collaboration ECT

21009-412: Was deliberately set in New Jersey to honor Gotham's location in the comic books. Electroconvulsive therapy Electroconvulsive therapy ( ECT ) or electroshock therapy ( EST ) is a psychiatric treatment during which a generalized seizure (without muscular convulsions ) is electrically induced to manage refractory mental disorders . Typically, 70 to 120 volts are applied externally to

21158-514: Was detailed in Rick Veitch 's Swamp Thing #85 featuring Tomahawk . Rumors held it to be the site of various occult rites. The 2011 comic book series Batman: Gates of Gotham details a history of Gotham City in which Alan Wayne (Bruce Wayne's ancestor), Theodore Cobblepot ( Oswald Cobblepot 's ancestor), and Edward Elliot ( Thomas Elliot 's ancestor), are considered as the founding fathers of Gotham. In 1881, they constructed three bridges called

21307-587: Was filmed in New York City and was an important requirement of the show's creative team. According to executive producer Danny Cannon , its atmosphere was inspired by the look of the city itself in the 1970s films of Sidney Lumet and William Friedkin . Clues to this include and signs showing phone numbers bearing the area code 212 . Donal Logue , who portrayed Harvey Bullock in the series Gotham , described different aspects of that series' design of Gotham City as exhibiting different sensibilities, explaining, "for me, you can step into things that almost feel like

21456-856: Was introduced by Dennis O'Neil and Irv Novick and first appeared in Batman #258 (October 1974); much of its back-story was created by Len Wein during the 1980s. Arkham Asylum has a poor security record and high recidivism rate, at least with regard to the high-profile cases—patients, such as the Joker , are frequently shown escaping at will—and those who are considered to no longer be mentally unwell and discharged tend to re-offend. Furthermore, several staff members, including its founder, Dr. Amadeus Arkham , and his nephew, director Dr. Jeremiah Arkham , as well as medical staff Dr. Harleen Quinzel , and, in some incarnations, Dr. Jonathan Crane , security chief Lyle Bolton and Professor Hugo Strange , have become mentally unwell. In addition, prisoners with unusual medical conditions that prevent them from staying in

21605-470: Was killed by a sentient fat-eating blob of grease. Hamilton Hill became mayor through the backing of crime boss Rupert Thorne but was ultimately ousted from office and replaced by George P. Skowcroft. An unnamed mayor is killed by Deacon Blackfire's followers and replaced by Donald Webster. Mayor Julius Lieberman is killed by a Predator . Mayor Goode served briefly before being replaced by an African American man. Armand Krol became mayor and died of

21754-527: Was killed by them. Archibald Brewster was mayor during the Great Depression . Mayor Thorndike was killed by the Made of Wood killer in 1948. Mayor Aubrey James was a contemporary of Thomas Wayne who was stabbed to death. Mayor Jessop was in office shortly after the Wayne murders. A man named Falcone was purportedly mayor during the earliest days of Batman's career. Shortly after, Mayor Wilson Klass directed

21903-484: Was reprinted with Detective Comics #784-786–a storyline entitled "Made of Wood," also written by Brubaker with art by Zircher. In the storyline, Batman and Green Lantern track the "Made of Wood" serial killer, whose killing spree was cut short when he was admitted to Arkham Asylum. Ex-Commissioner James Gordon is also pursuing the killer and he narrows the search down to the two men admitted to Arkham in December 1948,

22052-413: Was suggested to work via a temporary disruption of neural circuits followed by augmented neuroplasticity and rewiring. ECT is used, where possible, with informed consent in treatment-resistant major depressive disorder , bipolar depression , treatment-resistant catatonia , prolonged or severe mania , and in conditions where "there is a need for rapid, definitive response because of the severity of

22201-599: Was used as Arkham in the film. Arkham Asylum, renamed Arkham State Hospital , appears in Joker where Arthur Fleck steals a document about his mother Penny, revealing a history of mental instabilities and her being committed after working for Thomas Wayne . At the end of the movie, Arthur is imprisoned in Arkham for his crimes. Arkham State Hospital appears in Joker: Folie à Deux . Gotham City Gotham City ( / ˈ ɡ ɒ θ əm / GOTH -əm ), or simply Gotham ,

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