Doomsdays and the Eulogies of These Psychiatrists

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IN MEMORIAM

The Doomsday Clock of the Bulletin of the Atomic Scientists just struck 90 seconds before midnight. Though controversial in its methods of predictability, it is supposed to warn humanity of the coming end of our world. In some religions, it is thought to be a day of final personal judgment.

Applying this concept to our own lives, our inevitable deaths and that of loves ones can feel like doomsdays. Having lost 2 close friends in 2 months has felt like that. In our series of eulogies for psychiatrists who have passed away, we try to honor the end of their personal world, as well as provide some kind of personal perspective and empathetic judgment on their careers and the lessons they left us.

While we commonly do a collection of such eulogies at the end of each calendar year, we inevitably miss some from earlier in the years and those that occur right after the year end publication date. Here, then, is a collection of belated and more recent eulogies for psychiatrists that have come to our attention. As usual, information about them came from obituaries, public career information, and my personal knowledge of them.

Thomas Jobe, MD: Avoiding the Doomsday of Schizophrenia

It is rare for a psychiatrist’s work to change how the whole field of clinical psychiatry is perceived and practiced. Freud is the most obvious.

Much less well-known is Thomas Jobe, who died without much fanfare on March 16, 2022, at the age of 78. Obviously, I missed it.

Yet, his role in the Chicago Follow-Up Study on the long-term recovery rate of those diagnosed with schizophrenia has contributed to the reassessment of the traditional wisdom on the benefits and harms of antipsychotic medication. In that way, his research led to controversial criticism of prescribing practices. The 2007 research article by the psychologist Martin Harrow and Dr Jobe indicated that people diagnosed with schizophrenia can get better as far as symptoms and functioning without relying so heavily on long-term medication.

Although he retired from the University of Illinois in 2006, Dr Jobe returned quickly to contribute to this study. Over a 15-year period, they realized that patients tended to diverge and recover at a higher rate without medications after 2 years, and their improvement continued to increase at each follow-up. His research was still in process when he died suddenly. This groundbreaking research contributed to the understanding that many such patients were not subject to an inevitable downward doomsday process, nor to the necessity to indefinitely continue medications with their common adverse effects.

Overall, he wrote 4 books and dozens of articles, mainly about neuropsychiatry and neurodegenerative diseases, but also on the lives of President Kennedy and Lyndon Johnson. He was a renowned teacher, awarded a Teacher of the Year by the psychiatric residents in his department.

Syed Archad Husain, MD: Avoiding the Doomsday of Trauma

Dr Syed was a child & adolescent psychiatrist who died on September 24, 2022, at the age of 84 after a distinguished career path at the University of Missouri and Compass Health. His specialty was addressing trauma and grief from both natural and human created disasters. From that, he published numerous articles and received numerous awards.

Born in Delhi, India, and exposed in his childhood to the partitions of Pakistan, he observed the atrocities and disasters that religious conflicts can cause. His personal marriage in Columbia in 1972 brought religions together in having both Catholic and Islamic ceremonies.

When the Yugoslavian nation broke up into warring religious factions, he travelled to Bosnia numerous times to help the traumatized children there. He then founded the International Center for Psycho-Social Trauma of the University of Missouri. His innovation was to realize that treatment and resources need to continue after the acute disaster. His team trained thousands around the world to do so, including after the EF5 tornado in nearby Joplin, Missouri.

Willard Gaylin, MD: Avoiding the Doomsday of Individualism

Years back, Dr Gaylin was interviewed by the journalist Bill Moyers who had heard suggestions that society conduct a lottery to decide whose life was more important to save with limited resources. He replied:

“And wouldn’t that be strange if I’m 96, dying of terminal cancer, praying to God that I don’t wake up in the morning and it’s against my moral principles to take poison or something like that, and there’s a child that’s brought in with an acute intoxication, swallows a bottle of aspirin or something and we both go into a kind of emergency status. Is it not immoral to put his name and my name into a hat and pull one of them? We can’t do it that way.”

Ironically, Dr Gaylin died a year after that projected age of 96 at the age of 97 on December 30, 2022, having contributed so much to the debates of how to fairly distribute medical resources.

He was a pioneering Jewish psychiatrist in the field of bioethics. In 1969, with the former Catholic Daniel Callahan, he cofounded the Hastings Center—originally called the Institute of Society, Ethics and the Life Sciences. Along the way, he wrote and spoke to the profession and public on so many psychosocial aspects of being human: love, death and dying, the male ego, violence, suicide, morality, and the individual and community. He felt that the autonomy of the individual was an “insidious moral danger” at a time that autonomy was being emphasized over beneficence in medical ethics.

Being trained in psychoanalysis, he contributed a rare psychological depth of understanding to the emerging field of medical bioethics, including denial of risks, behavior control, and physician-assisted suicide.

Joseph Biederman, MD: Avoiding the Doomsday of Conflicts of Interest

Dr Biederman died at the beginning of this year, at the age of 75 on January 5th. Though he died before receiving it, he knew that he was chosen to receive the 2023 American Professional Society of ADHD and Related Disorders award from the organization he had founded and helped fund.

Given that award, there is no surprise that he has been viewed as a leader in the field of pediatric psychopharmacology. However, like the emerging controversy in the use of antipsychotics that Dr Jobe addressed, Dr Biederman got involved in discussion on using stimulants as well as the antipsychotic Risperdal. His Wikipedia profile lists his “Ethics conflicts”; he reported funding at Harvard and Massachusetts General Hospital.

Avoiding Doomsdays

To avoid a doomsday for the world, we must make informed moral choices. Currently, the United States has been faced with how much to support Ukraine amidst the threat of Russian use of nuclear weapons.

Personal doomsdays can occur during life outside of personal death. Deaths of loved ones, having a mental illness, and loss of a good reputation can all feel like a doomsday.

In psychiatry, these eulogized psychiatrists had to make ethical choices which could have doomsday impacts for patients and themselves. Drs Jobe and Biederman struggled with the public and professional debate about the possible overuse or underuse of psychiatric medication. Dr Husain struggled with the need to maintain a long-term focus on trauma outcomes. Dr Gaylin struggled with how to balance the individualism of the United States with the needs of the greater community.

Probably, doomsday precautions—which so far have failed as far as the world is concerned—have some value in stimulating preventive actions. Though it may seem like hyperbole, in their own ways, each of these psychiatrist leaders tried to advance psychiatry toward contributing to longer and more satisfying lives for our patients.

Some have also predicted the doomsday death of the field of psychiatry itself. In 1975, E. Fuller Torrey, MD, wrote the book The Death of Psychiatry. He maintained that the so-called mentally ill did not have medical diseases, but rather suffered from social adaptation problems. He, along with others, thought brain dysfunction could be completely taken over by neurology. Rather than a social or neurological doomsday for psychiatry, the field continues to advance, the key being to maintain all aspects of our bio-psycho-social model, as these eulogized psychiatrists collectively did so well.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.