“The Long Habit”: A Valediction of Professor Eliot Sorel, MD, DLFAPA, FACPsych (October 2, 1940-October 13, 2024)

SECOND THOUGHTS

Just a few years before I met Eliot Sorel, MD, when I was in medical school, I read a column by Lewis Thomas, a noted American biological researcher, called “The Long Habit.”¹ Thomas was referring to English essayist Sir Thomas Browne’s celebrated work Hydrotaphia, Urn Burial (1658) where he wrote,²

“The long habit of living indisposeth us for dying.”

And just as Browne’s philosophical discourse revisits burial and funerary customs in ancient times and his own, Thomas’ essay addresses life and death from the perspective of a biologist whose columns in The New England Journal of Medicine were considered models of scientific clarity and poetic insight. The death of my friend Eliot Sorel sent me back to Browne and Thomas, triggering second thoughts about life and death.

Eliot Sorel, MD was my mentor and friend, colleague and collaborator for some 40 years. I was introduced to Eliot while I was a resident in psychiatry at McGill University by Raymond Prince, MD, my first psychiatric mentor, at a meeting of the Society for the Study of Psychiatry and Culture (SSPC) in Quebec. As my own career progressed—often with Eliot’s advice and crucial support—he became psychiatry’s eminence grise and, as I often called him, world psychiatry’s “ambassador at large.” He was doing world psychiatry before that name was grabbed by Italian psychiatrist Mario Maj, MD, for psychiatry’s leading journal. He was practicing global mental health (GMH) before that movement found its legs and he edited the first volume on GMH with that name.³ He was committed to the integration of primary care with psychiatry, informed by the findings and insights of public health—what he called “TOTAL Health.”

We communicated regularly, often and at length, during which he had an unnerving capacity to take my most digressive questions, dilemmas, and critiques and turn them into challenges to do something creative about them. “There’s a problem here,” I would bemoan. “Fix it!” he always replied—and as many of us know, gently commanded! Out of this, I founded the Canadian Association of Social Psychiatry (CASP) and together we hosted the 16th World Congress of Social Psychiatry in Vancouver, BC in 1998. Similar conversations led to cofounding the American Psychiatric Association Caucus on GMH & Psychiatry, of which we were the first 2 elected chairs. One day, he called me and announced that he was planning the next step of my career! Out of this, I became the current President of the World Association of Social Psychiatry (WASP), which he had held from 1996-2001.

The long habit of his friendship poorly prepared me for it to end. The end came abruptly, suddenly through the surreptitious discovery of a fatal illness which by family accounts he met resolutely and with courage and grace. I had barely learned he was unwell through an email from him when his wife Christiane reached out to tell me the news that he was dying and receiving palliative care at home. Her next message came within days of that first one:

“Eliot passed away to the sound of a gentle breeze and soft chimes. He was at home, surrounded by love – as he wished.”

In a fortnight, he was gone. With 2 of his dearest friends, Rahn Bailey, MD, and Constance Dunlap, MD—like me, fellow mentees and beneficiaries of Eliot’s mentorship and leadership—we sent out the news of Eliot’s death to our friends, colleagues, and associates on every continent and received a multitude of messages of condolences, reflecting surprise, a deep sense of loss, often expressed as an irreplaceable loss, for Eliot’s unique qualities and contributions. Of these, the consensus that emerges is of mentorship, bringing people together across differences, and corralling, cajoling, and tirelessly encouraging us to come together in a mission that he summed up with the Jewish concept of tikkun olam—“healing the world.”⁴ We may call it social action in pursuit of social justice.

We attended his funeral service and burial today at the synagogue and in a community he was part of for many decades. The orations by his wife Christiane, his adult children Marc and Mare-Adele, and 1 of his 6 grandchildren bear witness to his devotion to family, community, and mentoring where he was as much a mentor and father figure to his children’s friends and classmates as to his own children. I can attest to that, as he always showed an abiding interest in the well-being and progress of my children, who admired him.

A Valediction

My friend Eliot Sorel has died. Words we heard in the last few days included “passing on” and “transitioning.” Our mutual friend from India, Debasish Basu, MD, the Editor-in-Chief of our WASP journal, World Social Psychiatry, expressed this evocatively: “I wish him the best in his last journey (in Hinduism we believe in the literal sense of the word ‘passing’—the mingling of the Ātman with the Paramātman—the individual soul with the all-permeating eternity).”

In the hopes that this is true, Eliot’s earthly journey has ended as he joined the all-permeating eternity. He was simultaneously rooted in and remained faithful to his native country of Romania and his Jewish religious tradition while always looking beyond them to the rest of the world. Eliot expressed this commitment by founding the Conflict Management & Resolution Section of the World Psychiatric Association (WPA). A world he found broken in parts and to which he did much to bring healing. Now that he is in the olam ha-ba, “the world to come” in the Jewish tradition, he leaves us with the legacy of his mission. The task continues, the mission goes on, transmitted to those of us who were touched by his life. I send Eliot my valediction in the words of Sir Thomas Browne²:

But man is a Noble Animal, splendid in ashes, and pompous in the grave, solemnizing Nativities and Deaths with equal lustre, nor omitting Ceremonies of bravery, in the infamy of his nature. Life is a pure flame, and we live by an invisible Sun within us.

On behalf of my family and myself, my dear friends Rahn Bailey and Connie Dunlap, and the WASP Executive Committee, WASP Past Presidents, and our many members around the world in our 27 WASP national associations, I send sincere condolences to his wife Christiane Sorel, Esq and their adult children, Marie-Adele Sorel Kress, MD, and Marc Sorel, Esq, as well as their spouses and Christiane's and Eliot's 6 grandchildren.

Eliot Sorel, MD, DLFAPA, FACPsych, was an inspirational and transformational leader in American and world psychiatry and a catalytic figure in promoting social psychiatry and social justice. Dr Sorel was clinical professor of Global Health, Health Policy, & Management and of Psychiatry & Behavioral Sciences at The George Washington University in Washington, DC.

Key Publications

1. Sorel E, ed. Family, Culture, and Psychobiology. Legas; 1990.
2. Sorel E, Favazza A, Sarwer-Foner G, et al, eds. Social Psychiatry in the Late Twentieth Century: Selected Proceedings of the XII World Congress of Social Psychiatry. Legas; 1993.
3. Sorel E. Social psychiatry: a mission and a vision for the 21st Century. Int Med J. 1998;5:247-249.
4. Sorel E, Padoan PC, eds. The Marshall Plan: Lessons Learned for the 21st Century. OECD Publishing; 2008.
5. Sorel E, ed. 21st Century Global Mental Health. Jones & Bartlett Learning; 2012.
6. Sorel E. Translating scientific evidence into global health policy: making mental health count for individuals' and populations' health. Indian J Soc Psychiatry. 2016;32(3):185-187.
7. Sorel E. The social brain: wired to connect and belong. World Social Psychiatry. 2019;1(1):23-24.
8. Sorel E. The COVID-19 pandemic: a national and global social contracts stress test. World Social Psychiatry 2020;2(2):2-73.

Two Proud Achievements

• Lead author of the APA Position Statement, “Healthcare, Inclusive of Mental Healthcare, Is a Human Right,” APA policy since December 2017.
• Initiator, APA Chester Pierce Human Rights Award endowment completed, Autumn 2021 and launched at the APA Annual Scientific Meeting (New Orleans, Louisiana, May 2022).

• Honors and Awards
• Commendation by the United States Congress (Congressional Record Autumn 2002) for Resilience in the Face of Terror: Healing the Trauma of 9/11 Scientific Program Chairmanship
• Star of Romania Order of Commander, decorated by the President of Romania (January 2004)
• Doctor Honoris Causa Carol Davila Medical University (Bucharest, Romania: October 2009) and by the Politehnica University of Bucharest, Romania (Bucharest, Romania: June 2014)
• Excellence Prize presented by the Government of Romania (Washington, DC: October 2018)
• Mental Health Champion Award, Universal Health and Mental Health for All Conference (Malta, European Union: December 2018)
• Pioneer and Leader in Public Health honoree, GWU Milken Institute School of Public Health (December 2019)
• APA Assembly Ronald A. Shellow Award (Spring 2021)
• Rehabilitation International Centennial Award for Global Mental Health leadership(Beijing, China: May 2023)

Dr Di Nicola is a child psychiatrist, family psychotherapist, and philosopher in Montreal, Quebec, Canada, where he is professor of psychiatry & addiction medicine at the University of Montreal and President of the World Association of Social Psychiatry (WASP). He has been recognized with numerous national and international awards, honorary professorships, and fellowships, and was recently elected a Fellow of the Canadian Academy of Health Sciences and given the Distinguished Service Award of the American Psychiatric Association. Dr Di Nicola’s work straddles psychiatry and psychotherapy on one side and philosophy and poetry on the other. Dr Di Nicola’s writing includes: A Stranger in the Family: Culture, Families and Therapy (WW Norton, 1997), Letters to a Young Therapist (Atropos Press, 2011, winner of a prize from the Quebec Psychiatric Association), and Psychiatry in Crisis: At the Crossroads of Social Sciences, the Humanities, and Neuroscience (with D. Stoyanov; Springer Nature, 2021); and, in the arts, his “Slow Thought Manifesto” (Aeon Magazine, 2018) and Two Kinds of People: Poems from Mile End (Delere Press, 2023, nominated for The Pushcart Prize).

References

1. Thomas L. The long habit. N Engl J Med. 1972;286(15):825-826.
2. Browne T. Hydriotaphia, Urne-Burial, or A Discourse of the Sepulchrall Urnes Lately Found in Norfolk. Signe of the Gun; 1658.
3. Sorel E, ed. 21st Century Global Mental Health. Jones & Bartlett Learning; 2012.
4. Lerner M. Jewish Renewal: The Path to Healing and Transformation. Putnam; 1994.