Paul Hoch

Paul Hoch was born on October 31, 1902, in Budapest, Hungary, and received his medical degree from the University of Göttingen in 1926. He trained at the Psychiatric Clinic in Zurich from 1928 to 1930 before emigrating to the United States in 1933. He joined the New York State Psychiatric Institute (NYSPI) as an assistant physician in 1943 and served as director of experimental research from 1948 to 1955, holding simultaneous appointments at Columbia University's College of Physicians and Surgeons, eventually as clinical professor of psychiatry from 1956. In 1955 he was appointed New York State Commissioner of Mental Hygiene, overseeing 28 state hospitals and approximately 100,000 patients. He died on December 15, 1964, in New York City.

Pseudoneurotic Schizophrenia and Early Drug Research

In 1949, Hoch and Philip Polatin published "Pseudoneurotic forms of schizophrenia" in the Psychiatric Quarterly, describing a presentation of schizophrenia masked by neurotic symptoms.¹

At the 1950 annual meeting of the American Psychiatric Association, Hoch reported that LSD and mescaline produced symptoms resembling schizophrenia and coined the term "psychotomimetic" for the class of drugs. He published a formal study with James Cattell and Harry Pennes, "Effects of mescaline and lysergic acid (d-LSD-25)," in the American Journal of Psychiatry in February 1952, based on experiments conducted at NYSPI and Columbia.²

Drug Experiments at NYSPI

The NYSPI held a classified contract with the CIA and Army Chemical Corps through Fort Detrick's Special Operations Division under the designation Project MK-NAOMI, covering the period 1952 to 1953 at an estimated value of $1,000,000. A January 1954 CIA memorandum described the program's purpose as "devising biological weapons that could be targeted at individuals for affecting human behavior," across a range from temporary disablement to death.³

Under this contract, Hoch administered high doses of mescaline and LSD to psychiatric patients through intraspinal injection, producing what he described as "an immediate, massive, and almost shocklike picture with higher doses." He then lobotomized some subjects to compare drug effects before and after psychosurgery, stating that "it is possible that a certain amount of brain damage is of therapeutic value." In one procedure, Hoch administered a hallucinogen followed by a local anesthetic, then asked the subject to describe his perceptions while surgeons removed pieces of his cerebral cortex.⁴

The Death of Harold Blauer

Harold Blauer, a New York tennis professional admitted to NYSPI for depression, died on January 8, 1953, after Hoch administered a mescaline derivative supplied by the Army Chemical Corps. The compound had been provided for NYSPI to test its psychiatric effects so the Chemical Corps could determine its suitability as a chemical warfare agent.

The Second Circuit Court of Appeals found in Barrett v. United States (798 F.2d 565, 1986) that Hoch "was well aware that the mescaline derivative was a new compound not being administered for diagnostic or therapeutic purposes but as an experiment to study its effect for chemical warfare purposes." Hoch later testified that Blauer's death was caused by the injection and that its administration "was not in accordance with generally accepted medical practice." Cattell, Hoch's collaborator on the experiments, told Army investigators: "We didn't know whether it was dog piss or what it was we were giving him."⁵

Within 48 hours of Blauer's death, Army Chemical Corps contract officer Amedeo Marrazzi directed efforts to conceal the Army's involvement. At a July 1954 meeting of federal counsel and medical personnel, Hoch and Marrazzi discussed apprehension about anticipated malpractice claims. The death certificate listed the cause as "coronary arteriosclerosis; sudden death after intravenous injection of a mescaline derivative," omitting the Army's role.⁵

Commissioner of Mental Hygiene and the 1959 LSD Conference

Hoch was appointed New York State Commissioner of Mental Hygiene in 1955, the year after the internal cover-up meeting. He oversaw the state's entire psychiatric hospital system while maintaining his CIA consulting relationship and Army Chemical Corps affiliation. In 1959 he chaired the first international LSD therapy conference, held under Macy Foundation sponsorship, with Harold Abramson serving as recording secretary.⁶