EAR Now, let me just show you what I'd like to be able to accomplish and how I hope to go about it, and then after I tell you what I am about to say, I'm going to shut up, because I want you to do all the talking. . BF I have nothing to say, yet . EAR That'll be the day. That will be the day. Did you have a chance read the notes I sent you? BF Yeah. They're right here- EAR All right. As I said in the letter, I have already started with both Stan and Phil Sapir, and I am hoping to hear further from Phil Hallen, but in any case, I am now definitely committed to doing the thing one way or another, if I get funds from Phil, where it will obviously go faster. If I don't, I'm going to do it anyway, and I'm reasonably optimistic about getting money. I've spoken to Phil. He seems favorably disposed with all the caviats that I don't need to tell you from a granting agency. BF As Allen Gregg used to say with all the traditional caviats but ab a philanthropoid. EAR I've talked to Jeanne Brand who is not at the National Library of Medicine and they have a program on the life sciences. She said it is not inconceivable that they might have money for this, the proviso being that.the agency under consideration will say yes. And I'm pretty sure they will, because Bert had one of his gals do these Council Minutes for me for 1946 through 1960, and I'll do the rest of it through '71. And the third possibility is the National Science Foundation, which also has a program for support of case histories of important programs. So one way or the other, I think we'll get the money for it. And, as I said in that little 2 EAR(cont)introductory statement, I really want to do this primarily from the standpoint of the key people involved, and of course, you're really the central figure in all of this, so it's, I think, tremendously important to have been able to see you early in the game and to get your thoughts on this. And the approach I want to use--again from the notes--is to talk about people. I think that just an old fashioned scholarly type history will be boring to most people maybe even including us, whereas, that's not the real story. I really think the real story is, what happened in the various decision-making processes. What were the key incidents and events· that you recall from the early days on. BF This is something I've always been interested in, and nobody has ever probed into. EAR You were starting to say that this is something you had hoped someone would be doing. BF Away back in the very early days, when John Clausen first came with us. If I recall that, it was the Program Planning Branch, or some such name. Joe Bobbitt, Dale Cameron, John Clausen, Danny O'Keefe, Larry Cobb was in that group, Mabel Ross, I believe. ·We thought that because of John Clausen's background that it would be very wonderful if he would keep detailed notes of the social dynamics of the situation as we came in, and how people--each person with their orientation and contribution would alter the_ group, and how decisions were arrived at, but we Never did it. Then I thought we could write this up some day as a sort of social dynamic history of NIMH, but it never was done. EAR Well, that's what I really would like to be able to do, and as I say, I think both the most interesting and even or equally important 3 EAR(cont)is telling the most significant and in some respects the most revealing way would be to concentrate on the people, so what I am going to be doing \s doing these various oral histories with a number of the key figures, and then with all the structured history which is already available--not just the Council Minutes, but everything else that is there in the NIMH files, I'll be able to keep the scholarly accuracy and at the same time be able to talk about the individuals from a more personalized point of view. So, what I'd like you to do and hopefully, we can make a signifi­ cant dent in this over the two days that we have, I really would like for you to'begin at the beginning and talk first (in a personal kind of way) about your own early career, and then what your first efforts were in Washington, how the Division of Mental Hygiene and you got together. How that developed into the NIMH and the National Mental Health Act, and the early years, etc. And with this kind of emphasis in mind, I'm sure the incidents will begin to flood in. What do you recall as some of the key events which were real turning points. You know, the Greenwood Foundation is now almost old hat. People know about it, and yet it was a very important incident in the early days. BF It was critical. It was critical in more ways than one, Eli. It did something to me, and by that I mean that I went to New York with my brief case in hand and asked for money. And I was not good at asking for money. I never have been. I don't like to work on a fund-raising drive. I'll do anything if I don't have to_ go and say to somebody, "Give me some money." That's one reason I went into 4 BF Federal_ government or~ginally--not the main reason, but one, because I just didn't know how I was going to collect my bills. If someone was to give me a hard luck story, I would probably say, well forget it and I'd_ go hungry. But I've always been concerned about how to bring services to people without somehow getting into the whole business of money exchange. 0 EAR Well, how did you start though, Bob. I know some of the story. I know that you were a big poker player in med school and worked your way through med school that way, but beyond that • • • EAR I never called that asking for money. They risked their money, and I risked mine. EAR And you always used to present yourself as just an old fashioned country doctor, which I think worked very, very well. But after you got out of medical school. BF But, I, I, I am. EAR I'm not going to contradict you. BF I've been lucky. I've been so lucky that sometimes I sit and think that this can't be me. Eli, I started out life in a little town in North Central Kansas, almost exactly half way across the State East and West. As a matter of fact, within twenty miles·of the place where I was born is a coast and geodetic survey marker for the exact _geographical center of continental United States. That does not include Alaska, but the United States that's all in one bit. That's how mid-America I grew up. I came from a long line of doctors. My father. His brother. My grandfather. His father, his father. Have I gone back far enough. I'm the fifth straight_ generation of physicians. In addition to which, my mother•s father was a doctor, my mother's mother's brother was a doctor. I didn't know anything 5 BF else. So much so 1 that when I was little T called people Doctor, because most -of the ·people I knew were Doctor. And it was harder to say Mr. It didn't. come 'as easily to my to~gue 'as Dr. My dad was a very interes:ting_ guy and probably (well, I was. going to say no one) he was one ·of three or four people ·that had the most profound influence on my life. He was a historian. He had gone to Heidelberg. He was teaching in college at Ohio Northern at Ada, Ohio, and he realized that he was never goi~g to get rich teaching school--not in those day~-, teaching college. And he met my mother, went back to medical school. He went to the medical school right here, St. Louis University. It was then called Merian Sims. I've got this tie into this school here. But Dad was a scholar. He was the kind of a physician that the old-time doctors were so much. At home he had a library which the kids in the school would come to and he would open his home to them. If they had a theme to work out for school, they could get better references in Dad's library than they could from the town library. We had a local Carnegie Library, as they called it, and it was a town of about 1500, 1800 people right on the broad plains of Kansas. But they could find it there, and if they wanted to know the derivation of a phrase, Dad had studied and could speak Greek and Latin as well as German and French and Spanish. Dad used to say he spoke broken E~glish and fluent profane. Dad7-I don't know whether it was intentional or just because I was the firstborn, and he and I were very closef-but he ·started taki~g me ·with him on his rounds seei~g patients. When I was very ·small--I suppose 6 BF(cont)five years old or thereabouts--I'd go with him. ·The peOple in the ·countryside knew that I was Doc's boy·, and so I. bec·ame known-­ my nickname until I finished h~gh ·school was Little Doc. There was Big Doc and Little Doc. B~g Doc wasn't much b~gger than Little Doc, incidentally. My Dad was a short rotund man, but I picked up the first rudiments of the doctor-patient relationship. I picked up the essence of the doctor-patient relationship of an interest and a love for medicine right there at my father's knee as he went from patient to patient. I cannot remember the first time I ever heard heart sounds through a stethoscope. I can remember some instances very acutely. Maybe I've told you about them~ For instance, I remember one time I must have been maybe five or six years old. I'd gone out with Dad on a case out in the country--a farmer's wife. She was in labor. And I remember Dad called me in and said, "Son, I want you to hear something. And I remember standing by the bed and I could see this woman with this great mound of flesh. It looks now like it was a mountain high--high as a mountain. And he put a stethoscope on it and put it in my ears and he said, "Do you hear something that kind of sounds like a watch going 'tick, tick, tick, tick, tick'?" I remember I could hear it. He said, "Now, that's a baby. The baby is ready to come out. Now, I can't leave. You're going to have to stay here with me, but I'll tell you what. They'll make a little bed for you on the sofa in the other room, and when the baby comes, I'll wake you up and you ca~ see what the baby looks like." This is how I learned the facts of life. And he did. I saw the· baby. And then he let me listen to the baby' s heart thro~gh ·the·. baby's chest wall • I was with him when patients died. I can remember some tragedies of this kind, and 7 BF(cont) how Dad I would ask Dad as we would leave, "Dad, why did you let her die?" And I could still hear him with that bitter tone in his voice. "Because I'm ignorant. Beca1:1se all of medicine is ignorant." He had a way of saying it. It was anger· in his voice. I remember when Dad one time took me down with him to the State Hospital at Larnet to see one of his patients that had been committed to the hospital, and how he told about how this was the greatest mystery in medicine--that there was nothing that happened that didn't have a cause. And just because he didn't know the cause didn't mean there wasn't a cause. But I think the thing,that I got mostly from him was his relationship to his patient, his concern for his patient. Never (and this was not only my father, this was all the doctors of that age in time) was a patient less than a whole person. The concern, compassion, compassion that sometimes they didn't realize--! can remember my father going out to see one patient and found out that they were utterly destitute. And as he left, I could see him open up his billfold and took a $5 bill out which was a lot more than a $5 bill today, and he slipped it under the edge of the family Bible that sat on the table in there just so you could see the edge of it that was sticking out. He just slipped it under there and walked on out to the old Model Tor what it was he was driving. At my father's death, which was after I was a physician, we went back and found $75,000 in uncollected bills with little notes after it which ·said such things as, nDo not try to collect this. They can't afford it." We did try to push ·collections on some, _but out of respect for Dad, there were hundreds and hundreds, thousands of dollars we never everi tried to collect, because we didn't think that's the way he wanted it done. In other words, I 8 BF{cont) learned early I think, that the privil~ge of bei~g a doctor carries with it the obl~gation of_ giving the kind of selfles·s service that I've tried to impart to the medical students duri~g the time I've been Dean. Well, that' s away back there.· I went thro~gh the usual edible problems and decided that the last thing r·was_ going to be was a doctor. The h-- with this • The·re ·had been nothing but doctors in the family and I was going to be something else. Which delighted my mother quite a bit, because she could remember how her father and in turn her husband had always been called away at the most critical hour when there was a party or something they were sµpposed to go to, and they'd always express regret, but still _go galloping off as they should. I won the high school essay contest, first the County, then the State High School Essay Contest when I was a senior in high school. And this decided my mother that my future was in.journalism, and that I must have the gift of letters. And she encouraged me in my interest in this. Well, an interesting thing happened. As a matter of fact, I can't believe that fate really, naturally--but I swear as you look back, your life through all the various turns and twists that I could have taken, it is interesting that I always took the ones which wound me up where I wound up. The best school of journalism in the Mid West anywhere was Neff School of Journalism at the University of Missouri at Columbia. It still is. So that 's where I decided:_ to go, and I submitted my credentials , and I was admitted. Paid my matriculation fee. That summer I went out on a thresh crew--that doesn't mean anythi~g to you, but we were thres·hing whe·at in tho·se days with ste·am tractor and a as they called it, separator/ and I was separator boss. This paid $7 a day. This was 9 BF(cont) the best money you could_ get on a thresh crew, and I was earning a man's w~ges, and I was only 16 and not any b~gger than I am now, obviously--well, not as big, when you think about my circumference. But, somewhere out around Hill City, Kansas, out in the broad plains of western Kansas, I got typhoid fever. They brought me home, and I d--near died. I wasn't able to resume normal functions again until around in November. Those were the days when they weren't treated as they are now. I remember, this was in 1921. I had to· cancel my matriculation. When my father wrote in for me and explained it, they said under the circumstances, they would hold my credentials and I could come the next year. Came the end of that period of time after I was getting better, and Dad said, "Well, you better get in touch with Columbia again.n And I said, "I don't think I want to be a journalist. I'm going to study journalism, but I don't want to go to Missouri. I got sick. There's something wrong. I shouldn't go there." 'Well, where do you want to go, to the University of Kansas?" "No, sir, nor Kansas State College.at Manhattan. No, sir. I was president of my class in the sophomore and junior year, and those guys are sophomores now. If I go there as a freshman they're going to take a lot of delight in making me wear my little green cap and get off the sidewalk when they_ go by, and I'm not about to do it.'' "Well, what do you want to do?" "Well, I want to go to the University of Colorado." "Why?" "Well, I just like Colorado. We've_ gone there every summer and I'd like to_ go to Colorado." "Well, if you can_ get in, fine." So, I matriculated at the University of Colorado in the Department of Journalism. They didn't have·a,.school. It was a Department of Journalism. And I started in, but the interesting 10 BF£_c.a,'\t) thi!)-g was that all freshmen in that day and time in the so-called coll~ge ·of liberal arts had to take ·a certain amount of basic so-called liberal arts courses. We ·had to take 15 hours of science, 15 hours of science and mathematics, 15 hours of E~glish,· and 15 hours of history and philosophy. I fell in love with inorganic chemistry, interestingly enough, and I took a course in zoology as my science course, my biological science course. And this a.tl\i\ coursed-- near cost me my matriculation. I_ got so interested, I'd_ go over into the laboratory and work when I should have been taking care of English and a few things. The result was that I _got a Bin English ·and an A in Zoology, and my English was the keystone to journalism. The Dean of the College or Arts and Sciences, Dean Helms called me in, and wanted to know what was wrong. That was in the day when Deans would still counsel with you. There were only 2,600 students in all the University of Colorado then. I think there's what now, 25,000? And he said, "Well, you're going to have to get down and dig a little more, because you're going to have to have that English." Well, the result was that because I had to get my English, I got it, but it became a necessity rather than a pleasure which English had always been. I took a course in English lit. This was fine, but then I found that I was also taking a course in history of biology which was a lot more interesting. I took a course in botany. The upshot was that I cha!)-ged from journalism to a major in zool~gy thinki~g I would go ahead and get a_ graduate d~gree and the·n: I would teach biol~gy. But I was interested to find that a·lmost all of my classmates in those ·classes (in the ·class that I was ·taki~g) were ·premeds,· and so I finally decided that I would shift over and_ go into medicine. I wrote my 11 BF(cont) dad, and I'll never forget the letter (somewhere I have it still), he wrote back and he said, " I can't tell you how your letter thrilled me. I have always dreamed that you would carry on the tradition and be a physician. In fact, I dared to dream that you might share an. off ice with me .·some day." (Which I never did do incidentaJ;ly). But he said, "Each generation has to decide their own life. All I wanted you to be was well prepared for whatever you wanted to do, so I have,with great difficulty, refrained from ever recommending medicine to you. But you don't know how happy its made me to know it." Well, there's an interesting story connected with that that shows you the kind of model tliis man made for me. On graduation he had dreamed all these years that on graduation from medical school he was ready to come and one of his patients who was in the last stages of - last three months of pregnancy - began to bleed (she had placenta previa, a kind of a condition that) •.. Dad,he went to her and said that he'd have one of the other doctors in town see her - there was one other doctor in town - she said, "Oh, I'll be so scared, if it isn't you I don't know what to do. Please stay with me." My dad sent my mother, my brother and sister on to Boulder for graduation. He stayed in Downs (our home town) and took care of that patient and delivered a normal, healthy baby; because that was his first obligation. And thats what I've tried to comm.unicate to my .:liids over the years. Ah, well, medical school I was interested in .• there was one thing I knew very early--that I wasn't a surgeon. I found this out •• anatomy was great, I loved anatomy, just like I loved zoology and so forth, but when ,·T got 12 BF(cont) to physiology where we had animal preparations I was always willing to trade off and let somebody else do the surgery and I would be the instrument man or the recorder or whatever, But I didn't want ••• and I wasn't good at it either; if there was any way I could foul up a preparation I would foul it up. I" just wasn't good at it. I didn't like it, I was uptight, I dreaded them, and so I didn't do them. So I knew I was going into some kind of internal medicine, some kind of non-cutting medicine, but then interestingly enough at the very end I decided that I was ••• that I would like obstetrics, but then I found I had to take gynecology along with it because they go together and gynecology was a cutting speciality. Well, came the critical decision •. I •• one other step. When I was graduating in my senior year I was called into the deans office and told that the school always offered an internship at the University Hospital, Colorado General, to th~ top seven members of the class. They always took seven Colorado graduates, and they offered the top seven; if they didn't take it they'd offer the next down the line. And that, therefor,e, I was being offered an internship at Colorado General. Well, I had lived in the interns quarters for the last 3 years of medical school because dad, being the kind of country doctor he was, was not flush by any manner or means. And I had driven the ambulance nights and gone to school in the daytime,for my board, room, and laundry. The dean had arranged that. Then 13 BF(cont) in order to (you know the other story) in order to pay, buy my clothes, pay my tuition, fees and so forth, I had found that I was reasonably good at applied statistics, particularly theory of probability. But, I also found, interestingly enough, there that the theory of probability practically applied is great, but it can be influenced if you know how to influence the thinking of a person whose probabilities are the subject of your concern. And one thing I found rather early in the game, for instance, was that there are certain classes of people who feel that if they bet high enough and talk loud enough about what great hands they have, they'll scare everybody off. And all you have to do is···to just give them enough booze so that they lose their inhibition and they will bet it high, and you can sit under them (as they say) on their left and call or check or pass--whatever you have to do--and then close in. And they were the angels that helped me not only go through school, but to pay some of the tuition for my sister who is going through University of Kansas. Well, I, in turn, I accepted the appointment and interned at Colorado General. Came time for deciding what to do next along about Thanksgiving time, and the chairman of the department of Ob~-~&-·Gyn had.told me that he would be very interested in having me in his office if I would take a residency in Ob & Gyn. Not onty that, but he would help me to get what was then a very choice residency which was a 4-year appointment under Luchas Burche, Chairman of the Department af Vanderbilt. So I applied at Vanderbilt, and Dr. Kuppert Powell, Chairman of the Department 14 BF(cont) wrote a very strong letter. Well I'd done a little extra work along the way in the department with the Chairman of the Department of Urology who ran a evening VD private practice clinic in his office. Particularly for gonorrhea. And he needed someone to work down there to -do installations and medications -- what they were using those days, they didn't have antibiotics yet -- I used to go down and work down there, and he decided that maybe I could •• like to be a junior member of the firm. So he offered to take me, and if I would take the two year residency and GU at Presbyterian Hospital in Chicago under Kretsmer, so I applied there. I had always been interested in Psychiatry, and I had gone to a lot of their seminars, clinical conferences, and so forth. So Dr. Rebar decided that I ought to be a Psychiatrist, and he told me that he would be glad to endorse me if I would put in •• if I would apply for a commonwealth fundLfellowship in Psychiatry at (Colorado Psychopathic) - which I did. Well, as you can well imagine, and they still do, everybody makes their selections about the same time, so you get all your acceptance letters rather close together - within a period of a week. Along, a little after, about January or February, sometime in there, I got acceptances from all three. Well, I was in agony, beca1;1se which-ever way I turned I was going to change my ••• that was going to set my life - it was as though I'd come to a road that had three branches, and they were going in such different directions - anyone of which would 15 BF(cont) have been a good road, but which one would be• best for me I didn't know. I didn't know. Well, theres a little story goes with that that, well, well I'll tell you. I couldn't make up my mind, I worried, ·and I worried, and I worried. So, one day, I remember I had the afternoon off, as an intern. It was a rainy day, kind of dark and rainy day, and I was depressed about the whole thing and just wished it would all go away. I got on old number 13 streetcar - which is the one - closest to the hospital - and went down to the cathedraL·- the Episcopal cathedral, Cathedral of St. John of the Wilderness it's called (why of the Wilderness I never did know, but thats what it was called), and I went in there and I sat and meditated and asked for guidance, and said I'll go where ever you tell me, if you'll just tell me, but I don't know where I am to go. Well, the rafters didn't shake, there were no flashes of light, no burning bushes, no parting of the waters, nothing happened except I could hear _somebody practicing on an organ way back in the recesses there somewhere. So rather disgusted with the whole thing I got up, went out in the drizzle, and .. drizzle and snow •• and got on the streetcar and went back. When I got back the gal at the telephone desk says, "Dr.,where ~ave you been?; I've been trying to get you for.an hour and a half. Dr. Rebal wants you to call him immediately." So I went to the phone there, and I called him. And Rebal said, "Well, Bob, its a 1ittle late now," He said, " I had to make a decision, and I hope its all right with you. I got a call from (can't 16 BF(cont) remember the guys name now, he was then head of the commonwealth fund. Millard Scoville was there at that time, but this was very - I've got it on a certificate somewhere ••• doesn't remember his name} who wanted to know right away who my .•• who had accepted from our place, because he had some other names he had to notify, and he wanted to know if I could tell him. So, I called you, couldn't get you, so I gave him your name as one of those who had accepted: He said,"I was sure thats what you'd want to do. Okay?" ~-r said, "Yes sir, thank you Doctor~ and hung up, .. and went, "God, what did I do? I did it." That was how my life-set. Of course, its not a small factor that the residency in Urology paid board, room, and laundry, a,nd nothing else for two years. The residency in OB & Gyn paid a total of $2,000 - ah, $4,000 over four years with $500 the first year, and it got bigger each .•• and the residency in Obgyn, in Psychiatry paid $150 in maintenance the first year and $200 in maintenance the second year - which was big, big money for those days. Incidentally, Eli, this is something that'll interest you in your later capacity as Chief of the Psychology section of the training branch. Thats why I was insistent that we have respectable, competitive stipends. If we were going to pick the best people and give them the best possible training - if we were going to get strong departments of Psychology, Psychiatry, Social work, and Nursing over the country, we had to have good people. And to get good people·you had to offer them something that others didn't. You had to over-offer, because we didn't 17 BF(cont) have all of the - shall I say respectibility - that they had in some other fields. Now thats why I insisted (and you remember the screams from Surgery, Medicine, and Anthropology, and what-not we were raping the whole academic community. EAR Right. BF All right. You can call it rape if you want, but when they lie down and kiss you, its a funny -kind of rape - at least you know, well. So I took my residency. That was probably fortuitous circumstance number three •. Fortuitous circumstance number one was having the kind of dad I had. Fortuitous circumstance number two was going to Colorado where the situation was such that I went into medicine. And number e b°':.1~"' three was Reba! making up my mind for me really involuntarily. But, part of this was also the kind of a straining situation in which I found myself. If you go back and look - at least under Eb°'\()~"" ~ • s day-i its changed much since then, I suspect - there were 3 or 4 training centers, and this was the one in the wilderness, the only one way out west, and each of these three or four training centers trained a different kind of person. McPhee Camel, at Boston, at Harvard.trained one kind of person; Strekard trained another kind of person - look at the people ·that he trained like Gaskal and Branch, and all the rest who R~M.~ became,and R:e:itiM and others, who became college professors. Meyer trained a different kind of person. Out of that came 18 BF(cont) people like Sam Wortis, Henderson, Gillespy, all these people. Rebal trained still another kind of person--a community­ oriented person. I wrote a paper on this once, "The Preparation of Community-Oriented Psychiatrtst" which:.:··_was taken directly out of our experience there. You never were allowed to get away from contact with the community; you had your service on the floor, you had your patients, but you also had out-patients all the time, and this was not outpatient that was follow-up on patients who'd been in the hospital or patients you were going to admit to the hospital. These were patients who were, lets say, refered through the juvenile court or through the school system or somewhere else. We work with community agencies from day one--number 1. Number 2-- we worked with our colleagues in the other professions. It came to me as actually as breathing when we started in IMH; that we had Psychology, Social Work, and Nursing along with Psychiatry--as equal partners, not as employees or something-­ but as equal partners. And I think that one of the great reasons that we succeeded like we did was the harmony we had, and it was harmony which came from re_spect and contentment that each guy had his job.~ As a Psychologist you did things that as a Psychiatrist I didn't do. Social worker, Danny OtKeefe, did something different. What was her name(?) the nurse that was with Sam Hamilton, Mary Corcorin--people like that--each did their own. Well, this influence was profound to say the least. An interesting thing happened--the depression hit just as I graduated. I graduated in the spring 19 BF(cont) of 1930, and the depression had hit in the fall of '29. Ah, so my two years of residency at Colorado were influenced by the kind of patients we saw. We were seeing patients in kinds of desperate depressions--kids that were reacting to insecurities such as they'd never k~own before. Ah, I saw a kind of patient, which was not just made up of schi:zophrenics, but were so many situational reactions - the kind of thing which has it's routes in the community. Well, I'm spending way too much time on this, but .• EAR No, thats all right. Go ahead. BF But, this is where the NIMH came from. If I had anything to do with the NIMH coming from anywhere. Ah, this was the kind of background. Well, there was one more phase to the story-­ Came time to finish my training, and I didn't know where I was going to go. I was .. I knew that there was .• that I was going to have one hell of a time making a living just collecting, because the depression in'33 was pretty deep. Dr. Walter Treadway, who was then Chief of the Mental Hygiene Division, Public Health Service - the first chief - who was succeeded by Cobb, who was succeeded by me, and then Yolles, and then Brown. Thats all there have been. A~, Treadway was interested in recruiting some young Psychiatrists, and he was ready, willing to pay them cash mane¥ - I mean real money - which was something that was awfully hard to come by in those days. Ah, to open an experimental - not exactly experimental, it was a unique institution - this was a hospital and prison, but really 20 BF(cont) without walls. We had security (plenty),the walls didn't show, in Springfield, Missouri. He had sent to Colorado to get a years training •• service officer,who had worked with Goldberger on Pallegra - had done a lot of good research work, had been stationed with the immigration work in Ireland for a while, and a guy named Lewin M. Rogers. Lewin Rogers was an older person - he intrigued, he captured, he somehow latched on to me and persuaded me that I ought to apply to go to Springfield, where he was going to go to ..• that there was a unique old duffer - then old they called him, althoagh he was in his early fifties - named Lawrence Cobb, who was going to be the commanding officer in that place. He was being brought back from Ireland where he was in charge of the Intelligence of testing and/screening. As a matter of fact, he wrote a paper which they never allowed to be published, in which he roundly condemned the thenBenet-Simone tests on the basis that it was culturally slanted, and to give that to a Pole or to a Lithuanian or to a Sicilian you would get entirely different answers,even if they had a superior intelligence, than you would get if you gave it to an American or an English or a Frenchman. And he had data to prove it, And they said they couldn't publish this because this would so upset the whole status of intelligence testing and that the psychologist would get up in arms. As a matter of fact this was reviewed by some psychologist who said that first place he was not a psychologist therefore didn't know what he was 21 BF(cont) talking about and besides that this was designed to wipe out the cultural differences. Then there was the Stanford Edition that came out and they claimed this was better and Cobb went through this and said this was worse. What this did was to just substitute the French cultural bias. -~i-.:subs,ti·.tue:c~ for the French cultural bias the American cultural bias which he.did the same damm thing again. He said as a matter of fact there-=.a.s no verbal method of testing the intelligence which will be applicable to all cultures,uniformly. That was a statement he made which was challenged no verbal method non verbal was something else. I remember he was so excited(this was when we were at Springfield) the first time he saw a copy of the Grace Arthur, non verbal for little kids. And he said this we can adapt for other culturals. It was completely non verbal. Well, I went there - I went to Springfield, the place wasn't open yet, this was a hospital for federal prisioners. It was a real cultural shock. EAR What was the year, Bob? BF 1933. The sixteenth of August 1933. That is when I entered the Public Health Service. That is a long time ago. I spent the first two or three •• I got there is August, the fiJ;"st patients were admitted in October, I believe it was or something like that. We spent that time getting furniture in and setting the place· up - they were just finishing up. Then they began with the patients in. I had been trained to work up every patient carefully and do a good mental status, do a good physical to get a good history both medical and social. The first night that we received patients we received 50 patients from Harrod Hall at St. Elizabeth's. 22 BF(cont} They were the sort of the dregs of the criminally insane. Of these 50, 35 or so of them I'd say were doing at least life for murder, rape, or double murder. As a matter of fact there were some real human interest stories. We had one guy there Old Chief Wapoos they called him, he was a Monamoni Indian who came home to his cabin up in the Monamoni Reservation (that is why he was in a federal prison because he was 6n a federal reservation} and he found another indian •• no, he wasn't an indian_· that was the trouble, not the only trouble - one trouble but it was a man, a non indian man, in bed with his squaw. So he just went in and grabbed him and spli~ his head open with an ax and he was doing life for murder, and he couldn't understand it. And he was just wasting away - he went insane, he went mad if you want to use those terms just as a caged animal would go mad. Well, there were many of these. I learned another phase of life from that place. I was there three years, Cobb was transferred to Lexington to open ·up the first u.s. Narcotic Farm it was called then ( they changed the name latter because too many people thought it was a place that grew narcotics).· I was told in the spring of '36 that Cobb had asked for my transfer to Lexington when it opened. Sure enough one day I got telegraphic orders - telegraphic;., God knows why, that was the way they use to do things. This was to discipline you to-always remember that the government was boss. I got telegraphic orders which ment that I had to be out of town in 24 hours, relieving me ·of duty at Springfield and sending me to Lexington, Kentucky. Those orders came on the eighteenth of·June 1936, my third 23 BF (cont) wedding anniversary, I remember that. One little story back of that. Peg right about the time we were getting married came down with tuberculosis. And during the time we were in Springfield she was reached the place where she was up for 2 or 3 hours a day, but that was about all. And we let out and went to Lexington there we were with the Cobb's again. I was at Lexington for five years and I served almost every spot except Commanding Officer. I went there as Staff Psychiatrist when they split the staff and half ••••••• Where was I? EAR 5 years at Lexington. BF Oh,yes. Shortly after ••• ·I had been there just a short time I was stll-1-well:·no - I was then Chief of Psychiatry I told Dr. Cobb that I was interested in what was going on inside the head, physiologically, of these addicts. We were doing Himbels Bock was doing extensive studies on the pharmacology and on the physiological reaction to narcotics~withdrawal. Isabelle, Williams, Oberse, Brown this wholegroup Brown, Ralph Brown the psychologist was working on some aspects. And I said I would like to know more about electroencephalography. Well, they didn't have any there wasn't an electroencephalograph I quess in ~entucky. I was sent back to Brown to work under Herb Jasper, who was then at Brown he was la"b:ter at Magail and there I spent while I worked about 20 hours a day, as a matter of fact, old Dr. Ruggles wrote a letter one time and told me years latter, he is now dead - bless his heart he was a very prominent psychiatrist, you may have heard of his name EAR Sure 24 BF(cont) that he heard the government was sending me there and he told - warned the people don't worry - he won't be in your hair very much he probably be out politicing so don't worry but I think its a good thing to give him an opportunity anyhow. I came in there and finally Ruggles came to me and.said that they were complaining that they couldn't go home - I didn't want to leave. I was living in the Bradley home in the Pendelton Bradley home but I was down there I was trying to learn all I could about. the anatomy of an electroencephalograph, how you read an'·elec­ troencephalograph tracings and I was working with a fellow named Howard Andrews who was a physicist who later went to NIH. Well, first of all I seduced him,away from •• from Brown, where he was a graduate student and had gotten his Ph.D. there in physics,to Lexington. He was there for years then he went to NIH and he was the Radiation Control Officer or something there for a long time. He had charge of the isotope building down there. I learned what I could, found out that I could get Andrews and went back and wrote the job description around him and got him and we got permission to build a electroencephalograph unit and a room. We screened the whole room with copper wire and oh boy! 11 I mean copper screen. I think we spent something like a couple thousand dollars - which was a lot of money in those days for the room lets say nothing of the equipment •• the machine itself. I was then made Chief of Research and Himbels Bock, who had been Chief of Research, was made Clinical Director. Himmie didn't like clinical directing and after about a year he asked to be re-assigned BF(cont) so I left the research unit and went down as Clinical Director. I went from Clinical Director to Executive Officer. I had become interested along the way, not so much in the physiology any more again in this community aspect of things, but I was interested in the stories I was getting from these people about why they relapsed to drugs or why they got on drugs in the first place. I'd get stories like bad companions, dissapointment with life, I couldn't stand the pressure and I used the term - !-"rem.ember with Jasper, who came down to see me one time. Jasper, I don't know if you ever heard •• knew of him. He had a Ph.D. in psy­ chology from Iowa under Seshore, the old man Seshore. He had a D.S.C. in physiology from the Sorbonne and he had something else­ I'd forgotten what. He was a psychologist turned physiologist but when he turned he turned all the way around. He wasn't like Patton Bepit and Neil Miller and someothers Olde and some of the rest of them - not Olde - what was his name? EAR Olds BF Olds the cripple guy. He just flipped clear over. So I used the word with him psychic pain. There were two words that would always get him angry - psychic pain and adjustment. He said - adjustment - thats like you do with a burner on a dial - you adjust it. He said you can't do that to a person, their too fluid you can't adjust them. He said you can adapt but you can't adjust. But I became interested again in the community aspect of things - what was - I remember one of the first papers I ever wrote some comments on the psychopathology of drug addiction. I talked about the social environment and that we didn't know 25 BF (cont) enough about this. I was talking about this - we set up a six class classification of drug addiction. The one that always intrigued me was one we called K-2, K for Kobb. Kobb's original classification had five categories, we put in this sixth one which we called psycho-pathic diastasis - a pre-desposition to a psycho-pathic personality which I think is sort of everybody as I look at it now. But at least we were trying to think through this thing and these people could make a good adjustment until the time came when they were so over-whelm that as we say today they decompensate socially and their decompensation took the form of taking medicine rather than doing something else, which may or may not be good. One day I got a phone call while I was Exec., Oh, one other thing, a very important factor, I was Exec. and I was at a very delicate situation because ordinarily at these stations everything was by seniority - the most senior officer was Commanding Officer, the next most senior officer was Executive Officer, the next most senior officer was Clinical Director like the Congressional System - it had nothing to do with ability. Well there was a irascible old cuss who really in many way I had difficulty with and yet he did a great deal to help me to came there as Commanding Officer named Riker. Riker had~; was looking around and finally said when the then Executive Officer was transferred he aaid the hell with it I am going to get the guy that I can do the best job and he picked me out from down in the line and brought me up as Executive Officer. I had been Clinical Director and this I could get along with because this •• I could show where I had more psy- 26 chiatric training than any of the others therefore, with BF(cont) John Hopkinson and Brown and Colorado behind me but to be Executive Officer, which is Deputy Commanding Officer, this was another story. This became a little trying because at one time a class mate of mine in medical school,who went into Public Health Service directly from medical school, did his internship and all there never did take a residency, therefore, was several years senior to me was assigned to the station and thought he should be Executive Officer and Riker said the hell with i t , I like what I got. This guy understands drug addiction, he understand the place and he said he is doing a good job, no, I won't do it. It created a rift with this fellow that I couldn't do any­ thing about. It was very difficult until years latter after we were both in NIH we finally patched things up. He is dead now and I am glad we were able to patch it up by then. Anyway, Riker use to take his vacations he was a bridge hound he and his wife, he would go to Atlantic City and they would get a suite at Chalfonte Hadden Hall, he was quite wealt~y in his own right and they had some old old crummies and they would play bridge all day long for two weeks. This was sort of an elimination contest as to who was the best bridge player. He had been gone about a week and I got a telegram from Dr. Parren, Surgeon General, that he was going to Louisville, to give a paper at the Southern Medical Association. Now, since he would take the Chesapeake and Ohio we would come .:tbroughfLexi,!J.gton and he would stop off for one day and would like to inspect the station since this was a unique station he had never been there since the dedication. Well, I sent a telegram to Atlantic City, Surgeon 27 BF(cont) General will be here certain day, please come home quickly. I got a wire back saying I am on leave, ha, ha, ha, you take it. Another thing that happened because I was scared spitless, I had never met the Surgeon General, I had seen his picture but I had never met him and I talked to Peg and Peg said now let us do, she said you learn, if you think thereis something you don't know about the station you learn it cold don't you use a note, you be able to tell him about anything. She said I will talk to the wife of one of the other people there who is Senior·tous but who was not competitive about it and I will since we have the quarters, the big exec. quarters, we will have a luncheon in which we will invite only the men - I won't even show. She said I will meet Dr. Parren when you bring him in and I will disappear and we will have ta house boys - we had Chinese house boys, who were patients, serve. I will stay completely out of the picture. She said don't you were a uniform, you stay in civies because then my absence of so many stripes wouldn't show and the Surgeon General was in civies anyway. It worked out very well­ he wanted to go down - and I didn't know the old devil was in those days shopping for young talent wherever he comld find it. So he said he wanted to go down to the Dairy Barns, he asked me about the cows, what was their milk production, which was a hell of thing for him to ask a psychiatrist but none the less I knew the answer. How did the pasteurizing plant work?rWell I told him what I could about that. He had been back I quess not more than, what happened that I didn't know about till year latter - Dr. Kobb told me about, he went back and he told Dr. Kobb he said well, Lawrence, I feel better now 28 BF(cont) I found your successor. This was in 1939 and I didn't become Chief of the division until 1944, this was in 1939. Kobb said who? An he said he had been out sight seeing with me, Kobb said that is the man I had been telling you about that I recommend that you look at. He said that is why I went out that way he said I was going anyhow and I took time off and saw him, but I knew nothing of this. Not long after this I got a phone call, no a letter, from Dr. Kobb saying Rockefeller Foundation is making available to the Public Health Service seven or eight fellow-ships in public health~ These were to be selected by nomin.ated by the Public Health Service and then selected by the Rockefeller. I'd like to send one, I was told that I could send one mental health person, which you like to go? A years education, a Master's degree from the Hopkins would I like to go. So_finally after 5 years I was relieved of duty the seventeenth of September 1941. That 41 rings -~a bell probably. From Lexington went to Baltimore and matriculated in the school of Public Health. I was told very early that I was as a mental health fellow, as a Rockefeller fellow nut in men~al heatlh, if I wanted to tailor make my course I could. I wouldn't have to take certain things and I said no! I want to::.:be a trained health officer. I am not going to leave mental health infact I will take my electives in mental health, I didn't take all of them in mental health, incidentially, but I want to be a health officer. Now, there were two other mental health people not in the public health service who were in that course that took nothing but child guidance clinic a few things like that ·except they had to take public health administration and bio­ statistics- they were two required courses. I took bio-chem 29 BF(cont) I took micro-biol~gy or bacteriol~gy it was called there, publ.ic health administration, bio-statistics, I took a course in housing which is one of the most important courses I ever took. I learned something there about how housing design can create psychological stress, that is a story in itself. As a matter of fact, the gal that taught that course who is now over 70 and still a beautiful woman I saw at Johns.:'.·Hopkins the other day when I got my award. She came up to me and said something about she was so glad to see one of her students that made it or something and I said Dr. Becher I said you know I always had the darndest trouble at time keeping you identified. She said what do you mean? I said hear you are a distinguised scientist and all I can see when I see you is a gorgeous, beautiful, desireable women. I can't ever think .of you as a scientist, -she blushed, she gave me a kiss and she said you made my day, no you've made my week. Well, this was the, one of the most critical years of my life, obviously, I said there were four things up to now, the fifth thing was Johns Hopkins. The think there that was most important was the course in epidemology~- ehis and statistics. The thing about statistics was the Dean, Lowel Reed, was Chairman of bio­ statistics then and he use to, oh, God! how he would lay into us about the lous!l statistics in medicine and he would use mental health as the most horrible example. Or he would take psychology take an article in psychological journal- he would gi~e you the data then give you the conclusions then he would go back and tear it to shreds. Then the guys would kid me, so I decided God, if ever I had the chance one thing I was going to do was 30 BF(cont) to develop the finast mental health statistics, the finast statistics in the world through mental health. Well you know the story, Mort Kramer came along latter, a Johns Hopkins man and knew exactly what I was after and thats how that started. A little aside there, years latter when I was Director of NIMH CV\ \ \ \:)a. V\. ~ the Mill-Baek Foundation asked me to give a presentation of their board one··~ in New York on mental health statistics and 1 where we had gone and what we had done. I had some slides which· Mort had helped - really had prepared for me on admissions, discharge rates, and how they change and projections and so forth. And when the lights went down and we started they turned the lights off arid we were showing this over at the New York Academy of Med­ icine. I told this story about Reed and Reed wasn't there when the lights went off he was a trustee but he wasn't there at that time·/r:::a member of the board, and I said I swore by everything that I held holy that I was going to develop statistics so good that I will make Lowel Reed stand at Washington's Monument at the corner of Charles and Monument Street and eat them·tfor: breakfast without any coffee to wash it down. I said he just made me that mad and I said that I don't really feel that way ~ow but I just wish he would say some time you're as g~od as the rest of them. The lights came up and there sat Lowell Reed - he had come in - he had a grin on his face and he said you have paid me the highest compliment a student can pay a teacher and he said I'll eat them. Well, while I was there at the Hopkins the war broke out on December 7, on December 12 my dad died back in Kansas he died in Colorado he went into a asthmatic paroxysm and never came out of it. 31 BF(cont) He strangled to death. I went back for the funeral, school was in full swing - I arranged so that I could make up the work when I came back. I had to be gone for a couple fo weeks because I was the oldest child and their was an estate not much of an estate to settle it was more than anything else satisfying or pledging to pay because I told you about his accounts - $75,000 worth. The only thing that my father had was $300 in the bank and a car. Everything else he had given away. You find where he had given somebody $100 because they had to go to Concordia for to get some treatment. He was a widower, my mother had died 5 years before and he just served his brothers - his mankind that way and this is why I quess it is an obsession with me. Well, I came back and I had several exercises in,. laboratory exercises in epidemiology among other things to do I was working away. I was trying to do this and keep up with my class work so I was working way into the night. This one night I was working and the problem that I had was the epidemic - polio epidemic in Chrichrch, New Zealand. Now this was before anything about polio was known other than that it struck and there seem to be some kind of a pattern it would follow lines of transportation or water - well, that would be transportation. The idea.: was to try to come up with some hypothetical some hypothesis that wouldn't that the professor couldn't shake you from too easily knowing that you didn't know what it was. And the more I worked at that the more I though - hey! - this is just like schizophrenia. I don't mean that there is a virus or something but schizophrenia is - we 32 BF-:(cont) don•t know what causes it but the phenomenon tends to cluster in certain areas like· ·in the more deteriorated part of the cities I knew about the drift or the so-called drift hypothesis as being a possible cause but I thought it might be something else. The more I go to thinking about it- this was about 2 o'clock in the morning, Peg had gone to sleep, and I was sitting out there working I got so darnm excited that I finally decided that I had to get some sleep. So I put stuff away and went to bed and I woke up about 4 - 4:30 and when I woke up I was able to thi~k through what I would like to do and I wrote down a blue print for a National Mental Health Program. To make a long story short I finished the year and went to New London and had another interesting experience which I got something in advice - I mean counseling cadets - I was the Senior Medical Officer the First Psychiatrist then Senior Medical Officer of the Coast Guard Academy. I EAR ~\ «.. Is that when Joe Boo JOJ.ned you? ·-« That is when Joe Bo~\had joined me. Joe came up there and Cameron both joined me there. We had a good show, ah, when I finally got back, for fear that I will forget this,- so we will come back to it - when! finally became Chief of Mental Health Parren called me in and said Bob if you had your head and could deal with it as you wanted to do you have any idea on how you would put on at National Mental Health ~rogram. I said well sir, I have it all written out - he said you may want to change it he said bririg it to me in a week or so. I said sir I will have it to you in the 33 BF(cont) morning. Apparent, I didn't know it then !_wasn't really playing up the - I found out later this short of thing he liked­ right now, you know, this is the way he was. I came in the next morning with it- this was this outline- well, I'll come back and pick up this strain up in a minute. My first assignment after I had finished my year and got my Master's was at Curtis Bay, Maryland which was a boot camp for Coast Guard enlisted men. And I was there just as a Medical Officer this was waiting for assignment for New London. I was there for 3-4 months and this was a very interesting experience - it got me back into the real practice of medicine again. Then I was assigned to New London as Psychiatrist, my job was to develop a screening pro- . gram which would make it possible to reduce the psychiatric and emotional casualities and the results of these, in the Coast Guard who at that time were having some pretty horrendous ex­ periences due to the fact that they were running escorts through torpedo junction and places like this without any degaussing devices and no sonor or radar yet and these guys went out and didn't know if they were going to come back or not and sometimes they didn't. S6 I was suppose to develop some kind of a selection program for these cadets who would be mostly enlisted men that they would bring in and they get 120 days,- I think it was - and then they would go out as a reserve and ensigns. I had asked for a Psychologist who knew something- I wanted a Clinical Psychologist - particularily someone who was good in tests and methods but I said I don't give a damm about intelligence tests. I want someone who could help me with apptitude tests because I 34 BF (cont) don't know this ver·y well. And there was_ guy from Mich~gan State io\\rtf named Joe Eeeit who was- had been recruited into the Coast Guard and I dortft know where he was - but he was assigned there and another guy named Herd who was from Michigan State who was in mathematics who came there as a Reserve Officer that Bobit and I had our own grief with. Well Joe crune, we worked together and then we brought in Sid Newman and Dale Cameron this was the 4 or us. We developed a pretty good screening program. We were trying to develop a- some kind of a apptitude test which would hold water. So what we would do, we would give some - we had a number of tests we would give to these cadets- the regular cadets) then we would have a locked file and we would - on the basis of our tests we would predict whether this guy was going to make it or not. And nobody both Bobit and I knew who was and where in this file. The Chief Engineering Officer Capt. OJConner- knew we had such a file, somebody had mentioned it to him, he had several students that were having trouble and he would come down and talk to us and said give me a peek - let me know if I am doing right­ what can I do. No, Capt. - God damm I will order you to. Sir I said that is allright you try. I have clearance from the Commandant, of the Coast Guard, ·-Admiral Russell Washy, himself a four star Admiral that no one can have access to these without my consent. We let nature take its course on these kids that were in this study group - I never counseled any of them - if they needed help I would turn it over to Dale or Sid Joe and I never touched those, we ·1et them_ go and then at the end of the year when a class_ graduated 35 BF(cont) we would open up and see how our predictions came out. We had I Had forgotten what it was - Joe would have to tell you but it was somewhere around 75-80% concordance with our predictions. Then the Coast Guard decided that •• that was a lot of crap there was a very simple way that ~ature provided - you take these guys and put them on a ship either they meet it or they didn't and if they didn't you'd bring them in and discharge them and if they made it - fine - they had been tempered in the hot furnace of experience. But still they developed a program which is still . going on. Well, on my 40th. birthday May 29, this year I will be 71, this week. But on my 40th.· birthday 1944 Peg had a birthday party for me, a little birthday for me, had the Cameron's there I think Bobit, Bobit was a bachelor. Kay was teaching at ewe, aolorado Woman's College, infact there were 2 girls that he was dating Kay Long and Kay Barlese, Kay Long is now Kay Bobit. Kay Barlese they were both.cutter than hell and they were both named Kay. And we use to take bets among us in the Coast Guard Officers Club which one Joe would marry. Joe would say if you really want to win bet that I am going to stay a bachelor. Well, where was I? When I was talking. EAR You just finished telling about the screening device. BF Oh, yes the b±rthday party. During the birthday party - Dale's father and mother were there to. During the birthday party the phone rang and it was Bill Austin who was Chief or Personnel of the Public Health Service in Washington calling and he started out congratulations on your birthday Bob said incidentially I have some news for you the team of Felix and Cameron are going to be 36 broken up. I said my God, you can't do that, I can 1 t do this BF(cont) alone. I said we were just getting started don't do that to me. He said Dale is not going, who is, you're going. I-where am I going~ he said you are going to go to Washington you are . going to be assigned as Assistant Chief of the Hospital Division, Surgeon General wants 4 months to look you over, he is going to through every kind of a problem at you he can, if you stand up he will make you EAR No your doing fine go ahead. BF I am going to run down stairs a second. He •• if you pan out you will succeed Dr. Kobb if you don't you go back to the stalk. OK want to take a minute aow. Well the those 4 months were a stressful time because I knew I was under the gun. SureI wanted to be Chief of Medical Hygiene Division but more than wanting to be Chief of the Medical Hygiene Division I didn't want to fail and I knew that I was being looked at and what would happen - not only was I doing things for the Hospital Divison and I had a wonderful old Chief Dr. Billy Beane who died during the time he was Chief. But Dr. Kobb would call me up and have me do this or that and I would say Dr. Kobb I can't do that I'm down stairs. Well your going to be up here so you !lust well learn how. Well I said I know but I am not there yet I \don't know if I am. _goi~g to be there. He said you' re going to be there, you come on up. Then, I still didn't get anything from Dr. Parren, nothing happened everything went on as though I was going to be there forever. Finally, I got word about 2 weeks before 37 BF(cont) Kobb's retirement on Novermber 1st. that I was to succeed him so then Dr. Kobb I remember he Parren called me down and told me and this was he hadn't yet asked me for this outline that came after I was Chief. He called me down and told me and then ' that day I got a call from Dr. Kobb. Dr. Kobb was a very inter- esting person he never called me Bob it was always Dr. There couldn't be a more kindly beloved father figure in my life than him. I love him like I love my father. This Larry can well tell you. Larry use to say that I was the third son for both his father and mother. But I_ got a call - Dr. can you come up I would like to start briefing you in. Well, one of the first things he told me I can see it as though it was happening this minute he said two or three things that you can use or not as you want but I found they worked over the years. First, He said Administrations are a lot like playing golf get your natural swing and stick to it, don't press or your hook or slice. He said another thing to remember is you have a lot of authority as long as you don't try to use it. Because the worst thing in the world is· a person with a lot of authority which gets challenged and then you can't carry it thro~gh. You can do more on the fact that you have it and don't use it. Then he said and finally, and this is the thing I remember the most, you can get a lot more done for love than you can for fear because fear breeds hate. That was Lawrence Kobb. EAR A wise man. ~·To~:jump.rahe:ad:.::for;· a second - that is what I I d tried to do over the 38 BF(cont) years. This is why we had the brown-bag lunches. This is why we talked about everything in the world from the origin of words to how we were going to plan the next program. This is why on rainy days we had out little get together parties at peoples houses and all of this. So that we would be reall~ a team, this was something that other people didn't understand. Well, I went upstairs- it was a small operation - obviously - there were Dale was still in New London and I had no Deputy, no Assistant Chief. There was myself and Dr. Sam Hamilton, who was the Hospital Inspector, he was called who had •• who really had a file on all_ the ~ state hospitals in the United States and Canada. Mary Coforan, who was a psychiatric nurse is now dead too. And I think there were 14 people totally in the office. Our responsibilities at that time were for 2 hospitals - Lexington and Fort Worth. That was and I think there was a Mental Hygiene Clinic or two that we were loaning some personnel to. I had forgotten. That was the entire responsibility. Well, then I told you about how Parren called me down and wanted to know if I had any plans - how I would plan a program. And I told him. Well, he •• when I came back the next day with the outline - I typed it up - I showed it to him and then I went back and typed it up so it was more in the shape of a proposal. I took it and gave it to him and he said let me have it - I'll study it. A couple of days later· or something like that he told me he wanted me to go down town and see the Administrator - this was then the FSA - it was not the TW it was the Federal Security the Administrator had a Administrative Assistant. The Administrator then was I believe, Watson Miller at that time. And he had the Administrative Assistant, a young 39 BF(cont) woman, relatively you~g, _named Mary Switzer, who" was interested in merital health and he h~d talked to her and she would-be_ glad to see me. I went down to the south no north building she was in the north building and talked to her about this. She became interested and she ·called in a gal who was in the General Councils Office, Gladys Harrison, and Gladys went over this and called fu~ her collegue, a brand new young lawyer who just come to•(the: FSA who - I guess he is retired now - a guy named Sid Saperstein. You must have heard of Sid. Sid was quite a guy. Sid was just trying his wings. We spent oh, I guess several weeks polishing up and working on this outline and finally put it in the shape -oh, we decided what we had been told by the Surgeon General and then by the Administrator was to try to put this in the shape of a sort of a draft legistation. Which we did. We gave this to the Surgeon General and he or to the Miller, (!'ve forgotten which). Anyway, we were told to take it to the Chairman of the Committee Labor and Public Welfare Committee, a guy named Percy Priest~ from Nashville, Tennessee. We talked to him. He was a interesting man. A little tiny wizened up guy, I think he had peptic ulcers or something, pleasant as he could be but he was just~ little tiny fellow and he gave it a quick glance, - he was a newspaper man not a lawyer. Then he said let me have it and I will get in touch with you. So we left it with him. I went, a couple days later to New Y9rk to the Academy of Medicine, I think it was, they were having a conference on the rest ho"mes for merchant seaman that Dan Blane, who was then of the Public Health Service, had put together and 40 BF(cont)Dan was under the Merchant Marine, a_ guy named Fuller, who had been Executive Officet at Lexi~gton when I first went there was then Chief Medical Officer for the Merchant Marine or whatever it was called - that is not the name of it - Maritime Service. And. What was I saying? EAR About carrying the stuff to Percy Priest. BF Oh yes. They were having this conference on these rest homes and I went up there and opened the New York Times and there it said that the Honorable Percy Priest, Chairman of the Committee·, had introduced the National Neuro~Psychiatric Institute Act. Incidentially, Overholster objected to the name Neuro---_Psychiatric Institute because he said that was to narrow and so that was changed to the National Mental Health Act - Bill - National Health Bill. So I came back and the bill was already in. It hearings were set for a few weeks from then. Dale and I and we got a -lone of a guy who names slips me now from V.D. Division who was very good at preparing testimony. We worked day and night getting our testimony together. We went down and we cleared this with Dr. Farren and the funny thing was we were told all the time that well, all-right you guys, don't get your hopes up, it is a long hard road, many are called but few are chosen and damm'few bills get thro~gh. Anybody can introduce a bill - that doesn't mean a thing. You have to go through committee to the house, to the senate, to committee, through the senate to conference and then you have the presidential veto to worry about. So the chances of a bill are pretty slim, statistically. Well, Priest himself presided at the hearings. And one of the strong supporters 41 BF (cont) we had in the house was Clareri.ce Brown of Ohio, the old man, who was-very interested. A very interesting thing happened then. He'd remarked one day- during the break- he said Dr. I noticed your middle name he said are you related to the Ohio Hannahsand I said yes. Mark Hannah I call him Uncle Mark I said you may or may not like him I said I don't know but he was a great Uncle and he said well, he said he was my mentor. Well I said there are those who said he was a ruthless politician and I said - he said well,<hewas. He said do you know what his rule and guide of life was. And I said I do not know what you mean, Mr. Brown. But I know what the family always said that Mark Hannah always said •• always punish hell out of your enemies and never let down a friend. He said that is exactly right, that is the secret of politics. Well that kind of cemented me with him. I was a Hannah and the bill passed the house. On a voice vote, one decending vote, and I didn't even know who it was, but I was sitting in the gallery and it was by voice vote just I, no teller vote. It went to the Senate and Mr. Hill was Chairman of that committee and the sponsors on that bill read like a Who's Who of the Unites States Senate, I have forgotten who ~hey were, but you can look that up. But Bob Taft, the old original Bob Taft, Lafolit, Hill, oh heavens, Smith of New Jersey, I forgotten who all they were, but there were 20 or 30 sponsors to this bill. EAR I'll look them up. BF ,, Some very interesti~g things happened- little things along the way­ at the hearings in the Senate. There appeared and asked to be 42 heard a young,_good looki~g, trim Captain of the Marine Corp., in uniform. And so, of course, this was, war was not over yet, I don't believe. Was it? EAR Still in '44? BF '45 no I quess the war was over - just over. Well, anyhow this fellow said I've asked to testify because I want you to know what mental health can do. He said I am a patient at St. Elizabeth's Hospital, on leave. He said I was on invasions over somewhere in the South Pacific and he said I was in so many days and weeks that I broke down. He had the silver star, and he had all these medals up here. This was a stroke of genius whoever did this. He said I went to St. Elizabeth's and I could have been thrown in with just alot of patients but he said I was put for some reason in a group in which I got individual care~ He said I am going to be well. He said I will be a citizen again like anybody else, ·Thanks to Psychiatry and Mental Health. Gee whiz, Mr. Hill came up afterwards and he said I don't know who plated that but he said you passed the bill right there. He said, you can't vote against the Unites States Marine Corp. Well, the bill passed, went to conference and I'll never forget that conference. I was called over there and there sat around the table Hill, Lafolit, Taft, Priest, Brown and I forgotten who all they were there were 5 or 6 from each •• some of the biggest names and I was really over-awed. And, there was reported out went to the vote, passed, was handed to the President to sign and he signed it on the 3rd. of July and you know the rest of that story. It was sort of an interesting 43 BF(cont) I think it was the 3rd. of July - July 3rd. 1946. That is right and so there ·was no chance for aff·appropriation and you know the story about the going to New York and getting the grant. I need not tell you that. There was something I was thinking of it happened back before and I can't remember what it was. Do you want to back up. EAR We are just about done. I think infact, it is going to_ go off in about 30 seconds, or so. BF OK so lets call it quits here. EAR I'm sure you must be a little tired. BF No, I'm not tired. EAR This is August 15th. and 16th., 1946 presiding Dr. Thomas Parran. The meeting was called to order by the Chairman and then he called on Dr. Robert Felix to introduce the members of the Council, consultants and quests. The following were reported as present: Dr. William Menninger, Dr. John Romano, Dr. George Stevenson, Dr. Edward Strecker, Dr. Frank Tallman and absent was Dr. David Levy. Consultants included: S. Allen Challman, Dr. Frank Fremont-Smith, Dr. Nolan D.C. Lewis, Dr. William Malamud and there were a whole series of quests including: Dan Blain, Joe Bobbitt, Dale Cameron, R.E. Dyer, Sam Hamilton, Mrs. Albert Lasker, Winfred Overholser, Miss Mary Switzer, Dale Wolfle, Dr. R.C. Williams, and then Miss Switzer was called on in the absence of the Honorable Watson Miller and gave a short welcoming address. Mr. Clarence Brown spoke and Mrs. Albert Lasker spoke. BF Do you know who Clarence Brown is there. That is Congressmen Brown of Ohio. The Senior Clarence Brown. EAR OK that first meeting took place where now? 44 BF :, We met in what was then the Public Health Serivce Buildi~g. It was a building especially built for the Public Health Service and later was the headquarters for the Atomic Energy Commission before they moved out of the country to Germantown., It is on Constitution Avenue it is next door let's see there is the Academy of Sciences, National Academy of Sciences. EAR Oh yes. BF . : -~ And then you face the Academy of Sciences on the left I think is that National Academy of Pharmacy or something like that and on the right is the buildingwhich is something else now. It is a . white stone building, it was the Public Health Service Building and it was then during the war and for a number of years afterwards was the headquarters for the Atomic Energy Commission. EAR This is on Constitution Avenue. On Constitution Avenue - about 19th. from Constitution somewhere along in there. And there was a auditorium in there and I believe we met in there, at least I know we registered in there. That was a very interesting meeting. EAR Tell me about it. BF ~·.~ · There was a meeting in which we - now I am not sure that I will get this meeting and the next meeting straight, because at this meeting we had no money. I had gotten this grant to get us together but I was concerned - we had to set up regulations under wnich to operate, we had to set up general guidelines, at this meeting we did several things. Now it is beginning to come back to me. We decided on as the law had said there - the thrust would be equally strong in 3 directions; training, research and what we call community services. The training would be along the four quotes 45 BF (cont) traditional lines· to ·start with :psychol~gy, psychiatry, social work and nursing. The ·res·earch ·would be of 2 kinds: would be primarily supportive ·research ·through_ ·grants and we would work toward inter-mural research as a matter of fact, we did start to do some inter-mural research, shortly after that because we got some space in old building T-6. That is another story that comes a little later. And then the Wade Marshal came with I us and Seymour Ketty. Community Services we sort of patterned ourselves what I tried to do on the 2 very successful programs of Cancer and V.D. not Cancer T.B. and V.D. EAR What do you recall at that meeting that were some of the interesting highl_L;rhts? I think I have all the substant matters covered here. It is a very comprehensive 35 page summary BF I'll be darn. EAR Do you recall any interesting highlites that took place, inter­ changes of any kind, or anything that led up to the meeting that would be worth noting. BF It was either at this meeting or the meeting following that I had my first shocking dissolution~ I don't know whether this should be on the::-record but treat it accordingly • EAR OK BF These people, a number of them, had been like gods to me, particularily, Strecker and ~~ - -wasn't with this group at this time. Strecker was one, EAR Frank T~llman tA LL rr, P: ;-{ BF.,· ·--,~k Frank 'Pe=llnan I didn't know so well. Frank Tolman was then Mental Health Commissioner of Lefrel, Ohio at that time 46 EAR Thats r~ght, Commissioner of Menta.l Diseases·, State. of Ohio BF : · )t:t Then he went from there to California EAR Bill Menninger BF. oxt Bill Menninger. Bill Menninger stood up to what I had always thought of. You see, Bill was a little different category. I'd known Bill, we had known each other since we were boys. We are both Kansas boys. His father and my father started out as General Doctors in the State. People I knew through dad were people like C.F. Menninger, Halsted, the famous Halsted Clinic - I mean Hurtsler at Halsted. Dr. Hurtsler of Halsted, Kansas, famous Hur~sler Clinic and people like that. But I was •• they had been at the next meeting and that was so far back I am not sure but because we may have had some money to dispose of and not much but I was amazed at how _these people were almost crass in the way they were grasping for this money for · their own programs. If they had their way there wouldn't have been any money for anyone but them. They would have divided it somehow among themselves and they would have tried to see who could outdo the other in getting the most of that. I quess I learned fast but I remember walking away from that meeting feeling a little sick. I had thought as I had said to people along the way and as I said to you I am sure some time that I thought this was a program for the people and I really meant it and to see these people grabbing for their own programs was kind of shocking. Dr. Parran presided in his usual statesmen manner· I rememb'er we ·were all in uniform·and the war must have still been on - at ieast we~:were still in uniform.: August '46. I don't 47 BF(cont) remember - the only thing that I. do remember is this shock that I got at either this· meeti!l,g or the one after. We spent­ Did we meet more than a day? EAR 2 days - August 15th. and 16th. It was a Thursday and a Friday. I am not sure what time you adjourned on Friday. 3:15 on the 16th. So about a day and one-half. BF ( ,#·• C: '~: ~: ., I don't remember more than that about it. EAR Well OK what do you recall? BF (c :1r- 1 : JOhn Romano may remember something from that. EAR I'll ask him. What do you recall aside from the point that you've just made about the people being kind of selfish about the a,iTailability of some of these funds. What do you recall as the development of the character and the nature of the council over those first few years. Oh, I can tell you something else about that meeting now. In our training program it was at that meeting- I had made the recommendation '-.-.which they had bought that we resist all efforts at mass production for awhile and train teachers and that as we expand on our long term program there would be 3 levels of support. There would be expansion which would have to do with making grants which would enlarge already excellent programs without comprQmising the offering. Improvement which would mean improving marginal programs to where they were good without necessarily increasing the number and establishment which was to create programs where they didn't exist at all and it might be several years before :there be anything that came off of this 48 €:> f (sot\t) production line; We ·we.re ·aware ·of the ·fact that if we followed this track we ·were_ going to very quickly get complaints that we had been in business for x-numbers of years and not a damm thing happened. That there weren't anymore psychiatrists in the world and nothing was_ going on that they could see and we would have to be able to brace ourselves for this. Several, Menninger for instance, who had his experience with the Army during that time strongly suggested that we keep very good data on where our money went and for what kind of purposes and justification for the kinds of grant we made. In other words, if we were going to train teachers we had to justify training teachers. We all knew that we might have a 10 year period when it would be pretty rough. Until the first of these people coming off the line could establish their ouw departments of psychiatry someplace. As you look back Eli, over the years we did pretty much that. I don't know how it is today because this is a generation later. But how long ago was that? That was '46 - '66 20 - 15 years ago there was hardly a department of any significance of psychiatry or psychology at least - thinking of those two in the nation who chairman and principle facility had not been trained in some part on NIMH grants. And deliberately trained to be teachers in most cases w~ -~did just what we set out to do. Of course you were in that program you know that just as well as I do. But this was decided at that first meeting. EAR Can you tell me anything of how you ~repared for a meeting, was it clean that this was a .historic meeting. Did you have that kinq of sense of history about you or were you too busy just_ getting 49 EAR:cont; prepared for it. Do you recall? BF(::":•'::. You know I suppose I am a slob. At the time, as I look back, ·r can see it but at the time I wasn't concerned with a sense of history. We had gotten legistation through which I thought was really going to be important for the American people and the thing was to get the damm thing on the road and I knew that I had a short honeymoon but I could mess it all up if I messed up the honeymoon. I worked like crazy to get all - everything in line the recommendations for the polic.i.es and all of that and the justi­ fication for it. I went into some length with Dr. Parran talking about how we were going to be sure that this was opened up for discussion by the council members. If you notice there were 6 council members, not 12, not yet, there were two others even then. There was a representative from the armed forces and a representative from the VA, I don't know who they were. But there was at least the law added maybe they didn't show for this. I EAR Captain McDaniels from the Navy BF Freddie was there, ha. EAR F.L. Daniels BF Freddie Mc Daniels. Freddie Mc Daniels was a psychiatrist in the Navy who had been stationed as Navy laison Officer at the Fort Worth Hospital during the war to take care of that 400 or so Navy patients we had in there. Then there was someone from the VA and I don't know who it was. EAR Someone from the VA. BF Maybe he didn't show. 50 EAR I don't see it. I donft think so. Nolan D.C. Lewis was there as a quest. It doesn't show anyone from the VA. BF, ·' No I wish I could say that we that I stood in a moment of silent awe at the birth of a great movement but I didn't really have time and I was too scared that something would go wrong. You know in retrospect. EAR How did these people get ·s;iru.:eC:ted as members of the Council. This first Council group? "- BF (cont) I proposed a list to Dr. Parra·n and in those days there wasn't the politicizing there is now. Some of those people, Oh, I can tell you some things that have come back again. Some of those people were picked for political or pay-off reasons. Now, if you go through that list the law said that 2 chould be chosen for 3 years, 2 for 2 years, and 2 for 1 year, so we were to draw the names out of a hat. So we put a name in a hat and drew it outand that way we got what we wanted. The one year TA! ! i': "V people were FrankjTolrn~~ and George Stevenson, I believe. EAR I'll check it. BFf:ont': And they were chosen for l year. George Stevenson, this was a pay-off to the National Committee for Mental Hygiene and now the NIMH. Frank Tal'lman this was a pay-off to the Congressman of Ohio. Brown.:~·w.a.ll®n was a good man there was nothing wrong with either one of these people but this is why this made Brown very happy and he had worked hard to help us get the bill through, even though he was the minority party, he had worked hard. So those were those two. The Dave Levy and Ed Strecker and I can't remember who was for 3 years and who was for 2. But these were 51 BF (cont) not chosen for any pay-off purposes. That was Levy, Strecker, Menni~ger, and Romano. These ·were all strong men. Ramano was a young man then but he was a comer he had been very active he had done he made some considerable contributions to the whole field during the war. Menninger of course had been with the Army and made his reputation there. Strecker had been a Consultant to everybody - Public Health Service, Army, Navy and everything else during the war. And Dave Levy was chosen because of his interest. in Child Development. Remember he was the one who did the work in Child Psychiatry and he also did the work on animal - Child Animal Behavior, remember? He would go down to the zoo and observe them and all. Dave Levy was a one of the most brilliant keen men I ever saw. Now his wife, incidentally, this was not the reason we chose him. I didn't find this out until l~ter. but it was sort of a secondary gaina She was a Guggenheim or somebody like that one of those very wealthy families. Guggenheim I believe she was a Guggenheim. EAR That is a good name. BF {cc-r':t~ Yes, they are known to be solvent. But Dave had made tremendous contributions and they were chosen, I think what we did really was to chose Menninger and Strecker for 3 years because we knew they had great charisma. Then it must have been we took R mano, but it seems to be Romano was a 3 year man. EAR I think so, we"will check it. EP:.E(ccnt)Dr. Dyer was there from the NIMH BF Ah, Gene Dyer was Director of NIMH. There is a story that_ goes with that a little ·1ater when NIMH came into existence. Gene had been very interested. Gene was one- of the great microb 52 BF (cont) hunters, if you know- what I mean. He had done some of the early 1 work on typhus fever and on severl other diseases, as a matter of fact, he was one of those people who strapped the little cages on their arm with the infected fleas in them and let them bite them and got the disease. Now he had another interest that I knew about, others didn't, he had a daughter who had a very serious psychiatric break and she had been in several institutions, She was at Menninger's I believe I know she was interested in living because I visited her up there at his request. A lovely girl, she finally came out of it and is doing fine now and she was the reason for Dyer's more than passing interest. You probably know that a little later on we - when the first re-organization effort came about when they were going to take the NIMH apart not the famous one in the '60's but the one back in the late 40's, I guess it was wasn't it. The one that Joe Mountan shared. That was the time that they were going to divide us up the same way again EAR Oh really! BF (::.cnt; They were going to take the hospitals a.nd put them in the hospital division and they were going to take the control programs and put them in the dura-state services, research would go to NIMH. I fought this but I was not having very much success and there were severl programs, one of them they wanted to abolish was the division of foreign-quarantine. And Gilbert Donahue who was the Chief of that division was desperately trying to hold it together. This was the division out of which had come such people as Carter and other who had done the work on yellow-jack and on leprosy and on malaria and on hook-wornt... and on all the rest of them. So I was try1Iig to fight for myself they".'"' the Surgeon General had 53 BF (cont) given them a dead line ·and said they had to have the ·rep·ort in by a certain time so they were_ g9i~g to cut off their hearings at 4 o·• clock on this particular day. I figured the only way I could save myself was to scream bloody murder because I had no chance to be heard. So I went in that morning all armed to speak for foreign quarantine, they were before us and Donahue talked for awhile, then he kind of ran out. So I launched forth with ·a passionate plea to point out all the great things that had come out of foreign quarantine and how the sleeping venom was in our culture - society -and;wo.u:1:-d;:sprang up again if we ever let it commend from abroad and leprosy and I went on through all. I would say things that I knew would challenge them and that they would disagree with then I would fight for my points. We broke for lunch and at lunch I kept talking to him so that they didn't come back at 1:30 as they expected but about 2 ·: 30. And I kept them going until about 3: 30 when all of a sudden one of them, I thin!: it was Al ..Siepe·r:~; who was then- he was lat_er:~ Executive Officer at NIMH when he was down town then on this first task work. He said my God, we got to wind up in 30 minutes and what are we going to do. I said well you sure aren't going to cut me off without a hearing are you? I said I just believe my constituency wouldn't like that and I said I would make damrn sure they know. So they finally decided that since they had no chance to hear me and since the Surgeon General had given them a dead line they would pass me over for then, maybe some other time but for then they wouldn't do it. That's all I needed was breather. I went out to see Dyer and told Dyer you 54 BF{cont) know how much ·we need a pr~gram like ·this. We need the research and I need to have these other things - control and training with it - this has to be a comprehensive program and inter-grated program. We have a law. wlrltch:~RSet:s= up a National Institute of Mental Health,· now that leaves a building and there is 10 million dollars authorized to be appropriated in that building - in that law for that building. And that will be know as the National Institute of Mental Health. Now if you take me in lock, stock and barrel, I will make the 10 million available - I will go get it - to join with whatever money you can get for the new clinical· center you want to build. Well he said he didn't want those hospitals, they weren't really part of NIMH, he didn't want the control programs, but he could understand where he might take that because I showed where he was doing kind of a control program­ work and cancer and several others. I went back to point out again how much I had done to help him personally and how I could only do this because of knowledge that I had been fortunate enough to get through fellow-ships from the Commonwealth Fund·:but at the rate of 4 or 5 or 6 or 10 a year, they weren't getting anywhere and we needed to get this in a big way and this was NIMH's job- I sold him. Then I went back and R.C. Williams, Chief of the Division of the Bureau of Medical Services where I was was very unhappy. He didn't want to lose me and he became •• but then I convinced him that it was a matter of survival. Parran agreed or Shealy whoever was then I think it was still Parran. We transferred the 2 hospitals to the hospital division where they were for a number of years and the rest of us moved lock, stock and barrel to NIMH. As soon as that 55 BF(cont) happened Williams said OK I want your space down town. So we moved out - back out - into old T-6 from which we had come a few years before ·and that is how we happened to be the NIMH in the Niof Has Burney use to say. And the reason that we had the favorable location on the lower floors than· the Clinical Center was because I put up the original seed money of 10 million dollars and then they got the rest- it was 62 million altogether. So they went and got 52 million more - I'll admit - but the first 10 million they already had - it was my money. Not only that but then they were starting to look for a Director of the clinical center and they couldn't get anybody at any kind of a price at all. And I said I know a fellow who had been with us during the war as a reserve officer he is now I think Superintendent of Montefiore named Jack ·Masur-. . I have 20 numbers at advanced grades authorized below- I got that built in the law·too - which you could be awarded once but not again. I will make a number available for Jack M~suro if you want to get him at a 2 and a half or 3 striper and they got Jack Masur . at 3 or 4 stripes. So, it was my number that made it possible for them to recruit Jack Masur and it was my money that made it possible the Clinical Center - my money the NIMH. The NIMH money. So that is how that all came about. EAR And Dyer was there all during this time. BF Dyer was there - I didn't know it then but I played on it later that he'd seen this in from the start. As a matter of fact, I always liked Gene Dyer, Roler E. Dyer, he was one of the gentlemen from the old school. When I really wanted some advice I'd go see him. There was someone else whose name doesn't appear in any of 56 ; BF (cont) thes·e thip.gs that may come ·as a complete surprise ·to you who was most helpful to me, he is long since been_ gone. His name was Norman Topping. Norman Topping left us when Sebrellv'as made Director of the NIJi.,-;J when Dyer retired. Topping: had thought he was going to get that. He went to Philadelphia the University of Pennsylvania as Vice President and he went from there· to Southern, Cai.: .. a.s~~Preaident of Southern Cal. he was there for a number of years. That is another little interesting story. EAR His name is in here somewhere BF Is it. I took care of some ·of: his -f-amily. EAR And Jim Shannon didn't come in till '54 - '53, '54. BF Jim Shannon came to the NIMH as Clinical Director of the Heart Institute. And was Clinical Director of the Heart Institute when ,.... \ I I ::) -e. !) re.,- L- -- . . . - ·-·· Sebrellfinally left.~Sel>tel."l· ·-left,Se_brel:IL. caught all of the heat of the polio vaccine, that was in his time. And it just broke him up. He just, he was not •• Henry Sebrel.l I love him, he was a fraternity brother of mine, I have known him for year he was a sweet guy - that was the trouble with Henry Sebr~.llhe was too damm sweet. He was never made to be a tough hard bojled administrator of a bunch of wild men such as you would find in a,creative in­ stitution such as NIMH. They just about broke him in two. Now Jim Shannon could handle it. And under Jim Shannon was organized what I think is one of the most- I was talking about this at Johns Hopkins the other day - when I_ got my award. I have never known in my life, and I doubt it very often that there has ever been collected in one place such ·a group of top~iignt people as those 'i!. Institute Directors. They were so far as I know,. without exception 57 BF (cont) uncorruptable.· They really were selfless. They were fighti~g for thefr Institute ·and they weren't allowed - there were a few that always figured you kept your cards covered always cause they would steal your chips if they got a hold of them. But that was among themselves. Let outside threat come and they would coalesce like a piece of steel. We had the freedom. and used it to critize the Director - to him - not to his back­ we never said it to his back. He was perfect, we were always sure of that. But in the Director's staff meeting we would :.ta~e him apart, it was eamelot, it was camelot and it can't come again. EAR Well that's true and yet it that atmosphere, Bob, over time the NIMH increasingly was seen as a kind of a - if not an outcast - certainly different from all the other institutes and there was something growing between you and Shannon over time. Tell us something about that. BF It wasn't between Shannon and me. EAR It wasn't, OK. BF No, If it was so I didn't know it. I felt that Shannon was my true and good friend. Shannon went out over and beyond the call of duty. Go back and read Carver's •• Carper, or whatever the name is. EAR I think it is Carp. BF And you will find out that she says in there where Shannon would -~~ protest that ·i:~was~:not:.getti~g a fair heari~g EAR Carper is right BF Carper that she would protest that I was not_ getting a fair hearing 58 BF{cont) when they had those meeti~gs at Keybri~ge Motels, or whereever it was and would vote no,_. for he might otherwise had voted yes, because I hadn't had a fair hearing. No this was Jim Shannon. What was driveri betwee·n us, not Shannon and me, but between us and the others was the fact that I wouldn't •• I would play on the team to the point where I thought that anymore playing on the team would wreck the program that I felt was too great to be wrecked. No you can criticize the hell out of me and if I was somebo~¥ else I could criticize the hell out of myself because it sounds like I am talking out of both sides of my mouth. I believe that you have to be a good team player up to a point. But if you are morally convinced that what you are doing is right then you don't dare cave in, just because public opinion runs against you., You take the bitter with the ·sweet. When ~u:rney; organized that task force, Carper talks about him there, and they began to come out to talk to me. I very soon began to sense that things were going to get hot. You could just feel it the kind of questioning and as she said, this was accurately reported, when they questioned me and I gave them my position and I was uncompromising. I figured don't give them a chance to think you are going to compromise., or they will move in on you. Then I began my under-cover work. After that first meeting when I saw the questions were, I had made some phone calls. I talked to the people in APA and NAMH, the American Psychological, Jack Darley I think he was the guy who was Executive Director then. EAR He was BF And who was it Barton or it must have been Dan Blain or whoever 59 BF (cont) it was was over at EAR Matt".-Ross BF No it couldn't have been ~att, :_ he gidn '·t.,have- ·the ·s·tuff. EAR It must have been Dan. BF It must have been Dan Blain. And I went to these various people. I went to people like Alan Gregg, Menninger, I went to all these people and I pointed out we're liable to be in trouble. Stand by, stay alert and I will tell you as soon as I know something but every~hing we have done can go down the river. So I knew I had my forces on the alert, they were on stand by alert. So then I became more uncompromising. Then the thing that was unforgiveable in their eyes the day that Jim Hunley, he was going to give this unveiling of this program in the auditorium, maybe you were. there, o; the Clinical Center EAR No I wasn't BF And he met me •• no he singled me out and he said Bob, can I see you a minute. He said Bob we are going to make a report and your not going to like it. Your not going to like it at:_all. And it is going to be in a different kind of program for you. I just want you to know that you'll look like a fool if y~u try to protest it - it is settled, we've cleared with the Surgeon General, now it is done. I just advise you for your own sake, don't be a fool. So I was set when I heard what they had done I could have died but I didn't say a Gog. damm word. Everybody was turning around and looking at me and waiting for me. I didn't say a word, I didn't say a damrn word I walked out of there stood aroud, chatted and smiled and this I understood later worried some of them worse than if I exploded 60 BF (cont) because I di.dn' t say anythi~g. I went r~ght to the ·phone and called Lester Hill, I said I have to see you, can I see you in 30 minutes if I get down. Sure he said come on down. I told him what would happen and I said you know what this means. He said well what do you want to do. I want the appropriations of the Senate, the appropriations committees, committee report is do out, is it written yet. He said it is being written right now. Herman Downing is writing it. I said I want a p~ragraph in there· if you will do it Senator? Which will say do you understand that there is some re-organization and redistribution of the functions of NIMH and that is your committee does does and your committee does not want anything like this done until there are full and complete hearings on it. Sure, that is fair enough, he said of course • He said you write it. I sat down in his'·office and wrote it on U.S. Senate stationery long hand. He read it and corrected it and said this isn't strong enough here, this isn't quite factual and he called up Herman and said I was coming down · with it, put this in, right in a prominent place. That came out in the report, the next week. Now here is what you get for being too much of a team player. Burney saw that and he says we can't do anything. The committee had dictated that, he said aren't you going to protest that, no use protesting it is out now, I can't do anything about it. I had counted on that. I had known Bernie, he and I served together in Springfield, Missouri many years ago when he was a 2 stripf;!r::. and I was 1 and 1/2 striper. All I wanted was time becuase at the same time I did this I alerted everybody I called and called and called from the office and I had them call 61 BF(cont) others and the word· was out withi~g 48 hours that they were ~oing to dismember us. T_hese then came ·into Congres·s ..· EAR Ok that I think you just described very vividly the successful effort to prevent the dismemberment of NIMH but all of that must have had a kind of growing history. Was it really that we were different than all the other insti~utes? BF Well no, I don't think:so. I think first there was this alienation because we didn't play the same rules. I wouldn't play the rules. Even thosef .who thought it was a shame what was going to happen couldn't quite approve of me because I didn't play the rules. I had turned maverick. This was •• I had to weigh this and I decided that it was my responsibility as Director to serve the Institute as best I could and if my friends didn't like it I was terribly sorry, extremely sorry, but I couldn't do anything about it, number one. Number two, we had become two almost despaired units. There was the intermural research unit which was very biologically oriented. They had some psycho-analytic sorts of things to over there with Bowen, wasn't that his name? EAR Yes BF And Bob Cohen and some of those. But by and large it was the Julie Axelrods'.:~and the Seymour Ketys and the Wade MarshaL~s and so forth. This was distinguished research. On the other hand you had a group characterized by Duhl, Clauson, and the others. Now, the basic research people were over in that building over ·there with the other NIMH and they are still reasonably accepted. They had never been thought •• but the rest of them were around - 62 BF(cont) they were around the Director's office and their only contact ~- :C:'.:;:.tise ·to_ go over there and hold meeti~gs with the staff in the Clinical ceriter, our people just so that­ some of them didn't even know who I was. But that wasn't true with our people in the other place. And we began, I could see it coming and I couldn't stop it drifting more and more toward a , I don't know what word to use, approach a non-organic approach sure its non-organic, liberal approach, that sounds like I am opposed to liberal points of view. I don't know what to say but it comes out with such people as Fuller--'):'orey that I cann't except as being the same breed as the people I know. If I understand him right. EAR Yes, I think you do. BF And we moved in this direction. I have privately criticized Bert Brown bitterly for some of this and then I wondered if I was fair. He took it and his head was down, kind of like I was beating him and he wasn't any use to fight back. Maybe he can't help it, maybe this is the way things have to drift. Maybe this is like a flower, it starts out as a bud comes to full flower then opens so far that its petals start to fall off. EAR Well I wonder though too Bob and I'd like to explore this with you a little further. It seems to me that, and you correct me, maybe to some extent your efforts were almost too successful for some of the other institutes. And I think that the institute •• there was a kind of a •• we were_ growing too fast, we were_ getting BF Eli, this was what was back of the reorganization. We were 63 BF(cont) _getting too b~g, I was told we ~ere_getting to big for our. britches. That we were telling others, rather than others telling us. This would be bad enough anywhere but amont this bunch of head shrinker kind of people, it was worse of all. I ran into this way back at the Coast Guard Academy, when I had around me a group of people all of whom were psychiatrist. Dale Cameron was doing the surgery and I was giving the anesthetics, somebody else, I have forgotten, what he was doing. We had 4 psychiatrists there, one was doing ear, nose and throat, that was their original, and the Chief Medical Officer of the Coast Guard, Dr. Karl Marshell:#'., came down and sais he was getting sick and tired of having people kid him about the neuro-psychiatric Institute of New London, he wanted us to quit all that psychiatric crap and get down to real medicine. And I suggested that he get him another Senior Medical Officer, I wanted to go to sea anyhow. I knew he couldn't do that because I knew what would happen to the Public Health Service if he tried it. So I felt fairly safe. Yes, we were too successful. We were winning away people, or at least they were coming out and talking to us from other institutes because they saw better success. When you pull people like Vanstaton out of the bureau of the budget, folks like this. And also, because of our success we were identified in the minds of many people, there was the NIH and the NIMH, even though we were part of it. EAR And to what extent, ~gain you've touched on this before but to what extent was what you said earlier namely, that early in the _game you say three parts to the total program: research, training, and community services. And of course it was the latter, it was 64 EAR(cont) the so-called service part of the ·program that they felt didn't fit into NIH. So eh.ere 'is another apparent BF There is 2 apparent thi~gs here one is this whole area of service. Shannon felt that it didn't belong and it wasn't until I pointed out that it was in the law. I remember that I went in one day and said Jim your telling me I must get rid of this and this is not part of NIH. I said your forcing me out of NIH, look what the law says. I read it to him in the Mental Health Act, he said if that is what the law says well that is OK he said OK I won't say anything more. He never aga~n said it. Now, when I said a bit ago about my relation with Jim I say again I think if there hand't been a special rapport between Jim Shannon and me I think I was very fond of him and I think he was fond of me. I was his Senior Institute Director. May of times he would call me over and just bat things off my head. EAR Was that unusual? He didn't do that with all of his Institute Directors. BF There were only 2: Rod Heller and me. He could trust us both to keep our mouth shut and he had to talk to somebody and we weren't involved, it was problems that had to do with the organization of NIH generally or something down town or something. We weren't involved so we could be reasonably objective, but also we were older than he was. EAR Talk a little bit more about him. I think we need to put him into the picture ·somehow in a way you have already intimated that he was a brilliant man. 65 BF Jim Shannon was a uterly brilliant person. Dedicated, he had all of the political procl.ivit;i:es of a good Irishman. He loved politics, he reveled in it. He was an excellent investigator. He had done good investigation in his own right and few people in government in the Administration of Programs ever understood, honest to God, understood research. How you do it, how you support it, what liberty you have to . give it and what liberty you don't have to give it, like Jim Shannon. He had a way of addressing himself to Congress so they believed him, they wouldn't necessarily always buy him, but they would believe him. I don't thing anybody ever~·· questioned his integrity. The same thing was true of the NIH, though people had come in contact with. He was a great leader. He was imaginative, he was •• unless he was being yanked heather and yarn by Congress or something he would have time for you, he would see you and talk to you. He didn't go off on his own very often, he would talk it over with people first. He might then go his own way but he wouldn't do it until he had a lot of input. And that I can't ask of more from anybody. EAR Can you recall what you would feel as a illustrative incident or a vivid incident that inter-changed between you and him that kind of typifies some aspect of his approach? BF Yes, I can.~ You can't use the names here EAR OK I am going to leave them out. BF There came to me ·one time• a man who·was the most woeb~gone waif you'd ever saw named Wade Marshall. Wade has just come out of a psychiatric institution. He had a degree in physics and a 66 BF(cont) d~gress in pysiology. Well trained in both ·and he had a paranoid break and he had be'e'ri on a locked ward for part of the time. He was coming out now and he couldn't get a job. He came to see me, heard about this new institute, was there any place for a neuro-ph1siologist. I was impressed with his tickets and I was •• I must admit I had a little selfish thrills suppose I could take this person and through proper handling he would come up with some .. +ea-l_iy great contributions, which he did. What a feather in the cap of mental health this would be if we would take him. So, all I had was the $5,000 :·,fellowship I had no place on my manning table. I took him on and he started out with a $5,000 fellowship. Before Wade died he was making $25,000 a year he got a five~fold increase over the years and earned very cent of it. We set him up with some space in building 3, I know which one that is, when you face the main building it is the one to the right. EAR Oh yes, right. BF He had just a couple of rooms. He had equipment packed in there so tight it made me think of a overpacked submarine. He came up with some new data on spreading cortical depressions w~th potassium and calcium irons and all showing how this spread. This was contrary to the established theories, particularly of Warren McCullough, in Chicago, and of the guy whose name slips me now, the physiologist in calif-ornia. He published •• wrote this paper and submitted it for publication, and I cleared it, his data were good and sound. I_ got a call from the Associate, The Scientific Director, whoever it was, over at NIH over in 67 BF (cont) headquarters, .the frontoffice ·and said Bob, we can't publish this_ guy has been crazy, look what he ·says, he says its contrary to what every •• ever·ything in the books. I said does that make it wrong. Well he said it sure casts a great doubt over it. I said doesn't he have a right to publish, aren't we strong enough that if he is wrong we could stand the embarrassment. Are we . going to say that a scientist that we trust with equipment and animals and all, we won't let him publish his finding. I said do his conclusions follows from his data. Well, yes. But what about his data? I said I'll vouch for his data that it was gathered properly. Well, I can!t do it. I went in to see Shannon. I presented it to him and I said Jim to me this is a matter of psychiatric, of scientific morality. Jim listened and he said I could see him sit back and lit. another cigarette and he said by God, of course you are right. He said you know he has been crazy McCullough and others, he said there is going to be a big debate if he reads this paper whereever it is going to meet, the American P~ysiol~gical. Shannon says well, we let him do the work, he said that either you believe in scientific integrity or you don't. Well the upshot was that his p~per was cleared by the Institute, the Director of NIH, nobody else, he signed it. I signed off as Institute Director, he signed off for himself as Director of NIH. Wade presented that paper and all hell broke loose. Wade stuck by his guns and was proven wight and the whole damm theory of spreading cortical depressions was changed as a result of his worA:. The interesting thing is Shannon never once said to anyone I told you so. That's the way he'd·go. We were sitting one time, maybe I told you this before, in the. 68 BF(cont) Institute Directors staff meeti~g and we'd meet around the corner there ·in building 1. You would come in the ·fr.ant door and you would turn to the right then to the left then it was the door on the left. And he had gotten, he said I am getting damm impatient we are trying to get certain of these training programs through and these; guys just won't move. He said I am going to take some money and going to set it aside and I am going to say if you want this money you have to do so and so. If you do that we have a grant for you. If you won't want to do it, no money, not only that, but you might have a little trouble getting some of your other grants. We sat at that table like this, Shannon sat in the middle, Vanslike sat on his right, Smadel sat on his left, I sat on his right around the first Institute Director, Endicott sat on this side and the~ we went down in seniority down the table Wipaloy down here. And I said Jim I don't know whether my over whelming emotion is shock or grief. I said I am shocked to hear those words to come out of your mouth and I grieved I never thought I'd hear you say that. You've gone contra~y to every concept of intellectual freedom I ever heard of. If you want to say that,you won't •• you want someone to make •• to carry on a program and if its meets certain criteria of excellence you would have special money for it, that is one thing. But that has aothing to do with any other grant. And to_ go at it by saying that if you want any of our money you have to do so>and 1 s0, that is not the same thing. He said it is the same thi~g. I said it is not. It may sound the 69 BF{cont) same but it is not the same ·as sayi~g I have some ·money that had to do with ·a certain job, if you want to do that job and can meet certain standards then we will consider making a grant to you. Endicott said I agree with Bob, we too Colorodians agree ·on this, in his husky voice. He said I think this is morally wrong and I think if we ever let this thing creep into this there will be no end to it. Shannon got kind of red in the face. Smadel started to say something about you know, you guys don't understand the facts of life or something. Shannon said just a minute I believe they do understand the fact of life, maybe we have forgotten them. We won't do it. That was Shannon, his Shannon. EAR Well there is a whole additional episode which is prefer.enced with the phrase The Fountain Committee, we won't go into that right now. I think that is where he had his problems. BF Yes, and that came almost after my time, I think. I heard about it. I think it was starting while I was there but was that about 65, '66? EAR Well a little before that I think. BF They were starting I know]~~this.. this came about incidentially, you know all virtue is not all on one side nor is all guilt on one side in these things. We had gotten a little loose in our auditing of prog~ams. We decided that just because you were a scientist or were a member of the academic committee you were honest and clean cut and a all-American boy. And they are just like ·anybody else, .,,you have the good and the bad. 70 EAR I want to take you back ·Bob',J;,ec:ause Wade Marshall· reminded me that I think it is terribly important for us to_ get on the record your thoughts and c·omments about the b~ginning of the your whole inter-mural program and how that began to fit into. BF Oh, well we had star~ed out with a research grant program. And the good part of this was I quess you would say sociologic, psychologic, program primarly because I was continual!¥-~ impressed with how utterly naive most all psychiatrists were in research design or in research execution. They seemed to feel that all you do is you count one, two, three, four, five and then you say that this number two or this that makes it so. And I was upset about it, we tried to get some research training started and I began to be kind of shook by the fact that our people, even those who were going to evaluate the research training programs were not really investigators themselves. John Everhart, was a social-psychologist. Phil Sapear was a whatever he was, he was not EAR He was the son of anthropologist BF He .was the son of an anthropologist and had a baccalaureate degree who was more analytically, he had done a lot of work at the Washington School of Psychiatry, I think, but that is about i t , about all. And I decided that I was going, I went back and looked at the law, I found •• and the legistative history. The whole thing started because Dr. Cobb, before me, and I in the early day;~~ad proposed an Institute ·for Res·earch ·.in Mental Health. 71 BF (cont) Here was a chance, bec·ause of the_ great tradition of the public health service,· particularly the ·NIH, to set up a research program inter-murally. Well, then I got concerned about how to start it up. I really didn't think I knew enough about it, I had done some p:e11ro-physiology in my time but I was certainly not a hot-shot at it. I had already been siphoned off into administration and I feltlike I was sort of a •• some kind of a faker anyhow. But I knew we had to do it. I went over to talk to Norm Topping and I told Norm that I wish I could find somebody who was really good, who was young enough that they would take a chance, that I could bring in as Scientific Director. He tole me that he knew of a fellow from Philadelphia named Kety, Seymour Kety, in the Graduate School of Medicine. I m~de a date with Kety, went up on the train, I remember, to Philadelphia, saw him in his laboratory there, which is a basement room. I met Josie his wife and first I was, he was sure that he,~he had told since about that he doesn't know what the hell ever got over him •• came over him he had no intention of coming. And I began to paint a picture of what we could do and the more I talked the more excited I got. I talked about, that I wanted the bases in physiology and I laid this back on celluate and stress and all the rest. And this would mean bio-chemistry and he said the thing that convinced him was that he found that I had a tolerance for a broad range of research that none of it was outside of my field of interest. And I seduced him to come down. We set him up in T-6, he and Wade Marshall, they were the first, then he began to bring the others. 72 BF(cont) There is a interesti~g little Story that you may have heard about, I like to te1·1 it, I am_ going to tell it San Diego this fall when they are going to_ give Seymour an award and I am to give the ·presentation. It is one that Seymour always blushes when I tell. I always claimed that Seymour's great scientific success was due to the contributions that I made to his research, which he never tells. And the real story is this, he was doing some work one time, I remember he did a lot· of work on radio isotopes, and where they are located in the brain and he would decapitate the monkey and it would fall into this liquid nitrogen, and the head would freeze immediate~y and then they would section it and take fingerprint plates whatever they call it after this and to do all this you had to have the scintillator, scintellation counter going and a lot of other things. They were already to start the experiment, they turned on the switch and nothing happened. My God, they began to look around all over the place and were just about to tear the thing apart to find out what was wrong and I looked down and the great big cable was lying on the floor, it wasn't in the plug. So I looked at it for a bit and they were just about ready to start taking do~n one of these amplifiers and I said Seymour does that have anything to do with the experiment and he looked at the plug and pluged it in and everything went fine. So I always said that he wouldn't have amounted to a dangle if it hadn't been for my pragmatic approach to research and,;imy practical suggestions. EAR Bob, Seymour came in before Bob Cohen did then·? 73 BF Oh, yes. Seymour came in first. Seymour was •• it was ·fortuitous we_ got Seymour. He ·is a Clinical Psysiologist, but he is a physician, so he has had, even though he has never practiced, he has had the sensitizing influence of clinical medicine. And his wife is a clinician, she is a pediatrician. Seymour had a great interest in mental health but in stemmed from his bio-chemic studies, he still does. He has worked on genetics and he has worked on well I quess it is mostly genetics now. Bob Cohen was Clinical Director at Chestnut Lodge and one of the principle teachers:in the Psycho-analytic Institute. He began to see the handwriting on the wall that Bullard had a daughter and two sons coming along and that the time would come, at a time when he couldn't afford to have it happen, when these kids would be grown and they of course would come in and he would be squeezed out, or he would take orders from kids that he was now baby-sitting and he wasn't about to do that. I knew him because I was in the Psycho-analytic Institute. And I'd known him and I knew Maybe!, his wife, his first wife. So I talked to him, got him intereste~, and brought him out. He and Seymour hit it off. That·;_±s how we got that started. Then Seymour brought •• he recognized very early Wade Marshall's assets and his liabilities. _Then he brought in that Italian, pharmacologist, head of the head of the section on pharmacology in the laboratory of pharmacology over over in NIMH. I quess he is still there, hm-jhni}h~~::But Seymour was broad enough,· one ·of the peo·ple· he went after. early, he and Cohen 74 BF(cont) t~gether· was. Dave Shako. · Then they' brought . in Bill, the ·guy ' f ram Harvard who died of ·cancer. EAR Oh,· yes. BF He married the Japanese girl, beautiful girl. Bill EAR Begins with a M? BF Well I'm not sure it begins with a M. You know who I mean. EAR Yes, I do. BF And this thing began to proliferate. WE were never able to get bio-chemistry off the ground. Bradley was there, but he was in the position of sort of a Section Head in a laboratory without a Head. That was one area we never got •• never really got to go, never got under way. The others went pretty well. EAR When you say Italian your·not talking about Samarog:i are you? BF No, ho, no EAR He came much later. BF He came later and he was out at St. Elizabeth's. I can't even think his name was Giavonni. EAR Cantoni? BF Cantoni, Cantoni, I told you he was Italian. Then one of the things that always tickled me, Seymour for some reason decided that he wanted the touch of the sacred. So when he was offered the Phips Chair at the Johns Hopkins he took it and I warned him you will not like it. I know I had my training there, it is not your kind of psychiatry, Seymour, you won't like it. I saw him a time of two duri~g that year and each time he was a little more dissatisfied. And I kept sayi~g Seymour the day you have your belly full, provided you don't wait too long, your jobs waiting 75 BF (cont) for you. He ·was there one year and he came back. I was kidding him about it at Johns Hopkins the ·other day and they said he was one of the.few people that they had stollen from anybody who they lost back to the same place. EAR And Bob Livingston came in. BF Bob Livingston came in. He came in and replaced Seymour as Scientific Director. He started in on a special laboratory. A labortory of something or other, I forgot what it was called. EAR Something about the brain. BF Yes. Bob is a funny guy. EAR By that time hadn't John Everhart come back, No, No. BF John wasn 1 t back yet. He was still at Commonwealth. EAR Right. BF But eating his heart out; EAR Yes, I'll have to call ~ohn BF John told me the other day or someplace, not too long ago, when I saw him. It-·was at the House Office Building, on the signing of the incorporators, that he has never regretted coming back. EAR There also, even though you said earlier this afternoon that the NIMH inter-mural program fit in with the rest of NIH, even there I think to some extent the breath of the program was or was it­ was":dt such and people like Fritz Radel who were there early in the_ game and caused all kinds of waves. BF Fritz caused me more grief. EAR I'm sure.· BF I asked him one time I said Fritz, if you have ·anything worth 76 BF (cont) while rep·orting why report. it in Parent's Magazine? He said what is wrong with Parent's Magazine? I said it is just not an established scientific journal. Well, that wasn't his style. Fritz was an intuitive type of person who had a lot -of' knowledge, but he ·was no resea·rcher. So far as I can see Bob Cohen will still stand up for him, but I have never felt and I don't feel yet that his contributions to the research effort, I am not talking about treatment, but his contribution to the:.:.-research effort was significant: I think that was one of the mistakes we made bringing • . t, -·him .in. EAR Well you mentioned before that sane aspect of, you didn't use these tenns, but maybe it was :implicit when you said sane of the softer aspects of the NIMH program may have been part of the reason that the rest of NIH didn't look altogether kindly on us. Did the fact that the NIMH inter-mural program early on think toward a very comprehensive investigation of psycho-therapy have anythlng to do with that, all of the efforts of Bob Cohen and Dave Shake had definitive trying to do the ~ ·f;.1'c:.. study of psycho-therapy. Did that have any impact on the inter-mural programs place in the totality of the inter-mural program at NIH. BF I don't think much. I don't think much not that people turned their nose up at it. '!hey just didn't understand it. I think they approved of the idea that we were trying to evaluate treatment and I think they agreed that nothing could be nore evanescent th.an trying to evaluate psycho-therapy, because psycho- I therapy is whatever you say it is. You had no landmarks that you could use in explor.ip.g. But the fact that they were trying to evaluate it. I don't think this • • this hurt any. On the other hand sate of the basic research I think•• for instance people like Axelrod and Brody in the Heart Institute worked hand and glove. 'Ihey were highly regarded. 77 OK lets jump rather· l~ng distance fran there to I have a whole chapter in here Bob on the· mental health project _·grants and early:.~ty efforts and the Prince George's mental health study center· and when we get to it tarorrow the Health Ammendments Act, the::•1956 Health Armendments Act and what that did to cannunity mental health. BF I've forgotten what those were. You'll have to give me EAR OK I will tarorrON. But the early mental health project grants and the Prince George's-mental health stuciy center which began under your stimulus and your whole interest in camnmit~ mental health. And that brings into sane extent the regional offices in the relationship between NIMH and the regional offices. BF 'Ihis was an area, the regional offices for instances take it which ever way you want. EAR Go ahead BF This was sanething .which- I was odds with evecybody except the NIH. In the •• except the NIMH people, Lrnean. 'Ihe. • and the field. The NIH couldn't see all of this rroney being spent on a bunch of people. Why douldn 't one person do all of this stuff. This was really packing it. 'Ihe people in the regional office, I mean the regional office people m Washingtcn, state services or whatever it was called later were nervous because we were packing it so there were more of us then there were of them. I started out with a psychiatrist in each region and quickly added a psychologist and I had in the manning table a place for a social worker and a nurse and in ··sane cases others : health educatoc~:and several others and we had them out there I den 't knON hON many we had at any one time. I was able~ get a pretty good travel budget for this program and I would bring these people in twice a year for a week and I 1 d practically live with them during that time. We'd meet•• I remanber~ when we 78 BF(cont) use to have an office over in Silver Spring and right· across the street was a synagogue.· It was the· only auditorium big enough and we worked out •• we got Mill Whitman's,_ good son of a rabbi he· was , he was able, we taught him to do the negotiating for us. We got their auditorium, is that the right word for that roan. That's the roam they hold their services I quess. EAR Yes BF For all day, evecyday, for a week, everyday up until Friday, it broke off at Friday noon for them and I would stay with them and I would take one full day and I would stand up in front of them and I would tell them what I thought was wrong and I knew everyone by name and where he came fran - 50 of them and I'd say you didn't do this or you didn't do that or I liked what you do and so forth. Then they could care back at me, I hadn't done so and so and we would go at it and t.ry.ey .-,,x:,u.ld practically shout at each other, but we would work this all through. They knew one tltlng- that I knew them, I knew what they were doing and that fundamentally we were on the same wave length. We were arguing about details and they ate ·it up. They would go back out to the field rejuvenated and ready to go. I would never go into a region I didn't notify~ .r:egional people that I was going in the region or where I was going to be and what I was going ·to do. I would never give a paper or a speech in a state that I wouldn't noti~ our people in the region that I was going to•• had been asked to give a paper there should I give it and if I do give it here is what they want me to talk about what should I talk about that they want and what should I stay away from. And I would always get a reply. I asked for reports on periodic intervals, at least once a n:onth, fran all regions and I got them. Now what I did was to build up a network of people out there who felt that they even though thE:;Y were in San<:Francisco and we were in Washington felt that they were an in~igraL:.j.ntimafe :l)art of the· body politic. And as such they were 79 BF(cont) thrcMing themselves into it fully. I think this is a • • there is a lesson to leam here that I don't think that.other programs had. I did one other tlring, I was very careful to stay to make.·. to be personally sure that the regional medical directors were knCM:n to :rre and I knew their problems and I would stand up for them and I'd always say a good word for them but I knew them all on a first name basis. 'Ihat meant that I •• and this is one of the reasons why we had our problems with some of the other institutes, other programs, not only institutes, like cancer and T.B. and sane others. If it came right dCM.n • to the nut cutting I could cotm.ton those regional medical directors to back me and to defend :rre against other programs. I told me people whatever you do do favors for the others. Now, this is a pragmatic cold blooded approach but it works and it is a good tlrlng to remember. Always keep them oweing you and if possible never <:Me them. Don't ask them for anything if you can help it. But always give to them so that you always have chips to cash. 'Ihats as I did with Congress too. EAR I want to get to Congress taronov. Now, go ahead. BF Now you asked about the Prince George's Mental Health Center. EAR Right, that is what I wanted to ask you. BF I wanted sane place. I wanted 2 of them. I wanted nnre but I finally settled on 2 to have a couple of denonstration centers. I made a tactical error that I learned for.m but I learned it too late to do any good. You camlot engraft a foreign substance on a cannunity and have it grow. It•• you can plant a seed and have it grow out but you can't just move in an organization. A good example is Phoenix. We moved· in there although there were several, John Clauson was the Washington contact for that and John's concepts were not quite the same as Bob Hewit's who was out there. And it was •• it ran fine as l~g as we kept putting the nnney in and paying everybody I s expenses. 'Ihe day we began to s11ggest that 80 BF(cont) they had a local board and evecythlng, the bishop was on the board and every­ thing. But the. day we suggested· that they put up sane of the rroney they began to get cool. 'Ihe day we pulled out that thing folded up carpletely. Now we had never pulled our rroney out of Prince George's. It is closer and we can kind of count. it as an extension. What I wanted there and I brought in Mabel Ross, an old oolleagueof mine fran Johns Hopkins days. She was head of the Child Guidance Clinic in Buffalo, I think it was at the time, and she was ready to rrove. I brought her in and told her what we wanted and what the future would hold and sold her. I wanted to develop a program which came out · of the a:mnunity. We would supply the people because I wanted to control what we did. If I wanted to do a study I could do it. So she set up a very inter­ esting, this was her concept, the way to do it. She would assmre that all of the people of Prince George's County were eqqall stock holders in the corporation. Through various organizations, the Board of Education, the Bar Association, The Medical Society, The Rotary-Club, PTA, Chamber of Ccmnerce, whatever they 'W'Ould each elect a representative director to the board of directors which would have their regular meetings and this was hew this was nm and they would report back to their organizations and I'll admit through that as long as that was going that way they were able to keep the interest of the people up. I would go out to their annual meetings and they were really all gung-hoe. I wanted to use it as a basis for a whole variety of programs. , For instance ':. it was out of that program that we developed our deal with the Prince George's County Hospital to allcw us •• we paid for 8 beds I think it was which not any special 8 beds but we could have 8 beds on demand - up to 8 beds on demand, for alcoholics to treat alcoholics in a general hospital setting, then we went to psychiatric problems and demonstrated what we could do. We wanted to do a study, what was that study that caused so much hell. We did a study of kids 81 BF (cont) in the fifth or sixth grade then we repeated that study in as they went into senior high we made predictions as to what we • • what would happen to these kids , how many would drop out,· how many would be•• which ones· would be in juvenile court or sanething else and then we can.pared our results. And sOirebody leaked this. And God did we catch hell. We knew these kids were going to wind in jail ve:ry soon and we didn't do anything about it. And all I could say .was-t_.:.-:that. if we had done anything about it we would have sp:,iled the experiment. Well is an experiment that :important that you would let a kids life be ruined. What kind of creatures are you? EAR Incidenentally, I don't want to devert you but as you well know now there has been a traumatic shift so that that question would be asked much more intensively of us that we couldn't so experiments that might si;oil sane child's life for the sake of an experiment. BF Oh, that is right EAR And that hasn't changed BF '!his is the whole thing under the new human rights, ethnics.' I had to set up a corrmittee on this and everything fran fetal research up and down. I mention it not to devert you but I thinl<>one of the things that I hope can con:e out of this entire effort is, and that is one of the reasons I chose this so called title "after-image" that it is so terribly :important for us to be able to present the nature of a program in the context of the times in which it lived because those times were what the circumstances were then and it is both inappropriate and unfair to criticize saneone after the fact because the presmnption that they should have known then what you now know. You were talking about the Prince ~rge's Mental Health Study Center and the fact that the one here at Prince George's worked and the one at Phoenix didn't. I quess you just about covered that. 82 BF Well there was a difference I think m the· way we set them· up. And we involved the conmunity in the. one.· If I was set~g up a clinic for other than denonstration purposes I would insist the· conmunity do it. We might get sane assistance but this would be on a diminishing scale, if you know what I am tr¥ing to say. 'lb.is could be a long or a slow slope. I mean an acute or a gentle slope but it would none the less be diminishing so that the oommunity would have to ·increasingly participate in it. And this was I think the reason for the success there. They •• the treatrrent program was essentially the same I think their health education progtamwas essentially the same. EAR Allen was the first Director? BF No, oh no. MabeL_ Foss was the first Director. 'Ihe next one was a guy whose name slips me now who was in the Public Health Service. He drove an oldsmobile station wagon EAR I remember that BF Who went fran here back to the Mayos. He was on the staff at Mayos. Was using an electric drill during a rain storm and was electrocuted, killed. His names slips me. He was a gifted young fellow. He was followed by Stan Yolles. EAR Stan preceded Allen. BF Yes, I'm almost sure he did. EAR No, I think it was the other way around. BF Well, OK, maybe it was. I won't argue because I am not sure. I do know that I first got a beam on Stan when he was out there. EAR '!hats true BF And sonething happened and I needed help EAR Joe Bobbitt was on the 20 studies BF Joe Bobbitt went on the 20 studies. Thats right the· 20 school studies. EAR Save that for tanorrow BF And I brought m Stan. And that is when I first got to know rum. 83 EAR .I. want to go ~ugh that. OK let me take you back. I am sorry to shift your train of thought this way but there is a lot abou"t: getting to that point that I want to have lead up to it. But there are 2 things early on in the inter-mural program that you haven't even touched on whcih I think deserve some special mention of their own. One is the early developnent of support in the field of alcoholism and the other is the whole psycho-phannacology program which I think I want to go talk to Jonathan Co~e. But certainly wha~. can you tell me about alcoholism didn't becane a separate program until rronths later. But you were doing work earlier with.. it. BF We were doing work on alcoholism fran the start. There were 2 things wrong in the •• people who were pushing alcohol programs. There were 2 things wrong with our program. One was that is was tied to mental. illness in mental health so that alcoholism became a mental illness and they maintained -- its the sane old story you hear in other tenns with retardation or anything else. It is an unfair accusation but none the less one that sounds good. They maintained that we said if your an alcoholic your mentally ill. Alcoholics are crazy in other words to reduce it to its crudest essentials. And the other was they maintained that our studies were prlltlarily in the areas of the sociological and psychological aspects or psychiatric aspects not in the bio-chemical and that this was an analogy, kind of an analogy. I probably pulled a tactical blunder here as I did in phannacology in that I didn't yield a little rrore to them but I couldn't see putting rroney - I cx:me from a part of the country that no body is rich and noney isn't easy to came by and we don't like to pay taxes anynnre than we have to because we think the government doesn't do as good a job as sanebody else. I was brought up that way that as I have heard :rey dad say you send money to the government and what they do they take out a brokerage fee and send it back to you where it was in the first place. It may or not be true but I had this •• I 84 BF (cont) was constantly and I think this may be one reason why" w~ got so little· criticism we got our share but like the study of mate selection and a few of those things back there.when we had our big donnybrook in Congress. But Windle's works was what I was tJ:ying to think of. But I felt that we would have to take our pay-off •• take our efforts where we had the people to do it. We had people in the bio••• soci6logic and psycilological fields who were interested and ready to go. I couldn't find anybody really , very few at least, really qualified in the 0 biodlemical and the physiological areas. '!here was a guy down in Texas narred Williams who came up with sane ideas whicil some said were good, same said weren't. Well we supported him as heavily as we could. But I didn't put as mucil noney in it and all the people would play back to me was look how much money you are putting into psychology and psyciloanaly9is and how little into the biology of it. Well the same thing was true in a way with psycilophannacology. We had all been praying for the pill, not the pill, a pill not the •• the indefinite not the definite article for a pill or a draft of medicine or whatnot which would cure the madman. Well we would sit over and over again sanething would oome up and it was the answer shock was, insulin was one thing after another. 'Ihis was FAR lobot~ BF Iobotaey was another one. This was going to cure all kinds of ills. I said early on that certainly if nothing else the tranquilizer was better than lobotomy because it was a reversable tJ:tlng which labotaey was not. I wanted to approacil it a little nore conservately and I think I was wrong. I think this is one where Mike Gonnan was right, nore right thant I, we had sane bitter fights. You've heard probably the sto:ry told that somebody asked Mike Gorman what kind of relation~··· ship he and I had had over the years he said productive but abrasive. 'Ihat describes it pretty well. We got along fine but there was always sparks flying. I wanted .as BF(oont) to see and evaluation .set up, I wanted to see a chain of· institutions where we could study these patients. The··tranquilizers caught on so fast that withing 2-3 years you couldn't find 100 patients who·:would rneet other criteria of age, sex, that you could match who had never had any drugs, or who hadn't had, first hadn't had any drugs at all or hadn't had drugs in x period of times even in the hospital. And we didn't even knc:M whether or not there was sane lasting effect of the drug just not transient but lasting sane change. And I remember that our concept had been with narootics that one of the thing that rrorphine addiction does is saneh.ow suttley change the physiology so that you are never the same again once you are addicted. You make look the same, act. the same, feel the same but the way you can be so easily addicted a~second time it is almost as though you were sensitized. I resisted, the first place, going over board, Mary Lasker insisted that I put a major portion of our research effort, take it out of everything else and put it in this, massive approach. She was particularly" maybe contemptuous isn't the word .inpatient with some of the sociological and psychological studies that were going on. Studies of the family for instance what difference does it make your sticking your nose in sanebody else business anyway. Why don't you take that money and put it into developing new and better drugs. Find out the seed of action of the drug. Get you a whole island full of rronkeys and use them. EAR Was she behind that first three million dollars worth of money in the early 1950's? BF Oh yes;-" she and Mike Gonnan. But she particularly. She and Florence Mahoney who was her hatchet wanan. Well her real hatchet wanan was her sister,Fortisque, not Fortisque you know who I mean but I can't think of her name. But Mike was her advance agent·really. So I resisted them, they had their way anyhow and when I was asked afterwards I said that I think on this one I missed the boat. And the 86 BF(cont) only bad tiring is that in the kind of·work I was in your not allCMed even one strike. When that pressure built up to really get rolling and the original money for three million dollars the first year, if I recall correctly, that is what you were given as an appropriation. By that time you had already started to look for people, Johnathan Cole. BF Johnathan Cole we had already started we had gotten I believe two tirings happened. We were looking anyhCM but I believe Fogarty or Hill or both put into the appropriation a piece of money that could be used only for psychopha:tmacology research and with this we set up a psychophannacology service center. 'Ihen we set up a psychophannacology information center what we called. EAR Yes, right. 'Ihen Johnathan came first then Johnathan hired a psychologist you would recall by the name of Shennan Ross. BF Sheman Ross and a guy named Cass. Whatever happened to Shennan Ross, he went to Maryland. Sherman Ross n<:M works at two places, Howard University and also works for the National Research Counsel. He is still wheeling and dealing all over the place. But not doing a great deal. BF You know these wheelers and dealers they wheel and deal but they never arrive. EAR Sherman missed the boat. He was a very bright guy. Now Johnathan, of course, did fine. Johnathan kept on moving he eventually became. BF Johnathan, not Shennan, his department is where at Cornell? EAR He is ? I haven't· follOw'ed him since he took Mel Green: 1 s last place at Eoston State. He left there I quess. BF Yes, I think he is Chainnan of the Depart:ment at Cornell, or saneplace. 87 EAR OK , well maybe this is ~ good place to stop, Bob. What Itd like to do tonorrow is taJk the·rnenta1 health title grants lilat's your title 5 program. Talk a little bit about that. I'd like to get your thoughts on how the whole joint carmission began and our involvement in the joint carmissicn over time. And then, go back again, and talk a little m::>re about sane of the things that are illustrative and perhaps truly infonnative incidents and general description of your relationship with people in~-Ccnlgress·. The further developrent of the advisory counsel the developnent with the professional association which we realy haven't talked about in any great length. I think it is very illustrative to talk about the year when you were wearing 3 hats simultaneously, you were the Director of NIMH, the President of the APA, and you were doing sanething else that was equally. I said that I had a little poem about Felix doesn't go around in circles anymore he goes around in helixes. I had a two line cutlet, you were doing so many things. BF What was I doing? I remember I was President of the APA and EAR You were on a number of canmittees. BF I was a member of the Professional Training Ccmnittee of the APHA. And I was on the WHO Expert Panel, I think all at the sane time. EAR I think that epitomizes very nicely if you tell us about it in your ow.n inimitable way. The sort of thing that again for NIMH I think is so important the very intimate linkages that key people had yourself and others of us at lesser levels with our professional organizations. NIMH was the only one of the institutes in which your professional career was canpletely coequivalent with your professional identity. I mean the heart institute had people who were a variety of identies who worked in the heart institute but in mental health there was a mental health and a mental healther and I think the people 88 EAR(cont) at NIMH identified. themselves· that way. BF Yes, we were all mental healthers. With the exception of the· basic researchers, who were phai:macologists or chemists or physiologists but even then they were more identified even Wade Marshall considered hims~lf a NIMHer. EAR Right. And even the sociologists like Cohen•• what is his first name? BF Mel Cohen EAR .Mel Cohen. And I suppose the one who began least as a mental healther became the roost mental healther of all and that is lt>rt Kramer. BF That's right. FAR Who really began as a statistician. BF Well, Seyrrour Kety was a hell of a the •• Smith-Kety technique on blood circulation had nothing to do with the brain except their were blood vessels running through it. EAR It was catching to work for NIMH. BF Well this is one of the things that has never been discussed really. Why it happened. I don't know if I can tell why it happened but I know how I tried to make it happen. And it was this constant personal interchange in which you just bounced ideas of all kinds off of each other and you allowed eve:cyone an equal opportunity and really reserve the right for yourself secondarily to yak on anything. I also think that it is a very suttle phenomenon that happened to us Bob. I think the ve:cy difficulties, the fights that we had, the struggles for our own identies with people on the outside and sane instances mild and sane instances severe. It is a little bit if I can make this kind of an analogy like people of Jewish faith the more you a:te repressed fran the outside 89 EAR(cont) developable yo~ get on your own. And I think that is what happened to us. BF This is well known that the best way to·str~gthe:h. a race or an ethni~ group and to increase population of them is to persecute them. EAR Well I think to some extent I won't say we were victimized because we did very well. But I think we were looked on that way and I think we were pushed that way. BF We weren't victimized we did a little victimizing oftoer own. EAR Thats true. Well the Jews managed to do that once in a while too. BF Yeah, they FAR I think•• I think that part of our identity, part of our self-identity came from within fran our professional roles and came fran partially fran the pressures without. So that I know by the time I was at NIMH for 1 year and struggled with people on the outside of NIMH and the rest of NIH I even was strongly identified with NIMH than I would have otherwise. Whats his narre, who became the Head of General Medical Sciences originally the Division of General Medical Sciences. BF Halsey Hunt EAR No, no not Halsey Hunt. Stone. Fred Stone. Now Fred Stone did as much as anyone to give me religion as a NIMHer because I was fighting him tooth BF Is it going EAR Yes it is BF let me say it first to get it. on the book EAR Please do. BF 'Ihe second Director of the Prince George's County of Mental Health Center was Bob Faucet. He is the one I told about yesterday who}is~5dead. EAR Right BF OK, . FAR Ok now let rre ask you BF Thank you 90 EAR May I close the door. OK. What I wanted to ask you first is to give you a chance.. Is there anything that you th~ught of after you quit l~t night of this morning that you wanted to begin with. MY kind of loose ends I have a lot of stuff here so don't won::y about it. BF I don't know whether it is the kind of stuff you want or not. But to me one of the unique aspects of the early day~ of the program which carried over I think I felt it did as long as I was there and sane maybe m.etanorphic fonn a little bit was the spirit of canradery which I deliberately set out to try to achieve and this goes back to what I said., Well first I suppose, partly it is my nature. You can't do other than what your naturally predisposed to do. But the fact that Dr. Cobb had said long •• early on I rrean. That you gain rrore by love than you do by f ~ because fear breeds hate. EAR Right. Now go ahead BF Md so we started long before you came with us. There was a small group. First Bobmttz:.t..11.en cameron came in then we brought in Larry Cobb, Iawrence C. Cobb who was at that time just caning out of the Navy. He was taking... he was doing his psycho-analytic traing and in fact he .. • I couldn't start my analysis as part of my psycho-analytic training until he was finished because the same gal Freda Foneycm3n analyzed him and analyzed me and she said she couldn't take me until he was through because he was on my staff. Larry Cobb was working part time while he was finishing his analytic training and he had the;.research~iarll. And Veste, Danny o 'Kiefe, there was a sociologist with us for a while, infact, one of the best dam papers I ever had my name on was written j9intly by a socio~ogist named Rayrrond Bauers and sare of the early Mill.bank papers were written by him. I don't know what ever happened to him. We made it a point unless we had to do it sane other.way to bring our brown bags . . 91 BF(cont) and go down to the little cafeteria in T-6 an~ get a sandwich and we'd sit around the table and eat and talk. FAR In your office BF In nw office. Th.is was part of•• later we graduated· into Veste's office because mine didn't work too well, he had a bigger table. But the point·is however it worked out: and if I thought I could tell you sare rrore of the people, Alberta Altman was another one. Alberta Jacobie she is nCM. This interchange, infonnality we were a family this is what I deliberately tried to achieve and I think this was sanething, Eli, I'm bias but I think and I kind of hope that this was sanething aJ.rrost unique in government to this program. Bob, I have to ask you, well I know you won't_ believe this an embarassing question when did you start kissing the girlsJ, - BF Oh, I've always found.that that was a very pleasant and effective means of establishing rroral and immunity~ F.AR I see your still doing it. No, I think your absolutely right, I think BF -Uridemeath there is sanething and if sanebody ever asked me what I thought the good lord had given ne which rrost stood me. • rrost in good step I hope brains had sanething to do with it but leaving that out it was a innate I don'.t know what to say, capacity that I really loved people. You can't fake this sort of thing you cantbe phoney about it. I really lov~ people. I think this is why I could get bitterly angry about how patients were treated in hospitals. I just loved people and if you love people I quess it shows. - EAR Well there was a side of that Bob, that you would be too rrodest to say yourself but I can tell you that Phil Sapear said in an interview that I had with him that an offslmi;. .o:E~that was your ability to pick good people and then let then do their thing and this really was a very major str~gthing. 92 BF Well, this was _again scroe~g that•• there were occasions when· it was awfully hard to keep·my hands off either.because I though I had a better idea or I thought things weren't going well. If they weren't going well I would move in as soon as I was sure but I would be sure first and if I thought I had a better idea I would always say to myself, if your so God damn smart why don't you do it? Why do you have him there you know, if your so smart why aren't you rich. But another thing that I tried to do and I was told by sane of the old tilrers that is was going to wreck me, I was always· trying to get people who were the very best I could get and they i;:ointed out that I had too many people smarter than I was and that I had too many people getting more rroney than I was that I should get more money than anybccy -in the whil Institute. '!his was ••• there was a number that got more than I did. 'Ihis didn't matter, hell, I couldn't care less. If sanebody was real good I had the sanething that they didn't have -I had ,1\ .vision for the whole tlung. And if they had a better vision I still didn't care to nmch because it sound phoney, Eli, there is nobody but my wife that knows that this is true that I cared more about doing sanething for people who couldn't do for themselves than I did about anything else including my own advancement and I wasn't insensitive to the fact that I wanted to get ahead myself. EAR Right, well, I remember well even when I came you use to ~ t to the fact that so and so was smarter than you are or that so and so was doing things that you couldn't do, you would take pride in bringing those kind of people in and it wasn't a threat at all. BF Where _c,ould you find another Shako, or another Kety, or any of these people. My God, they were tops in their field. Do you::orealize that by the time I was ready to retire and for sane years before that there was hardly a question in the broad spectrum of m:mtal health, not with all the pieces broken up 93 BF (cont) but :including alcoholism, &;ugs, ·mental retardation, criminology, housing and whatever. 'Ihere was hardly a question that anyone could ask us that we couldn't tum to.sane person :in that organization and find an absolute recognized authority. Just think what that means. What a collection. EAR Bob, on that score because I thing that was a tremendous tltlng for the Institute :that fact that we were so almost BF And we all respected each other. EAR Ahrost all encarpass:ing. Was there ever any thought :initially of calling '·• it the National Institute of MentaL Illness instead of the National Institute of Mental Health. BF No, No, not by rre. EAR OK BF Now, I was told by sane of the people way up on Dr. Parran' s staff and sane of the PR people that I was making a tactical error that nol::xrly would go for health. But they would go to stop illness stamp put mental illness or I' 11 kill you sort of thing. They pointed out it was the Cancer Institute, the Arthritis Inst.j.tute, or would be later, the Hearth Institute, this was heart disease was what it was understood by this, it was the Institute of Microbiology, arthritis and metabolic diseases and so on. EAR Neurological Diseases. BF Neurological diseases and blindness not sight but blindness and that.we were wrong and I said I was sorry but what I was after was more than stopping mental illness that !f I oould achieve elimination of mental illness I would only be if I could achieve magically the elimination of all the mental illness in the countJ:y I would only be half way dcMn the road that I wanted to go. I was talking aoout and you heard ire say this, Eli, I was talking about positive mental health.· Positive meaning not just absence of disease well, I was saying 94 BF(cont} it bef<rire but thats what was in the WHO charter. It is notmerely the absence of disease it was a state of well being, health and well being of adjustrrent of ability to live with your neighbor comfortably to give•• and to let•• to live and to let live. I never· talked about this very much before because it sounds so gosh-dam comy when you say it that people don't believe me, ··I dt,n.Hi~tee-lieve so I've never said too much about· it. I was also, I think, I hope, reasonably hard boiled and able to negotiate with politicians and others and I can be reasonably cold blooded about it when I did it. I was being cold blooded about it for the same reason that a :rrother can cold bloodedly do sarething for her kids. EAR Well, your a rare bird,,.~~i"¾}'Ott1 re sincerely i,COmyt=..-: BF. Well, OK, I' 11 take that. EAR You mentioned yesterday and I would like to carry you along on that thread you mentioned yesterday that Dr. ·Parran and the Senior Dr. Cobb had tholl~­ through very consciously about Dr. Cobb,'s successor and you described Parran a:ming to visit you and their the interchange. Now that must have set in :rrotion in your mind when you took over the same kind of thought••when did you start to think about your successor and how did you go about it? BF The answer, I know the answer I am just wondering hCM to say it because it is on tape. Well, I' 11 tell you. You can't use this quite the way I am giving it. EAR OK BF I brought in early on two people who were my closest associates they had been in New IDndon, Joe Bobbitt and Dale Cameron. We were sort of triplets, Joe had a gift of. • that the other two of us didn't have. Dale had gifts that the other two of· us didn't have and I hope I had sane. Joe was to my knowJ.edge, to II¥ way of thinking, one of the last of a breecl of broadly bases psychologist I don't know what you would call Joe, clinical, not really. He could talk 95 BF (cont) knowledgeably.._ ·and did and educated me beyond rreasure in socialpsy and develo~t psyand experimental psy, statistics after what I had at Johns Hopkins then to run into a guy like Joe who could make statistics fun. But I was early aware at that point in time, I was thinking war·back there, what i:ff Ji get- killed in a plane wreck what would happen. At that point in time they would never, the nedical group was so strong, they would never accept a Ph.D. of any stripe as the Director, the Deputy Director and doing all the work, making all the decisions as long as it looked like sane doctor was - they would buy that. But he couldn't be" 11.Mr.. It". In addition to that, as Joe went along he became sort of frozen in sane of his ideas. He•• it was a little hard•. I loved the guy, and I don't know how to say it except he got soft in his ways and I felt that he wasn't growing, I didn. 't know what to do about it. He had been, at first, the Deputy Director, Dale was still at New Iondon. So I finally brought Dale down because I thought this would be the cravn. prince. Dale, if anything happened to me, Dale could take over and we'd talked about this in the days up in New IDndon, when we were up there together. Dale didn't have a MPH and' I thought that was .important but I didn't know exactly how to do it. Little by little I began to realize that Dale had great ambitions to be sanething in his CM.tl right and he had the ability. But danm it he was too near my age. The only way ~e would get to be Director before he was so old they might pass him_over was if sanething happened tone which I didn't want to have happen. And then one day, I heard sanething. Somebody said to me you know your lucky to have Dale cameron, he is one of the best number two mm I have seen. And I came back and I thought that guy is not a number two man. I'm really selfish, I am holding him dam. He is better than what I am•• what he will be. And I started to talk to him about it and to my utter ama.zanent he interpreted what as I was saying as saying look I had enough 96 BF (cont) of you, I want to shove you out. I tried to explain to him but nw thought was that he whould be his CMn. man he· was too damn good. And I proposed that he take on the Directorship•• the Fellowship at Johns Hopkins the School of Public Health. But that he wouldn't cane back to me that he should go out and make a name. And then when I retired maybe they would bring him back. It took a number of years •• I could have stopped there and said OK Dale if this is the way you want it but damn it I guess the same thing I've done with my students dcMn here I've played God to much. But I knew that was wrong for him. And I wouldn't give in. So he went to Johns Hopkins with sane bitterness knowing he was not caning back. 'LAnd he went from there, I'd forgotten where he went. I quess he was loaned or what not to Minnesota. And he resigned frcm the service and went out there then he came back in the service as Superintendent at St. Elizabeth's because this gave him aln:ost an equivalent position at least in the hierarchy in the department. As a matter of fact it gave hlm a better position than me because as Superintendent of St. Elizabeth's he had direct aacess. His imnediate superior was the Secretary. He was in the Secretary's cabinet meetings, I wasn't by two or three notches and Dale and I are good friends and I think_-we•:re~~=good~iends:as-we ever were. But there was a time so I was thinking about it then. Then who did I bring in after Dale? EAR Well the rurcor is that, no I'm sorry no but the run.or is somewhere along the line you started to think about Allan Miller. No, there ItltlSt have been sane­ one before that. BF Allan, :t;'ll be damned. I always had somebody on stand by and there was always a Deputy, but Allan was never a Deputy. No, wait a minute, Joe Bobbitt came back in, didn't he? EAR Well, this carries you beyond the point where you are right nCM, Bob, but Joe 97 EAR(cont) was officially narced Assistant Director in 1957. BF Ah, ha and there was no Deputy for ·awhile~ That, now I know. He was made Assistant Director, this gave him more freed.an of notion because the AMA Council on Mental Health and evecybody else would deal with him. The American the Psychological wasn't very happy and I got this. This is beside'f'point, this is a very amusing tJ:ring at'.-t:qe .. time of the second conference on psychology training there was a Bolder Conference EAR And there was one in Miami BF Stanford, wasn't there one in Stanford? EAR Yes, and there was one in 1958 in Miami. There was one in Stanford. BF There was one in· Stanford. I' 11 cane back to your question but this was so cute, Dave Shake came to me and he said you know you ought to be a Fellow of the American Psychological, I said I don't have my Ph.D. in Psychology. Well, he said, I think you would pass the examination. He said I want to sign your application. I made it out right there, he sidned it and then I carce up and I'd forgotten who all signed it. Dave Shako signed it, Jack Darly signed it, Neil Miller signed it, Stark Hathaway signed it, Olds signed it, oh, hell there were about 15, Jack Hilgard signed it, it was the damndest honor roll you ever saw who signed it. Well, I went through zipp like that of course. So I had••• this is part of saretJ:ring that we ought to talk about saret.ime:::._today,~·is... my philosophy .of why we achieved, how I built my constituency EARr. Oh, absolutely BF deliberately this is one of the. ~ig.. this is what saved us at the time of the second reorganization. Well, Joe Bobbitt was Assistant. EAR In November of ' 57 he was officially named Assistant. BF And there was no Deputy because I didn't know who to put in that place. I had my eye on Allan and Allan I decided needed more seasoning. He had been 98 BF(cont) at Prince Geo?Je. · Your :r;ight· he·. was there.· And we irovecr this ••. he had an Assistant namea.·Yolles. EAR That's right BF Who had a wife who was in personnel and evezybody knew about the wife but they didn't knav about Yolles. She was the one evezybody knew because they were all going down there ••• she was, one,I quess is still one hell of a good intemist. EAR Yes, she is. BF So I assigned, where the hell did I assi~, it is all messed up in my mind. I assigned Allan saneplace for further training. Now he wound up in Denver, but that was after he was married to Judy. EAR Yes, well of oourse he spent that year in En.gland. BF Before that. I sent him there as part of his training but I did sanething before that. What year did he. go to England? I wonder. EAR I think it was'SS '54-'SS. BF That long ago! EAR I think so. BF Then I'm all bawled up. All I knav is that I finally, as a result of that experience in England, I di9D,'t know what the story was but I was damn sure that he was not the man to be Deputy. I'm not sure whether f was right or wrong but to me Allan is well, I won't analyze him, he is not all that a lot of people think he is. Now, that is kind of cruel to say without elaborating. But I just, he and I,.3:L~think are still good friends. But I would not have him in that job. SO we had appointed Yolles to succeed him out of Prince George's. And I needed sareone·wheh Bobbitt went on the· 20 school study and I asked, and this is an interesting thing and I don It ~ anybody. ;ha§ ... ev~knb'wrr;~,?•~,!_I:~:.J;.:,;::: 99 BF(cont) asked Mabel Ross, who hasn I t had a hell of a lot of use for Stanley anyrcore I quess, but I said who' should cane in here as my Deputy, I said your out because your too damn old, she is the· same _age as I am.. She said well she thought that one of the· nost bright·, alert, gifted guys she ran into was the present Director of the Prince George's Center, Stan Yalies. And she said why don't you bring him in here at least and look him over, because you have to have satebody and he is the only one available. I brought Stan in and I was tremendously impressed with him. EAR What impressed you about him. You brought him in November of '58. BF I brought him in November of '58. '!here was no such tiring as too much work to pile on him. He was an indefatigable worker. He would can:y out a project all you had to do was tell Stan I want to get this done and I'd like this kind of an end result, and go away and leave him and it would be done. Now and then he was not perfect, now and then I would get a canplaint that he was too rough. '!hat he was my hatchet man and that I wasn't the sweet guy that I was pretending to be because when I had a nasty job I let •• make him do it. And I would still look good. Which wasn't so. I didn't know that he was - apparently he was sanewhat rough on people. Now, I • • the reason I am furril:>ling I am sure that my .impression of Stan, as is true with any man in my position, was not the same as the people who were subordinate to him. I have heard since that he was not entirely loved by evecylxrly. '!hat there was a reasonable, sizeable group of people who were less· than passionate about him. EAR You were a hard act to follow BF Well, I would like to think that that was it but maybe he just, I don't know. Well, anyway still he was good and when· he went back out to Prince George's and Joe came back I found that the·_ pace was slaver with Joe and I knew that we were rebbi:ng up for •• because· we were getting up to the· point where we 100 BF(cont) ha~ gotten ~ugh the.Mental Health.Act we had gotten the.HIP and all that . go~g, we ha~ gotten· den:onstrations programs and t r ~ g and we had had all of this now we wanted ~ get on with what had been . :th«i:oore of my original idea. Which was break down these :pig institutions and deliver the services locally. Rather than ~ g the people to the services take the services to the people. And I used all of the reasons that I have used nC1M in praroting ambulatory care, later on , on a broader basis. I won't get into that philosophy nCIM. But anyhCIM, Joe would go along but he was not as irnaginative, Stan was. So, I finally brought him back in. But in doing this he could not do sarething that Joe could do very well and I set up that office of program planning and evaluation. And,put Joe in as Chief. I am sure that Joe felt that that was a step d9W11, but to me it was a step up because I gave him canplete freedan. I tried to have one of each of the disciplines in there and he was the co­ ordinator and I gave him a budget but I knew that I could never put him in as Director, not in that time, I'm not sure whether they could nCIM or not, but not then. EAR IX> you recall any, I am talking about Stan and some of the other people who were subordinate to··him, do you recall anything in the initial interaction between Stan and Hector Vegas. Hector was at your outer office at the time. BF Yes, Not that I ... well, I suspected sane things but I was never able to nail it down. '!here was not the nost cordial relations between Hector and Stan and it was because Stan apparently got inpatient with Hector and pushed him harder and Hector felt that. his many years there entitled him to a certain arrount and he was approaching retirercent himself and he resented it bitterly. And, I am sure he felt that he was sanewhat d~graded. Several things happened to:·poor Hector I b~ught in one of· the. nost brilliant men·, I think, as executive officer, Chuck Mills. I don't knC!M · if you ever· knew· the· story of Chuck Mills 101 EAR Please tell it BF He was verj interes~g. Chuck, in the· first place,· Chuck's nother was Jewish and his father was Gentile.· Chuck really never· cleared up in his Q'v\ffi mind his CMn identity, whether he· was Jewish or Gentile. He couldn't adjust himself to being aGentile-Jew or a Jew-Gentile. He was one or the other. He had been in the State Department and apparently he had not let it be known too well that he was Jewish,· half-Jewish. He was assigned to Arabia, or saneplace in the State Department and they very quickly detected, being Semites themselves, that he was significantly, partly, Semitic. He had one hell of a tirre to the point that he finally came dCMn with peptic ulcer and a depression. And this is a guy who had his Ph.D. in Public Administration fran Wisconsin. He was really hot and he came back to this countJ:y. He got better, and he was errployed in the State Department in Washington but he wanted to get out where he had bigger fields and hear :\-ias rrental health that was growing and who had preceded him, Paul Cork, I believe, and gone down to the Surgeon General's office and I found out that I am a member nw-self of the Academy of Public Administration. I am the only M.D. member of the Acadeey of Public Administration, The National Academy of Public Administration. What a closed corporation they can be. Paul told me about th.is guy, Mills. I interviewed him and was terribly in-pressed with thri:s-·guy and then I talked to sorre of my friends in Wisconsin and I was convinced he was good. Just about 2 weeks before he was to cone on duty, one noming he got very faint, vam.ted blood and he wound up in GeorgetCMn Hospital, George Washington Hospital. He'd had a massive herorrhage fran peptic ulcer. God, well the job we were going into was stressful and there wer~ going to be frustrations and all of that. About a week or two later he· was do~g much better, looking fine and an old friend of mine,·rest his soul died in the· last year, a biochemist psychiatrist 102 BF (cont) named I. Arthur Mersky. who had done a lot of ~ - - on peptic ulcer and Art was in town and I said ·Art.~w.ould you do sorre~g for· me ~ it is critical for the program. This guy is good but here is the· sto:ry and I told him the sto:ry and I said now, I can't afford to have this guy caning down with a peptic ulcer and I better· never take· h.iin at all, because I am going to have to unload a hell of a· ,,lot of work on him. 1 I want him in charge of all the Administration, other, than the technical professional part. Art went down and talked to him spent a couple of hours with him-in the hospital and he cane back and he said with you his ulcer will clear up. I said what about the pressure. That kind of pressure isn ';,t going to get him. 'Ihe kind of pressure that is going to get him, he says it is just like my nonkeys, you restrain them, you frustrate them, you put them in an inp:,ssible situation and then you drive them to distraction. Art says you .knowt..yoo::don't know a Jf:M from a Gentile. He said the fact that he is a Jew is never going to bother him here. He said that the fact that the kind of frustrations you have you share together, you don't have any personal frustrations as far as your work is concerned.. Your frustrations are everybodies frustrations. And you can let it out of you. He sayd he will get better. Chuck cane, and his ulcer cleared, he died of cancer sane years later, of the liver. I don't know where it started. But an-yway, he served for a number of years. Now, he was a tremendously, unstable person. He would cane in my office and little Mal:y !Du McVictor, you know she is dead to.-now. Little Mal:y Iou McVictor said she would hold her breath, he would care in the office and beat the table and scream at me, you phoney son of a bitch, he would just came unstuck. And I'd listen to him for awhile then we would talk a::bit then he v.uul~ go back, he was ~ignt. · He would explode to me and then he would channel. all his efforts the· other way. '!hat is a long way about say~g that sane of these ~g~· ~an to change when Stan came in. I didn't realize 103 BF(cont) that this was retrospect, but there was a coolness. It use to be that folks _would care tumbling into-my office. - I ·tried' to channel as much as I could through Stan, although I ·always kept the door open' to people. And I noticed that people didn't cane not only to me but they weren't, we had a ccmron reception rcx::m there, they didn't ccm= to the reception roan. I never leamed why' until after I left. Apparently, Stan cut them off. I am wondering if part of what happened to the Institute in the later, after my time, was because of people reactions to the Director. And if so, does that mean that part of what happened while I was there was their reaction to the Director'? I don't know. Well, of course, it is also true that the period when you were Director was a period in which, and I want to frankly expand on this theme, and I want your comrrents and reaction. I think you were there, you as Bob Felix with all of the characteristics that you represent. You were a perfect match for the develo:r;m:mt of the Institute. Everything that you did I think, fit in with a new growing vital imaginative, free, open, creative effort. BF Well, I've thought of this. You know sanetimes you are in the quiet of your own chamber you can think things you don't dare think othe:rwise because it sbun.ds like your too egotistical or scared or whatever it may be. But I wondered whether, call it divine providence, luck, fortuitous developnent or what not, but whether the reason that NJM:I developed was the 'right guy was at the right spot at the :tight tine. EAR I believe that. BF And I thought that to the poµit. You know I didn't have to retire when I did, I had four years ~ go. I made up my mind that I reached the point after I had given everything I had on that second reorganization and I was told that the NIMH was never going ~ go any place further as lo~g as I was Director because 104 BF(cont) I had done them in. Portifield didn't loke it" Bumeydidn"t like it, Hundley· didn't like it, ~aret Peg Orangestein who" I had frustrated on this thing, I ran into·her· at the.Dupont Plaza· Hotel". I came down to breakfast one rroming, from sane meeting and there was Peg sitting there and I went over and sat, she was sitting by herself, I sat beside her and I didn't realize that she was cool. )I just never, I was oblivious to the fact, we:had::;~. always been friends. And I said sanething about that I hadn't seen her since the old days of when we were working on the reorganization. And she looked at me and she said yes and the days a little too soon. So I knew where I stood. So I began to realize that II¥ time was passed. It was a terribly painful thing, the nost painful thing that I had ever done was to walk out of that office. There had been two things in It¥ life that had been similar. When It¥ nnther died in '35 and I went back hane and::iwe knew that dad, we had this great big old rambling house 6 bedrooms, and there was nobody left by dad, the kids had all gone. We knew we had to rrove him out.;,: · My sister, brother and I got a little apartment for him and a 1kc1y that would look out for him dad was then about 75. And nothing had been noved and I had to go back first. And I remember the morning I left in the car I •• before I •• the last thing I did was started upstairs and I walked through every roan of that house to fix one last time in II¥ ndnd the meno:cy of this house where I was bom and brought up~ I walked into the roan where I was bom and there was J the fumiture just like it was when I was bom 30 sane years before. Well this same thing happened on the last day of October 1964. I started at one end and I walked through eve-gy roan the day before I walked through all the laboratories in the clinical center that I had planned from sketch pads ~ugh architect drawings and all. And then. finally the· ev~g of that day Lorraine came in and Grady and Barbi, the: three girls, they said before you leave we just want to 105 BF (cont) tell yo~ good-bye and they each gave me a kiss~ And then they left and I said just leave me alone for a bit because they had _agreed that they thought it would be better for me and better for thein if I walked out of that office with everything in place. They would pack everything up and ship it later. I didn't know where to send it to or what it was going to be like. So I walked out of that office that night as I had done every day since .I had been in that office. But I shut the door and I stood inside and I looked at all the walls and I looked out the window at the trees out the window and I walked out and I looked out there. I went to the door and it was all I could do to put rqy hand on the knobe. The only thing that kept me going on this was you got to go you' 11 hurt the Institute· ~li::.y.o~st.ay they have told you that, now get. So I remember I had that briefcase right over there in rqy hand and I opened the door and I gave one last look around and I said well so long girls, shut the door and walked out, down the ele\ ator, 7 got in rqy car, the last time I ever parked in the reserved parking place up there, and drove off. The next day I left for St. IDuis not knowing a soul in town except I knew sane people but I had no close friends her at all. Then to a foreign environment here I am a Protestant, high mason, 33rd. degree Mason coming to a Jesuit School as Dean, knowing that I was being hired because of what I could produce not because we were sinq;,atico at all not knowing the culture I was ~ g into. Not knowing the biases and prejudices and I have had soma embarassing experience because I didn't know about holy days and stuff like that and things like that. But I walked out of that office, I left sare of me back there. I don't know how to say it any different. Well Bob, I think you put it very beautifully but I want to take you back · because you mentioned a couple of ~ g s now that we need to thrash out a little bit nore. '!here are so many , so many important nuances· to things and 106 EAR(cont) one of them I think, I want your ccmrent, is your secretaries. You were very fortunate in the· people· that worked for you at all levels.· But I think in many respects, expecially so, in tenns of your secretaries. So talk a little about them. BF I •• each secretary I had. I had observecL·for· sd:a:iie .time in operations somewhere in the organization. In case of I.Drraine and Mary I.Du, not in NIMH, but I . knew them. When I first got there there was a girl working with Harry Adams, who ;y:eu=-newer,-'1mew,· Harry Adams canmitted suicide later, he is buired out at Park Lawn Cercetery. Har:cy Adams was nw Administrative Assistant, who was Executive Officer, he was everything that had to do with budgets, money, property, travel vouchers, everything. '!hat is when we had 14 people. And he had a girl that was brighter than hell and rrore as his secretary. And I observed her for awhile because.I had a girl who was going to be there not to long her name :::was Eyster. What was her first name? She was a sister to Pokey Amold' s wife. Co you retrember Pokey Arnold. His wife and he~.·are both dead now. Frances Eyster, I think her name was. Well, she was her husband was going to school or·srnething and when he finally got through she left. I brought Ann M:x>re in and I told her that I wanted saneone that I could absolutely her rely on. '!hat I wanted no secrets from her and I wanted to knON everything that went on. That I wanted•• no matter where I went, if I went t~ the john, I would tell her where I was so she would never be at a loss. Then I told her what I wanted I wanted her to screen calls, I wanted her to make appointments, I wanted her to nlil the office as far as nw life was concemed. 'Iha.t she was a partner in the operation. 'Ihat she muld hear many ~gs that should go in and stop and not come out. And this is one of the ~gs that I picked them for. I picked•• I tried to pick them for brains, for discretion and for devotion. '!hen I tried to treat them with war.mth and well, how do you say it, I tried to treat them with 107 BF(cont) affectionate friendship. No hanky-panky stuff, I don't mean that. But they were just not paid employees they were part of the family and as I do my _girl here, she does. sanething nice I will go out and give her· a squeeze and say that was great thank you. Never, did I. • I tried at least never to forget to tell them when they did sanething well because I certainly wasn't going to forget if they did sanething that wasn't well. Ann was with me for quite scm:tirre. And then she married a guy who later cormtltted suicide. And she is nCM I think working sanewhere at the Atomic Energy Corrmission, or saneplace. And I got Mary Iou. Now the thing I was interested in in Mary Iou was she with her handicap .she was a single minded person. Smart, that gal was the smartest thing you ever saw, you probably know this. Utterly devoted, but she was a compasionate creature. I have seen sane of the people like John Everhart and Seynour Kety and Veste particularly could just wrap her aoung their finger up to a point. But she was always my gal, my secretary. That hunch-back of hers, she had certain privledges of expression which came naturally to her. For instance, you know the fannus story when I made Assistant Surgeon General and they bought sare big flowers in and congrafulated me I was nCM Rear Admiral, lower half. She said she couldn't see what was so dignified about being the lower half of a Rear Admiral. Th.is was Mary Iou. She was with me for years. She took over the office. She made my reservations and if she. • she went so far that one time she couldn't get me somewhere and I said why not? Well, I can't do it there is no reservations to make. And I said what about sane airline and she said I am not putting you on that airline. That is not safe, that is a little jerk-water airline and as far as I am concemed it doesn't_exist. I said well I'ye··got ~ get· there and she· said you better get a car because you are not going on: thau ja±rpiane. · She·. just took me over and nothered ~me. But 108 BF(cont) all the time she·was I tried.to impress· on her, as I did.on Ann and later on IDrraine, · that the· pi;ogi:'am was the thing, everything was geared to the program. That It¥ door was always open to people who wanted to see me that they should first, if possible,· clear it through sanebody else because I didn't have enough hours in the· day to see everybody. Mary Iou finally realized that one of these days she was going to be unable to work, her back was caving in rrore and rrore she was starting to wheeze badly. So she went to work back in Pittsburgh not far fran where she lived, up off the turnpike for social security. sane time before that I had been struck with this very intelligent, sharp, srrooth, . gal who was Paul Cork's secretary, downtown when he was Executive Officer at the Public Health Service and when. L-.. wo.uitl;goc.down to the Surgeon General or something I would drop in and chat with her and I'dasked her where she lived. She lived in Silver Spring and she •• I said isn't it hell to go clear out and back down here. Yes, I said why don't you cane to NIH. She said well where is a job. I said well, this is not casual, I said I have been watching you for some time. If you really want to, It¥ secretary is going, I had forgotten what the grade was, but I said I think I could work this through Al Sepert· to get the grade up. W:>uld you cx:me as what I would call, not just secretary, I think she was called office manager or sanething, I got a better grade for her. And you are close to hane and all. So she said fine, she would. , So I got her, witjl her I got a gal who was highly intelligent, college graduate, who was an excellent. Iorraine was a lady. Now, I don't mean that the others weren't ladies, they were ladies, but Iorraine was a cultured lady, if you know· what I am tI:ying to say. She was special that way and we had reached that point in the bottan of the Institute where we needed ••• J:im Shannon had such a gal, her name was Verda Retrod. He had such c3: gal in his office. Rod Heller had such a gal in his office in the Cancer Institute. I had to have this kind of a person. 109 BF(cont) She was the official hostess,·if you will, for the.Director's office. And .again, I had no secrets fran her. She· knE:1¥i what ~ go~g on, she· knew what the problems were and you never heard a word out of her. She had her domestic problans which had begun, and at that. time she didn't knav how serious they were going to ~, because·she::t't•1amitH.fa:l:1rdng .into sanething and earning out with a gold watch. She married the second time a very wealthy guy and she travels all over the world and she deserves it. EAR I am going to get .in touch with her. I really think she will have sane interesting stories. BF Oh, Iorraine, IDrra.ine can tell you much. When you see her tell her I send ~ love. EAR Ok BF I haven't heard from her except for Orristmas cards, she always sends us Mrs. Stokes. EAR I did want to get that on the record because I think that that is an irrq;x:>rtant part as were as you said yesterday. BF These people were so close to me and so much a part that I would not have thought of it if you hadn't mentioned it because I just incorporated them into the situation. 'Ihey were part of me, or I was part of them or sauething. EAR And by extension, Bob, as I mentioned briefly last night you had other people •. ~-£-:~±ha,t;close as secretaries but we had a tremendously group of gals like the Haddy Arnolds, Doris Smith. BF Haddy Arnold, Doris Smith, Carolyn Evans EAR Agnes Cosby BF Aggie, I still get Christmas cards from :Aggie. FAR 'lllat was a selfless person. BF Oh, yes~ She-•• 110 And I think thats what: the strength of the· Institute, the· devotion to what we were all tl:y~g to do went thr~ugh all levels. It was certainly not just the professional ·-people by a long shoot. BF Now, I don't know whether it was the grcmth and the time or the person or what. But. under Stan and even :rrore so under Bert I get the .impressions as I talk to the people that this identity is not there. EAR I mean I think it is an unfortunate, sad, but inevitable part. BF A person like Fuller Tony would have never done under me what he did under Stan, under Bert I mean. You know 'Ibn:y and sore others were shooting off their :rrouth like this and we felt pretty upset about it. And a number of us had a lunch meeting sanewhere in Boston or sorreplace with Bert•. 'Ihese were really top brass of the APA, Walter Barton, Frank Braclen, Jack Ewalt, myself Harden Branch, John Whitehorn. I organized this and we told Bert that this guy was, John Fanano was another one there,. EAR Well you know he is leaving. He is_ going to Alaska for a year as a General Practioner. BF I hope the son-of-a-bitch freezes to death. No I don't either. God forgive me, I don't mean that. Well I hope he likes it so well he never cx::xnes back. Ok, lets go back Bob. I really don't want to miss the opportunity this time. I hope I can cane back again but I don't want to miss. the oportunity to go on withs~ of these other things that only you know and only you can put on the reoord with your own insights and recollections. But could we shift again talking about people and your interactions with them. If you want to talk about sanething else don't hesitate to say so. But could we shift nON to sane of the things that happened between you and people m Congress, Hill Fogerty, and by extension people like Mike Gonnan and Ma:ry Lasker and others. 111 EAR(cont) It you want to leave that for later. BF No, no any way you want to take it. Because you know what you want to cover and you knCM what your prioritjes· are.· Well, back of this. '!his is sOitEthing that I got fran my course in Public Health Administration at Johns Hopkins. I learned there and I found it was practically so true that if you are going to really be successful with a innovated public program. There with a program that isn't so innovated in treatment but particularly an innovated public program you got to have a broad and dedicated and.active constituency. And you've got to serve that constituency. Serve them so that they CMe you but you don't own them any rrore than you can help. '!his is why I stayed away from labor to a large extent because labor was. • they would do all kinds of things but they wanted paybacks so did the AMA, I stayed away from them. But I began by doing what I had done at the Institute but on a little different scale. I began to identify myself with these organizations. I became active in the American Psychiatric Association, I joined the American Psychological, 'Ihe American Author Psychiatric, I became a member of the board and finally first Vice President of the National Association of Mental Health. I you look at my CJ you will find that during that period of time because they had all the things I would belong to in there. There were 20 or 30 organizations in one way or another I was a nanber of the Council of •• a member of the board of the Council in Social Work Education. I worked for years with the VNA on their board and so forth there before I cane here. What I am trying to say is that I built up this kirid of a constituency. I made myself selectively available to give talks. Now, I was ver:y careful, this was a planned thing. You go back and look where ~ gave talks. Sure I gave them to a big meeting of the.National Association of Mental Health but I also every year would give a few· and everybody could understand that I couldn't give to many 112 BF(cont) maybe in a tCMli of 5,000 people sanewhere in Georgia, or Arizona or ~ e or sorooplace,·maybe to a small audience but I would get around that I was not just talking to "Mr. Bign. Ok, in addition to this I cultavated rey relationships with the regional office because these people had contacts with Congress. '!hen I particularly identified reyself as a person that was available and chat with him to the members of the canrnittees and there were 4 carmittiees. There was the Appropriation Camtl.ttee, sub-comnittee, and sorce of the members of the Appropriation Camtl.ttee of both the House and the Senate, that was two. Then there was the Subsii:riva-~ntee, the labor and public wel~e_:and I'd forgotten what the other one was called. But I made :reyself available to them. '!hey would call me up, I would never forget when Melvin Leard called me and wanted to know if I would give a speech for •• in Milwauke and I was very careful to say that I was so pleased to hear fran Mr. Leard th.at he was so interested in mental health that he wanted n:e to cone and explain ~ sane of these things to him. John Fogerty who ran all the year round for his job would aske me to cane up· and meet him up in Providence and we would do what he called pub-crawling. We would make a bunch of bar~, he would meet the people there, they all kne:.w him and he say this is nw friend the great international psychiatrist Dr. Felix then he preceded to call me Bob and I'd call him John and you know they would say he is a gr~t guy this guy he knows all these big shots. This letter that I just showed you yesterday I quess fran this gal. What had happened John Fogerty, I find, as I look through this had asked me to see if I couldn't get her a fellowship. · She had the qualifications there was no stretching it, I got her a fellowship and I wrote John and said I have taken care of it for you. One mre chip he owed me. Nunber one then. build a constituency, number two maintain gocxi relations with Congress and personal relations with the key people. Now we ll3 BF(cont) developed a little arrangement with both Hill and Fogerty. Before we went up on the hill, I thiiik I told you·this before,·Fogerty for instance would call me up and say can you rreet rre for lunch over at the Rotunda the Botunda was a restaurant, not very far fran the capital up·on Capital Hill. I would go by his office and we would go over there and he would buy a drink or two and have a meal and we would talk about what I wanted to get through. He would listen, what kind of supi;:ort you got for that, I am going to have ·trouble with that, who can you bring in to testify. Now, · don't bring in that same old CX'eV"i God daron it, now get sanebody new, a big shot or I'd say I'd like to bring this in but I don't dare because I've been told by the Bureau of the Budget that 'r can't discuss it. Oh, he'd said the hell with it, well fine he said nCM :,lets see. Supi;:ose I ask you so and so what you you say? And I'd start no, I don't answer that way. He said answer so and so because if you do that I will cane back at you highly irritated and say you are not being resi;:onsive. I demand an answer. You look through the record and you will find time and again Fogerty has asked me a question of very gneral nature and I have given rum a veiled answer and he has cane back and said I have to remind you, you are talking to the Congress. You are required to be responsive, fully responsive, this is •• he bawl me out. 'Ihen I would crumble and be very cooperative. Bob, excuse rre again, I don't want to interupt you but 9.ail. you recall when it was when you first began to give your professional judgement budget under this kind of duress. BF No I can't. But it was in the '50.~s saneplace. EAR I'll check the record. BF But we developed this because since I couldn't talk about what I wanted to do it was either Fogerty, I think it started with Fogerty, maybe Hill. 114 EAR I'll check it. Yo~ go ahead. BF But, then in~ relation to Congress I found that if I could find sane way to relate to thein on a person to person basis, I.was better off. You heard the story about the· time I_ got the· extra rroney for epinephrine, studies of metabolism, epinephrine for the Senate. EAR Tell it. BF Well this was an interesting story. Seynour Kety had felt that we ought to knCM rrore about the metabolism of epinephrine. You know if you get epinephrine, for instance, injection for a tooth you get this quivery feeliI?.g. You feel scared without being scared. You have all the reactions of being scared. Or after a frightening experience that quive:ry feeling you have after it fran too much epinephrine. Seynour began to wonder what if this is broken davn inadequately or degraded only partially. Would this account for sane of what we call free floating anxiety, you have that same quive:ry feeling. It turned out this wasn't so but we had to chase. • it was one of the things that a negative finding was as good as a positive butw.e.:could forget about. We wanted I think it was a million a million and a half dollars for this purpose. Serre of it in grants and sane of it for:.intermural research. So I. • this was cleared that I could. • I wanted about -a million a millicn and a half and I think I was in for $250, 00 or sonething. And Fogerty, I mean Hill, asked me what was this about and I said I wanted to do this study. Senator Margaret Chase Smith, I believe it was, said Dr. what is this epinephrine. Well, I said Senator Smith it is excrete€:J:>y a little gland that sets one on the top of each kidney and it prepares animals, human and others, for f_ight or fl_ight. She said what do you mean fight· or flight·, I don't understand. Well, a th~ught came to me. Ok, here is my chance this is the· kind of thing I wait for. -~~~~:tme llS BF(cont) to tell you another· sto:r:y of another.kind about a time when Hill and I had an inter~ge. · I said well I th.ink the· best w~y to describe this, Senator, is to tell you an instant out of rqy life when I was a young boy. I said this is part of rqy .juvenile delinquent youth and maybe I will have Ir¥ security clearance ~ g away when· I tell you this but I said when I was a boy out in Kansas it was considered by all young mm,J.young fell~, kids that the n:ost delicious watennelons were those that were plucked in the dark of the m::>on out of sarebody's patch without their knowledge or oonsent. And !ester Hill said, off the record, you nean stealing watermelons? I said yes Senator, that.::is;.-exae:tr.~~what.I:.mean. Oh yes, he said, I remember when I was a boy and Senator Th.ye from Minnesota talked about sane of his escapades, Magnesonr- there were several of them there. And Senator Smith looked around and he said when they stole watennelons, I said south of town, this is a true incident~ I said south of tcwn right at the edge of our town was a little river, the Solanon River, you~ll find it on the map. You can throw a stone across it but the bridge went across it and right across the river on the south bank thei:e was a man named Willy Jones had a wate:rmelon patch, he grew these ccmnercially. So we figured he could afford one n0w and then. Now, I said there is one thing you should know about in my country. It was a I?Oint of honor that if you couldn't tell a ripe melon by thumping that was just tough but it was unsportsmen like to plug a melon, take a plug out, because the melon was ruined, if you didn't pick it. So you just well thump it. And they all talked about thumping melons and they would talk about it went thump, thump, not thump, thunp, off the record, but they were all getting their expert opinion on just what a ripe nelon thunped like. Obviously, I had than with rre.· So I said Willy didn't like this and Willy often watched his patch at night which made it nore challenging. He was always armed with a 116 BF(cont) shotgun. Not this sho_tgun was not loaded with buckshot. He would take the buckshot out and load it with little chunksof·bacon rind and rock salt, I said it would be the nost _agonizing thing if it hit you it would go right into your body and the sale would start to dissolve with the baoon rind. Oh yeah, they knew about bacon rind and rock salt. '!hey knew about this, I had them right with ine again. So I said the· four of us we crept into his patch and we thumped out nelons and we were just ready to pluck them when out in the skyline here jumped Willy we could see hi9 gun, alright boys, stay where you are and we broke and ran and we heard this gun go bang behind usand it happened he hit nobody. I said the next thing that was in my conscious merrory I was running across that bridge, I was outside that field. I said my feet seemecL.as -though they weren't even touching the ground, the wind was whistling by my ears, I was going like I never thought I could go. I said you have to remember that my father was the village doctor, he had been President of the School Board and was at that time Mayor of the tcmn. I was supJ;X)se to be the rrodel of good, law-b.j::ding, God-fearing, all-American boy, youth. Which was a hard role for any kind, and one I resented quite a bit. Oh, yeah, they knew about that too, so you knew. I remember the little son-of-a-bitch in_.m.v town and so forth. So, I said hON did I get out of that field? 'Ihis was a 3 strair~~ high barbed wired fence, I didn't have a snag or a cut on~- Did I jl.lrrq? it? I don't see how I could. Because the top stran was just about chest high. I don't think I can jurn that. I don't think I even in my wildest fright I would try to, but I got threw that sanehow. 'Ihe only way I could have done it was to hit the ground and rolled under it - cockle burrs and all. And I had cockle burrs on me. Now, I said Senator th.at was fµ.ght, that is what adrenalin did. Now su_plX)se that that adrenalin wouldn't rretabolize for sane reason, something was wrong with itw body, and this wouldn't break down to 117 BF(cont) rretanephron. I said can you ~ge the· .terrible anxious state. I said I'd just· stick to the· ceiling. Oh yes·,· she· understood· and others understood so I said that is, go back on the· record now, I said I have explained to you Io you understand? She said yes·, but she said rnctor can you do this for this small anount of rroney? I said no rnamm. She said what did you ask for originally? I said we asked for a million and a half. She said well if you had n:ore could you do better? And I said Senator, I have, this is what I have been authorized to ask for and I defend that budget in spirit and in letter. She said I know :coctor, but in your professional opinion could you use 5 million. I said easily Senator, easily, but I am not defending that, I am not asking for it. She said can you use 8 million. Yes, Senator, but under­ stand that you are pushmg rre into a position that I don't like, I am not asking for that • I am asking for $250,000. She said won't it take you a lot longer to get the answer? Oh yes, it will take us years longer, but we have to think about evei:yt:hing in the government. I am a good servant. I got 5 million dollars. The other sto:ry, which is the same sort of thing, when we were testifying, you might have even been there, in the Senate on the carmunity Mental Health Centers Act and we'd sat there for 3 days. I'd give the only testinony and I sat around all the time. Remember this sto:cy? FAR Go ahead, tell it. About the shadcw? BF Yes FAR It is going to be in there Bob. You don't have to tell that stio:ry. I think that was tops. BF lester Hill, or ne. FAR What was your ·first interaction with hi.in? r:o you recall the· first time you net rester· Hill? 118 BF The first time I really r ~ him well, there ~- .was during the Truman administration early in the Truman, it must have been Truman, Roosevelt must have been dead by then. There had been a member of the State Department staff defending a guy ~ Perifoy, who died later, who came out about how diligent they were in rooting out hanosexuals. And this gave McCarthy something to start on and Truman got tough and said he was going to through all the haro­ sexuals out of the government and so forth. And I was asked by Hill, who was . chairing a sub-ccmnittee then to care down and testify as to what hano-sexuals were, what we knew about it, how they got that way, what could you do about than, how dangerous were they. And I went dCMn and he also had George Raines from the Navy and sorrebody else. I gave a very. • I took Kinsey •• I did a lot of research •• I tried to do on all of these, you know if you can really deliver the goods they are going to ask you again. And the more they ask you the more they know you. The more they know you the more they are going to listen to you. The more they listen to you the better off you are. The better relations you have. And I gave a very frank discussion which I pointed out that the big fear in horcosexuality was because of the social stigma. They could be blackmailed. That•• and I told a story there about a harosexual that I had had when I was at the Coast Guard Academy, who cane to me and said that he was a hanosexual. He couldn't stand it, he was •• this was one of the cadets. In the morning they would get up and they would go into the shower and he said here are all these gorgeous, beautiful bodies of boys and he said one of these days I am going to make a pass I am going to p~t sanebody' s fanny or sanething. And I had: gone to the Admiral and the Admiral said well, let 1 s court marshal the bastard. And I said, sir, what would you do if you, a nonnal man as you are, were ?5S_igned to live in the SPA.R's ,:idonnitory, over hear, as far as the· wanen· coast guard, and every mo~g you 119 BF(cont) had to getup and shave and bathe· and do all the rest of.the· ~ g s you do in the n:oming with about 20 or 30,-2tl ~cL;25J$~oi~.:g~~zgirJls".:·runn.ing around naked'. He said I would go crazy. I said this poor devil is just like that except he is ttlllled around, he can't help it. The Admiral said, old Admiral Pine, he said, by God, I never thought of it that way. It is kind of tough. He said alright, we have to get him out. I said, sir, I would suggest that we find that his skills have no place in the service and we give him an honorable discharge, not a medical discharge because he can get a pension, honorable discharge, just discharge and that is what we did. I explained all this to Hill and Hill called ire back after.wards and he said Felix, you've made . it very 9lean but he.-1~aid,. damn. it, I can't use your test.inony. He said it is so plain spoken, he said the carmittee understands, I understand ·but you said ' things here that I don't think we ought to put in the reoord. I would like you to•. he said and he was apologetic, he said pardon the words, clean it up a little bit, he said your words are not offensive, but what you've said. So I went back and edited it but I said Senator if I do I am not going to change the thrust of what I am trying to say because this I feel is nw obligations, this is nw feeling nw professional feeling. Well he was impressed. He use to talk about that, how I really gave him the low-d.CMn on honosexuality so that he understood it but he understood it so well that he didn't dare say it. Then we came up ••he was interested in the Mental Health Act, he was not the Chairman. I have forgotten who was then. Then he became irritated at one time. 'Ihere was an old Senator from New Mexioo, Shabez, who had nore damn problans in his family. He had an alcoholic wife, and an alcoholic son and Shabez himself was not the nost~ast.ute guy. o He was a shre.wd politician but that is about all you can say and I was getting nervous because the· Chai:anan. of the overall carmittee was probably one of the "WOrst bastards I .~have ever known named· Kenneth McKeller, Tennessee. 120 BF (cont) And we were havi:n-g our troubles ••and what would happen· when McKeller would COite into these mee~gs, these ccmnittee·hea:rings,·he·woul~ go to sleep. He would wake up in the.middle of a sentence and he would swear that you said sarething you didn't say because he got the last half of the sentence. Then he would just chav you out and have it on the record that he was going to be sure that we didn't get an appropriation for that kind of a program. What he had gotten was the last half of the sentence. He was getting so senile that he would fall asleep. So I went to Hill and told him I was getting desperate al::out this and I thought that if this was the best we could do maybe I would do better going out to one of the states and doing sanething. And he told me he didn't recarmend that. He wanted me to stay ·and he would do what he a:ruld to help. So I developed a very close working relationship so rruch so that when the big crunch came with the second reorganization came I could go to him, it is written in the conference book. EAR Right. You had just finished talking about your relationship with Lester Hill and that he had urged you to stay. We are on now. And I had asked you about your early relationship with Hill but can we take a minute naw and round out this part of it. And have you talk about Mary Lasker and Mike Gorman and any one else that was also of importance in your relationship with Congress. BF My relationships with Mary Lasker were always friendly, saretimes wanner than others, someti.nes wann because of friendship, and sometimes wann because of anger. We got along, we got along because we had to get along. I don't knaw what she thought of me personally. She was terrihJ.i:~tient with me because I was •• I insisted from the beg~g on a balanced program. So that we were doing, particularly in the area of research, but she didn't mess around with anything like demonstration programs and carmunity services that was there and that was alright but that wasn't her bag, her cup of tea. But she couldn't see why we would waste our time on such things as psychological problems or 121 BF(oont) sociologic problems,·why' didn't we go down to the·ver:t guts of things the biochemistry of schizophrenia,_ get· into the· chemistry,_ genetics, physiology. She had little use for those parts·of our fields which she oouldn't taste, smell, feel, weight, otherwise materially analyze. On the basis that that is what you would have to cone back to eventually. And I resisted this. At tiltes, early one, she would invite me up to New York to her place on Beekman Street and she would have me for lunch and tell me about sare of this work and some good people, why didn't I get going with them. When this didn't work to well she put us, through her influence with Congress, and then with the Capital at the White House, got a series of people put on the Council, Ben May, Florence Mahoney, a gal­ I can't think of her name now that and each one of these people except Florence Mahoney I was able to convert before I got through. A gal from I.exington, Kentucky what was her nane? She was another one of her people, Mike Go:rman and so on. She always stayed in the background and worked through these people of she would try to influence the members of Congress to put pressure on me. And she would give them a list of questions to ask: me at hearings. And it just happened that because of sane of the friends I had I would get wind of these questions and be prepared for them. What I wanted to be careful about was not to pennit this program to be pressured so that it got off with a broad base into certain disiciplinary lines at the expense of others. I was ·perfectly willing to follow up leads. Now in rey effort to do this I pulled on bonor that was I didn't go gung-hoe for psycho­ phannacology as I should and they_-:-: never let roo forget that. And I never use the plea that your entitled to one bonor because your not entitled to one boner in this business. One bonor can be en~ugh to i.mdue you. But that was one that I did. Mike Go:r:man, as he went al~ng an~ gained m::mentum an~ gained prestige became and also nore success with dealing with inembers of Congress he· became rrore insistent that the· p:r:ogram go in certain ways. Now, Mike· was another guy 122 BF(oont) we had•• I think one of the reasons why' I think there was so much abrasion between· us we had many things in camon were inuch alike. He goes to the philosophy also do all the· favors for the other guy but don't CMe him any­ thing. He would write speeches· for Fogerty for Hill for others and give them to them to just. Mike would care out but also Mike, as I said once before, just yesterday, he was a ver:y, he is a very bright person he is a Phi Beta Kappa. This guy, you knCM he puts on this Irish bricklayer kind of front. This guy is a college graduate, journalism, good writer, Phi Beta Kappa, he can quote you Shakespeare just as easily as he can quote. you captain Billy's or something. He puts on thatfron~ because that sells. NCM, he would cane in well ahead of time when we were putting our budget together before it went to the Bureau of the Budget. The point being there that he and I would sit down and talk about where the program should go and he with some reluctance would agree that there should be a broad base program. He was not as adamant on this as Mary Lasker was. He was always known by me and he never said it himself because he wouldn't that he was can:ying out his orders although it would look as though he was his own man. He was really Mark Lasker's agent. So we would decide where the program should go, what kind of things should be stressed then we would build a budget around that. The first was down at the Bureau of the Budget it would go to the department first. It would be cut then we would came back.and all that we were suppose not to do this we would bring•• deal Mike in at every turn. So Mike would know where this was cut, where that was cut and where sanething else was cut. Then either Mike or I or both of us together would see that the Congress knew about this. So that in questi~g we woul~ get such questions as, ,what did you ask the department for? as oppose to what did you ask the.Bureau of the Bll:dget for? They would ••• this would all be: done ahead of time. What did you ask the department for? What did the department allow you? What did you enter the budget with? How 123 BF(cont) do you justify that cut? What did the· Bureau of the· Budget do and so on . dow.n the· line. Mike would•••Mike and I would also ••we had presented a front of solidarity. We weren't••we worked solidly together. We would be on panels together. The Cpuncil of Mental Health would have these conferences on mental health and we would be on the panel together. Well, that is about all I can say for Mike. Ok. lb you recall any particularly vivid instances in which either with Mary Lasker or Mike the sequence of events culminating in a budget defense or some change in program support occurred? BF Well I mentioned psychophannacology in which over••while I didn't feel it was the time to do it they did and the nnney was put in the budget and they were right and I was wrong. EAR The other one was the GP Program. BF The GP Program was another one. That's right. I am not sure that the way Mike wanted to do it has panned out to be the very -best way. I was interested in. I wanted to see this program:ievelop but I didn't want to see it develqp;~te that way.. EAR You were nnre in favor of it than·Veste was? BF Yes. EAR He was very much opposed to it. BF What I wanted , where I had my difference with Mike. I wanted to see a program developed in which people, doctors, physicians, pediatricians, and family practitioners and so forth could get sort of a continuing education course. They would care in for a nnnth or 2 or 3 weeks then go back but we wouldn't pull them out of their field. God kn<MS we needed obstetricians, and pediatricians, and family doctors we couldn't put thenf all in psychiatry. I didn't even believe 124 BF(cont) that all psychiatric problems had to be handled by· a psychiatrist. I don• t yet~ So, I felt that these people should be. given·enough training to take care of the problems that they· run into their office everyday. Mike felt that that was alright for a little bit but the big thing was to tum out a lot nore psychiatrists. Then of course she ran into a problem that the Jdnd of psychiatrist they wanted to tum out where not the same kind as I was thinking of anyhow. These were really guys who would prescribe pills and things like this which I felt was a lopsidedkind of psychiatrist. So, as I remember I was trying to think. I believe we wound up with a GP Program in which we had just about both kinds. EAR Right. .We·had two parts. OK I just wanted to get your. • • Now, you said you had gone over the budgets before hand in an infonna.l way with Mike. Where there any other people that had this kind of prior privledge. Was Frank Braclen for example? BF Frank Braclen because he was a member, a fo:r::ner member of the Council. We always went over it with the Medical Director of the APA and the Executive Secretary of the big APA. EAR Right. The Anerican Psychological. BF The American Psychological. EAR Alright, that takes us to the next major point then. '!hat is, you wanted to talk about this I believe, the relationships with the various professional associations. And I think you worked very hard at bringing them into the picture. :co you want to talk about them a little while. BF I felt and I still feel that the only way a program of th.is kind a:ml~ go fox.ward is if it stands finnly on the· 3 legs: the profession, the administrator of th~- government and the people ~ general. '!hat would be epitanized by":::the professional society, .the NIMH staff, the· Congress or-:the···NAMH/{~~-§~:__ • ~ .<Ji .... ,.. ... , 125 BF of this kind. Now, addressing myself to the professions part I felt that a program could be no better.than. the· degree:of excellence dananded by the professionals. And I felt that the professionals if they were really going to do their job shouldn't won:y about being politicians. Sane of them may be politically astute, we could use them, but we use them then in a political way not as ••but only a knowledgeable politician kind of way. '!hey should insist on excellence they should uncanprornisingly insist on excellence. 'Ihey should be pulled away from a position kicking and screaming. Because if they don't nobody will. 'Ibis is their cord of last resort. '!hey should constantly be alert to improverrents to changes. They should give only secondary consideration to political nuances of a situation that can be ironed out at another level using sane of them. But as organizations I felt and I still feel and I feel this way about the AMA and the American Psychiatric and others as organizations they shouldn't be political organizations and to the extent that they becane political organizations they are going to destroy themselves as scientific and academic societies. I just don't see how they can help it. So I maintained membership in these organizations or other members of our staff did. So that within our staff, I .don't know how many divisions:-",af . ±he APA, American Psychological were represented on our staff. There were a hell of a lot of them-fran school psychology to experimental psy., social psy, developren.tal psy;, clinical psy, you name it. '!he same thing was true. I was active in the psychoanalytic field but I was also active in psychiatry in the non-analytic type of psychiatry. But I felt that I was representing the second leg of the stool. The gµy to carcy out the laws. Now the fact that I knew~ technical professional requirarents would •• should be was good. I"t: gave me a bridge an~ gave me entJ:y into the professional societies where I worked hard but I worked hard to influence them. I tried to 126 BF interpret to them as much as I could what the realities of life were concerned. For instance, sure we have to have so and so·but the· time is not right to ask for that how, we have just asked. for so and so and we have just been turned down on so and so. Inn' t damn the Congressman because he didn't let. • he wouldn't sponsor so and so. This would have spoiled his political track work because he would have gotten turned down hard so he didn't do it. 'lhe same way with the so-called public societies, organizations such as the NAMH organizations of this kind. Organization ~of mayors, the county, organization ofcounty or sorrething. FAR State and territorial. BF No, no, I've worked with them to. But I worked with them as a fellCM professional governm:mt administrator. I sincerely believed this and I tried to practice what I believe. So that I never, ever let them forget that I was the government I don't mean it in an lordly way but look guys here is what I see as Director of NIMH here is what I think we_ have to have and here is why. Now, I need your support, you think that this is right, what do you think •• if I got a strong tum dam , no that is professionally unsound I might not agree with them. But I would ask and I would follCM that by maybe pulling back a little bit and then caning at them again. If you look at rey track record you will find damn few things that I really finnly felt that we should do that I ever gave up on. I might back down and then win again the next year but I knew-:-~ year-·one what I wanted to do. It was a matter and I knew about the order I wanted to do . it'. Well, I slapped a lot of backs and attended all the meetings and all of this. Drank alot with the boys and so forth. While I was deadly serious I knew where I was going all the time and I knew where I was. And anybody thinks that they can take a program like this play it sort of a half time job or a vacation is nuts. '!hey can't do it. 'Ibis is dead seriousbusiness and it is damn hard work and you have to love it to do it. 127 EAR You remaneber a few· key· people in the· r~rganizations that you were nost closely tied in with tied in with is a ~ng phrase but you ca:mrnmicated with••Frank Braclen. Frank Braclen, Jack Ewall and I were old friends. He was behind me a couple oc years in school I knav his first born so well she use to mind the telephones and I knew him. Of course. Frank Ebaught, Ed Strecker in the old days, and one of my dear dear friends·who was so inp::>rtant in the very early days has been dead for many years was Arthur Ruggles. He did so much to help us. With this older group I played a different role than I did" a few years later with Ruggles with with all of these I was a respectful younger colleague I was not a boy but a younger colleague. I didn't sir them I called them by their first name but I always I to them first because they eamed it they were good but it was Fa Strecker not Dr. Strecker and I would say yes sir and I would differ with him but I would differ with him in a restrained way th~~::;differ with Jack. Ewall which I would say your nuts. In the American Psycholtgical there people like Shake who was then ••• \o....~ %"-'v- 'Ihe same was true with nursing there were sane people there in the nursing ~viCJ 1 field. In nursing of course there were 2 groups, there was the hospital type institutional type nurse then there was the public health nurse interested in nental health. But we worked in social vJOrk as in psychology and in nursing through the people on our staff. Well I urged them to beccme active in the· organization and to take roles·. Milt Whitman, Warren Lamson, Handlin and all these guys and the sane was ·true with the· psychologist,"-::-:~ and Ruth Sirroneson·and these in the.nursing field which they did. I thought 128 BF(oont) this was much better they.could identify and then we would coordinate at the top level. It was the· same tiring with•.• in psychiatcy except by virtue of the fact that this was my field. I suppose I may have usufruct it so that other psychiatrists didn't have the· same break as if they had been psychologists or social workers but it•• I was interested I wanted to plead my own case with this group which I tried to do. EAR What did••you said that you used your very words just a rrarent ago. You usufruct the psychiatcy. What do you think if anything is the reason that in all of the, I think I am correct, in all of the psychiatrists in NIMH really you1'are the only one who held any really senior office in the American Psychiatric_ Association, certainly the only one who ever became President. 'Ihey've served on various carmittees but no one has ever really, at NIMH, been visible. BF I have sane ideas. I am not sure I was going to say I don't know oould it be because I usufruct it? Was it because, well you know, lets have the director not sanebody else? Now, dann it Eli if I am going to tell you the truth I think there is rrore than that to it. EAR Why don't you! BF But I, it sound so God damn oonceited, that I am not sure. I always felt that anong my own field-psychiatry- uniquely r seemed to understand or to me it seemed that I knew nore about the broad field about where we were going than any of the rest. '!his wasn't true in psychology or social work or nursing there were people who really knew it. But when I would go to the American Psychiatric and go on the oouncil and so forth I could talk with reasonable facility about clinic programs, hospital programs, research programs, training programs, under-graduate an~ graduate maybe it is because a lot of it grw · up through our efforts and I had:,:-lived with it. I don't know. And I was the::one person in the· psychiatric field with· continuity. Vest'was a trainer he didn't pretend to know anything about research.· Veste was nore interested in clinical 129 BF(cont) neurology than he·was clinical psychiatry as a clinician so he·was not a hot clinician in psychiatry. I was seeing patients all the time that I was Director. ,J EAR Curtis Sotherd ,J BF Curtis Sotherd. Curtis was a nice guy but Curtis didn't want any trouble. We had a guy, I can't remember what his nacre was, it wouldn't matter anyhow, who was a psychologist on his staff when he was Chief of the Ca:rmun.ity Services Branch and this guy was just not panning out•. He was in civil service and we felt that we wanted to rerrove him because he was occupying a slot and we needed the slot and he was not doing his job. I asked Curtis to write an evaluation on him, it had to be in by a certain deadline. Curtis put that in his outbox, went on vacation, didn't tell anybody so when they found that this thing was not done I had to write this evaluation and I was.not close enough. But saoobody had to write or it would be too late, he would get his permanent status. He challenged it on the basis that I was prejudice and I wasn't there and Dr. Sotherd had not told him anything like this. EAR Your not talking about Joe Ma!l;go?\ 1\ ~ BF That's the guy. That• s the guy, I had forgotten his nacre, I repressed that. ' I was furious about this because I took the heat and Joe Mar¢~finally left on his accord but he, which was alright, I didn't want to ~rsecute the guy but the idea was that if he hadn •t wanted to leave we were stuck. It was all becaase he ducked it. That told ne something about Curtis. And you go through the list, Jim I.c.Mery, when he was with us. Of course, he left us earlier, was a cxmnunity services man with a very sharp tongue who in many ways was his own ~rst enemy. He could say cutting ~gs. You take folks like Bill Holister·, Jim Osb~, and these people they" wer~ good. 130 EAR Huit BF Bob Huit I'd known and had so much hopes· for. Bob I'd known, we were together in Lexington years _ago. I remember when his boy was born, Don, or sorrething they fomd out he had a congenital heart. He was operated on while over at the clinical center'~ miraculous recovery, but all those years he lived with that. Bob didn't do the best job possible at Phoenix maybe we would have had sanething rrore pennanent otheJ:Wise, but we didn't. .And he just would not take initiative. He was the number 2 guy or number 3 guy and I tried to make sanething nore out of him because he is one of the old group that I thought I knew and could lean on. EAR Bob Stublefield was with you for awhile. BF Bob Stublefield. Bob Stublefield had many attributes but you always knav that Bob would rove sanewhere else before to long, or I felt we did and it is proved up to how.- Whether at Silver Hill he has found his final r haven he will go a long way to get nore noney that may hold him there, I don't know. EAR OK. I was going to ask you, I was going to say to get it on the record. But I think it is part of the picture. You had certain feelings of nursing which soIIEtimes came out during the discussion of the nursing training program you had some concems about nurses with Ph.D.' s who weren.~t going to be interested in can:ying bedpans anynore. Would you want to talk a minute or two about that? BF Well, you got it quite right. My feeling was that nursing, once they found out that there was a place for selective people, was striving to rrove out of the nursing field as nurses and going into administration. Which was leaving the field wide open for untrained people. That is why the LPN's developed like they did. And I made the crack one time and Ester:~,Qttinpf1lled me up short that it was getting so bad..nCM that when somebody said "Oh doctor cane quick", he didn't knav if you would get a M.D. with a stethoscope or a R.N. with a bedpan. And 131 BF{cont) her reply was r:octor you have it all ~ng, R.N. don't carry bedpans anyrrore we have other people do that for us. And I said that is exactly what I am talking about. I felt that, I could see where selected people who had admin­ istrative ability and all might very well go ahead and get graduate work in nurs:ing administration, nurs:ing teaching or what not. Because you needed these. But we needed nurses, trained, educated nurses to take care of patients, particularly in the psychiatric field. But there was no such thing anyrrore as a R.N. that is what they called the diploma school and this is said with a kmd of a tum of the lip, a diplana school, so and so hospital school of nursing. As opposed to a degree school and they would take pride, the school of nursing here at St. Louis takes pride on the fact, most of the girls they tum .ou~~.g(?_._.ipto administrative positions. '!hey don't turn out people that take care of patients, they use LPN's and people like that for that. And I think that in the end they are going to suffer because Gretchen's Law will apply here like anyplace else and people will buy the cheaper product because it is cheaper and they will find that there maybe less and less market for there expensive catalogue. EAR Ok, I did want to get that on the record because I remember so vividly your saying things. lets turn to one other group because you touched on this a m:i.ment ago and that is your relationship or the relationship at NIMH with various citizens groups :including the NAMH. What ~--yau..;want.to. say about . that. BF Well, there is not to much to say. I always maintained, tried to maintain close and wann relationships with the NAMH. '!hat was about that and their local groups. I knav somebody in all of the state associations, saneoody in key position. Might have been like in Michigan, Harold Webster who was the executive there when he· retired. he· asked me to 9ate up and give a paper. And I wound it up by saying there were 3 great Webster's, I had forgotten how I put it, Noah 132 BF (cont} who had the word, Daniel who had the law, and Harold who had the heart and canpassion. And that is when· he· retired. I don't know, I servecl on oorrmittees but I. .this was not~ central passion. I worked with thein. I always felt that they ·. could be stronger and but they were all we had so I get working with them. EAR Did you not include anyone fran those groups in this small nucleus of people who were kept infonred about budget develoµnents so they could testify before Congress or didn't that cane until n:n1ch later. BF It didn't cane until I1U1ch. later. In the early days when George Stevenson was there I used him. When Bill Malanud came along I used him. EAR But the strong people like Gerry Josephs and others who came along. BF Oh, Gerry Josephs I could use her because she was on our oouncil. EAR Right, but that was much later. OK, now turning one rrore time_,:-you have wqrked to some extent closely and I quess varingly with the three Surgeon Generals Parran, Shealy and Burney. Would you want totalk, you said a fe,, things already about Parran~ BF I came in under a.mmings, served under Parran, Shealy, Burney and Terry. Terry was Surgeon General when I went out. Infact, Terry signed ~ distinguised service medal. Well, you said a number of things about Parran and it is pretty clear what your relationship with him was. Is there anything else you want to say about the interaction between you the NIMH and Surgeon General Parran',:;that you would like to talk about? BF Parran gave me strong support. Parran was a shrewd. Parran came fran the eastern shore of Maryland theParrans are one of the great families of the eastern shore of Maryland. '!hey ~ great politicians they are still Pa:trans over there, good Irish family. He was a shrewd politician. He was a vecy 133 BF(cont) smart man. He had•• I used him to do a lc3f'ge account as a rrodel deal~g with Congress. Parran had aspects to his personality which I knew lurked there, that I was careful not to stimulate, which in his later years came out so unfortunately. Parran had a very cruel streak in him, which didn't show ordinarily. He was one of these people-you watch him. I can tell you 2 or 3 of them who talked, we talked about this,·~Lthink,_ at lunch. He talks with a soft voice, soft and gentle, watch him. Usually we talked about 2 t>e9ple we know, we were like this, one dead and one not dead. Parran was like this, he could take 2 or 3 drinks fine but then he would take one rrore and he becane cruel, very cruel. I've seen it happen several occasions, rrost uncomfortable. As he got older, after Carol, after his wife died he got to drinking more and rrore and he had a very unfortunately episode with Jm Crabtree , who was his ...who had been his Deputy Surgeon Ganeral,one of his deputy's at one ti.me and succeeded him as Dean of the School of Public Health and he just reputated him and it just broke Jim's heart. Jim died . I quess from cancer of the lung, he was really dyincjrwhen this thing happened. But Parran was the great man with great vision. He was a pragmatist but he was a real operator in the sense that he operated in the public good. He was followed by Shealy. Shealy was much nore politically oriented. Shealy was a strong person, but Shealy had a bigger feather on his atr?W so that he was more sensitive to wind. He would tend to veer. Shealy was, I shouldn't talk too much like that, he was the one under whan I was made Assistant Surgeon General. But he backed me strongly. When I first went out t<? _NIH-; was Director of the cancer Institute. Is that :r:ight? EAR I can check it. BF I am not sure.· When" I first went to Wa~gton he was Director of the Cancer 134 BF (cont) Institute because ~ renanber, no lets see, I renanber the· night we just found out he was going to be. made Surgeon General. We were at a party at Top Cottage, which has been. gone for years so that was before the clinical center was built. So maybe ... well anyhow Shealy and I got along very well he was follaved by Burney. Burney was not a strong person, Burney was a good health officer, he had been health officer in Indiana and sane other places. Burney was a stubbom person in many ways he combined two character­ istics which don't gQ tpgether well stubborn and timid. Maybe they do maybe you can afford to be stubbom if your timid because you don't stick your neck out to far. Had there been anybody else but Burney in at the time of..,:the second reorganization I might have lost. But I knew my man because I worked with him when he was a two stripper and I was a one and a half stripper out in Springfield. In fact, I did a little surgery on him one time he had a tranbosed hemorrhoid and I got him up on the table, ·:incised ,it, -._and got the clot out and easied him. That is when I could still wheel a knife without being to unsure of myself. I knew that if I could get a staterrent out of the Congress saneway I would block him for the tine being. I knew further that if I insisted that they have sane nore comnittees examined this he would go along with it. And if I could get 2 ccmnittees working on the sane tltlng they probably wouldn't come up with the sane answer and they would be working at cross purposes. I, had an old philosophy that F.dith Carper brings out in there if you have any worry about whether you are going to succeed with something get a comnittee and as long as you have the comnittee working you have tine to organize your defenses. And that worked beautifully here. Luther Ten.y, there is a story here that I don't know whether anybody has ever told or whether it should be told. When Burney was going out I was approached by sorre people on the.Hill who said that they wanted•• that they were pus~g me for Surgeon General. I said I really didn't 135 BF(cont) want it. Infact, when' I told P.eg what I had heard she' cried and said that was the last thing she wanted to see· me do. Mary Lasker was infuriated by this. She was pushing Jim Watt. And it never appeared on the surface but I would get reports from a neighbor of mine who was very active at the White House, who is now dead, incidentially. I lived over in Rock Creek Hills then, it was neck and neck and neck and neck. Finally, the support was sufficiently close that, was it Eisenhower EAR Yes BF Had said the hell with it. Either one of these people can get a significant majority support and neither J:im nor I had done any politicing ourselves but there had been all kinds of working at the White House. Lester Hill went to the President, who I thing was Eisenhower? EAR Yes, I am sure it was. And he said look we have to have a Surgeon General, things are hanging on and hangin on, you have an acting Surgeon General, now look either ori.e of these guys are .• roth are great rren I know them roth one is the Heart Institute one is Mental Health Institute I have known them for a long time either one would be fine but you are not getting anywhere. Now, we have a man in the Heart Institute who was narred franrrw father, a good boy fran the red.clay hills of Alabama, Luther Leonitis Ten:y. Who was brought into this v,i'Orld by Luther Leonitis Hill, Lester Hill's..father•. He is a good roy.:.we.never::had:·asAlab_qmian" in. l;l.ere.... :Lwould sure appreciate .it if you could do this •. Easy out, does a favor, old sto:ry .again, you owe me I don't owe you. He does a favor for a man of the opposite party, slides 3:'.ight through, Hill sees to that and Terry became S~geon General. Teny I'd known and I still~·know wannly and affectionately. Our lives have been. crossed in so many different ways. When rcw sister was dy~g in Baltim:>re, dying of cancer, on the seventh floor of the Marine Hospital, Ter.r.:y 136 BF(cont) was Chief of Medicine. And I will never forget, I'll never· f~rget the afternoon•• the·noming she·was dying, she.died that afternoon on 32I and I was .• she was my baby sister•. my only sister, she was the· baby sister of 3 or 4 years younger. We had just been like twins all the years growing up. And I was pretty broken up and Luther came up and we wa~ed out on the solarium, I remember he put his arm around Ir¥ shoulder and he said Bob I would like to ask you a question. Which would you prefer, to see your· sister in there dying, or to go out to Spring Grove State Hospital and see her as a deteriorated schizophrenic. And I said there is only one answer to that I'd much rather see her there. He said alright then use this constructively if you feel so strongly lets find the answer to cancer but lets find the answer to schizophrenia too. And it gave me a comfort. I remembered that. Later on he had sorre problems in his family and I helped him. So we had been good, dear friends but Luther Terry was no Surgeon General. As a matter of.-~fact, Shealy was strong, not as strong as Parran but you begin with Parran after him you,could see the deterioration of the Surgeon General, each one weaker than the one before. Until you get to EAR Stuart BF Yes, that is interestin g I was thinking of the last one and I had forgotten that Stuart was ever Surgeon General. Th.at' s right, he was Surgeon General he was kind of weak too. EAR Butalas was the one BF Yes, he was so emasculated when he took the job that he shouldn't have taken it. But under Ten:y, I had reached a point then whid1 was the sort of thing that you reach a certain plateau and you have it for a short time then things start . going down~ I was then, if you look at the blue book for the last year or two I was in the service I was in the top 10 ranking officers of the public 137 BF(cont) health service, seniority, on a linear list. I was the.Assistant Surgeon General. I was the government authority in mental health,· whether I was or not, :that is what I was recognized. I had reached the point where I could be as crusty and crotchety as I wanted to be and I could be as blunt as I wanted to be. As a matter of fact, I was senior enough that blmtness and crotchetyness, so long as I wasn't abusive, were looked upon as signs of · wisdom. It was the ancient talking and with all his backgromd. So I played this as part of iey- role. I would "hurump" and all like I told Jim Shannon . that I was shocked and grieved by his decision. I was sufficiently senior in my field that for a short ti.Ire, 2 or 3 years, I was, one of the last of the old school elder statesman still aromd. Now that sort of tiring works but when it is over it is all over and you••• that is why r·went into another area altogether. I knew this would happen, I knew this is what it would be so I would go into medical education. And I stayed away fran psychiatry as far as •• I would go to staff meetings, infact, I am a rrernber of the department, infact, I am a me:dtus Professor of Psychiatry and also hCMever, a meritus Professor of Ccmrnmity Medicine. I had been irore active inxh~ty medicine program that I had been in the psychiatry program. EAR OK, nCM that takes us because of the relationships with the various Surgeon Generals as nominal if not actual Chainnan of the National Advisory of Mental Health Council ••. I was starting .to talk about the relationship of the Surgeon Generals to the Council and if you look at the minutes of the·Comcil over the years the Surgeon Generals becon:e less and less visible at COmcil~..:meetings and the Council increasingly takes on a very interesting kind of character with you opening the meeting an~ giving introductory remarks and the Surgeon General, Surgeons General have gone. Parran was there for the early meetings, Shealy was there, Burney was there a oouple of tines and then their increasingly 138 EAR(cont) absent and you are, infact, not only the actual Chainnan but they are not even around. I'd like to ask you on the· fEM. remaining minutes· we have on this side of the· tape to taJk a little bit more about your relationship with -the Council. How did you see this group, how did you prepare for meetings, what was sane of the early highlight incidences in your mind. How did you really see them•• I know and yet I would like to ·-;_ge.t it fran you. BF One think that ought to be said, you mentioned this about the Surgeons General,. you have to renanber that there was a oontinu.al proliferation of Councils and that man, poor· devil, whoever was the SUrgeon General oould have spent all his tine going to Council meetings and had accorrplished nothing else if he had accorrplished anything there. He had to rely on these people. Now that didn't m:an that we didn't know if he wanted sane message carmunicated, that now and then he would come and spend a few minutes or to deliver sane, for instance, I think it was under Bumey he came and talked about the reorganization. As a ma.tter of fact there is one point that has never been brought out really yet - so far - I talked to the oouncilmen, they passed a resolution damning the reorganization which also had a very strong impact on Burney. ;The Council •• I made it a point without regard to who was appointed and as tirae~ent on it became nore political, nore politized, I made a point to try to know each manber of the Council personally to find sane ground on which I could relate to that person and then to oonvert them. And there were damn few occasions in which I didn't. Florence Mahoney was one, her head.• her mind was made up ahead of tiire I had no use trying for that. Mike Gorman was another one. '!hey were about the only two that cane into mind. Julius canrole was sure he didn't like us and I had him pretty well oonverted and then I'd forgotten what happened· :at sane council meeti:ng they voted sane grant of a good size in 139 BF(cont) sociology or social-psych.o~ogy and he was so disquistedhe·never came to another rreeting. He thought· it should all go for physiology or sanething. But r tried to knew first, as quickly as I could, either by going back to that hare camnmity and having somebody the regional office:.pe:thaps would help with this to tell me what this person liked and didn't like and how did he get on the council, what are their political connections if it was a political appointnent like Warsaw or sane of these. What were their soft spots so I would know them and I would be very careful to leam this and at first rooetings stay away from sensitive points if I possibly could and when I would make •• give a decision or make an opinion, renaer an opinion for the whole council I would really be talking to this person very frequently along the line that I though would convince them most that this was ahonest sincere effort that we might disagree on concepts this was not a bunch of crazy galoots. That was mmber one, number two every item on the agenda I was very careful to know quite well. You may renanber, that I would be briefed, there would be a week or two, I would be briefed everyday by somebody on what was caning up. On the grants lets say there would be that large group which we would take on block. Eve:i:y controversj:al grant we went over the pros and the cons, what happened if you do this, what happens if you do that, how do you want me to rule, if it canes to rule on this? I was alwasy careful that I kept nwself out of the picture until a vote was taken: I think twice mall the years I was on the Council there was an absolute tie and I had to vote. And I remember there was •• this was a big hilarious event, ha, ha, we srroked you out, you have to ccmnit yourself and I voted to break the tie m each case but that was the only two times I voted. But afte:twards I would either say I had a time keeping iey rrouth shut because I was affraid you were going to vote the. other·way and here is why I think this is_ good or when they 140 BF(cont) did sane~g that had to do with training one time psychoanalytic institutes, they were go~g to do sanething with than· and after· theypassedthe·vote I said you have made this recanmendation, I've asked. for your advice that's why you are here, I value your advice, I think that you are people who know what you are doing and I knCM you are honest and sincere, I think your wrong, I think your wrong as hell. I am going to follCM your advice and I will sincerely t:cy to make it work but I am going to tell you if you don't, believe me I am;-going to tell you. And in one instance I did and in one instance I didn't. '!hey were righter than I was once and I was righter than they were once. But I kept this kirid of a relationship, I tried to. I would, remember we use to••• after_ they had a happy hour maybe we would all go over there as many as would and we would sit around all evening and have a happy hour. I liked, if possilile, one evening to have an evening meeting. I liked it for two reasons: this gave me sane expansion tine so that I could use it for discussion in extension of some problem plus the fact there was an intamacy to meeting at night then we would drive them back to their hotel or rrotel whatever it was and we would have a chance for a drink and a chat again. It kept~ relationships.:up with them. I wanted to be very sure and I insisted that no ItEIIlber of the staff try to talk a member of the council into a position by pressuring him. If you had something to explain as for instance, it might be sanething in psychophanna:oology and Ewalt had said he wanted to get the whole story because he thought Gorman was too pushy and we would explain to him what we could. I enjoyed those council days, they were tiring we had every kind of experience frcm having an assaniation of a President in the middle of a council meeting to meetings in which we spent a good part of our time just zipping through with nothing of any conseqtience. EAR Bob, though,· you said and I am sure that you are too much of a realist to believe 141 EAR(cont) that the· staff always followed. this carpletely. '!hat when you just said that the staff was not suppose to··tJ::y to influence any of the· council members before the· fact. BF All I asked was that if they did they would be sure to insist that this was confidential and that the old man didn't like it. 'Ihat kept me clean. EAR OK. But did you yourself ever use any of them before the fact to alert them to sanethings that were ooming up that they could take a leading role in the discretion. So that you really••• BF But I did it•• what I did I would take a person who I knew where he stood already, I wasn't trying to influence him, this is going to carre out, so and so is going to say this and so and so is going to say this now, here is what we have to have if we are going to succeed and then they would take it frcm there. EAR Right. And the other source BF I've sat around with people EAR I'm son:y BF like Ewalt and Gonnan let us say and patched a whole strategy. EAR And the other source of influence as you well know saret.imes came fran council members being approached fran the outside by various grantees or others so that they came prirred to talk about sonethings one way or the other. BF _ Oh sure, this was obvious. FAR So it was an interesting kind of interpl~y of a,whole series of if not secret · agendas partially hidden ~gendas. BF But if a guy was approached by cl: grantee he damn well presented this o:e.ly as a _grantee tJ::ying to explain saoothing that wasn •t clear. Because we were all ·sufficiently jealous of the· fact that this was a peer review. EAR Right. 142 BF That it•• they weren't about to let themselves be influenced by another member of the council who" was being pushed fran ·the outside.· I was just thinking, ha, this award I got at Johns Hopkins,- .. when· I was inducted last week into the Johns Hopkins University Society of Scholars. The citation said that among other things I was being cited was establishing a peer review system in mental health which was a evanescent view, they thought it was so difficult but I established a successful and working , workable peer review syste:n in research and training in nental health. EAR Well, I think and this will cane out in the book I think one of the most irrq;,ortant side effects of everything we did both in terms of the interplay at council rreetings and the interplay at the various meetings of the various study sections and training comnittees was the nation wide network of carmunication that we established about what was going on in the field of mental health by the review of grants at the study section and training:.·.conmunity level by the review of policy at the oouncil meeting. You were constantly educating these people to a perspective that was never available before that time so that this really served as a means whereby we greatly facilitated the entire inter-relationship of the field through the study section meeting 3 times a year, council meetings 3 ~s a year. BF And people rotating off. Before long you were getting a larger and larger coterie of sophisticated people. They knew what good research design was because they sat there hour after hour and looked at good and bad research or training. They knew what good training was and bad training was and as this became greater and greater we had rrore good applications. The decisions of it became harder and harder. EAR No, I think it has not been sufficiently discussed or sufficiently emphasized 143 EAR(cont) that the peer reviav system and the·use of cotmcil..consultants was a terribly, terribly .inportant way, not only of adding that kind of scientific prospective in judgem:mt, but of welding the entire field. BF And in a way, Eli, what nw plan was and I hoped it worked it was kind of a non-directive therapy. We didn't say you've got to do this or it is bad. As they saw what their peers fran all over the cotmty thought of certain kinds of projects and certain kinds of designs they began to get the idea what was good and bad. 'Ihey leamed together and I think this is terribly .inportant. EAR Well the Cotmcil as I started to say a rroment ago if you read the minutes it is interesting how the cotmcil really developed a character of its avn the three day sequence of events that you chaired so well. I want to say it was alnost like theatre, I don't m:an that in negative sense I m:an.that in a very positive sense that is it was dramatic there were three acts sort to speak, you knew how the opening went. There was a plot to it. I really think it was a very .inportant, a very .inportant phenomenon in the totality of the Institute histo:cy_and I think again it is a unique aspect of your initial. BF There was another thing that we talked about yesterday and I didn't say one thing that I :rrent to say. EAR Please do. BF But a thread ran through here, talking about training grants. You know when we go to, ,: who was the guy, Fotmta.in he carplained aitDng other tirings about the mild distribution of grants. Now, nw concept was that the grants had•. there were certain grants that you would make out of largesse. But otl)ers were an expolitation of a asset and you had to keep both go~g. If you had an excellent program yo~ gave thenf rrore ironey so that they· could take rrore students without canpranising their offering. If you had a program that was 144 BF(cont) not so good you would build it up, others were the largesse part where you would create them· where the:Y° presently weren't. This is what Fountain wanted to get this spread around. Although Fountain's reason and nw reason were quite different. Fountain thought that every state ought to get there share and what I thought was that there ought to be educational opportunities available in as many parts of the country as possible because I was convinced that alurmi, by and large, the great porportiori stayed within a finite radius say 2 or 300 miles of their alma-mater. And whenever you had a nucleus like that, with the exceptions of certain trans-boundery places like Harvard or maybe Columbia or maybe Stanford, with the exception of a feM like that, people stayed closed to alma-mater. I think though to say a few nore words about the nature of the council.meetings again, it is a interesting contrast between you style and Stan-._.:? That, and I think it is also what we said before, partially a function of the organic growth of the entire Institute. And Institutions came a point where there were just too many people to attend council rreetings whereas early in·':the day you introduced every new member of the NIMH. I remember in 1958 when I was introduced to Council as the Program Analyst caning to the training 1:>ranch. rater on people could never attend council meetings where as early every professional member had his day in the sun and all of-us had a chance to get up and talk to the council members. It was a tremendously important part of the year to be able to. get :t:JP before a conncil meeting and say something about what you did. And you alway~ had that chance early in the day. And that is the way you did it. Stan of course was totally different. BF , Ev.en.if it had been a smaller group, Stan, didn't quite see it as a important function. I felt and I still feel' that there is a size beyond which a organization 145 BF(cont) begins to cane apart. '!hat you have a optimum size and then you have a naximum size and after.that it ~ins to break in two and the optimum size is the size in which all of the key people can participate. And I felt and· I kept pushing each fellow you got your program, your responsible for it, you get·the credit for it or by the· same token you get the criticism but it is your show. All I ask is that you keep this dove tailed in with others so that we don't have a whole lot of little cells vibrating independently. But it is your cell and it lives or dies by what you do. Stan ran a different kind of shav. Burt runs a entirely different kind of shav. Burt is politically completely politically organized, oriented and sensitized. And if it'.is not what the politics want that doesn't happen. And I think if anything••• if I proved anything and I don't know I did. I proved that you can participate•. you have participation by your staff so everybody gets their share of what is going en without being yourself in the shadav. I think that Burt particularly, but certainly Stan, who is different act, guy from either one of the other two of us, was always affraid of being over-shadowed. I can think of sane of the reasons for this in his personal family where this might be, I don't know. But I never felt that because Veste was "Mr, Training" that I was any the less the Director of NIMH in the eyes of the public. I really didn't care too much, I cared, of course, I wanted to be recognized I mean that is a nonnal drive but I wanted to be sure that Veste was "Ml:. Training", Everhart was "Mr. Research Grants 11 , I tried to do the sane thing with Sotherd. EAR It didn't quite happen. BF It didn't quite happen. As a matter of fact, I finally attacked that one some­ what differently. I really decentralized that to the regions·and that I had to reach his report to me while he·was there and they reported to him they still knew where papa was. I was •• 146 I think you still haven't tole the ccmpJ.ete stocy though, Bob, while we are talking about you and Stan and Burt as to hCM the decision was finally made and your part in it for Stan to becane your successor? '!here must have been other people involved. I knCM Jack Ewal names was mentioned at one time as a possibility fran the outside. Is there anything you care to say about that? BF Oh, you mean when I. .oh, yes. Oh, well I was not a party 1:o this, I know about some of this but I was not a party to sane of it. I refused to be a party to it. I think as a matter of general principle there is nothing worse than having a person who is leaving a job designate his successor. 'Ibis perpetuates •• this is real in-breeding. '!his perpetuates all of the bad genes as well as II@.Ybe sane of the good genes but sanetimes the bad genes outweight the good genes. So when I left I was asked for~ suggestion and I said that I thought that Stan was quite c:x:npetent to do the job. I pointed out who was Surgeon General,Teny, and I also talked to Shannon. I pointed out that nobody was perfect. That if they were picking me for the job nCM, they would find that I didn't qualify either. That Stan was a loner carpared to me. Stan was not a good mixer. Stan had a paranoid streak in him which sanetime detennined his actions in a way you didn't like. Stan was not a good o:mnunicator. Stan was one of the best darm organizers you ever saw. He had a good concept of the program, you would have a good tight nmed ship but they wouldn I t bleed and die for him. And that you would begin to find people sluf off but you would find that anyhCM. Shannon said well I think we want sane big name fran the outside. He said you have gotten a big naire over the years and nCM we need a big name. So they wanted to knCM who sane of the people were. And I said look, I won't do it th.at way. If you want to ask me whether a certain naire would be a good person if you could get him I will tell you that but I won't naninate anybody. So they went to Barton, and I believe they asked him if he would take the job and he said no! They asked h:un to cane up with a slate and 147 BF(cont) I don't know who all they asked. I know Jack Ewal because Jack told me so. I know Jx>ug Bond because Jx>ug~said they would have to make it 50,000 instead of 25,000, no way 'WOuld he do it. And I don't know who else they asked. EAR Bob Stublefield was not in the running at that time. He had gotten sanewhat visible but not enough, ha? BF No, don't think so. EAR OK. I do want to find out•• I think ••• BF I had forgotten about that. Now I'll tell you something that I had forgotten. I went on and on and they would see this one and that one and nothing would happen. Mike would call me on the phone or write, no he never wrote me, he never put in in writing. He always called me and said look our boy Stan is not goimg to get there he is going to get another job, you better do something. Arid finally, Doug had turned him down, Doug Bond, Jack Ebaugh had turned him down and I don't know who else. There seemed to me there was someone else they'd asked and I'd forgotten who it was. Well, EAR Mil Sreenblight? BF I don't thing Mil Greenblight was asked. Walter Barton was I believe and somebody else. EAR Not Dan he was too old by then. BF No, Dan wasn't brought it. Mike called me Mike Gorman called me and said will you get in touch with Lester and tell Lester you thing this is the guy and that you really support him because if you do Lister has said that he is waiting for an endorsement from you and he will move. I had no reason to fell than Stan wouldn't be a good person, I am not sure that even yet that he wasn't a good person. He did something that I think I wouldn't have done at all, I would never have gone for a separate bureau. 148 BF(cont) Everybody said that I was movi~g in that direction. I was not I was moving to keep it together but not to make a separate bureau. The minute they moved ••• let me_ go back I'll tell you. I called Lester Hill and told him that I would unequivocally support Stan. He said fine thats the way you feel, we would take it from there and Stan was appointed. Stan began to move toward a separate bureau and I cautioned against it. I said you are too damn vunerable. As one of the Institutes of the National Institutes of Health you have built in strengths and mutual support. I said the same thing when I heard they were going to do it to cancer and if they had done it to cancer, cancer would have fallen too. What happened to NIMH, it grew and grew and finally gnew out of its place in the constellation or forced its way out. Then it set out here by itself. And it grew and grew and began to break apart. Now, we'd had two break offs while I was there and I could see what would happen if we got too big. We had neurology coming off. and we had Kety's Institute, both split off from us. And I could see where this was going in the way of alcohol and drug addiction, probably criminology and I don't know where from there. So, I suggested that they concentrate on keeping this together and part of NIH so you could interchange. They didn't do it. As soon as this happened then they let it run for a short time until it was gone to the point that they were no longer getting any kind of built in support from NIH. Then they moved in and they split it three ways, at least the alcohol;!drug addiction and mental health.· EAR Bob, of course you know that happened even bef<5re with the so called 149 EAR{cont) which was a previous arra~gement. BF Thats right. Thats right. And the fact I __:think that shows they could have played it differently if they had started ·diff·ereritly they never were able to_ get rid of the mental health name. At the NIMH now is not was the NIMH was. EAR No, no thats true. OK, so I'll have to pursue further because I think there is some interesting stories about how Stan finally got the job. And I am sure he was trying very hard to get it himself. BF I understand afterwards, that he was campaigning. I dodn't know. You see, I deliberately, when I was getting ready to retire, and I knew that I had to go and this was hard enough. I knew that I was going to have to get very far away, so far away that it would take me a good part of a day to get back unless I flew. They wanted me to take the Deanship of the new medical school at the University of Connecticut. I turned that down, that was too close. It was at Hartford. They wanted me to take over Butler Hospital in Providence and they wanted me to take over the Deanship of the new medical school set up at the University of Rhode Island, not University of Rhode Island but Brown. And I went,up aand looked at that. Well, that was a depressing place. I had had some work their earlie~, as I told you yesterday, and I knew Providence pretty well. But someone said well, to but it kindly said one person, Providence matured a long time ago, and it sure has. So here came this job way out west, I could be so far away that they ••• I wouldn't hear too much about it. This is the only way I could tolerate it. Had I been back there ·r might have ·said somethi~g that m~ght have 150 BF (cont) unpopular. I had to_ get away ·:ftortt·~-it. EAR Well, I had a final question here which ·I was goi~g to save for the very, very erid Bob btit you· have just_ given· me ·a perfect entre for it so let me bring it in now and that is. If, it is one of these "iffy" questions, If yo:µ had to do it all over again what are some of the things you think you might have done differently? What are you proudest of? And what do you feel is your greatest dis­ appointment? BF I'm proudest, I belive, of developing a peersreview system or having a role to play in a peer review system in a very evanescent kind of a field like mental health which is so multi-discipline. Which worked, through ·which I brought together, I say "I" as I did it, the role I played, whatever it was. People from a variety of disciplin~ some of them rather desparate, because there is· not" a hell of a:::-~lot in common between a cultural anthropologist and a cell biologist. And yet they worked together, and they worked together for a common purpose. That is my proudest thing. My greatest failure, was in not getting the mental health center's program off the ground better before I left. And now they are talking about it as though it is demonstration. That was never intended as a demonstration, it was never defended as a demonstration. EAR Right, that's true. BF I don't know whether I can take any blame for it or not but I have a feeling of sadness and defeat over what's happened to NIMH. I don't know whether Brown, Bert Brown has just accepted the inevitable because that is better than nothing or whether it could have been prevented somewhat, I don't know. I don't know. But I thi~~ there 151 BF(cont) was a_ grave mistake made whrie we pulled it out of NIH. EAR Are there any things you think, ~gain, one ·of these· :ques·tions th~t are very difficult to answe~ but at least you get a little of your thinking on it. Is there anything that you would have done differently? You say that we in the mental health centers program a disappointment. What are some of the things that you might have done differently now in that respect, other than that? Does anything come to mind. If it is to "iffy" don't bother. BF I can't, you see this is a hell of a thing to ask a guy. If I say nothing that means that I did everything just as I intended it and I don't mean that I just ••• nothing comes to mind now that is major significance. I had a program laid out and I tried to follow it. I don't know if I had to do it over again what I would do different! EAR Don't struggle with it, Bob. I thought maybe if it stimulated something fine, if not, not. What I would suggest is that we stop at this point and give you a chance to relax. I would like to come back after we meet again after your meeting or whenever we can get back again. Talk a little bit more about the joint commission because in a real sense that is the precursor to the community mental health centers l~gisiation in avvery interesting kind of way. And how the joint commission got started? What some of the problems were? The discussions that took place when the report was finally written and some of that background information. And then after that I have a whole series of very specific questions on a whole host of things. 152 BF You know what the very seminole idea was from which the joint commission came about was Kenneth ·Apple's Presidential address. And if you have a book · In Directions in American Psychiatry'T940- 1968, those are the Presidential addresses and the biographies of the Presidents up to and through Brosin in the second century. EAR I'll have to get a copy of that BF And in this you will find Apple's and Apple's presentation contains the recommendation for a new study. Change of concepts of nature,. it was one of the greatest statesmenlike presidential addresses. I can say because mine was rather:;pedistrian·, I think. EAR Yours was the greatss.tethoscope speech. BF That's right. He talked about a second Flexner report here some­ place. You'll have to read it, I don't know where •• EAR Ok, I'll find it. BF But if you'll ge the APA, should still have it, it was sold by the APA. This is a cornmerative volume on the 125th. anniversary of the American Pjychiatric Association and you will find Kenneth Apple's address. It is on page, begins on page 129 of that. EAR OK, I'll get it verygood. That is how it all started?'54-'53? BF~ '53-'54. It was in '54. He was President in '53-'54. This incidentially is an interesting book if you want to know something because you will be interested in how m~ch NIMH played a role they play from Strecker on, 1944 he was President and it is a tremendously interesting volume. It started there and then it sort of germinated for awhile, justated~~:~·for·while and then Dan Blain pikced it up and got a joint resolution introduced into Congress to set up this joint commission. After we had ••• I wasn't sure that that was 153 BF(cont) the best way to_ go about it, as it turned out, it_ game out alright but I wasn't to sure that that was where the money should be spent but that is what they were going to do and that is what they did. But the way it was set up it was decided that this would be administered by the NIMH and that there would be one grant made, it coulbe be to a consortium of organizations not necessarily one organization but one grant, they weren't going to make it a lot of little grants, one major grant. And on the basis of this they organized the joint commission on mental illness and health as a corporation. Some interesting things happened there. Organized moved in with big clout and they damn near wrecked it. The American Medical Association they had to have five votes out of whatever the total number was and the American Psychiatric had to haye five\:"Votes. That was 10 votes out of a total of 25 or something like that. Then the American Psychological, which is as •• was twice as big as the American Psychiatric got one vote, I think maybe two. EAR Yes, right. BF And other organizations similiar. This created a lot of bitterness. Then they set up an Executive Committee such that the majority vote was the AMA and the APA voted together could out vote every­ body, if they voted in a solid block. Then they got Jack Ebaugh, which was a good thing because Jack is nobodys creature. He is Jack Ebaugh's creature. And I don't always go along with these ideas but I respect him for his independence and he is a brilliant guy. He set up the study. Well, as it went along Jack would come down to see me from time to time and finally Jack gave me a 154 BF{cont) draft of the final report the •• what was it called? EAR Action for Mental Health.· BF Action for Mental Health. And I read that and I began to realize what they were going to recommend. This was the old State Hospital thing again, just a perpetuation of that. Give us enough money so we can hire enough people and will gettthem well in the l}ospital and we will take care of the rest after that but lets not worry about the rest of the stuff until we take care of the hospitals •. And I knew, I'd learned long since that that won't work. That is just not the way to go about:it. I went down to see Rufus Miles and I showed him what the problem was and I said when this thing comes in, Congress is going to ask us for our •• this will go to the Congress I believe they were the prime •• they ordered it, copies to the Secretary, to the President and so forth but it was addressed to the Congress of the United States. We are going to be asked for our reaction. I said I think somebody ought to get to Kennedy and point out that we have a position, I think we better settle on what our position is and move there. I told him that I thought this was a great opportunity to really bring the community into it. And do you ever stop to realize, Eli, that I believe this was almost the first program that was community oriented like the HMO's and all the rest of them. We were back there in 19 whatever that year. EAR 1961. BF 1961 before all of this other started. And I can still see us. We were sitting in my office in building 31, I remember that coffee table there in the corner, talking about how to do this. Rufus had stopped by on his way downtown in the morning. Rufus was 155 BF(cont) interested in mental health. His wife had been an officer in the Montgomery County Mental Health ·Association. And Rufus was quite interested. So we werit. he and I went together to see Fulsome, who was secretary, Fulsume caught it very quickly he. was a sharp. Come in •••••••.•.•••• Well as I said before we were interupted, we went to see Fulsume and I had pointed out that I felt that the data which was the back up material for the final volume were good. The work of Maria Hodor and I've forgotten who else. EAR George Albie. BF GEorge Albie and all these. This was good. It was all that we could have had, we could have used more if we could have gotten it, but it was exactly what we wanted to back up our position. But we were never going to get anywhere if we just continued to take care of the patients in the hospitals. No matter how well we did it. We had to do something else. And I pointed out that I thought that with the advent of some of the new drugs and things that were coming along, we were going to see some changes. So apparently he . got to the President and the President appointed a committee made up of Secretary of HEW Chairman, Secretary of Labor, Administrator of Veteran Affairs, somebody from the Council of Economic Advisors, and the Bureau of the Budget. I think those were the ones. Now it was interesting who the Secretary of Labor sent his Assistant Secretary, Pat Monahan. EAR Do you know that Stan is asking about that and he says he doesn't remember it. BF Oh, my God. I remember Pat so well for there and I have run into 156 BF (cont) him since. He_ got an honorary deg·ree liere ·a couple ••• three years ago and I had a nice :1ong talk with him. Of course,· he is now going to be ·our Ambassador to the U.N. Pat Monahan, EAR Rashe Fine BF Rashe Fine for the Council of Economic Advisors, that guy that had a stammer from the Bureau of the Budget. Oh, God,:I can see his face. He was a fellow interested in mental health. He was a conservative, as they all had to be at the Bureau of the Budget but he wasn't, but he wasn't bad. Then when you got him away from his clan he was particularly good. What the devil was that guys name? EAR You don't mean the young Bob Atwell? BF Oh, no, no, no. Bob Atwell was on our staff by then. No he wasn't, he came with us later. Bob Atwell was working with us. ~hat was not this guy •• he was an older person, quite a bit older. EAR You don':t mean Mike March? BF March, Mike March he didn't stammer another guy •• or did he stammer? EAR I don't know. BF No, it was another guy who stammered, Mike March he was the guy. And I have forgotten who represented the V.A. now. EAR I don't remember either and Stan can't remember. And of course, it was Bofalete Jones •••• EAR Bo Jones from our place and Rufus chaired it for. I don't know why Rufus was there but he was there in all of these. And we before this somewhere and I think maybe at home I have it somewhere if I know where. You probably have them. Where in the devil it would be I don't know. 157 EAR What are you referring to? BF Position paper. EAR Yes, I have one.· BF I don't know where it is? EAR On the joint commission. BF Yeah, I remember seeing that sometime in the last year. It was a fairly good size volume. EAR I left it home, I have it. BF Well, it is about so thick. About a inch and a half to two inches thicko EAR Right, I have it. BF Position paper we wrote and that is where we took off. We beted this back and forth and again this is one of those things where we talk about the crossroads of fate:; The people selected for that committee was just the right people and I don't think this was premediated because I don't think anybody had enough idea other than some of us at NIMH where we were going. But Rufus knew what we were talking about. Pat Monahan caught it right now, he is human being oriented. March, Mike March knew and we went through this group and I can't think who was in ':.the V.A. Now I know but I can't tell you his name. No, wonder because, I'm glad I can't think-of his name, I wouldn't want it on the record. He is a guy, the kind of pimply faced and just always faded into the woodwork. EAR Yeah, Stan can't even remember. Well, I know who he is now and I have seen him around there every once in awhile. But he just sort of fades in the woodwork. He kept his mouth shut and didn't say much. And we. gradually evolved 158 BF (cont) out of that the ·report to the :Pres·ident which he bought and then I don't know who, by this time Mike Feldman was over in the White House, was one of the counselors to the Pres'ide:fit. And he was delighted with ·this report and he ·was the one ·that we dealt with. I use to_ go over to his office at the White House, talk about this and he wrote the President's message on mental health. The first Presidential message on mental health. That's it, that's it, that's it, this is it - The National Institute of Mental Health, Position Paper on the report of the Joint Commission on Mental Health and Illness. God ••• EAR Carries you back. BF It not only carries me back but I have that strange feeling of a father who sees one of his children years later, when the child did pretty well and you think maybe all that sweat and worry about rearing it wasn't so bad. That is a good document, Eli, it is a good document still. "Prevention should be given the highest priority in this effort'!says ou:t President, on page 9. I am not going to read it through. EAR Ok, you should, I'll just refresh your memory since you mentioned Mike March is a positive way. I want you to know that for quite some time Mike March was the bane of my existence; because I had to come up with all those manpower2 figures between systems that they had ••••• BF Oh, Mike was not a unmixed blessing. EAR No, he was the_ guy who scuttled Jim Forres:tof, you know that was his famous, famous, background, that he had been the bu~get officer when Forres·tol first bec'ame ·the 'Department of Defense head, the 159 EAR (cont) first Department of Defense head. And Mike March made his name by makin.g Forrestol back ·down on· his first budget. So he was a tough ·cookie. BF Oh he was a tough ·cookie.· He was a cold-blooded cookie. We made one convert out of that who came with us and that was Emory Fairbe. EAR Yes right and Bob Atwell. BF And Bob Atwell too. Yes Bob was working with us on that. EAR Those were interesting times. BF Those were interesting times. EAR I wish we had some of the minutes of those meetings with Bo Jones. And of course isn't that the time though when you gave Stan some responsibilities for coordinating all the task forces and Bert Brown came and we were all working like mad •. BF This was what year '60? EAR Well this was '62 and through early '63. Because the President's message was on February 5, '63. So it was really late'61 and early '62. BF When was the reorganization of the Public Health Service? EAR 1960 was the Huntley Report. BF Well I thougtso because theEe is something sticking in my mind and I can't get it sorted out chronologically. But there comes to me a deshavou. I have just experienced just now a feeling when you talked about these meetings that I had so often and that was I was there and I was fighting hard but I was already dis­ engaging. I knew that I was going and I did leave within::· 18 months. I hadn't said anything to anybody except Peg and I 160 BF(cont) talked it over and we knew that now. the ·time had come and that I wasn I t . going to ••• this was my last big effort and I was affraid that it might be scuttled by the Public Health Service because of their feeling over the reorganization b:ecause ·this strengthened my position. EAR Right. BF Am I am not sure that I got a great deal of tcemendous support from the Public Health Service on this. I remember mobilizing all our resources from the outside and I knew one damn thing I had to do was get the joint commission people behind me. And I had gone counter to them. So I got a hold of Jack and I put it on a pragmatic basis, Jack- a great idea, this is fine, but God damn it, rub that out, dog-done-it - it won't work, not now! We have to come up with some package, they've got to have a new mouse trap and here is what we can do. He bought it. I said we can talk about this but this other has to. go along to. We got him and we swung over 2 or 3 of the others and then I knew since we had those and we got Mike sold we could move right from there to the White House and it didn't matter what said. Because I had the public health service boxed. Bo Jones an~ Rufus Miles both agreed. Wilbur Cohen was in this picture somewhere. Because I went down and talked to Wilbus in his office one time. Was he under-secretary at that time? EAR I think he was, yes. BF He was around there because I remember goi~g down and talki~g to Wilbus and he ·got it •• he. ·got the ·idea. I was :just as busy as I could be doing my ••• going from door to door. But the feeling of deshavou came from the fact that all brings back that feeling of sadness that 161 Bf (cont) you can't know unles·s you've done ·it. I had it •• the most acute form the day I said good;,...bye ·and walked out of that office. But it was coming then. Here I was still working and this was going on. I remember a funny thought I use ·to have, how does one feel, this is morbid but, how does one feel when one is going to die and they realize that today all these people moving around tomorrow they won't exist because I won-~t exist and the whole wor~d exists because of me. Therefore, they wri>n~'-tbe here ••• yet they will be here, yeah, you know. And I thought it is the same thing, here I am working with this, very soon I will not be here, how can it_ go on! I mean I gave ·it birth I brought it ••• how can it go on? That is when I realized that I had to get far away or I wouldn't be able to keep my hands of off it. It was hard enough far away because I would have people call me, do you kn9w so and so is happening, do you know such and sue~ went on at the NIMH, what are you going to do about it? I was asked by Congressmen so and so, what does Felix think of this? And I remember I use to say "just figure Felix is dead." I said if I were taking that job and my predecessor came in with hid dead hand trying to steer me I would be so furious I .would tell him to either give it to him or give it·to me but don't give it to both of us. I said the man they have is competent, capable, he doesn't do it my way just like the new Dean down here at the Medical School, 39 years old. I left at 70 he is 39 now God knows he has ideas that I don't have. He is bright he is capable. He is just a m~gnificent_ guy, a kid, my God he could be my_ grandson. 39,49,59,69 he is 32 years younger than I am right now at 71. I stayed away, I don't even go down there. I wasn '~t going to go this BF(cont) meeti~g today. It is_ goi~g to be at the Student Union so I can do that but I wouldn't have_ ·gone ·to the Medical Scho'ol. This is the same way I fel·t about this· and this is why I am having so much trouble, Eli, with some ·of this I am telling you. I have some strong fee·li~gs. EAR Sure, sure BF But I am the old goat that they didn't do it just my way and damn it that doesn't mean that they didn't do it better and I am just . .not going to let mr old "fuddy-duddy" biases creep into any kind of an oral history. I don't think it is right. Come in •••.• EAR Ok, we want to finish the side. I am sure that when I get home or later on I am going to want to come back and see you ·again. BF Love to have you. EAR But I think this has been fantastic and I am sure it is going to be very useful. OK these really are •• there is norhyme or reason in the sequence except that they are chronoligical from the stand point of material that I picked out of the council minutes that I had. In the first council meeting a technical library "was.to be developed to be the outstanding psychiatric library not only in this country but in the world" to the best of my knowledge we never did that did we? BF We started it, as a matter of fact I did some interesting things. Some where I got a hold of •• where was •• somebodies library or something and I_ got as nearly a complete file that I could_ get of the American Journal of.Psychiatry and its predecessor The · American Journal of Insanity from July 1, 1844. Yes, we had a library, where did we have ·that, downtown we had it someplace. 163 BF(cont) We had it someplace ·in T-6. I. don't remember where we had it. EAR But it didn't_ get to be.· •• BF No, what we ·finally did. We had a very significant library. We had the beginnings of it. Someone, Sam Wortis or John Whitehorn or someone had saia it was the most well rounded nuclear library in mental health that they knew of. When we went to NIH moved out we kept this for ourselves someplace. Damn it I don't remember where but we had it. I remember standing in the stacks and looking at. looking at them. Then we finally on pressure for space and economy and better utilization of government property, we blended this with the NIH library and it is now all that is over in the clinical center library, I suppose. EAR OK. I'll double check on that. Now, let me get straight the strict crinology and details on this very interesting little Greenwood Foundation Grant. Council met, the first Council on in August of 1946. And then met again in January of '47. At that second meeting in January of '47. You said that the Greenwood Foundation would give $15,000 for expenses of the council meetings. Who paid for the first council meeting? BF Well you know that is interesting, I don't know. I thought Greenwood paid for the very first. EAR Well you didn't mention it until January '47. Now, maybe that was a suttle little statement and in fact you already nailed it down and they had already paid for it. BF Maybe, maybe they had agreed. I hadn't gotten the check yet. I don't know. But now I can be wrong but all the history we_ given and all the testimony I have ·given on it was that I_ got the money _ _J 164 BF(cont) for the first council meeti~g because we had no appropriation, that was the idea. EAR I know and ••••• BF And I still think that is right. That could have been a slip on the part of the person who took the minutes to. EAR It could be BF That what they should have said was that the Greenwood Foundation supported the first meeting. EAR Right, yeah. Well I would like for my own sense of bei~g an immaculate precise historian would like to be able to say that the history said that the Greenwood Foundation paid for the very beginning but on further examination someone else paid for the first meeting and the Greenwood didn't pay for the second. I~ll double check. I just really ••• BF I don't know where you would find that out. EAR Well, I am going to try. BF You didn't report •• they didn't report foundation gifts to the government in those early days. EAR No, but maybe Joe would remember or someone. BF Joe may remember. EAR Or Hector BF Hector, yes. EAR Yes, I'll check. BF Hector~.::· might be the very best source. EAR Ok, I'll check.· OK now totally different as I say this is hop, skip and jump all over. In 1948,· 8% overhead was discussed for research grants, as well as traini~g grants.· 8% is a very funny 165 EAR(cont) figure. Do you recall where the· 8% as a precise figure came from? BF No, it was a negotiated figure.· EAR I see. BF We started out •• the governmerit ••• the philosophy originally was look these schools want to do research and they can't do it because they don't have any money. They ought to be just damn glad that we got some money and be thankful for i t and go and take it and go use it. As a matter of fact, in the field of training this was the philosophy for some time. Training is your business and therefore, we are just helping you do your business. Don't ask us to pay for the overhead on it, that your going to have the overhead just the same anyhow. We changed that in time too. Then it seems to me there was some small overhead figurr:e~,originally like 4% or something. I don't remember. EAR It is not mentioned ••• BF Then 8% maybe this was the first and Fogerty and some others were kind of outraged. They thought this was way too much. They were haveing to subsidize ••• first they had to subsidize together and they had to pay to subsidize. There was a strong pressure on the part of John Romano and some others to show how much research was costing and they wanted 100% overhead. Well they were told get out of town, we can't even talk to you. So it held at 8% for a long time. Why 8% it was just a figure that they could agree on that nobody would nobody ••• half of them thought it was too much the other half thought it wasn't eno~gh. So it was just r~ght. EAR OK, it is a interesting figure because one would say, well 5%, 10% 166 EAR(cont) and then make it· 8%. And as .you said a moment ~go 8% actually remained the ·figure ·for training_ grants and still is. It is still 8%. For re~earch grants it is now ne~otiated, as you know. OK, now, a very interesti~g sequence of differences as you know better than anybody developed in the manner in which we ran our program at NIMH vs. NIH. And one of the early differences comes out in a brief discussion in the May 1948 council minutes about summer salaries. The National Advisory Health Council was opposed to summer salaries. The National Advisory Health Council was in favor and they passed a resolution saying that we at NIMH should pay summer salaries. Did that have any repercussions in relationship to your interaction with NIH or was it too early? BF It was too early. EAR OK BF I believe back then we were in NIH. EAR No, you weren't BF But, and I don't even know whether we were able to pay summer salaries, even though we passed a resolution. Because the Surgeon General considered the National Advisory Health Council as the premiere council. It was a SupremefrCourt, it was the council's council and if they said no, he may we'11 have said, and I don't recall, I just don't remember, but it could be that we didn't get to pay it. But there was no repercussion. EAR But I am going to check. But it is interesti~g that even way back then NIMH took the liberal position, the forward looking position in opposition to whatever ••• BF I remember we were accused of being crazy, wild-eyed which showed 167 BF(cont) our lack of experience. We should have .•• they wanted us to turn over all of our this sort of a thing to NIH which had years of experience,- something like 3 or 4. EAR Right. Well, that reminds me ·r must_ get to talk to Ernest Allen. Because I think Ernest has been in this picture •• incidentially, a minor little note and I want you to say something about Allen Greg and a little bit more or all the peopleand w·ay back then he probably is as important •.•••• BF I can tell you some things about him. EAR Oh, I do want to hear that and maybe for now. Ernest Allen apparently, was the one who pushed Phil Sapear to you to take John Everharts place. They were good friends. BF That1s right. EAR Because Ernest, of course, had the same kind of background. A doctorate degree. BF That's right. EAR And I didn't realize, even though I had many interactions with Ernest myself and he really was a good guy to work with. He really, he sometimes he was kind of conservative about things but he really tried to get things done and tried to consiliate where you needed consiliation and I think he was a friend of NIMH. BF - He always was. Ernest Allen had his start in the B.D. Division as Administrative Assistant. He had a baccalaureate degree, I think, for memory. EAR He had been an English teacher. BF Was something, I don't know what it was. His .·._:sthel-d'illt~tr~o:f's:Dr. Allen is SCD on and as soon as he got that he called himself 168 BF(cont) Dr. Allen, which .is alr;i_ght. Your entitled to. do it, I never heard of it done ·really before,· but that is alr~ght. EAR But that is why he ·was helpi~g Phil because they were birds of a feather. BF I can tell you the ·spot whe·re ·••• we ·were •• Do you remember T-6? EAR Of course. BF Do you remember at the· far erid, the end farthest away from Wisconsin Ave. At each end there were some stairs that went up, concrete stairs with iron pipe kind of railing. We had come down the stairs and he mentioned this on hhe way down from the second floor to the first. And we stopped at the foot of the stairs and he put his hand on my arm and he said I wan~ to_ finish this before we oet out into the corridore, will meet V somebody. And when we came down there was a door that werit out from there outside, I remember. And he told me about how good Phil was and did I realize how good he was and that I couldn't do better outside. I had loyality, I had experience, I had all the rest and I said I agree. I said what will happen if I propose him he said I'll push for it. And I said alright I'll do it. EAR Well, Phil knew this and of course, as I said I told you the story \ about his dinner with Allan Greg. And I gather that came up after you were then exploring. Talk about Allan Greg •••• BF Allan was one of the great statesmen of that time. He became intrigued with the pr~gram before he came on the council. He was not on the original council. He uses to •• here was a kind of things he would spend his life in--developing help ••• medical education and research and so forth. He could come down to see me 169 BF(cont) and I_ got to know him quite well. Allen would come out to my house. We ·would_ get a bottle of burbon-a piece_.and we would sit down on a couple of chairs, I can still see us in the living room, some ice on the side ·and we would •• there had been nights that we would talk to morning until the sun came up about everything and how we should_ go. And Allen said don't let them get pushy.J don't let them call the shots, that is the staff •. Be sure that the staff stays non-directive you can say no. He said remember • the tactful words, Dear Professor Jones, I have nothing but praise for your project. I quoted that one time he said you bastard don't tell that on me. Allen could make his point with a story and he was like Alvin Barkley was. You may •• I have probably have told you Allen's favorite story, one time when I was sure that everything was going to go to hell and I wanted to push in and do something and Allen says you remind me of the guy that was dashing down, he wanted to get over to Staen Island from the Battery. And he came dashing down just as he got at the foot of the ramp there at the Battery and there was the Staten Island Ferry it was about a foot and a half to two feet away from the shore and he threw his bag aboard and gave a big leap and landed aboard down on the deck, tore his pants he said. Well, thank God I made it. And the deck hand said what is the matter with you Mack, we are coming in, not going out. I've always remember that story, that is the kind of story that he would tell. He is the one who such afforisms like as nothing succeeds 4'\. · successors. This sort of thing. He would tell me I'd been at so and so and I got this kind of complaint. Now, I don't know whether it is true or not, you follow through. 170 BF(cont) He counseled and I wanted so badly to. do it, I never. could_ get it through.· He wanted us to es·tablish what he ·called •• what they have at Oxford a1r'i Cambridge ·or both_. school lea~ing fellowships. You know what they are, you know what I am trying to say. That money enow:g!l;s.or..,±hat::::.:lats>. ·ssl:y·:~riut- of a three :or four year research fellowship a person would have ·to spend one year elsewhere in some other place. This was called a school leaving fellowship. I could never get it through the Bureau of the Budget. EAR What year was this? This was after '46? BF This was in. When was the Mental Health Act passed? EAR '46. BF Well then it was in '47, 8-9 along in there. And after he was on the council he would still come in and I would meet him at the Cosmos Club for diner. We would spend hours when he would tell me •. talk to me about what •• how he thought it should go. I have never known a person who was such a wealth of wisdom, such a sense of humor, such a tolerance and compassion for the foveals of man- kind. Such vision, such a hard-boiled gentle person. EAR Yes, so this is one of the important inputs that never officially appeared. BF Allan Greg did more to shape my philosophy and policies that came out of that philosophy;~ef grants. As he said he was_ going to try to make a philanthropoid out of me. A philanthropoid is not a philanthropist. A philanthropist is a_ guy who has the money and .. gives it. A philanthropoid is a person like a philanthropist, they . give the money but it is somebody elses money that they_ give. EAR OK, alright. Another· interesting early phase ·of the NIMH individuality 171 EAR(cont) the council iri May 1948 discuss.ed payip.g for publishing a book. And there was a great ••• that is publication cost and there was a great deal of discussion about that. Some ~eciple ·said no, and some people said yes. And the council in its wisdom decided that each project that came in would be ·trea·ted individually. . In other words : not a blanket yes·, not a blanket no. But it is one of the early phases in which the council really showed what kind of deliberation about things that were so conscientieus and thought~ul about what t.o do, these are a certain policy and that is interesting. BF You see, Eli, we were aware that we were for<.#;ng:;mew weapons. We were building new roads. You could say well the NIH was there before you but the NIH was different. Ours had a much broader front. We were in areas that had never been in before that many part of the public health service didn't think were respectable like sociology and psychology and whoever heard of research in nursing or in social case work or something like this. So, we had to bring desperate ideas and eespeatate disciplines together and we had to do it by compromise by negotiation, by long tempers, instead of short tempers. Nobody else had this problem. If you were de-alip.g with microbiology you were dealing with microbiologj.:st. If you were dealing with chemists you were dealing with 'chemists. And no self respect to chemists they had nothing to do with mental health in those days. But if you were dealing with the impact of society on mental health, you know, what iR--the:.she:&l::;~s·:·.·this. doi~g in a health organization. EAR Well, I think that es·serice ·is •••• BF And we were probably were •• ! think it was fortuitous that we started 172 BF (cont) outside of the NIH. We had thi~gs established and once we g0~.~out there ·and they b~gan to raise their eyebrows I said my God, we have been doing this for years, several years. EAR OK, in May 1948 a quote"·commission on lobotomy" was recommended do you recall that and what can you say about that. BF I just remember that there was such. There was a guy who was a professor of anatomy at Columbia some name like Mettler. EAR Yes, that is right, Fred Mettler. BF Fred Mettler, I remember only that he was bright and the most profane man I have ever heard. He couldn't say three words without cursing. But he was bright as the devil. Now, he was introduced in lobotomy, primarily from the point of view of brain function. And he ••• it is hazy Eli, but it seems to me we made him a grant to set up this commission and he did a study and there was a report. EAR OK, I'll check it. BF And this report ••.••• EAR OK we were talking about Fred Mettler. BF The chages after lobotomy as he found it were subtle ..· There was some gentling of the person. He could find no intellectual deficit. The only thing he found was a ••• there ·was statistically significant was a statistically significant less ability to properly run the fortius maze. And but I don't remember anything more, I don't know what happened except that on the basis of this we decided that we weren't. goi~g to endorse lobotomies .. But why I can't tell you. I just r·em:ember that and that :prej·udi.ce stuck with ·me,· if it is a prej:udi.ce: :to: .this day. I just .de.feated." helped l73 BF (cont} to keep the·m from du:(i~g loboJ'(loties at the state hospital here in Missouri. While ·I was ·on· :the· mental health :coininissi:on. EAR In December 1949 the 'National- Film Board was endors.ed ~ Now, tell me that story. BF Alberta Altman she ·was then, Alberta Jacoby she is now. By that time was she ·off our staff, I wonder? Yes, and this was a project of herssnow she gathered·around here some ·of the psychiatrists, MO Kaufman, Tom Reriny, Howard Rone,· I don't know who else Harvey Tompkins, Dane Blain I have forgotten. And they were_ goi~g to put out educational films on mental health. We had put out a film at NIMH which wasn't a bad filmt by-golly, did you ever see Preface to a Life? EAR Yes, it was a very good film •.. BF And then there was another one we put out on aging. Which wasn't bad. I can't think of the name of that one. But I remember the opening words of the second one were the thoughts of the old are long long thoughts, those were the opening words in that so she organized and incorporated the ·National mental Health Film Board which was an organization which would contract with ·states or other organizations to produce mental health films on order and according to their design or specifications. And she did put out a number of very good ones. I don't know what happened to it beyond that. EAR Well I think actually •••• BF I think this was sort of a •••• first Alberta had left us and she was sort of in between jobs and even after she married Jacoby I think they continued_ because ·Jacoby was a film producer, _a documentary f~lm producer. But I can't tell .y.ou more ·than that •. ~----- ---------~----·-----·- --- . -~-·----~--·---­ 174 EAR :i:. ga,ther she wa,s a ra,ther .p;t.opg wi..lled person .. BF Very, utter·1y brilliant. I told you· the ·story· aj)out_ gu.ildii;w the lily.. That ... she was dynamic,· .br~ght,: very convinci~g almost scary bedause ·she ·was be·autifully proportioned but larger than I am that is taller. She would come ·in the office and she would turn on all of this and r just felt kind of overwhelmed. I use to always keep the· door opened when she ·came ·in just because I don"t know why ·but ••• and she knew it. She just delighted in this and she would tty to over power me. And she was the one person I didn't know how to f~ght back with.· EAR OK, in December 1950 you had a very auspicious meeti~g of the National Advisory Mental Health Council. Because it was the first meeting of the 12 man council. And it met at Top Cottage you saw Angry Boy, you had dinner ••• BF Angry Boy that was another one ••• EAR You had dinner at the naval officer's club that was the first full council meeting. Can you recall any of the other aspects of that first meeting. BF I don't. I can only know this there was great misgivings among some people that they were really going to hell now because they were bringing the public in part of these would be what we now Gall under the new health planning act''consumers~ EAR Right, exactly. BF And I felt that this was the best thi~g that could happen. Until we quit talki~~ to ourselves ·or as ·I had put it one time that as lo~g as we ·were just a converted .c.onverti~g the :conver:ted we were not savi~g any souls. And that we ·should_ get on with ·:our business beyond that. ··And this wa·s the: 'first ·one ·and to' me ·this was a very 175 BF lcont} exciting group. I have fo~go.tten who the •••• EAR I'll tell you. This is the ·one ·r mentioned to y.ou· earl.i'er today. It was Franz Alexander, Leo .Bartimer, Carlyle Jacobson, Hugh Level •• BF Jake was there ~s a psychdl~gist. He ~as not yet D~an. He was maybe ••• I have ·forgotten what he ·was doi~g. Maybe he was still at St. Louis then, I don't know. Who was after Jake? EAR Florence Mahoney, oh ·Hugh ·Level. BF He was a health ·officer and had been I have fo~gotten where he had been •• whe·re he was then, Louisville or it was the Harvard School of Public Health.· EAR Florence Mahoney was in there. Bill Mallimid, Ben May, Mr. Wilson McCarthy. BF Wilson McCarthy was from Deriver, or Omaha. He is dead now. Wilson McCarthy was a stock man, not a stockman, he ran the stock yards, owned or was the principle owner or ••• he was a very wealthy man. He was interested in mental health because his wife was a very serious alcoholic. And he came to one or two meetings. We have one picture :of the.· c.o.unc·i:L. with:,'.him'.~-s:~tti~g in .the background, sitting like with his hand up to his face. He hardly opened his mouth and I believe he only came once maybe twice and never showed up again. EAR Then Helen Micklejohn Helen t,,ticklejohri, of:course, was a_ great_ great leady. Her husband was, what was he, sociol~gist. They were the ones who McCarthy that Joe McCarthy part of that so~called Conuni~group which they weren't at all.. And their son Gordon· Micklej·ohn was Chairman of the Dept. of Medicine,· internal medicine :at Colorado and retured :r·eceritly. 176 EAR And Charlie -Slafer. BF Charlie ·s1af·er who was the :pubri·c ••• well in the :public relations department at 20.th." Century Foxhe wa·s a man given responsibility for publicity for the film 'tsn·ake ·Pit" that is how we_ got interested and went from there ..- EAR And Mildred Scovil. BF Mildred Scovil was my dear, dear friend. I always use to bug her by calling her mother. Mildred was not any •••• I quess she was. a little older than I was. Yes, she must have been because she was one of the junior executives of the Commonwealth Fund. When I received my first Commonwealth Fund Fellowship in Psychiatry and I was alway~· very proud of the fact that I was a Co1Tu1nonwealth Fund :,,,, Fellow and she claimed that the Commonwealth Fund was proud to claim me as a fellow which was alwasy nice to hear. But then I made the mistake of calling her really my academic mother one time. And everybody howled and she flushed and said never again was I to call her mother. I don't know if Mildred is still alive or not. EAR I don't know. And the last one is S. Bernard Wortis. BF Sam Wortis, of course, had been our friend for years. He is now dead. EAR OK, that was that meeting. Then another interesting kind of early gerontology indication of things to come. The t t · study section was recommended as a study section in February 1951 and to the best of my recollection ••• BF We never implemented that. EAR. No, _but you· did get in aging b.ec:ause ·Jim Bearin .worked with you for awhile.· 177 BF We bro~ght Jim· Bearin in .and we wer"e interested i.n ~gi!1g. Isn't it ironic that my principle :interes·t in psychiatr.y- is aging. Maybe it is '71 that has done :it.· But the paper I_ gave ·in Texas the one that this rotary club talk.-.all of these were on the field of aging. I've become very interes·ted in it. EAR This is February '51? BF That was a long, long time ago. I was not as old as I am now then by what 25 years 23 or 24 years. This was recommended and this was part of how I operated. I pres·ented my position, I thought it could be done thro~gh other means they felt it couldn't so I let them discharge their affect by making the motion debating it and passing it. It was a recommendation which I did not accept. I made no fuss about it, I just didn't do it. By the time they came around the next time and this happened, you_ ·learned this pretty soon, except on very critical trigger.1=isaues. They could become passionate in one meeting and forget all about it in the next. Forget about it so much to the point that they would criticize you for doing what they had said and want you to do some­ thing else. You may remember that. So I just didn't do it. We were taking care of this through other study sectio~s anyway. EAR OK, in May 1951 Seymour ·Kety was appointed as Scientific Director for both NIMH and NIMDB. BF There is a story behind that. EAR That is what I want to know. BF We •• remember there was no NI ,DB, :it was NIMH. And then they s_plit off and we had, I tho~ght, _a pretty. good basic sc.ience ·section section· in our intermural .res·earch :_pr~gram. Theri the law was NI DB, 178 Bf lcontl no, no, yes ,yes neurol~gic~l dise~ses and blindness·. 'l'hat is r~ght, I_ got· the ·initials mixed up. The ·1aw was pass:ed and this institute ~as created. Pears~ Bailet was the "first diredtor. Pearse I had known when he ·was at the VA and we were working back and forth. We ·agreed that we ·could buy more ·by pooling our money then we could by each havong our own intermural. Basic Science Program there would be so much ·duplication we were ·sooner or later_ going to_ get in trouble. But I warned Pearse ·that if we "did this we were_ going to have to be very careful to so mes·s up our money that nobody could find a line or cleavage ·or someday they would split up apart and this would be an econpmy move. We were so fantastically successful that we hardly knew in our own shop how to divide the money up and where it came from. Once the money was appropriated, we dumped it in and stirred it uo real quick." And this was jointly run •••• Seymour Kety was responsible to both ·Pearse and later to Dick Mazelin and myself. And ran that program out of this budget which ·was a fairly ample budget. The bureau of the budget time and again tried to do two things which they never were able to do because we would always get all confused and mixed up and stupid. One was we couldn't tell them where a neurology dollar or a mental health dollar went. It just went into this program which was joint. The other we could never break out research from clinical care. We were very careful that got so smeared up that we never were sure whether a dollar was a research dollar or care dollar. Because we knew if we ever did that was the first step then they would start directi!).g as they are doi!l,g now. WE were •• I was told by one :of the people ·of the ·bure.au of the bu~get that he suspected that we weren't -as stupid as we :appeared because :if we ·were we should 179 BF (cont) be "j~i~.ed. EAR That is an inte!iesti~g stor.y. ·well, OK still another new development. In February 19'52 Hal Halpert was :identified as the new chief of ..... BF Hal Halpert. EAR publications and report section. That was the formal b~ginning of publications and reports? BF I don't think so. Alberta had that from the beginning. That was one ·••• EAR That was her job? BF Yes, she was publications and r~ports chief. This was I thciught •• this was an idea I had and I went out hunting for some- one and I got Alberta, whci was recommended from someplace and I don"t know where. Now, but I wanted a strong publications report section •• I said if we weren't able to keep contact with the public and keep good relations with the media we were dead in out tracks. Hal was not bad, he was no Alberta. Alberta brought in such people as Millican whatever her name was. She died of some liver disease. And that gal whose father was the famous cryptographer Freidland, Freedman. Barbara Freedman, she married one of our scientist there and then divorced him. And several others, she had a Trackman, Leo Trackman was another one. But Halpert came in. Halpert was alright I have forgotten, he went from somewhere else. I never could relate to him too strongly. He was a bit mousy. EAR Yes he was. He went on and_ .got a l?h.D. BF That is ·r~ght. He ·went to .-s·ome ••• Columbia or someplace, EAR OK. Now this one ·may not ri~g· a he'll at all. In June ·1952 John 180 EAR(contl Eberhardt talked about the· ·fed:eral reports act ·of. 1942 .and BF A-20 EAR Circular A-40 BF Circular A-40, that was it. I was fairly close. EAR You were. And there was a_ good bit of discussion by council, they were upset this was going to wreck the whole program because if you were going to send out more ·than; 10 questionnaires you had to ••• BF You had to get a clearance EAR From the b~reau of the budgetand as you know, it is a long story which I will follow through because I think it is very interesting. It was a kind of a gen·tlemeri' s agreement with the bureau of the budget that especially for the intermural program and for the_ grant people in the NIMH it wasn't considered to be in contradiction to the federal reports act a..nd so neither the_ grantees or the intermural program had to go through this kind of federal reports act clearance. BF But we walk •• one thing with an eagle eye. That whatever forms were sent out that as far as possible hhey were not forms which somebody could jump on as being a boon-doger or a bunch of peeping-toms sort of thing. If we had anything like that and we had some, we sent that through, in other words, there was something we sent through that took a long, long ••. ! know I believe it was all the forms that Mort Kramer used. EAR Yes, it could be. BF They all had to_ go thro~gh.· And that occupied a lot of their time and kept them busy and happy. EAR OK, I want to talk to Johri ab.out :that because :that who.le ·:eederal report act is interes·ting. Now: in May 1.9 52, Norman Topp.i~g res~gned and 181 EAR(cont) Shannon· was made Associ.ate: Director of NIH. Nowr- had 'l'oppi~g been the "Director·? BF No, No. EAR Or was it alwasy called Associate· ·Director? BF The Director had been Rauler· E. Dyer, I had forgotten who was before him, it doesn't matte-:r:. And Rauler Dyer had either one or two associates. Lucious Badger and Norman Topping. Or else Badger left and Topping took :Badger's place .. It was so long ago I have forgotten .. Topping was appointed under Dyer as Associate Director and Badger had either gone or what, I don't know .. We all considered Topping as the •tcrown Princen. And we knew that Dyer was . getting along and would retire before lo~g and we assumed that Topping would take his place. But Shealy who had been at NIH as Director of the Cancer Institute before he became·· Surgeon General had different ideas. It was a bolt from the blue when we found he appointed Henry Sebral as Director to follow Dyer. I'll never forget when we heard that.. Topping turned white. Very quickly after that Topping resigned and went to the Univ. of Pennsylvania I think as Vice-President of Medical Affairs and from there to Southern Cal. as President of Southern Cal. where he was for a number of years and made a distinguised record for himself. But Norman Heller Topping lived on the campus, in one of those two houses up there you know, the one next to Shannon's where Vanslike lived later for:-=a number of years. EAR OK, so that is how Shannon came ·in. He had previously been at the Heart Institute.· BF That is right and when Toppi~g .res·~gned he came.·. he had been clinical director •• Shannon had bee·n clinical director· of the 182 BF (cont) Heart Insti.tu.te. and he came :;Ln as Ass:ociate Director. under Sebral .. And_ gave ·s.ebral ·treniendou·s supj;mrt. · It was the :only thi'~g that kept Sebral from comi~g unstuck.' I am sure because ·they had all that terrible ·hullabaloo about ·the ·polio vaccine and Donny Brook at Fairfax County where they were_ ·going to do a test of innoculations and so forth.· And then Dyer· ••• Shannon ••• Sebral left at the end of his 4 year term and Shannon took his place. EAR OK, this is just a passi~g comment. I don•t think we need to talk about it. But the ·first time ·the· ·intermural research was mentioned to the ·council was in November 1952 council meeting and then, of course, the whole ·intermural program developed. John Eberhardt left in February of 1954 there was a very nice commendation to him from the council at that time. BF That is when he ·went to Commonwealth.· EAR Right and then you already talked about Phil Sapir. getti~g the job. Was there any other candidates inconsideration for John's job? BF Eli, I know there were because I can remember talking to Ernest Allen1 and some others about several people but who they were I don't know because it was almost a forgone conclusion that we had to look at others in order to be fair but Phil was ••• there was no questions in my mind after ernest recommendation. EAR OK, we already talked about the Joint Commission that was first mentioned in June 1955 and we talked about that. In June of 1956 Horris Mcgoon pointed out that ~.the National Science ;Foundation is interested in the history of science and the national advisor of mental health council approved support of a histo~y of psychiatry and then in February of 1957 almost a year •• not .quite ·a year later there was rec·ommendations for a lectureships in the history of medicine ·related to psychiatry 183 EAR(cont} Was there any special bac~gr.ound to that story about? No, as you were talking ther·e ·was a_ guy from the national science foundation he was either a .sociblogists or a ps.ychologists on the staff of NSF who use ·to attend our council meetings. I cantt think of his name. He was a nice guy, I liked him very much. EAR Yes·, right. :r know who you mean. He went to •• he went west. Oh, gosh.· BF It doesntt matter .. EAR I know who you mean. BF This is how this all came ·about. EAR Harry Alpert. BF Harry Alpert that is the guy. I' liked him very much and he was sort of stimulated this. :r think it was at a coffee break or something and thatit came up. EAR OK, Bob Livingston came in Nov. of 1956 to take Kety's place as the scientific director. And Kety was relieved of administrative duty and went back to being a full ••• BF By his request. EAR By his request. BF And over my strenous objections. EAR What was the story? BF Seymour came to me with increasing discomfort when he found that young men he had helped to bring up were coming to him or he would listen to seminars and they knew more about his field than he did. And he realized that he hadn't. grown any scientifically. In 2 or 3 years his publications had fallen way off and as he said he was livi~g off. his hump rather than_ .getti~g new. .And he became increasi~gly diss-atisified and said that he ·was bec'ommi~g almost !..... 184 BF (cont} f r~ghteried .f·or his: future.;. And he wanted to_ go ba;ck :to: the laboratory. And r- pointed :o.ut :that he was maki~g a disti~guished record and couldn't he· ·take ·some: :cr.edi t out of what he was doing what about me,· :r didn't like ·it either- Well, _he ·said I have to take care ·of my own problems and he didn't want to do it- And he finally told me ·that if he couldn't quit and_ go back to the laboratory, he was going to quit and go somewhere ·else. So then we·=recrui ted Bob Livingston and he ·came ·in and Seymour went back as Chief of a •• we had a name for his laboratory ••• I haye forgotten what it was. EAR It is in there,· I'll find it. BF And he had, I can't think of his name either. EAR Ed Everts. BF NO, no. Oh,· hell I can see the guys face and I can't even tell you his first name.· He ·was very closely associated with Kety.. It doesn't matter. EAR He went somewhere else? Sy Krelen? BF No, he was a physiologists. Kind of a physiologists. The name is completely gone. EAR Don't worry about it. Ok, now we have talked about Joe Bobbitt being named assistant director of NIMH. I have that story. In November of '57 the Board of Scientific Council was established at NIMH had that been developed being kind of idea that something that John wanted? BF No Bob Livingston was in back of this. EAR Y~ur r~ght, I am sorJ:;y. BF I tha~ght .it was a hell of ~ go.ad· .i.dea and I was kind of mad that I hadn •t tho~ght: ·of· it mys·elf bec.ause· ·r- alwasy wa·nted to be ·in the fore­ front. it was sort of a NIH's university senate.· Not exactly that 185 BF (cont} either. Bu.t it was a. gr.oup of' people 1n our inte;orrqr.al J?r~gram who would so:rt ·of be the fo:rtnn of.· discussionof· .pollcies:, _problems, headaches which ·they would carry :to' me. I was invited to sit with them but I was ver'y careful never to sit with them because I felt that I would inter·fre with :the. 'democratic proces·s if I' did. That they were ·free ·to come to' me ·in a_ :group or by del~gation or by an individual person but I had to be ·free ·to make my decision and they had ·to be free to make ·their dec·is ion. This was ••we were severly . eensored by the some ·of the NIH f·or this. This was no way to run a railroad but as it finally wound up the whole NIH_ got the same damm thing. And it was something else oftN:IH:·.tihat became a NIH wide thing and started at NIMH and I bet nobody remembers it. EAR Well, that has happened some many times including the small grants program. BF The small grants program there were several of these. EAR That we started and other people picked up. BF And then they gave us hell for doing it. EAR And then they did it. The first time the idea of fluid funds was mentioned it is very interesting because it comes up a number of times. November 1957 someone recommended the fluid fund research grants. It was always a desire to get flexible money. Do you recall anything about that? BF I don't know whether I am talking about the same thing you are or not. We were interested in havi~g some kind of a_ grant in which a person would have to have a name because the law said you had to have ·projects .. Grants were to: be ·made for proj.ects., So we coined the term ••pr~·gram plf.9gectn s.ince: :it had to be ·a project but it was a project which ·was a pr~gram•. And_ t,ne· of the 'f-irst of· thes·e we_ gave 186 BF (_cont) was a large grant _toRalph Gerard,..in neurophysiol~gy on neurphysiol~gic correlets· ·of· schizophrenia. It was as broad as that.· · And we :got a hunk of money like· $300,000. or .some ·great big amount. And it was fluid in that he could •• came ·in with a broad protocal. He wanted to attack it •• for instance,· I m~ght do this, I might do that depending on where ·it leads. We ·would work ·this out ahea'd of time,. There were a number of these given and we finally I believe they pulled back on this about the time of the Fountain Committee because it looked like to them that this was a device for giving money to our friends. EAR And also bed costs. BF That is right, bed costs. There was another program that you haven't mentioned. We called in contractual authority. There was a time when we wanted to try to assure a project of so many years of support for damm sure. We worked on a agreement with the appropriations committee and with the bureau of the budget that on a demonstration bases we could commit a certain amount, for instance, I could commit to you a grant of $25,000 this year and $25,000 for each of the next four years. And this was a guarantee that whatever else they did they appropriated enough money to cover you. Well, this was great. Allen Greg, I remember, thought this was ••• enthusiastic about it but it became a bookkeeping nightmare. In two or three years when you had . grants that go 2 years more grants to go 3 years more grants that were terminating this year ·and so forth. And then we·_-got the wind about all it was about. Why the bureau of the budget was so damm happy about it. This was when the b~gan to think about retrenchment. And we saw where they were_ goip.g to try to restrict us to the amount of money cominit'ted. Which ·would mean in f.ive years they could phase us o.ut by each ·year_ givi'~g us just eno~gh ·to take :care ·of our commit­ ment and no more.· They had_ gotten us on this and we ·couldn "t..get off. 187 Bf (contl And I went to the aJ?J?;rOJ?X:iation comm,ittees ano. we wo;r](,e,d; out a little ·scheme whereby it was: understood tha;t we. would. hono;r; thes·e ·commitments but we would. go in for no more.: We ·would continue .. EAR OK, in November· of· 1957 the :training_ grants prep·ared a 10 year report to be ·sent to co~gres·s. BF You were partLof that. EAR Well, not quite.· I hadn"t quite come yet •.. But r wrote the one after that. Now, I have ·that 10 year report and I know what is in it. But do you recall if there ·was anythi~g that precipated · that request from the senate other than it was just 10 years? BF I·t was just 10 years and Lester Hill wanted that and ·he hoped that we would ·give a 10 year projec·tion. We had the record of what we had done ·in the last 10 years and where we were going in the next 10 years. And I protes·ted that if things had changed so much in the last 10 then a 10 years projection would be out of date in a year. So he said fine write another one next year. EAR OK, this is also something that I can double check on. I didn•t find it anywhere in the council minuted altho~gh I know that is it etched in some kind of history and that is the old 40~20-20-20 distribution of training grant funds,. psychiatry's • BF I am so ashamed of this that I hoped to forget it. This is part of the old power struggle. Remember I told you yesterday that in the early days or did I say it on the record. I was so dissolutioned by what I saw. Well, this didn't change remember also even as late as the joint commission. They had 10 votes from the M.D.'s and the rest was divided up and hopefully some of them would be M.D. '·s. They were ha;vi~g a lot of_ good apJ?lications comi~g in and some of the very best :applications comi~g in wer·e from psychol9gy. Who are 188 BF (..contl natural born ... -. EAR . g;rant wr:i.ter·s BF Grant writers,·. grantsmeri and :also statisticians.. · Th_ey ~ ..... some o:e · the ·pretties·t applications we ·ever got. This was in training .. Well, some of the ·people ·b~gan to-_ get nervous because they •• a lot· of them •• could one ·year for instance they took them right as they came down the ·1ine.· · 60 or 70% of the money would have gone to psychology. Because they were ready and the rest weren't and so this was bitterly protes·ted that you couldn •t do anything without psychiatrists. They were captain of the team everybody else followed them and here ·are ·these others getting out of line and there would be rebellion in the ·ranks. So the council passed a resolution that a) since under the law you cann't make a_ grant unless approved by council although ·you don't have to make all the_ grant council approves of you cann't make ·a_ grant unless approved~bY council. Therefore, council set as its policy that they would not approve_ grants other than in the proportion of 40 for psychiatry, 20 for each of the other three and there was nothing left for anybody else. There was a lot of screaming. Remember in those days there was one psychologists on the council and some laymen. who were mostly psychiatry oriented. I believe one of the people and he was opposed to ,this who was on the council at that time was Ward Darly. I was opposed to it but it was obvious that it was not going to_ get anywhere. And that 40-20-20-20 stayed in for several years. EAR Y~s, it did, And when I came I had to make up a b~g new formula and we won't. go into it now· but .there was a, b~g council discussion about it and then Don Mark was ~- .. ~ · .at BF Don Mark was most ·eloquent.';.~. council meeti~gs. Infact, I wish ·you 189 BF (cont} had the ·verbatum of that bec:au.se. he_ ·g.ave the most scath.i~<J critiqueof· .it.· Just scathl~g ·cr'iti:que ..· EAR OK, the ·very lat point of· th.is .·is:: kind of a symbolic way to end I suppose.· Other question·s -r. have·: you may still want to say something. Veste died in February of· ;195.9. ·.and it is mentioned in the March 1959 council and there was a speci:al tribute to Veste.. But I remember very vividly that you and. s·ome :other people worked very hard to do something about his retir·em:ent :or· whatever it was to make sure that I he_ got everythlp.g that he :poss:i.b_l.y could.. Should we talk about that? BF If I can. It is hard f·or· me ·to ·t:alk about this"! Veste and I were very dear friends<\ Ves:te knew he had a fatal illness.. We had been at a party at ·R.C~ Arno.ld·'s house ·and I noticed that Veste wa,sn•t eating. He had the most beautiful charcoal broiled steaks and so the next day I kept sayip.g Veste what is the matter you are not eati~g. , He came in the of.fi.ce ·the next day and he said I want you to know I am_ going over to the Marine Hospital he said I think I have ·something serious. He said I didn't eat last n~ght because I have no room to put food he said I vomited food I ate two days before. I have some kind of obstruction he said and at my age you know what that may be. He was operated and they found a carcinoma with metastases. He did better for awhile. He came into my office ohe day and said I am going back into the hospital tomorrow. This is right after Christmas that year. I remember because we went to Christmas services over at the St. John's episcopal church he and Lucille and l?~g and me. Then. he. had ehristmas dinner at my house the next day. The ehristmas :eve ·services and Christmas the next day. And Ves·te ·went down in the bas·ernent in the recreation r.o·om at our house ·and laid on the.couch·a11 afternoon. He was· 'justfoo sick. 190 BF(cont) He went into the hospital and I have :fo~gotten whether they did more :su~.gery or what but they kept f ollowi~g him and ;following him and we had told Ves·te •· · Ray Shaw and I under the law if you ;retire ·and die within 60 or· 90 :days it was then of your retirement your survivor_ gets both ·death ·berfefits and the retirement benefits. If you retire before ·th~t ·time ·you only_ get retirement benefits. If you retire to that time ·so you r.etire on active duty. You get only, that is if you are ·on active 'duty when you retire you_ get only death benefits which was burial and a years pay or something. So Ray and I said we.found out from personnel that it would take about 30 days to proce~s the ~apers and so we talked to Ve~te.· Veste realized that he was going to die so we said Veste when we thing the time has come we will bring the papers over for you tb sign applyi~g for retirement._ I ~-11 never fo~get that._ We went over and he was sitting on the ·e~ge ·of his bed and we said we have some papers for you to sign and he looked up with that smile and said it is that time is it and s~gned them. He was dead in about 45 days. EAR Well, he was quite ·a. gentlemen. He was, of course, the man who hired me. And I was never so impressed with anyone. He was a real gentlemen of the old school. I just had never met anybody like that in the government and he said well we are going to hire you and with that very cortly aire that he had it just never left him. We would say hello and it would sound like a victorian_ greeting of some kind. BF Srnoki~g that pipe. Oh,· some of the thi~gs he did. When Ester Garrison had her su~gery that horrible thi~g .. She had a hysterectomy they tho·~ght ·she had cancer~ . 1-\nd while she ·was ·still. convelesceni~g they found ·out that it wasn•t mal~gnant. She was then castrated. And they came ·in and said Miss· 'Garrison· we :have_ :go.ad news for you 191 BF (cont} that wasn ~ t cancer.. lmd .they .c.ouldn' t understand why she flipped.. . Then she ·went thro~gh ·.the menQpause f: pf course,· that ·you_ go thro~gh ·and she wa·s :in a hell of· a· mes:s·.. The only person that could deal with ·her was Veste .. Veste spent hours with ·her. r could still s.ee· Veste comi~g down the office .. I' would be ·uptight about somethi~g and he would say, how are you doing? Smoking that damm pipe.· How are you doing? EAR He was quite a_ guy. BF He was a_ great_ guy. EAR Bob, I have·gone ·through ·everything I have but we have a couple of minutes left on here.· Is there anything that you can think of that we haven•t touched on? I am sure there are a lot of things they may not just come to mind right now. BF I can't think of anythi~g. The point I wanted to_ 9et across I think I've said in as many ways as I know how. The basic philosophy was we ·were a group of colleagues worki~g together and any team has to have a captain because someone has to coor­ dinate but that doesn't mean boss, that means coordinator and that is what I tried to do. I had to take the heat for somethings some­ times. Sometimes I took the heat for somethings I felt I wouldn't have done myself but I wasn't going to say so that happened with J.ohn Eberhardt one time. And he felt so damm bad about that when I went ahead and announced some_ grants because he was sure and they weren·tt sure and then we had a lot of trouble. And I took the heat and God how, if I ever I want a friend John never forget the fact that I never told a soul that it was my decision. EAR Well I think ·that is a_ goad· .note ·to end on and I should shut up but we ·have ·1eft so many thi~gs. :out that neither of: us had a chance 192 EAR.tcont} to touch ·on. BF Well come back.• EAR I will. I would l·ike for· y:ou to ·talk about thi~gs like the Harry Harlo~ grant that_ got all that flack attached to it. BF And we ·haven't talked abo.ut the. Menin::.,Rites· not. the Menin;..:Rites:1 but the Hutter Rites the famou·s Hutter Rites Grant. Oh my God ••• EAR I don't remember that. BF All that the Hutter Right Grant Bob Wincherts Grant on the Theory of Complimentary Needs. There were 3_ grants ••• and the Pioty Grant. There were 3_ grants that broke in the papers and we . got all kinds of hell. And Allen Gregg, I remember came in and said, steady, steady, steady. Say nothing back, just bow your head and he said go back and read Aesop's Fables. And I said which one. And he said the one about the open • And he said there is nothing shameful about bending with the wind so long as you spring up again. EAR Well it is quite ·a story. It really is. OK let •• BF Lets go to slapsy maxie. EAR The end of a historic occassion. Tomorrow is your birthday. BF Tomorrow is : my ·· birthday. \ ROBERT HANflA FELIX, M.D. Date and Place of Birth: May 29, 1904 - Downs, Kansas Education and Training University of Colorado 1930 -- M.D. Interne, -Colorado General Hospital 1930-31 Commonwealth Fund Fellow in Psychiatry 1931-33 ·Colorado Psychopathic Hospital Rockefeller Fellow in Public Health 1941-42 - M.P.H. The Johns Hopkins University School of Hygiene and Public Health Washington Psychoanalytic Institute· 1949-55 Licensed: Colorado, Maryland, Missouri Diplomate in Psychiatry 1946 American Board of Psychiatry and Neurolo~y Certified Mental Hospital Administrator 1964 American Psychiatric Association Hospital Staff Memberships St. John's Mercy Hospital, St. Louis, Missouri Consulting Staff in the Department of Psychiatry 1965- St. Louis University Group of Hospitals Medical Staff 1964- St. Mary's Hospital, St. Louis, Missouri Active Staff in the Department of Ne~ropsychiat~y 1964- Fraternities Delta Sima Phi Phi Chi i _Alpha Omega ~lpha 33° Mason 2 Pro f es s i on·a 1 Ca re e r ~ · // M1 11 J~-- ? rt1j/"/<,,J1 /~or,//J/.-1.!pr-- / /J/- Jfdf<' /?P)'/~11,q/ /J/c_c'A1,'/4et1/ /61'" 7 / ~,.;,. . Sa i n t Lo u i s Uni ve rs i t y S c hoo 1 o f Me d i c i ne l 9 64- ~e-s-e-n=-t- 1 '7 7 cy Dean, .J,,>~,1-/.,/l 1_..=,_;i_,,•• ,,...//;.fs//s,;.?-✓- Professor of Psychiatry and Professor of Community Medicine />rt-/'..---.::.:, Y ~ ,.- l:~.¥1-::J r / ' -/vi's,, /cf ,7 7-:. I As sis tan t Surgeon Gener a 1 , USP HS 1 9 57 Director, National .Institute of Mental Health, USPHS 1949-64 Ch.ief, Division of Mental Hygiene Bureau of Medical Services, USPHS 1944 Medical Directo_r, USPHS 1944 Assistant Chief, Hospital Division Bureau of Medical Services, USPHS 1944 ' Medical Officer, U.S. Coast Guard Academy 1943-44 Psychiatrist, U.S. Coast Guard Academy 1942-43 Public Health Service Hospital, Lexington~ Kentucky 1936-41 Executive Officer 1939-41 Clinical Director 1938-39 Chief, Psychiatric Services 1937-38 Medical Center for Federal Prisoners, Springfield, Missouri 1933-36 Clinical Director 1935-36 Commissioned Assistant Surgeon, USPHS 1933 Professional Appointments Washington Unlversity Social Science Institute, St~ Louis, Missouri Research Associate 1966- George Washington University School of Medicine, Washington, D.C. Special Lecturer in Psychiatry. 1947-64 Georgetown University School of Medicine~ Washington, D.C. Professor of Clinical Psychiatry. 1947-64 3 Editorial Board Memberships ' American Journal of Psychiatry, American Psychiatric Association 1962-65 Baby Care Manual and Your New Baby, Parents Magazine ' 1964- Journal of Pastoral Care Pastoral Psychology St. Louis Medicine, St. Louis Medical Society 1965-66 The Qua~terly Journal of Studies on Alcohol 1951- Membership in Professional Organizations Academy of Me d i c i n e , Was h i n g to n , D•.C. l 9 59 - American Association for the Advancement of Science 1967- American Bar Foundation Advisory Board of Psychiatrists Committee on Mental Illness and the Law 1965-1970 American College of Physicians Fellow 1942 American College of Psychiatrists Fellow 1965- American Medical Association Council on Mental Health 1963-66 Chairman, Committee on Narcotic Addiction 1955-59 American Medical Association-American Bar Association Joint Committee on Narcotics 1955-60 American Orthopsychiatric Association Fellow 1956- American Psychiatric Association 1935- Life Fellow 1965 President 1960-61 Treasurer 1958-59 . Chairman, Internal Management Commission 1961-66 Museum Association, Board of Directors 1962-64 Chairman, Nominating Committee 1963 Chairman, Committee on Budget .1949-58 Ad Hoc Committee on Non-Medical Specialists 1954 Committee on Certification of Mental Hospital Administrators 1954-58 Chairman, Coordinating Committee on Community Aspects of Psychiatry 1950-52 Chairman, Committee on Committees 1949-51 Executive Committee 1949-50, 1958-61 Council 1947-50, 1958- Committee on Reorganization 1946-48 Committee on Public Health 1945-47 American Psycholog~cal Association 1956- American Psychopathological Association 1946- 1 American Public Health Association Fellow 1946- Governing Council 1956-61, 1965-68, 1969-72 Section Representative on Committee on Eligibility 1965-67 Committee on Professional Education 1956-59 Program Area on Mental Health Mental Health Section Chairman 1958 Vice Chairman 1957 Nominating Committee 1967 Association for Research in Nervous and Mental Diseases 1951- Association of American Medical Colleges Nominating Committee 1967 Executive Council 1967-1970 ·can ad i an Psych i at r i c As soc i at i on Honorary Member 1961- Central Neuropsychiatric Association 1968- Council on Social Work Education Board of Directors 1966-69 Eastern Missouri Psychiatric Society 1965- Group for the Advancement of Psychiatry . Member of founding group Missouri Public Health Association 1965- Missouri State Medical Association 1965- Delegate 1970-72 National Academy of Public Administration_ 1968- National League of Nursing Education Advisory Committee on Psychiatric Nursing 1952-55 :New York Psychiatric Society Honorary Member 1967- Royal Medico-Psychological Association Corresponding Member 1956- St. Louis County Medical Society _Honorary Member 1966- / St. Louis Medical Society 1965- Ethics Committee 1967- Chairman 1969-70 Bulletin Committee 1965-66 Honor Member 1970- St. Louis Psychoanalytic Society Honorary Member 1966- Southern Psychiatric Association 1940-62 Honorary Member 1962- President 1946 Washington Academy of Medicine 1949- Washington Psychiatric Society 1949-64 Honorary Member 1964- Chairman, Program Committee 1953-54 Washington Psychoanalytic Society Honorary Member 1965 . World Health Organization Expert Advisory Panel on Mental Health 1952- World Psychiatric Association Elected one of five members from the North American Continent to the International Organizing Committee for the World Psychiatric Association which was organized in Montreal, Canada, during the World Congress of Psychiatry, June, 1961 · Committee on Publicity 1961 Other Professional Affiliations American Cancer Society, St. Louis City and County,Unit Board of Directors 1965- Executive Committee 1965- Professional Education Committee 1965- American Society of Mental Hospital Administrators Honorary Member 1960- \ Brookings Institution, Conference on the Public Service 1961-64 Emeritus 1964- Catholic Charities of St. Louis Board of Governors 1966-69 Technic~l Advisory Committee of the Home Care Program 1964 Committee on Pc~toral Counseling of the House of Bishops of the Protestant Episcopal Church Subcommittee 1960- Executive Council of the Episcopal Church National Advisory Committee for College and University Division 1967- Federal Aviation Agency \ Medical Advisory Committee 1960-65 International Congress on Mental Health, London Member of Delegation 1948 Fourth International Congress on Mental Health, Mexico City Chairman, U.S. Delegation 1951 Governor's Task Force on the Older Missourian 1966- Greater St. Louis Council on Alcoholism Board of Directors 1965- Health and Welfare Council of Metropolitan St. Louis Board of Directors 1965-71 Mental Health Planning Committee 1965- Mental Health Planning Advisory Committee 1968-1969 Committee on Reorganization of Health and Welfare Council 1968- Hogg Foundation for Mental Health National Advisory Council 1962-65 Joint Board of Health and Hospitals (St. Louis) Board of Health 1965-73 Joint Commission on Mental Health of Children, Inc. Ch a i rm an , Task Force VI : Inn ova ti on and Soc i a 1 P,r ogress i n Relation to Mental Health of Children 1967 Maryland Department of Planning and Planning Commission Advisory Subcommittee of Committee on Medical Care 1960~64 Maryland Mental Health Board of Review 1958-62 Maryland Mental Hygiene Society, rnc. 1954-64 Board of Directors 1955-56 Professional Advisory Committee 1956-64 Mental Health Association of St. Louis Professional Advisory Council 1965-70 I •Mercyville Hospital · Executive Consultant Staff 1965- Metropolitan St. Louis Foundation for Psychiatric Services for Children Professional Advisory Committee 1965- Missouri Association for Mental Health 1967- Board of Directors 1967- Missouri State Mental Health Commission 1965-1975 Missouri White House Conference Committee on Children and Youth 1969-70 National Advisory Council on Correctional Manpower and Training 1966-69 National Association for Mental Health, Inc. First Vice-President 1966-67 Second Vice-President 1965 Research Foundation, Board of Trustees 1965- Board of Directors 1964- Executive Committee 1964- Professional Advisory Committee 1952- Councilor 1947-50 National Committee for Mental Hygiene 1944-47 National Association for Mental Health of Nigeria Panel of International Consultants National Association on Standard Medical Vocabulary Consultant 1962- National Committee on Aging Steering Committee 1950- National Committee on Alcohol Hygiene, Inc. Consultant 1953- National Council on Alcoholism Board of Directors 1950-1968 .National Disease and Therapeutic Index Advisory Committee of Physicians and Educators 1967-70 National Family Life Foundation, Inc. Board of Directors 1960- National Health Council National Health Forum Committee 1957 Omaha Midwest Clinical Society Honorary Member 1945- .,: .... ·Psychoanalytic Foundation of St. Louis Advisory Council 1964- • Scottish Rite Program of Research in Schizophrenia Professional ~dvisory Committee 1966- Social Health Association of Greater St. Louis Board of Directors 1968-71 Southern Regional Education Board Commission on Mental Health Training and Research 1954-64 Suicide Prevention Foundation, Incorporated National.Advisory Board 1965- Symposium on the Definition and Measurement of Mental Health Texas Christian University Institute of Behavioral Research Advisory Committee 1965-70 Tuberculosis and Health Society of St. Louis Board of Di.rectors Health Education Committee 1965-66 Medical Committee 1965-69 Public Relations Committee 1965-66 Urban Living Project Citizens' Committee 1967-70 Veterans Administration Special Medical Advisory Group 1965- Vice-Chairman 1970 Chairman-elect 1971 Washington School of Psychiatry Board of Managers 1950-58 Western Interstate Commission for Higher Education Consultant 1955-64 White House Conference on Aging Technical Committee on Health. 1970-72 World Federation for Mental Health: U.S. Committee, / Inc. Sponsoring Member 1964- World Health Organization Second World Health Assembly, Rome Member of Delegation (Technical Advisor) 1949 Awards St. Louis College of Pharmacy Physician of the Year Award 1966 9 Norlin Achievement Medal -· Associated Alumni Colorado University 1966 Eighteenth BamJton Lecturer in America Columbia University 1965 Golden Plate Award American Academy of Achievement 1965 Distinguished Service Medal U.S. Public Health Service 1965 Samuel Rubin Award in Mental Health 1965 Parents Magazine Award 1964 National Conference Award National Conference on Social Welfare 1964 Bronfman Prize Achievement in Public Health 1964 Nolan D. C. Lewis Award (Psychiatry) 1963 ·. Edward A. Strecker Medal (Psychiatry) 1963 Salmon Medal, Achievement in Psychiatry 1963 Rockefeller Public Service Award 19 61 Distinguished Service Award American Psychiatric Association 1974 Honors Sc.D. - University of Colorado 1953 Sc.D. Boston University 1953 Sc.D. - University of Rochester 1964 · New York LL.D. - University of Chattanooga 1957 Tennessee LL.D. - Ripon College 1959 Ripon, Wisconsin ROBERr R.A.NNA FELIX 87th President, 1960-61 .American Psychiatric Association A BiograJ2hical. Sketch Francis J'" B1"aceland, I,L D.. , Sc,, D., There is a kind o:f' Ghara.!:!ter in t;by llfe that to thu observer doth thy history Fully unfold~ o o~ ~• o Heaven doth 'With us as we vl th t:orches d.o ¢ ,, ,, Not light them for themselves ~ o ,, ., ~Meast:tre for Measure- Character, it is said, like :porcelain, must be printed. 'before it is glazed, but once ~bu.med h;; ·there ea.n be :no change., As to the :print­ ing, :many diverse materials may ·be utilized,, Walter Pater WT'ote of' it long ago: uB',ow insignif'icaxrt, n he said., useems the inf1uence of' the sen= sible things which are tossed and, f'all and. lie about us i,;n early childhood, how indelibly, as we discover afterward, t~hey affect. us, as ·they secure themselves upon the smooth ~r-eix o:f our ingenious soulso" This coul.d well have been 'Wl:'i tten prophetically a1:>out. the 87t,h president, of the .American. Psychiatric Association, for 7 :as oi:;,e not.es the influences that, fell about him, it becomes evident that they ~:r,')ttld. lead, him inevitably ·to medic:i.ne and, eventuall,.y, to a form i)f' pulill..t:: service which would call forth and utilize all of his attributeso Though Vol.ta.ire stated that he 'Who L:nes his country -well has no need for ar1cestors, Robert Ha.nna Felix had. been thoughtfully provided with plenty of th.era.. 'J:hey ,~am.e f'rom all dlrect:1.ons, with a profusion of physicians amo:ng them.. There were Whigs and Tori.es and rebels o:f every size and description.. There were several big ones, including Robert J:Ianna, Su.r,reyor General of South Carolina u.nder George III; yet the Revolution round him fighting for the colonists 'With B~ price upon his head~ In the other vs a:nc:estors lined, u:p ent,ree !I a1.1 marmer en= him t:o be at one w:l J?elix sante is f'or is derived from in the wheat: for the pay of of the was he road to fOl" in the entered his work him, he worked to drove the full houses at the but; he as the his :reren.t. A master, a11 The PrintL"1g ma:n w:b.o upon f'orces and of his chie:t"''s,, an career on his rode him saw evidenJ~f;S as nLittle , wa,a and f"I"O:m wa.s soun,cls a himself' as 8, h.e.ve no how From the age o:f seven his aumme·rts were spent on a farm and thes-e were some of the happiest days o.:e' h:ts li:f'e ~ He talks of threshing :machines and of oi1ing anrl repairing themo He remembers t:~1e sweat of' the hot days in the wheat fie1ds and he e&1,,tl grew lyrical about what it was like to wake UJ? early on a r.;;old Kansas moi-ning, whe:n. si1ow was on the ground and all seemed blue, the wind was quiet an.cl the sun rose slowly" He can recreate for his listeners his love for the snowy f~or the earth, and for eve:rything that was Kansas. i.Ihrough h:i.s love of the land and hj,a pride in his f'w.ly-, he has an almost, nzy-stical sense of' be1"ng bor1ded to the cou.ntry.. He can 'become nos'talgi1.~ a1:,otrt J~:baugh anl J:d.s bypoma.r.d.c drive, which was conmunicated to all of hhJ t~olleagueso or h:l:m Ebaugh s~·s: ';His nuisance value w,s considerable.. He Wt)uld ask me ·the t::ause ot schizo­ phrenia. and push :m.e regarding d.ef:i.:a:d.-l">io1·::;s crf' ever:rthing ., ~ ., H.e was a classical bypomanic, so we had martr t1Li,ngs in connuono n Dtu ing his first 0 year of residency_, the ymmg :neo:pbyt,e Tmderweri.t a:nother expe:t"ience vihi.:,th still infJ.uences him" Just; as Petrarch saw Leu.:ra, :Bol'J saw Ii:st.her Wagner (Peg), a me:mber of' the nursing sta.:f:f of (Jh:ild.ren is Hospital, and neither poet was the sam.e ever after~ Bob i a <lescriptions of" "Pegu outd.o by far the poetry of his descriptions of Kansas. She was ill f"or a while, so their me.rriage was delayed. unti.l ~June, 1933, and then, ·bel:i.eve it or not, they were married in Loveland, Colorado. Everyone who kn.ows Dr. Felix knows of the place she holds in. his life, one shared. o:n.Jy "by Kathy, a daughter, and. each is a joy tunto the other. The residency was over in 1933, the depression vas not,, A variety of' circumstances placed the young psychiatrist at the Depa.rtmen·t of' Justice Medical Center in S:pringf'ielil, MJ.s sm.1ri ., as a. f!ommiss ioned of'f'icer in the s. Hospital , and he:roe this versity for dent of the l\.e:ni::;11c.BY young doctor, ing and role the look o:n .,...a,,i;,-,f'l',r,"f degree as the war 0 progmrtt :f'or the w.s here the yom1g there are stood out Division Kolb had also and recent~y, as his staff to the :fore, and spoke of who ti.on for the of the.Se -n·,c;,ta>'1>'""" of the second chief' was to Parran. Of He was an inspiring leader who believed in giving his eta.ff' their assignemnts and in letting them alone" Alwa;rs avs..11... able for consultation and advice, hews most generous with both, if asked"' From the start I bad a very great admira­ tion :for Tom Parran and a sincere affection :for him. alsoe Hi.s insight into the mental health need,s o:f this country was pheno.m.e:o.aJ.. .. ., ,, The ~ . would~ never have gotten off the gTOm1d with.out his support with the Bureau o:f the Budget, the Department. ai'ld with Congress,, Coast Guard T.b.e Felix saga at the Coast <}uard. Academy deserves a lengthy chap­ ter, but editorial demands require that it merely be touched upon. How he placed psychiatcy solidly in the program, how he gained the c~onfidence of the o:ff'icers, staff, and line, how he e'Ventually beca:me a highly respected physician, confidante, and model ftor young medical. officers, all must "be passed over lightly. His program there was run with integrity, with a capi­ tal "I", as it was before and has been since, and here is the cornerstone of his success., It was at New Loud.on, too, that he worked closely' with "Vesty,n Dr,. Seymour Vestermark, he of great aml good heart, a lovable, dedicated ph_ysician and publl.c serva.n.t~ No biography of Rm1 would be complete withm.1t mention of hin10 It "'was i~o Vesty that he looked 'With :filial g1a.nce and there w.s a mut,1.1al. :respect and loyalty between. thein. 11 Everyone knew of the famous triple play team: Bobbi·tt to Vest,y n to Felix o If one wanted something done, ·the 'best w-ay to have Bob do it WB.S to con.... vince nvesty. 11 Frequently it required Bobbit to do t.he original convincing. When nvestyu d:ted all who k.:new him were distressed but :l.t -was an es.pecially sad blow to his chief. Washingto11, On his 40th birthday, May 29, 1941~, Dr. Felix wa.s ordered to Washington as Assist.ant Chief of The Hospital Division. This was obviously for the of retired he W,S of his The Mental to Parra:n ±"'or people involved. too vast to the Oil Mental Health there 'WS no to Bob was nthe business◊'~ T.b.ere be a new the other's vieoey ,VM.;.a:,,_,.,,::,,,.,,_, a meetingo were in limbo, about the fact bute millions, if we had the occurrede says, she became sees no need for a:ny fuss; she When. came amo1.mting years the:m done w:tll The 1secrret co:n$c1oust:i:ess Of Duty ~ell :perft''.'.>'.t'ffl!ai,,nDthe publ1Lc voice praise honors virtue rt~tW\::trds it, All of these are y-ou.n.