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January 12, 2016

Resolving to Remember These Psychiatrists

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Hopefully the words imparted here convey the scope of our profession and psychiatry at its best. We have been-and should be-so much more than the current 15-minute med check.

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IN MEMORIAM, PART 2

One of the benefits of writing for Psychiatric Times is to have readers constructively “call you out” when you fall short. That happened after I wrote a year-end collection of selected eulogies of those in our field who died in 2015.

A reader quickly pointed out to me that the year was not over, so “Don’t count your chickens before they hatch” (Practical issues-such as the editorial offices closing for part of the holidays-necessitated the writing and posting of that blog before the calendar year was over). Other readers pointed out additional psychiatrists worthy of remembering whom I didn’t include, for one reason or another.

Now is the time to correct both omissions, for doesn’t any New Year call for us to do better? With your help, I will try to do so in 2016.

It may also be time to review how these eulogies are selected, for once in a while that is questioned. Ever since I began to write them on September 13, 2012, close in date to that year’s 9/11 anniversary, it depended on what psychiatrists I found out had died and whether I knew enough, or could find out enough, about them to do a proper tribute. The model for such eulogies would be religious ones for funerals, to emphasize the good done in that psychiatrist’s life.

The American Psychiatric Association (APA) does put out an online listing every 3 months, but it only includes APA members. Moreover, the list for the first 9 months in 2015 had, as far as I could tell, 160 men and 13 women, perhaps reflecting the past dominance of men in the field, but also limiting the likelihood of women being eulogized.

Hence, the following are those psychiatrists I knew and admired in some sense, and the list includes some personal comments that hopefully do not reflect my narcissism, but make them “come alive.” I’m sure many, many more deserve to be remembered, and if you know of any, let us know in a comment.

These are in order of those who died in 2015 with, once again, a couple of exceptions.

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Robert S. Wallerstein, MD

Given that our deadlines are likely of no concern to death, we start with one psychiatrist who missed our year-end eulogy for 2014. This is Robert S. Wallerstein, who died on December 21, 2014.

Dr Wallerstein was probably best known for his expertise in psychoanalysis, having authored many books and articles on the subject.

He served as Chair of the Department of Psychiatry at the University of California, San Francisco, from 1975-1985. It was there that I met him while I was being recruited to lead its Doctor of Mental Health program, his innovative attempt to create a new profession that combined the best of all the mental health disciplines. Although I was fascinated by the premise, it seemed practically and politically unlikely to succeed long term, so I declined. The program did come to an end, but the ensuing overlap in what many disciplines do, such as psychotherapy, fulfills the soundness of Dr Wallerstein’s concept.

Prakesh N. Desai, MD

The last personal contacts that I had with Dr Desai were from 2012 and 2013. Upon the announcement of my retirement in July 2012, he kindly wrote me on June 22: “You’re too young to retire, Steve. How am I going to learn more if you hang up the towel?”

Perhaps that question inspired me to keep the writing and presenting I still do, as reflected in the October 30, 2013 note that he wrote me regarding one of the early blog eulogies: “Thank you, Steve. Well done, as it should be done.”

Dr Desai died on January 5, 2015. I write this brief remembrance, hoping that he would think it is well done.

Born and raised in India, he became an expert in Indian psychology and culture during his career in Chicago. He theorized that people from that area tend to have low, fragile self-esteem, possibly related to a history of conquest and colonialism. We continue to learn from him through his magnum opus, written with his mentor, Hyman L. Muslim: Triumph and Tragedy: Psychohistorical Decisions of Mahatma Gandhi (New Delhi, India: Har-Anand Publications; 1998).

Though he received many rewards over his career, those who knew him-patients and colleagues alike-will probably most remember the twinkle in his eyes.

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Wayne Katon, MD

I heard Dr Katon speak many times. He was a pioneer in the development of integrated medicine, well ahead of his time. His time to die was March 1, 2015, from lymphoma, at the age of 64. When the Beatle’s song “When I’m 64” asks, “Will you still need me . . . when I’m 64,” I’m sure we still needed Dr Katon-but fortunately he taught enough of us to continue his legacy.

Not only did he advocate for psychiatrists to work more with primary care physicians, his research at the University of Washington proved how valuable that kind of collaboration was for patients. Fortunately, the Accountable Care Act seems to have caught up with him by supporting such endeavors.

Sherv Frazier, MD

Dr Frazier died on March 3, at the age of 93. I saw him at many conferences, where his leadership in professional organizations was self-evident.

When so many private psychiatric hospitals were having trouble surviving, he led the expansion of McLean Hospital into research, training, clinical care, and expansion. It remains one of the premier psychiatric facilities in the world.

"It is hoped that the words imparted here convey the scope of our profession and psychiatry at its best. We have been-and should be-so much more than the current 15-minute med check."

-H. Steven Moffic, MD

Richard Lippincott, MD

Dr Lippincott was the director of mental health programs for several states. No surprise, then, that I came to know him from his involvement with the American Association of Community Psychiatrists (AACP), which included those psychiatrists who worked in the community as well as state hospitals. He died on March 3, 2015.

Dr Lippincott was a tireless advocate and testifier for the inclusion of mental health coverage in state and federal health insurance programs. Because it is so political and funding is always tight, mental health advocacy is a thankless job-thankless, that is, until you realize how important it is for the poor and underserved in our tiered, rationed mental health care systems.

Herbert Peyser, MD

One of the benefits of working in academic psychiatry, as I did over my career, was the chance to meet so many scholarly psychiatrists. Dr Peyser was one of the best. He died on April 6, 2015.

All professional organizations have to have dedicated and active members. Dr Peyser was that for psychiatric organizations, both in New York and nationally.

In my more limited national organizational involvement, I saw Dr Peyser from time to time. Most of all, I admired his humanistic knowledge of the classics of literature, almost always ready with a relevant quote from Shakespeare, a master of human nature well before the field of psychiatry.

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Stanley R. Platman, MD

I don’t know what greater honor a clinical psychiatrist can receive than when a reader, identified as a patient, asked this psychiatrist to be acknowledged in a eulogy. The reader made the recommendation in an online comment to my article, “Eulogies for Psychiatrists Who Inspired: April 1, 2013-June 30, 2013.” That, along with further checking about his career, is why I am including Dr Platman now, even though he died on May 7, 2014. The best I can do is quote from her comment, posted recently on December 20, 2015:

“He never missed an appointment with me. He was one of the most decent, honorable, ethical, kind, and caring individuals I have ever met. His heart went out to the poor and disenfranchised all over the world.”

His special area of interest, a rare one for psychiatrists, was working in the Baltimore area with those who had both developmental disabilities and mental disorders. I particularly admired that his patients always had access to his home phone number, as did mine.

Louis Sokoloff, MD

While I didn’t know Dr Sokoloff, who died July 30th at the age of 93, he was well known for his role in developing the research technique of positron emission tomography (PET). The brain is so well protected that it was harder than the rest of the body to research, but PET scans were one of the first techniques to make the activity of the brain visible.

Over his career, he began his career with the kind of psychoanalytic therapy initiated by Freud, but he went on to advance the biological-based future of psychiatry that Freud early on predicted to be possible when the needed technology became available. Dr Sokoloff’s history joined the brain with the mind, feeling they were inextricably linked.

Richard Warner, MD

As a founding board member of the AACP, I came to know Dr Warner after he became one of its early board members. He died on August 27 at the age of 71, working while struggling with cancer until the very end.

He was the first psychiatrist I heard repeatedly emphasize the potential of recovery from severe mental illness. His book, Recovery From Schizophrenia: Psychiatry and Political Economy (New York: Taylor & Frances), was first published in 1985 and was so successful, a second edition came out in 1994. He dedicated the book “to those who suffer from Schizophrenia.”

He was also wise-and curious-enough to become involved in other fields, which must have helped to prevent burnout. He was a photographer, learned to speak Italian, a runner, a reader, a lover of music, and enough of a gourmet to cook pizzas in a wood-fired oven that he built himself.

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Robert L. Spitzer, MD

Dr Spitzer was so well known that there is little to add to the accolades that came after his death. Coincidentally or not, he was a Jew who died on Christmas Day, 2015. Maybe that polarity was reflected in some of his work.

He led the movement of the APA to stop deeming homosexuality as an illness, but he later supported so-called conversion therapy, concluding that preferences of sexual attraction could change and thereby homosexuality “cured.” After much controversy, he courageously retracted his study and conclusions.

As the Chair of the Task Force for DSM-III, Dr Spitzer led the controversial change from a psychoanalytically-based diagnostic classification to one based on data and description. Though critics called it a “cookbook,” perhaps its clear recipes allowed the book to become an unanticipated best seller. For the next edition, he was replaced and ended up criticizing the ever-increasing number of diagnoses.

Dr Spitzer seemingly courted controversy everywhere. However, he ended up eventually getting some consensus one way or another. Only Parkinson disease, then ultimately death, slowed him down.

Conclusion

Given the challenges of being a psychiatrist, I wish that we could eulogize them all, but I am limited by my own work experiences and collegial interactions. It is hoped that the words imparted here convey the scope of our profession and psychiatry at its best. We have been-and should be-so much more than the current 15-minute med check.

We stretch from loving gourmet pizzas to seeing the part of the brain that lights up when we eat food we love or watch a Shakespeare play. We try to understand and diagnose what seems to go wrong in our brains and mind and to develop the right treatments for the right patients in the right setting. We become political enough to get the necessary funding for the care that most patients can’t afford. We never give up hope for recovery, and we have a twinkle in our eye when that happens.