Eulogies for Psychiatrists Who Inspired: April 1, 2012–June 30, 2013

Oct 29, 2013

A range of psychiatrists are remembered-from pioneers in psychoanalysis to trance studies; from psychopharmacology to reality therapy; from the normality of homosexuality to the psychopathology of “brain fag” syndrome; from flowers to film; from childhood to old age; from everyday clinicians to courageous challengers of the status quo; and from student to expert.

Life and death are one thread, the same line viewed from different sides.
-Lao Tzu, 550 BC

Having written an article on this topic last year,1 I waited with a mixture of inspiration and dread for the annual list of psychiatrists who passed, to be published in the official newsletter of the American Psychiatric Association (APA), Psychiatric News. It was getting well past last year’s publication date of August 3, 2012.2 Could I have missed it? Then, in the September 22 issue, I found it. Sort of.

In a little notice on the bottom right of one page, I saw, “Exclusive Online Content-APA Honors Deceased Members.”3 How terribly ironic, I reacted internally with some anger. These member psychiatrists disappear from the world, and now they disappear from our pages. How was this honoring them? I wondered how many members would take the time to go to a not-too-easy site to access. That the beginning date was April 1, 2012 (April Fool’s Day) is perhaps symbolic of the foolishness of this change.

I quickly moved on to the list of many names. Like last year, only names were provided. Nothing else. Like last year, I recognized many: some giants in the field, some I knew casually, and some I worked with. Certainly most of these psychiatrists deserved more than a mere listing of their names. I cannot list them all here, but I can cover briefly the ones I knew, adding some that died during the same period, but were not on the official APA list.

Dean Brooks, MD
If you had not seen him in person, you probably saw Dr Brooks on the movie screen, because he had a small role as the hospital superintendent in the fictional film One Flew Over the Cuckoo’s Nest (1975). You can easily find a picture of him online; in one article, he sits across the desk from Jack Nicholson, aka patient R. P. McMurphy, during the ad lib intake interview.4 After other refusals, and later criticism from colleagues, he courageously offered the hospital in Oregon where he was superintendent for use in the movie. Dr Brooks worked to improve conditions on inpatient wards, and he advocated for expanded psychiatric services in the community.

Paul A. Dewald, MD
Dr Dewald was a psychoanalyst who fostered the development of psychoanalysis in St Louis. One of his prodigious publications was a unique book, The Psychoanalytic Process: A Case Illustration,5 in which he presented 2 years of a day-by-day analysis of a female patient. Although I never became an analyst, this book, published when I started my residency training, was a revealing window into the most confidential of psychiatric treatments.

Louis B. Fierman, MD
Dr Fierman was a longtime Associate Clinical Professor at Yale. As a medical student there, I was fortunate to be exposed to his teaching. As the Medical Director of the nearby Elmcrest Psychiatric Institute, he established a “therapeutic environment,” including art, music, and horticulture therapies, which I tried to emulate when I became Medical Director of St Mary’s Hill Hospital in Milwaukee in 1990. It is our loss, and our patients’ loss, that such environments have all but disappeared in our cost-conscious times.

William Glasser, MD
Writer of the very popular book Reality Therapy: A New Approach to Psychiatry,6 Dr Glasser was way ahead of his time by emphasizing how people could find happiness. His focus on changing how people viewed their reality also seemed to be a forerunner of cognitive behavioral therapy.

William A. Glazer, MD
An expert in psychopharmacology, I was fortunate to interact with Dr Glazer in numerous settings, including a Point/Counterpointdebate in Psychiatric Times, based in part on a controversial book by Robert Whitaker.7-9

Richard Isay, MD
Dr Isay helped lead the change in the way psychoanalysts and many psychiatrists viewed homosexuality. He successfully argued, despite much criticism, that homosexuality was a normal, inborn variation of sexual identity and preferences. In his book Becoming Gay: The Journey to Self-Acceptancce,10 he described his own unsuccessful attempt to change his own sexual orientation.

Jerry M. Lewis Jr, MD
A best friend of one of my mentors, Gene Usdin, MD, Dr Lewis was a pioneer in understanding the dynamics of healthy families. I was pleased to see that my own family seemed to fit his view of a healthy family. On that subject, he educated not only colleagues but also the public, as he did on his TV show in Dallas, How Is Your Family? Dr Lewis was a long-time contributor to Psychiatric Times, in the popular column, “Practicing.”

David Mrazek, MD
A leader in child psychiatry and author of the A to Z Guide to Your Child’s Behavior,11 at the end of his career Dr Mrazek became Chairman of the Department of Psychiatry and Psychology at the Mayo Clinic. The Mayo Clinic, of course, is a pioneer in the integration of psychiatry into the rest of medicine, an integration which is getting renewed attention and emphasis as the Affordable Care Act rolls out.

Joaquin Oses, MD
Not well known nationally, or even locally, Dr Oses was a mainstay clinician of our community mental health center in Houston, where I was a medical director in the 1980s. A staff member recently told me how they played chess in between seeing patients. I wondered how I would have reacted back then if I knew that was happening. In retrospect, chess seems like a good stress reducer, perhaps even a metaphor for anticipating the moves of a patient’s treatment plan over time.

Raymond Harold Prince, MD
A prominent Canadian psychiatrist, Dr Prince was a pioneer in transcultural psychiatry and long-time editor of the journal Transcultural Psychiatry. He epitomized curiosity and paradox. An atheist, he studied religious experiences throughout his career. A Western-trained psychiatrist, he described a new somatization syndrome he saw in the Yoruba of Nigeria, which he called “brain fag” syndrome.12,13 He even experimented with LSD, supplied by a pharmaceutical company, reminding me of my own ingestion of thorazine to see what its side effects might feel like.

John Joseph Schwab, MD
Dr Schwab was one of those rare experts in two subspecialty fields-social psychiatry and psychosomatic medicine. As such, he was a real-life model, if there ever was one, of the bio-psycho-social model.

Wen-Shing Tseng, MD
Dr Tseng was a true global psychiatrist, a pioneer traveling the world to teach other psychiatrists, especially in China, as it began to embrace psychiatry. The scope of his knowledge was reflected in being the sole author of the 900-page Handbook of Cultural Psychiatry.14

So there we are! What a range of representatives of psychiatrists we have-from pioneers in psychoanalysis to trance studies; from psychopharmacology to reality therapy; from the normality of homosexuality to the psychopathology of “brain fag”; from flowers to film; from childhood to old age; from everyday clinicians to courageous challengers of the status quo; and from student to expert. May they remind us of how rich our field once was, and potentially still can be, just as I am reminded of the personal riches I received from them.

Halloween and the Day of the Dead should remind us of these psychiatrists. The pagan origin of Halloween was a ceremony to honor our ancestors, just as we are now doing for our psychiatrist ancestors.

References:

1. Moffic HS. Psychiatric eulogies for psychiatrists who inspired. Psychiatr Times. 2012;29(10)44.
2. In Memoriam. Psychiatr News. August 3, 2012. http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1284600. Accessed October 28, 2013.
3. In memoriam. Psychiatr News. September 19, 2013. http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1741060. Accessed October 28, 2013.
4. Fox M. Dean Brooks, ‘Cuckoo’s Nest’ doctor, dies at 96. New York Times. May 31, 2013. http://www.nytimes.com/2013/06/01/arts/dean-brooks-cuckoos-nest-doctor-dies-at-96.html. Accessed October 28, 2013.
5. Dewald PA. The Psychoanalytic Process: A Case Illustration. New York: Basic Books; 1972.
6. Glasser W. Reality Therapy: A New Approach to Psychiatry. New York: Harper and Row; 1965.
7. Moffic HS. How to end a psychiatric epidemic: Whitaker’s warning, Wallace’s wisdom-and the redemption of psychiatry. Psychiatr Times. 2012;29(8):10-11.
8. Glazer WM. The occupation of psychiatry? Psychiatr Times. 2012;29(8):11-12.
9. Whitaker R. Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. New York: Crown Publishers; 2010.
10. Isay RA. Becoming Gay: The Journey to Self-Acceptance. New York: Pantheon; 1996.
11. Mrazek H. Practical Pediatrician: A to Z Guide to Your Child’s Behavior. New York: WH Freeman & Company; 1996.
12. Prince RH. The brain-fag syndrome in Nigeria. Review and Newsletter. Transcultural Res Ment Health Problems. 1959;6:40-41.
13. Prince RH. The brain-fag syndrome in Nigerian students. J Ment Sci. 1960;106:559-570.
14. Tseng WS. Handbook of Cultural Psychiatry. San Diego: Academic Press; 2001.

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