/ / Dr.)otin 1·ams December 2, 1977 ,...• (.A. d? you have in mind sort of centering it around any particular decision points, I mean, do you, and I guess what I am doing now is reflecting the way I perceive, and that is from a particular issue and then a number around that, because it is a little harder, I guess I can say, some things in general about the gene:r:ral decision making, ;you know, sort of style, if you will •••• EAR Yeah, that would be helpful, but why don't you also d.o it in terms of.. some of the things that you were intimately inv·olv·ed with , ithe Homose:zualif~e is certainly an example. Also, I think what would be helpful since Stan did something with the sequence of spelcial assistants that I think was extxa­ orldinarily useful, to him, certainly and to the people involved. His style, I think, was probabl;w, if not best illustrated in that interaction, certainly well illustraterl. in the way he used people who came in as special assistants, all of whom have since gone on to very productive, very activ·e careers beyond that so it was a tremendous leaming experience for everyone who was involv·ed, but he certainly did it without using the word selfish. He did it for reasons that serv·ed his purpose extraordinarily well. So, I wish ~u would keep that in mind beeauee I think that is important. Stan's relation­ ship to people is dramatically different from Bob''s relationship to people. And I want t:o make that point without, in any way, making env·idious compari­ sons but I think it is an impottant issue, so maybe the thing to do, and it will come to you as you go ahead, is to begin with how you first got started with him. I"ll try to cue you a couple of :.k:Hi:~s timeS=:-if something I think I'd like to know more about but you go ahead. Incidental)y, if there is anything you•d rather I not use, either don't tell me or tell me and I'll exclude it. I will be, discreet. This is not an effort to talk aboaut personalities. JA Well, then, maybe:· just to begin with a little.bit of kind of backgroundas to how I got into the whole thing in the first place, .My being in that position at NIMH was in a major way engineered as was ce:etainly much of my earlier career by Dav'e Hamburg, as mentor of Stanford. And when I first went into th PHS and IIIIJ]GB maybe this will be some comments that apply to other parts of e the NIMH as well, my initial interests when I went into the PHS was to get inv'olved as a clinical researcher in the intramural program, and so I, at an appropriate time, which I recall was certainly very early in the first year of residency , was one of these V'ery long lead times kinds of things, was inv'ited in for the round of interv·iews. EAR8 What year was that? JA It would hav·e been "65, the early fall of 0 65 • Then I had indicated my interest in various of the programmatic areas and was duly interviewed by lhe people who were involv·ed there. But, as that day went along, it tumed out to be an increasingly frustrating interV'iew series for both myself, and I think, , also for those involv·ed, Because, I had, I think, probably coame there with pretty high recommendations, again from Dave. But, it was clear that the kind of commitment wanted of me, in terms of a specific interest in a specific research area, and I haV'e subsequently jokingly said that if I had presented myself as being interestai in the uncles of schizophrenics, that I would have been snapped. up very quickly, but at that stage of the game, when my research interests were really quite unformed and I had some general notion of what I might be interested in, and saw myself as generally interested in some of the activities, particularly of the psychiatry group. But it was quite clear that what they wantei were people who would plug li in, in a very John Ad.ams, continued 2 well defined way to studies that were ongoing at that xim:e point, and were presumably going to be ongoing three years hence and. that short of that, they really weren't interested, So, at the end of the day, we came to a sort of mutual pcn±ting of the ways, and sort of mutually decided that I wasn't prepared to ;make the kind of commitment that they wanted, and they weren't prepared to take a chance on me. EAR Wijo were some of the "theys" here involved? ja Well , Biff Bunny was inv·olved in that, and Lyman Wynne. Those were the principal people inv·olv·ed. So, I went back to Stanford then, somewhat bewildered. by this, and rather at sea in terms of what I really wanted. to do. So the next step was again some machinations on the part of Dav·e , involving this time, Joe English, who had. become the chief psychiaci.rist of the Peace Corps which preceded the OED thing, and on one of his trav·els arou.mi the country, he landed at Stanford, and I ended up having an hour with him and it went well and and, I am sure, there were again some behing the SEO see nes inputs and the next thing I knew there was a formal inv·itation that when my tour of duty came up I would be assigned. as a Public Health officer withlthe Peace Corps to he;ad up a Regional Area with the v·ery strong notion that some of the research interests that I was then developing in the whole area of coping and modeling and adaptiv·e kinds of things, again following Dave's lead., could actually be implemented in those kinds of settings:. and a research opportunityllay in i±hat area. So things coasted along that way pretty well until, I guess, third year residency would ha;v·e been early &68, probably late 1 67 when two things happened. First, I guess, the PHS regs were changed so that it was no longer possible to detail people to non PHS organizations and that, secondly, Joe English mov·ed ove:rr to OEO. So I was suddenly I rather late in the game, kind of' floating free inpterms of' where I was actaully going to spend the next two years • And, again, I think, Dav·e•s hand. aentered into it and the next thing I knew I was set up for a trip to NIMH and a series of interviews had been s e-'c. up fwith the various Div'ision Directors of that placJ, and at that time it was Don Oken and Dirke, and did I see you there, (I thknk that perhaps we did), and Mort Miller was just on board, just getting started with that one. And then some of the people within those units, the psychopharm group, those that regularly and trdditiona.lly use the Corps of officers. One of the people that I saw aas Dick Za.luck, John Adams continued 3 who was Stan/s special assistant. I act had met Stan briefly that rooming, the first time I had eV'er seen him I think, aJ.though I may possibly hav·e shaken his hand. on one of his trips to Stanford, and the message I had re- c ceiv·ed that morning was that I was to go around and. look at all these various things and. that I had an appointment with Stan at the end of the day to see what would be appropriate, if possible. So I ¥ent through ~he whole day of interv-iews and one of the people who I particularly enjoyed talking to was Dick Zaluck, who indicated., fi:r·st, his sort of fascination¢ for the job, and then also his intention of leaving at that point. I had some subsequent discussions with him, I think he may hav-e been sugar-coating it a bit, in t-erms of the way he really felt about it at that point, but that aside, so ~t the end of the day I met with Stan again and I v'ividly remember the conv·ersation, because Stan's office was one of the :;iore elegant and oppulent I had evei.-f seen and because I had a certain awe of all this. FAR This was in the Barlow Bldg? in ja Barlow Bldg. On the Fourteenth floor. And walked ~j~ and sat down, and I remember that when I had seen him in the morning, and had been rather hurried and stiff, and he was behind the desk and was sort of 0 hello, here is your schedule, and I 0 11 see you at the end. of the d.ay" At the e..nd of the day he was very much! more relaxed and unwound, and we sat down in a little conference area, and he looked at me and he said O Well, Hohn, you come very highly recommended, and essentially, he said, you can do whatev·er you want. Well, the things that had specifically been mentioned were various kinds of regular Corps assignments around the other parts of the Institute and did something that wss perhaps a little uncharacteristic of me , I proceeded. to go through and evaluate all the various ones that I had seen and express interest in a numbe:rrof them. And then I was more assertiv-e.; than I sometimes am and then I said, Well, there is one other position that we really hav-en't talked about but I did particularl;w enjoy' speaking with Dr. Zaluck and I wonder if th:ere would be any chance John Adams Continued. 4 of my working directly with you. And., he didn't give ln.e an immediate answer. He said that he would take that under advisement and that certainly t.hat wass not beyond. the realm of possibility ., so for me to go back to Stanford., and he would be in touch, and I think it wa.s a week later that I got a letter formally assigning me to • So I was very much excited about the prospect and spent a good deal of time talking about it with Dav'id and of course., I think, there may well have been some motivation on Dave's part in terms of hav'ing one of his boys close to the seat of things and., so., that was how I got there. I remember that waen I first arriverl. I was greeted in highly d.iffermng ways by different people. And I think that this does say something about the administrative style and the kinds of relation­ ships that went on. I w as greeted, first, I guess, by my office-mate Dave Mustow, who was aJ.so special assistant and he and I spent, he had already had one year on board., so we were ov·erlapping by one year. And he and I · spent sometime that aftemoon and a great deal of time later on talking about what it was like and I still remember Dave's comment • I said, 0 What is this job like.. and he grinned and he laughed • H said, "Well, it's interesting." You have to know Dave Mustow well. I can see his face saying "It• s int:eresting". And interesting it was. I talked. atL some 1 ength. I don't remember whether it was that first day, but early on with Goldstein, who at that point was extremely bitter, angry, thought he'd been undermined, short-changed or sold. out, or whatevEEr-, His feeling was that he had broken his ass for Stan and. that Stan had sold him down the river in some way that I didn't quite understand. I also talked to SteV'e Gmldston early on, who felt that way in spades, that hhat he was at that point in the midst of the whole Public Health Mental Health thing which unfolded over the coarse of that next year, a..r1d I was in significant ways inv·olved in that, and his bitterness became greater as that wnnt on. I also talked to Mort Miller John Ad.ams continued 5 there early on who told. me first off that he had. been a special assistant and he said., you know, of course, what the acronym is for your position, .u. don't you? I said. 0 no". He said, Special Assistant to the Director, SAD, sad, which also had. some meaning tgat .And then I had a,{ considerable experience down the road. with the other folks that I got to know. There was one other particular relationship that had a complicated history to it, and that is that virtually at the same time that I came on, as Special Assistant to Stan, a very old and. very complex friend of mine, George Hamm, came on board as Director of Mental 11.raining (?) and a small digression there. I had. knovm George very well when I was a kid back in Chapel Hill. In fact, I first met him through his daughter and. had. had. all of the complex relationships that go with being the boyfriend of the old.est daughter of a very powerful a:mtl. self-assured man. It has not always been a smooth relationship with George • The daughter had subsequently died and I fv/J had become, in sort of a funny way, almost the adopted s on almost in that famil;w , it was very much a father-son relationship. When I was back in Chapel Hill I would. visit with the Nlammk. I had. also h acquired a wife in the interim whom the Hamms had. met only very briefly on a quick trip to the West Coast, so that it was knowing George in a whole new thing, and I thlhnk maybe as we go along the whole thing of what happened with George and Stan might be something that would. be wor;th going into in some detail • I think I haV'e a real .&ense of where that didn't work and why. So I guess I finally began to get acclimated. to the thing. One other vecy key person in the system was Esther Kohn, and. if there is something that I had learned throaugh internship and in the Medical School, I think that I alrea.d.;w had some orientation to being cautious in dealing with people in the kind of position that she was in. I relatiV'ely quickly., and I must confess, somewhat by Kohn Ad.ams continued. 6 design, came to be quite close to Esther. As I said., I had lea.med. from my internship, for example, that the intern is a fool if he alienates the head nurse. She can either make ~is life infinitely easier, or she can kill him. And actually I had pra.cticed. this with some skill in terms of Dave Hamburg's secrErt.aries at Stanford.. They ll.re the keepers of i,he gate. And. if you expect to have s mooth access, let alone a smooth relationship yuou had damn well better pay attention to that and not lord it ov-er them, and. act uppity and all this kind of business. And I think frankly, that a I number of my predecessors/subsequently learned, largely from Esther, and from others, had really run fexy much afoul of that, that they had seen themselves as rank lind. of thing, and she killed. every one of them. Because it was very clear, early on, that if it came to be a. question of who was more important to Stan, between Esther and a special assistant, Esther hands down and. won, and. out of this// whole bunch of other encounters, I sort of developsd a notion about power. There are three, whattfevrJ!r, levels of power in a system, any system, maybe, and that one, perhaps in particular, there is power and that's the guy who's got it, there is delegated. power, that is specific task responsibilities that is handed to somebody else, to deal with, and there is borrowed power, which is really influence or effectiveness that is , not capriciously, but temporaril;w given around a specific issue and. can be just as quickly pulled. back, and one of the key lhings about the Special f!ssistant ytrole, is that_that individual always operates with borrowed power, and. never with delegated. power , and again, I think, some other folks who have been in that position got the notion actually that they had. the mandate to d.o iomething and. that never never happens in that system and ;wou can run quickly afoul of a.11 sorts of stuff. There were a coup.le of occasions in which I inadvertently blundered into that. I remember one occasion specifically when Stan had had. some political contact:, with an alcoBi.olic patient and so he told me to call Jack Mendelson out at St. E's and to admit this guy. So I called f-up. I had never met Mendelson, mind John Adams continued 7 you and. I called him up and. I said., well this man has come in, and I didn't mention Stan• s name, this man has come in and we would appreciate it if $OU would admit him. Well, I thought the phone was going to melt in m;w hand, and he said.. Well, who the fucking hell am-e you to tell me who we are to admit down ];.ere, and. I quickly realized what I had done, and I said, well, I am only bearing the message here for Dr. Yolles, who asked me. He said, Stan wants me to ad.mit this guy, Stan can call me, and you can tell Stan in the meantime that the minute he things he has admitting privileges down here, he can have this God damn job and shove it down his ass. So, occasionally, I blundered into thos things, but in general, I think, and I 0 11 be very immodest aboutt. it, I do think that I ggnction gene::mlly very well and very smoothly in that Special Assistant role, and I think that I had had a lot of tutelage in d.oong that at Stanford, it was not & new role for me. Well, I also for a lot of psychological reasons, ~tend to be tuned in to working with older senior people. I admit I have, my carrer has been heavil;w that of being an effectiv·a mentee and I have always had a strong mentor. And part of ithat is learning how to keep the Meni±ors happy witg you, and so on, and I think I did pretty well with that and didn't run afoul too much of some of these things. What else can I sort of say in general laboutthis. EAR. Let: me just prompt you on this point because I think you• re touching on just exactly the sorts of things I wanted to get at. I think the issue of :;row people like tyourself in that kind of position worked effectivel;w as, in contrast to some others, who you mentioned earlier on, did'nt realize that they is were playing, part of that kind of total process of what went on in the Institute. So, that's wonderful. Why don't JYOU, if jt;ou would, turn to a couple of more substantiv·e issues, unless there is more that you ,Swant to give me about the background.. John Adams continued 8 JA Let ¢,me give you a little more about the background, because I think thait does become relevant. Stan was in many ways a different kind of person from those that I had encountered before, and he could be a vastl;w different kind of person from one setting to another or one time to another. And ~u were never quite sure what ypu w:ere going to encounter in working with him. One of the things that struck me relativ·ely early on was the degree to which Stan maintained an element of distance in everybody that he dealt with. And I think this does haV'e something to do with the way in which decisions and so on got ~ade around more substantive issues. He tended to use qi different people for specific kinds of different functions but with quite strong com­ partmentalization betweennl:.hem. For example, small staff was no more a decision making body than the man in the moon. It was purefly and simply, I think, largely a fom or a mechanism to make people feel as though they were part of the overall decision making. It was a matter of going around the table and round robin and and a few sort of sometimes politically .i."l. sensitiv·e, but more often, just kbocsxm£:>g1oli£X generally public kinds of announcements. That was not how delisions were made. They were tended to be made much more, on a one-to-one setting with Stan and so on. One of the things that this produced was a certain element of jealousy or lack of communication in the circle of those who were responsible, because nobody ever quite new what was going on. I did sometimes get caught in the middle of that and I would sometimes be sent as message bearer from one faction to another, and those were the ticklish kinds of things. Just to sum it up, I felt very much as if I was in all of that but I was not really of it. With ihe exception of a few things, like the homosexuality thing, I really wasn't in a major substantiv-e role with my job. I think that's both the IJJ;.A strength~ the weakness of .the position, or at least, the way Stan handled it, but and I don't know quite what it says, at least with respect to me, he really did 'nt delegate specific kinds of responsibilities v·ery much to me. John Adams continued He tended V'ery much more, to Mort, to ~ou, Phil Sorotkin was clearly a very broadly inv·olV'ed person in all of this. Stan, had V'ery much, those who he leaned on, particularly , although, again, with some separateness, you, Mort and Phil being clearly the ones, and Sherm of course, being clearly the ones that he related most closely to, much less closely to Lou , and I"ll get to Bert. And. V'ery little at all, really, to Bert. That for a couple of reasons •••• EAR And when you came this was after a very serious strain had taken place between Stan and Bert ov·er the St. E's situation. Were you privy to that after the fact? ja Only in a kind of indirect way. The strain was immediately evident and became more ev'ident as time went on, particularly and frankly in terms of Bert's v·ery active efforts on many occasions to seduce me into his camp to use me either as information source, or whatever to Stan. I remember, one day, certain uncharacteristic of Bert. He came into m;w office , obviously vecy steamed up about something. He siad., you know, "Is Stan crazy? Is he clinically crazy" Obviously, I didn't giv·e him any answer on the subject. Something had happened. Those kinds of things I often did'nt dknow about, interestingl;w enough, despite the fact of being very much in the middle of things. It had come from other sources, usually. Stan didn't share a great deal with me at that lev·el • He shared a great deal with me a.n a more relaxed and personal way when we traveled and one of the other roles in which I functioned was that of companion add part of the entourage when Stan trav·eled, and that I enjoyed immensely, but one of the things that I very clearly lea:r.ned was that the very open relaxed relationship that existed on trips did not carry over in the office. It was pritty much strictly business. The onfly exception was that one of the sorts of rituals, sas that at the end of every day I I appeare:i in ;the office to go ov·er the mail and that inv·olved reviewing, I John Adams continued 10 this aleo, by the way, says something about Stan's administratiV'e style about the way that Institute was run in those days, and that was that ev·ery single solitary letter that went out of that Institute , anyplace, that went out oyer Stan's name , was personally read, yery oft en corrected , and signed by him. He would pick up the finest kinds of wording, things that made him uncomfortable. One of the more difficul;tt tasks I had, was the next moming to take all these letters that he had written all ov·er in black pen ba.ek to whoev·er had drafted them , and say, w.ell, you know, this has got to be changed, and in this and this way. EAR Ev en I got 1 ett ers back. JA So that there was an element of sort of real cenitnal control ov·er ev·erything. He was very concerned ov·er what went out ov:er his name. EAR That's a terribly important issue•• It sounds very small, but, but I know, both you and I know, that it is not. I think that Stan's style of adminis­ tration was, just as you said a few moments ago, about your relationships to the gatekeepers, and the realization that they were very imp.&rtant. Stan, obviously, also has a number of aspects of administration that he feels are hibital (?) to good ad.ministration, and he has long recognized that his letters with his signature are a mode of communication about which he feels very strongly and couple that with the fact that he has an absolutely incredible facitilty to see these nuances. Interestingly enough, he doesn't like to write himself, he is not literary, l.i JA.* He actually wrote very very little. The only letters that I was ever/ involved in, that he had himself dictated, were letters to personal friends. Not business, but letters that had to dea.l witlin people that he knew in Brooklyn, or whomever. Those he dictated himself, but everything else was farmed out for draft preparation but when it came back, he would massage it down to the last comma. EAR That's right, and literally to the last comma, and with an incredible capacity, skill, because I pride myself on writing good lettem, and when he made a John Adams Continued 11 he was invariably right. JA. I remember one that had to do with training and social work at the Post Master• s degree lev·el and someone had typed up a l:etter that had Postmasters. And he simply came through the roof on that. We are not training people for the Postal Service here. It is Post-Master's. But at those times, late afternoon, I vivdly remember the darkening Washington sky, as we would be sitting there, justgoing through the phenomenal conrespondence, load of stuff, There was a single drawer in his desk into which eveJYthing, with the exception of the Congressionals and. the Blue Folder ones and the executive mail went and all of that would be gone through at the end of every single day that he was in the office. EAR How long did it take you to realize that he had annincredible capacity for work/ JA That became evident within the first week. Because his ability to not only handle, but get through and retain and. remember the masses of stuff that he had to deal with was really phenomenal. Stan was very much a person, who, not only in letters but in terms of , he is greatly concerned with details of things. It is not the other ad.ministrative mrbdel, which is to paint the broad. brush strokes and then let someone else fill in the colors. For him it was a matter of really all the responsibility. The other thing that I think did preoccupy Stan and I think the whole Institute during this time and for obvious reasons was the political process. ihts We are talking about the capital P Political Process. There was a tremendous amount of politics ~r/4~ internally but the just phenomenal sensitivity to the subtle attitudes or shifting attitudes of Senators, Congressmen and the Congressional Staffs and I guess, I would have to say, acress the board much of the success of at least as I saw it, of lhe Institute during that period in its warfares ' with various Surgeons-Genexal and various NIH people and ADAMHA people and so on, had to do with the faet that those channels were kept very wall John Adams continued. 12 lubricaaed by very skillful people. Stan, himself, was very good at it, Phil Sirotkin, was of course a master of doing that. One of things that certainly causee an awful lot lof friction, as I saw it, between Stan and Bert was that Bert thought he was awfully good at it, but Stan a.ad a very low opinion of his ability to work ~~::;t,~~se areas. EAR Was it clear then••••• •••••r want to raise one more point, because there is a curious sequence between Bob Felix's tuse of Stan and then subsequent disaffection and Stan's initial use and development of Bert and then sub­ sequent disaffection different in many ways and yet fundamentally similar, was there anything else that you sensed, and let me just tell you, 1 think one of Stan's real concems about Bert, aside from the fact that Bert was not as politically skillful as he himself thought, was that Frankly Stan scbme thought that Bert's sense of integrity about/things was not that strong and Stan's, whatever people think of him, Stan's sense of integrrity is very very high. Was that clear at that tiame? Was that part of the problem? JA I think I anl;w saw that around the edges, here and there. Bert would, on occasion, suggest, at one point I almost got sucked in on that. It was fairly early on, I believe what had happened was that Sta.n was out of town and 1 didn't go along, Bert was Acting Director and some policy question came up and and somehow I got involved in that. Because Bert was going to be away and he didn't want to handle it and he said well why don't you hold that till Stan gets back but I woudl suggest we do thus and such. And so I made the mistake of going to Stan add saying, "Well, thus and so, and thus and . so and Dr. Brown suggests that we do thus and such. " And 1 got a long lecture. That pretty much said that, that Bert was slippery and thatthe••• little There's one other/piece of this and I don't know whether EAR Do you want me to tum it off? JA No, I trust you to•••• Bert thought, and I think let Stan know that he, Bert, John Adams continued 13 was a better trained psychiatrist than Stan, and I think this may be one area in which Stan , at least was, a little bit sensitive. Bert, a product of Cornell and Mass Medical and all Harvard, Public Health and all this stuff and Stan had vecy much come up the hard way, PHS, career training and although he had gotten the .MPH from Hopkins he subsequently had this -terrible falling out with Lenkow, you know, and I remember Sta.n's saying to me in the midst of all this Mental Health· Public Health squabble, I ;am going to cut Paul Lenkow off at the knees, and he did it. He did. And so at I think that this was/a point that as things got more strained between Bert and Stan, that Bert would sort of stick pins in that in a way that was destructive .My summary view on that Bert£Stan thing is xkax very clear , and that is that I think the fault lay with Bert in very large measure. I would imagine that Stan would not be a very easy person to be Deputy to. I can appreciate that. But I think that there is an absolutely unqualified issue of loyalty and support, particularly in semi-public situations. They could disagree like hell in the privacy of one /i,,jJ of their two offices but I think for Bert to attempt to undermine Stan 114 u aux fJDDciu~x) with Jte, for instance, and as he did fairly broadly was absolutely unconscionable and I am in some ways amazed that Stan put up with it because I 1 am trying to remember, but m;w sense of time is somewhat confusing •• EAR Did you hav·e any interaction at all with Jim Osberg? JA No, I knew him subsequently back in North Carolina, but I didn't know him then. EAR Why don't we go back then to George Hamm, if you want to. JA There was a relationship, or a professional as well as personal relationship I think that anybody that really knew George and Stan in advance, have looked at, they would ha.v·e said , predicted, that it would not work. John Adams continued 14 EAi Some of is did. JA I'm sure a number of you did. I'm sure that Stan went ah~ anyway, for what he thought, I am sure, were very good, largely,, I think, political reasons. Stan was in a lot of trouble then and later, some of it justi­ fied, some of it not justified with the Academic community and psychiat·ry and I think he felt, well, you know, I'll just take one of their beys and poor they ca.n.•t argue about it. That's I guess, ma!7be a '/#/4 basis on which to decide ultimately but it was worth the effort. Stan had to have Imown ;that very much George was/ov'er the hill a.t that point • George should have known that two, in a way, more similar yet more different peeple would be ;ta.rd to imagine both of them very powerful people basically with very strong egos, sometimes fragile egos, but strong ones , both of them very used to being Numero Uno, Number One in charge, being looked up to. There was an ad.ditionaJ. v·er:y strong factor in George Hamm that was what rea.lly dommed him, and .that is for all of his bravura and bluster George had to be loved in a very special way by those whom he worked for. A funny way, you would hardly expect that in someone with as much breasbeating as George, but he ran afoul of the Dean at Chapel Hill in exactly the same way, exactly the same way. And George came there with, I think, a much ov·erblown view of his own worth to the Institute, or at least his place in the system and he genuinely expected to be Stan• s #l friend, on a social basis , confidante, major policy adviso:n:. He expected to be, pardon the, the analogy is limited to the relationship, and not to anything else, he expected to be to Stan as Kissinger was to Nixon. General purpose,;most intimate kind of •••• And Stan didn't have that in mind at all. For a variety of reasons, I think, he simply did not respect George's judg­ ment in a whole range of different areas and he was already well placed with confidantes whose judgment he did ver:y much admire and respect so one of the JllOre complicated things that I got into was being in some sense party to, very much in the middle of this strain on that. Now it's an John Adams continued 15 increiible compliment to both of those people , and I think particularly to George • In a. way it would have been much easier for George to lean on me to be an intermediary and he really did not do that at all, despite the fact that Anne and I became v·ery close to George and Sa.J.ly on a. much more peerlike, it was a friendship rather than a bilsiness thing. But that was doomed to start with. I also remember terribly vividly tha.tanother component of the disaffection with George was the drinking problem, and I remember so vividly that sma.11 staff retreat down at Airlee House and the just horrible show that George a.nd Don Greaves put on and Stan's an in­ credibly moral person as well as the high ethical standards, I've never seen Stan either remotely drunk or out of control, in aZJ.'Yf ways he'd control himself and I think he found tha.t simply disgusting as well as anything else. He lost any respect he might hav·e had for him. At least, George had the good sense to Imow when enough was enough and to get out. EAR At that same time had Don Oken left, before pou left? There was a partial variation on the same theme, totally different in one sense, because Don's expectation were not George's expectations but, let me just tell you, since you don't Im.ow all of the details of some of these things that one of Stan's problems really was an amazing ability to assess people al.most immediately. By the time you walk in the door, he can tell you how good JOU are or not. That• s a slight exaggeration, but vei:y quickly on to be able to assess people and I think that when he decides that someone doesn't fit, then, whateve:zr he may hav·e told them before, no longer holds. Now, interestingly enoug h, you were talking about his being very conservativ·e and a high ord.er of initegrity, which I completely agree with, sometimes he conv·eniently forgets things that he may haw) told someone, or he interprets what he says differe-11.t.ly than people interpret it, or a. combination of both. John Adams continued 16 And I know three specific instances. That of Don Oken is one, Bob Weiss is another, then George Hamm is the third, in which ea.ch individual thought they heard something in their interaction with Stan that he didn• t think he said. Now Don has a stronger case than perhaps anybody else, because he ha.s something in writing which a.lmost discounts something that Stan said, but be that as it may, it's an interesting problem, and I think it speaks to a lot of complicated things. One, whs people m like Stan, whose mind works at three lev·els, at least, simulaaneously, say something to someone else, and they only hear one level, he reacts then, and afterwards, in terms of all three levels, you see, and it becomes a problem. Now, do you sense any other examples of this where, unfortunately, llni.s interaction with some people , literally what he may ha.v·e promised them, or what me may bav·e told them, tu.med out later to be different from what they actually understood? Do I make myself clear? JA I don't come to a specific and clear example of that. EAR Now, I want to say something though, and frankly, get it on the reco:t'd, too, because there is another interesting comparison. Something I did not know earlier, I am learning so many things in this effort. Apparently, early on, Bob Felix was known as "Promising Bob" because when people came in, whatever they wanted, he promised. them. And, of course, ~u know, very sincerely clearly, glad.I.handing, out-going, hypomanic character who, in many respects, was exactly ~he opposite of Stan in his interaction with people. W.hereas Stan could not tolerate the thi:rd minute in a sequence of Council meetings, and was ready to leave by the time five minutes were over, Bob Felix absolutely revel.led. in sitting up at the front of that room. You, unfortunately, never had a chance to see him do that but it was like the conductor of an orchestra leading the entire symphony orchestra., whereas Stan, by the time the CGuncil meeting came along, he was on to something else and really didn't want to be John Adams 17 EAR cont. involved and yet, in some respects, this capacity to be ti It was on a one-to-one relationship with people, you know, trying to get them to join the Institute, or whatever, which you made ea.rl:w on, on how at the end of the day tha.t he was relaxei, and very very open, and very very engaging, because he can be a. very engaging guy, he also tended, in a. sense, -.to promise people things which they took. I have yet to see somebody go into a meeting with him and not come out feeling, both impressed, enthusiastic, willing to go in. He has real charm in those circumstances, although in a formal meeting, he can be stiff and formal and not very verbal, which is totally the opposite from Bob. AJ. I had had some exposure in a very different mode, expressed in different ways, but the same type of thing with Dav·e Hamburg. And I really watched that awfully closely. I really think that I had had a superb tutelage for the time with Stan by and within the Institute by having worked in a somewh.at similar kind of role, not quite, but a similar role with Dave. And Dave bad 8 a wopping reputation for promising in usualy, rather vague and general. ways, the ;moon and the stars, and there was a. number of people who felt 'betrayed thereafter in not getting it. I guess I wa.s tuned into that kind of thing. But, of course, as I say, I stress again, that I think so much of the inner workings of Stan's thing were on a one-to-on.e basis and I wasn't in on those. I was, a.s I say, in it, but not of it. Well, I didn • t sta;w a.round long enough if you will, to become a Division Director and have the delegated kind of relationship or whatev·er, something grandiose. Mg~ Miller EAR.m I understand., but that•s exactly what 'J-'f, toolc••• the grandiose••• Jim Isbister was there? AJ Jim was there, and it is interesting that I haven't mentioned Jim yet. Jim was a. ver:y different character from most of the others. Jim, at that point a.t least, was very very much the loyal soldier a.nd the one one ••• Jim didn't JA cont. 18 Jim didn't become involved. in the substantive issues at that stage of the game. Now obviously, later on with Bert, he became very much involved, but, I think, there again he was bright enough to Im.ow what his relationship was vis-a-vis Stan. He was an exped.iter, a doer, one who took what Stan told him to do and got it done, not one who suggested. what Stan ought to be deing or got heavily involv·m in policy. Now, at that point, I don• t know whether that squares with•••• EAR No, no, not •••• AJ Because one of the ways in which I think he was••••• I had certainly at this stage of the game, held Jim in V'ery high regard, one of the sharpest and most effective and minimarlly screwed up people I had ever run into, really very effective. I think he may have gotten caught in the Peter Principle later but..... One of the prol:)lems thcugh, with, what was I saying. You mentioned Stan's ability to size people up and I would agree with that. I also think that Stan ope:rated, at least, on the covert assumption that he was brighter than everybody he dealt with, everybody, and the thing that made it work was tha.t at. lea.st 95% of the ti;,me he was right. Now in 5% of the he cases he wasn't right a.nd. then/got into some severe difficulties, particularly up the ladder, but, in general, that washi.s modus operandi. I think there were also some problems. One other thing, just a little bit of a.n aside here, that has to do with the transition , ev·en though I didn't lmow Bob Felix, I"ve hea.ni a lot about him, and from what you sa.id, just corroborated. it for me. I am v·ery much impressedwith the role that the style of the leader plays in . ,••b the way in which an organization functions a.nd the way in which decisions are made within an organization, and the impact that a change in style can have on an organization, Did I ev·er talk to you about the Micky Steinfeld­ Hamburg thing, maybe this evening••• There• s a very strong parallel in terms of a ma.ssiv·e style shift, people continue to respond in. terms of what a given message meant in the old style and it means something totally different in John Adams 19 AJ cont. the new sty~e and it leads to a. lot of confusion. Now, if there was in my view, a. strong kind of pro~lem with Stan's style and with %his business of consulting in a rather limited way with people and going ahead, it was that I think at some times, it led down paths, that had broader consultation been sought, you Imow, things might have gone differently. Stan is, and was, and I think maybe is in the best sense of the word, I think, an empire builder and he was V'ery desirous of having the NIMH grow and get bigger, and I rem.ember his incredible , just, plea., and there is no other womd for it, when it, for a brief period, attained full bureau status para.llel with NIH, and I remember his fury when the ADAMHA thing got crea.ted over the PO\lerty, and of course, the Alcohol and Drug Abuse Institutes spinning off. It made him furious. EAR I wish I cauld talk to you a little more fully a.bout some of tthose conversa tions••••• JA AJ So, but the problem is, and I think one that obviously is still very much an issue had to do with the whole community mental health center business. I was there at the lime when that was really felt •••• when the groundwork had all been laid, when it was very much a time when the push was to get those things out, to get them rolling and to get the budget up so that more a.nd.Jnore and more and ;more could be funded. And at that· point a. tremendous amount c,f the cengressional mail that we were getting had to do with people writing ha.v·ing al.ready negotiated it with NIMH , but then going the congressional route, making arguments that this or that aspect of the regulations for establishing community mental hea.lth centers, didn't apply to their places and essentially asking for exemptions or why in the hell does it have to be between $50,000 and $200,000 and our place doesn't break up that way, or we got this, why can't we do that, and all of these various and Stan saw aJ.l of those as subterfuge, and as attempts to destroy what he was rea.lly.convinced., or at lea.st, put up a. good show of being convinced., was absolutely the way to go. I remember &lso, tha.t fairly early on, kn the one midst, we'd had six or seven congressional.s from this/v·ery activ·e JA cont 20 pla.ce, so I said to Stan when were were going through all this, and hewas explaining to me h.ow these basta:rds were just trying to, YI ou know, and I said, Well, gee, you lmow, incredible naivety, wH¥ instead of pushing this one model , why doesn/t the Institute set up six different pilot 11od:els around the country using different mixes, different models, whate.ver a.nd see which one works best and then, you know, implement those or maybe have a range of different possibilities and he really ga.v'e me a tough lecture. He said, John, tha.t and a dime will get you a cup of coffee. He said, that's not the way it works. He said Jyou :nave to decide what you n.nt to do a.nd then push ev·e-ry button to get it done. And that approach, I think ha.sled us into some difficulties. Because it obviously hasn't worked in every setting. I remember so vividly a. sub-set of that which I think a.gain was & problem with it. I recall being in his office and , in fact, when he read a little blurb, I forget whether it was in the Blue Sheet or what, reporlting some of Alan Kraft's first findings out at i~. Logan that chronic patients were cluttering up the community mental. heal.th center and that more and more and more of the energy and activity was going to simply maintabing chronic patients rather than the kind of outrach and. social, Stan, had, of course, a v·ery broad definition of what mental health concemei. He genuinely believed in a kind of public hea.lth model of what mental health was. And he was absolutely furious at that. And one of the most incredible a.ssign•ents that I ever nad. Stan read this thing and he said, John, I want you on a plane tomorrow a.nd go· out to Denv·er and find out what they are doing wrong. Not, why is it happening, not, you know, is there something peculiar about that place, what they are doing wrong, in terms of that. And I think some of that ca.me, frankly, from Stan's not really being willing to listen to a. bJr.Oa.d. range of different adv"isories and consultants. Stan talked to those who agreed with him in a major way, who, at least, in a. way were willing to go with it and then zingo, anybody who objectei to that had ulterior motiv·es. JA cont 21 of Coming back to Bert, one/the needles that Bert stuck, and you probably remember this one, Bert came 'ba.ck from one of his sojourns, I guess, out to Boston, or some place with this big button which said .. Even paranoids have itrea.l enemies". And he gave it to Stan. And I think in one sense, not meaning anything clinical., in one sense he was kind of paranoid. He did really see enemies around a lot· and those who •••• as a general principle of the way in which, and I know, I am still being awfully general, I think as a. general principle, the way in which decisions were made in the Instit.Lute about a whole range of issues, you know, hea.lth centers, wnatever, had a. great deal to do with sort of limited consultation , usua.lly with a rather close group, largely in-house group, and then followed by a sCl>rt of a massiv« highly pplitica.l strategy !:;~,5·b:r:ing that about; and damn the torpedoes. EAR Now, you see, again, to get it c,n the record, someone in one of these inter­ changes said, knowing both Stan and Bob, that, in a sense, Bob asked someone tJ..to do something, gave them the responsibility and ga.v·e them their head, and assumEd that:it would get done, in a trusting kind of way. And that Stan was always expecting something to go wrong, so to speak, and always worked against that kind of contingency by a.11 kinds of preparations. He wa.s, and is, somewhat paranoid abou.t that, but it's also important to realize that, as yeu said before, he really starts with the premise that ov·er the :,ears lhis experience, abilities and his general competence lead him 95% of the time, and in his mind, it is probably 100% of the time, te be right, so once he makes up his mind, ev'eZjjOne, almost inevitably, has to go along with him, otherwise they are wrong. And that also carries with it something else. I think, maybe, Dave Hamburg would exemplify, and I would say, mere at the present moment than ev·em tha.t he did before, you geit to the point in terms of power, responsibility, people working for you and reinforcing whatev·er feelings lS()U have a.bout JSOUr competence and omnipetenee, you get to be somewhat imperial. You ean•t help yourself. That's an impassible thing to avoid. I think, you just get seduced John Adams 22 EAR eont into it without realizing. I don't know anlJOne who eould avoid. it. Stan has the same tlling, and he has had it for a. long time. Now, I would love to see Dave Hamburg now, because I don•t see, whatever he may nave felt wh.en he was back in Stanfo:x:d he's got it in spades now. There's no question about it. JA. You aren't kidding.- In some ways, he's a different person. Dave, to spin of the top, he's so funny. .Anything that Dav·e was guanied about, it was •• negativ·e statements about people. The biggest robber, and Dav·e would balance his nega.tiv·e assessment with some positive points about the person, and whis g0t Dav·e a long way. One could argue, as people ha.v-e, thatthis had a v·ery pernicious design to it. You never can tell when your enemies will be in a position where you need to•••Da.v·e•s changed, and I have heard him just recently in some of the most unbelievable, what I can only call, character assassina­ tions that I have ever hea.:x:d. It's just ZZammm•••• writing someoody off and he didn't do that before. EAR Ya, f think it•sa side effect of thesa.me•••• OK, you want to t&lk about ?St. E's? JA. Ya, I think that's an example, if you will, of one of these things that maybe some, I donJt pretend to lmow all of th.e true intricacies of that business, but I may actually be dead wrong about some of the circumstances, tha.t led to it~ but I think maybe it could be ·u example where Stan. sort of didn't realize , or at least, didn't make as much effort to find out as l:le might have, where the mines la.y on that. Because I think Stan•s moti- vation for wanting, and here's where I'm not sure where the first impetus came from, but I , even though somebody else may have suggested that the way to solve the St. E's problem was to have NIMH take it over. It's very clear that Stan thought that v·ery quickly, v·ery quickly indeed, and saw it as a real opportunity to do a variety of things. First of aJ.1, one other thing that Stan absolutely is, and it's sort o:f' :funny, because he l".i.a..s ha..d. himself, certainly in recent yea.rs, rela.tiv·elJ7 little kind of direct patient cc>nta.ct on a one-to-oae basis. In fa.ct, as a.n a.sidf, I ended up seeing a lot JA cont of people who were referred to him while I was there. But Stan 23 has a.n absolutely unalterable commitment to the welfare of the mentally ill. Whatev·er else one can say about his metivations, that is unquestion­ able. One of the few times that I ha.v·e ever heard Stan really raise his voice a.nd soream, the mad.dest I think I had ever seen Stan, was once he had taken some higher funetiona;ry down to St. E's on a tenr, shortly after the NIMH had taken ov·er, you may ev·en ha.v·e been along on this, as they went on to one of the wards, there was a patient chained to a bed. Wllen Stan got back, he didn't even go into his own office, he stood out in Esther's area there, and had her get, what was that guy's name, (BEAR -Robin.sen) no, preceded Robinson, career PHS ••• EAR I've forgotten his name JA Tha.t•s significant, tu.t we don•t •••• Anyway, he got him on the phone and he screamed. in that telephone • He said, "as long as I am director of this Institute no patient, in a.ny way, 1s ev·ers-going to be in chains. Now you get that man out of that thing this instant and I want to report you••• ju.st screaming at this guy. and slammed down the phone, so that I think there were sev·eral motivations invol!v·ed. b the St. E's thing. I think, one of them was genuinellf a concem for the patients there and the fact that the ca.re was just God awful. The second thing, I think, was that he really wanted. to be able to show all these people in the field who were saying, Well, we really can't do anything 1rith these old state hospitals or the sta.te hospitals are here, and the communit;w mental health centers here, and they can• t work together and I think he genuinely believed. that by doing it figb.t which meant the way he thought 1t ought to be done, and sort of by sheer force of will, he could set that up as a model. And I think the third 'thing was that here was a. ver., large expansion of the empire••• EAR 4,000 more employees JA 4,000 more employees with three new divisioms, a national center for mental hea.lth training services and research. One of the bigger jokes, at least to me, I never laughed in Sta.n's presence, but to call that place the JA cont 24 - Anacostia Campus, I thought a:as incredible. And I think some of that had aJ.sO to do with the NIH business, y(i)u know, they love to caJ.l that the NIH campus and they were going to hav·e their campus and. he was going to hav·e his campus, the Anacostia campus. But that was certainly a case, in which I would think a little 'bit more careful, advanced planning really seemed that unbelievable quagmires that were gonna. be got into there would really have led to seme more caution, in terms of marching into that. Because that I think had probably a fair amount to do, that it certainly led to some horrible confrontations with Bazelon, and I was around during a.11 of that time. Bazel.on, is cer.t:a.inly, whatev·er else one ma.y think of Dave Bazelon, he is certainly someone, who I would think, it is better not to nave angry with. And he certainly got that going in a very heavy way. Another problem with the St. E's thing, speci­ fically was that it was all done so sort of hastily that the key people weren't in place' and, we.11, you Imow, Don Greaves was stuck in, he was on sabbatical., a.nd the next jhing you know, pooff, he's a Div"ision Director at St. E's.. Henry Ledenr., whc was inbetween jpbs and floating around, and the only one, you know, that really had any competence was Sherm. Sherm issomeone that I'm phenomenally fond of and admire and how Sherm has caught up with doing Stan's dirty work ov·er a.ll these yea.rs, I don't know. But he's a phenomenally competent guy and great gulf • But again, the one other thing, and this belies what I've said abouitStan's attention to detail, but I think that on a nUD1ber of decisions like the St. E's one., for instance, Stan has some tendency to, or the Institute at that time, and in a major way I think it did reflect Stan and his style. I do believe that men make institutions often enough the other way around, Stan really felt that if he could only get sort of csntrol of something and get, you know, the political thing, that then somehow the programmatic things could be worked out and I don't think that always works. You can get control of something and it may still be a hell of a problem to do something with it. And I think the St. E's thing JA cont 25 wa.s very very good example of that. And I think in a· significant way, that the amount of time, well, one other point, the amount of time and energy and effort that was devoted by Stam. and all of the senior people to the St. E's problem, you know, clearly pulled him a.way from a lot of other kinds of acti- S:', vtties , that, you !mew, hindsight is perfect, that might have had better pay~off down the road. EAR But you see, you've touched on an important issue which is like a moth to a flame with Stan, and that is give him either a. new emp&re to build or give him a. new problem to solve and everyt.b,ing else would go by the wayside, so that what JOu're saying about this seeming paradox, that he's inordinately eoncemei with details , witness what he does with letters, and yet with the actual operation of St. E's, once it was pa.rt of NIMH, he didn't seem that much involv·ed. His perspective is different. To get St. E's was a problem. Once having gotten St. E's the rest of it was, well, thats routine stuff he doesn't get involved with. Letters, by themselves, ea.ch letter is another little problem to deal with, see, so there's a continuous problem, but running St. E's was net something that he wantEd to do, if a problem com es up, fine, buii he was off a.nd running on something else, whether it was Co!.wnbia. or whatev·er else was coming along at the time, ev·ery new problem. And talking a.bout Sherm, just to giv·e you some further insight, I don• t know what keeps Sherm doing what he•s doing either, but without Sherm, I don't think Stan weua.d be where h.e is right now., in man~ respects, but Sherm provides that kind of balance for him and Sherm constantly feels that Stan takes on all these problems prior to having solved the previous problems , which, of course, is exactly the point JOu're ma.king with St. E's, but Stan is incapable of avoiding what seems to be an insurmountable obstacle a.s a. challenge. It doesn't make any difference what he did yesterday, today is another day for jumping another hurdle and for solving a new problem. Without a problem he is lost and he has such a tremendous ca.pa.city for solving these problems. JA 26 EAR cont. OK, What h.s your interaction with Sherm on the St. E's thing? Do you recall any particular incidents? JA Only by the time that all this came along I think I was on sort of quite good terms with Sherm and in a way, very different from the way in which Bert, for instance would :~.try to undermine me versus Stan. Sherm and I could sit down and just sort of talk about, and what the hell do you do with this one, and I think in some ways I was just sort of kind of a souding board for Sherm because heobviously got very intensely frustrated many times when he felt he had been sent off to do••• r•m sue, Sherm, with his very much more clinical and management kind of, he knew whatthe hell he was getting into and another example, of course, is Lexington and Ft. Worth. There was another case where Stan was going to turn something around, and I think particularly Lexington he had V"ery vivid memories of what it had been like when he was there a.nd, byGod, now that he could do something about it, he wa.s going to. And again, you Imow, that did't just quite work out quite that way. One of the proudest possessions that he had in his office were some of the bars from Lexingeon, the last of the bars that were theee, cut out. I remember, in fact I think that one of the early trips I ma.de with Sta.n, the earliest one., interestingly enough, was out to Ma.cKinsey(?) Institute, One or the other was the first one, the other was down to Lexington, and I think it was very shortly after Lexington had been transferred to NIMH, I think it was at about that time, that I remember going on a tour of the place and Stan's feeling·, again, of a sort of out:ra.ge at this, and that, by God., it wasgoing to be changed. And I think he said to me, he said, "In one year there will be no bars in this place". Now that again, I think, is an example, you know, take down the bars, but then what do you do? And I remember then a whole series getting very angry, you know, a.bout patient management problems at Lexington and th:ere was a lot of vitJ:rol, sort of poured on these who were down there trying to run it, beeaus e they were ineompet ent and why the hell can't they manage it, now that it's different. Stan had JA cont 27 in some ways, an almost revolutionary view on changing things. For all his conservatism, he was al.so a revMutionary, in the following sense. A revo­ lutionary•s basis notion is that if you take something that is, and if JOU blow if up into the air, somehow, as the pieces fall, they will be better than it was. Just perforce. And I think Stan had some of that view, that if he would jlllSt change something, then it would be better. And that some­ times works, but sometimes doesn •t. EAR Well, that's what we all gossiped about at NIMH, you Im.ow, a.ll about •••• How a.bout a few woxds about the Homosexuality because I th.ink that's illustrative ••••• ~ Of a lot of things a.bout him, as well as probably theene case in which I almost did get caught out in left field with it. Let me give you the whole chronology. First of all, I didn't start that. That had actually been startai before I came and Dick Sa.duck had been the exeeutiv·e director of that. But I think that is a good example of again, Stan's really V'er, courageous williingness to take 0n what he saw as a real problem adi. to try to use his own personal, and the ·Institute•s leadership to do .:something about itl:, because eerta.inly th.at wasn't in the days of Gay Lib, it wasn•t semething he was forced to do. It was something that he did because he thought it was a problem that ought to be addressed and I know a.be>ut this only second hand frcm taJ.king with Saduck, But, for example, Stan personally picked the membership of that Task Force, it wasn •t delegated to somebody else to put togethe:rr a groap to do this. He personally did this. That was run out of his office and I was formally designated to be the executiV'a: sec of that, but the way in which he put that thing toge ther was in itself sort of int.eeesting, because he really ·did try to draw f:rom a wide ragge of' different disciplines. There were clinicians, there were psychiatrists a.nd psychologists, there were sociology contingent, theologic contingent and legal contingent. We were all sort of patchei together there. 'Ilhere were JA cont 28 terrible problems , of course, with Ev·elyn Hooker's illness right at the, in fact, when I ca.me on board, she wis hospitalized and Judd Marmor , I remember, ran the first of the sessions that I attended. And Stan had given sort of a complicated charge to the group, he had askei them to review the state of knowledge in the whole area. and then to come up with recommendations both for a research a.nd scholarship program, but also to loe>k a.t matters in social policy and to see what recommendations the group woul. have. Well, we sort of went a.long with that, and once, that's one instance in which once Stan set it up then he rea.lly did sort of pull back from that one, and ma.de me kind of the go-between or the doer on that. And he really didn't check on it da.y to day, after we had Rad. a meeting, well, he would say, how did it go, and what happened, but he was onr: to something else. Well, this gets away a little bit from the narrati.i·e but I think 1£ does, the way that thing evolv·ed I found absolutely fascinating and a certainly valuable lesson to me on commissionma.nship and so on. It was a very diverse group, not a scholarly group, and so with a few exceptions, the basic task of deciding what areas ought to be looked at and the preparing of the White Papers and you know, talking a.bout the meetings and collecting••• all that went s(i)rt of according to Hoyle and I was able to dr&ft, with a lot of input frem tb.e ,l.'1, cemmittee the first section of the report, which haD to do with what we do know, wha.t we don't know and a lot of it, of course, we don't know and aJ.se where more resea.rcn was needed. 11hat was fairly easy to de. What became a in lot tougher, with/the group, was deciding on the social policy business, and this ga.v,e me a very vivid lesson in what I think is almost the inevitable dichotomy between the clinician and the researcher and wn:w I think there are so v·ery few people who rea.lly and truly. bridge those two planes, because I think it's a.lmost a. philosophical difference at the premise le~el, a clinician 8 is trained from day one to be willing to a.ct on less than complete information. otherwise, you do not, no matter what area of clinical medicine or anything else, you just can't move. The scientist, if he is a. good one, is trained to JA eont 29 do nothmg, either publish, or anything else, until he is damn sure. So what quickly came out of the early pa.rt of the discussion in the genemu policy one was the split. And on the one hand, the clinicians lei particularly by Judd Marmor were saying, Well, ·OK, we don't hav·e all the answers , that's clear, but we know enough to be able to say that this a.nd this and this and this is inequitable and probably damaging and therefe>re••••the scientists, led on the other hand by Benry Reicken (?) said loud and clear, .,This is a complete non sequitur of that. The first half of our report talks abC!>ut all we don't !mow and all we need to learn and then we turn around and suggest doing something. Crazy. We should reject, or at lea.st be very guarded in what we say. We hada series c.,f, I guess, a.tleast ten, fifteen meetings, no•• three or four meetings, I guess. And Stan, I'd feed this back tc, Stan, and he had some sort of pit~y things to say a.bout the god damn scientists and re­ searchers, you know, if they want t<l> play it safe, they'd better not get out of bed in the morning. But, through a. lot of verbiage and waffle wonis all through it, we finally had put together a compromise report that everybody, could, more er less, liv·e with. i:Hhis also gave me a reall insight into a.t least some segments of the leg&l profession because clearly the dominant legal force on that commissio:n was none other than Bazelo.n. Bazel.on, I guess, had attended a couple of meetings a.t the very beginning and then he didn't come any more and he sent, what wa.s his name••• the social worker who was sort of his special. assistant ·and. aide•• eqe EAR Yess., I don't remember his name but I know wh.o you mean. JA difficult, to be his ear in an obvious wa:w. This guy had said nothing in all of this and finally we come to the last round-up meeting, one that's going to finally ratify this heavily w0rked on draft, and I had spent a tr.amendous amount of time, writing all of this thing out and passing drafts around and getting feedback, and waffling here and adjusting there and on the phone••• Who should show up, but Bazelon. He walks in, and listens to the first five JA cont JO minutes of the discussion, cuts right in and say,s, "La.dies and Gentlemm, whis first whole section on research adn on what we know, that is trivial. Absolutely trivial. w·e cCf>uld have '!1"itten that without •eeting once, any one of you could hav·e written all ef this. Tnere•s nothing new. What's really important a.bo•t this report is the section of social p.iliey. That's what really counts. Tllat's where we rea..lly got to put our energy. But let me wam you a.bout one thing. Don't you dare base yo1:1r social policy recom­ mendations on some kind of, you know, good guy humanitarian kind of ground;. It's got to be based on facts. Now, I'm a. layman, I don't know·what the facts are 1:n this field. You experts ;ome up wit& them. And he walked out. He wa.s there for a. total of, ma3Jbe 45 minutes at an all day meeting, and he absolutely and completely and totally destroyE!d the whole fabric that had beem put together. Scared Reicken and company to death and they immediately pulled back from everything they had agreEd to and we ended up, as you know, with a. watered down report, with a minority rep0rt and all this kind of stuff. And that was one of the more frustrating things. Therre were two occasions when Stan really got angry with me, in a very forceful. kpp way. One of them had to do with that report, because after all of this, you know, I was frankly discouraged with the whole thing and I got awfully involved with othe:rr things and it just sa.t on ay desk fe>r months, and I didn't get it published and I didn't get a.11 of it cranked out, and so on. And for some reason, I guess, some query came to Stan a.bout it, or wba.tev·er, he ca.lled me in and he said, ''Where's the report on the Task Foree"? I think the question was, you know, 0 When's it coming out" Whem.'s it going to be published.? And I kind of went •••••• (gulped) and he gav·e me a v·ery steely look and he said, ..You go get that God damn thing published now and he threw me out of the office. The other time, a.gain, was the same kind of thing, this procrastination.. I think this must have been near the end of his tenure and he was applying for medical lieensure in a number of other states and he had delegzted to me the JA cont Jl job of getting himself and Tam licensed in New York and elsewhere. I'd worked on it same, and I'd ask my secretary to collect all of the stuff, and then we'd go at it. And he called me up one day and said, ..Where do you stand on that license••• and I Sa.id., we'V'e been working a.t at •••and he said, I want that done now. Zapp. Again, really harsh, sort of••• he didn't tolerate dawdling around. That whole homosexuality thing was really a phenomenal lesson, but I think it also says something about the way Sta.n•••I don't know whether that thing ever had any impact to speak of, it comes up certainly, ev..e ry once in a while••• Another a.rea., quite similar, that I al.so had a fair hud in was the business about sex education in medical schools there. And in fact, was fairly heavily involv'ed. in working with Paul Gebha.?.'dt, in setting up the first, and then, I guess, I was involved in two of the summer training sessions out at the Kinsey place for meiica.l sehool,,,,,,,psyehiatric educa­ tion and a.gain that was an area. where Stan clearly saw a need, well ahead of the world, the rest of the world, and where he reallypushei it. And I think it had a major kind of impact. EAR Stan a.nd I went out thre, ea.rlYf on started working, and they clearly sa.w him as their guardian angel. They felt that he had saved them from total destruction at the time, that he had provided the necessary funds, tha.t he had giv·en them all kinds of financial, moral and professional support and Gebha.mt, who is a v·ery delightful :man, rea.llJr, mf anyone , massagei Stan's ego well, it was Gebhard.tin his intemctions, and that was v·ery pleasant. I'm trying to recall •••• JA There were some other incidem.ces of this s~e general sort, where it didn't work out so well. I was the first NIMH person for some four ;-ea.rs who had set foot in Master's place and. that had had a very stormy previous history EAR Oh, yes, that's a story in of itself••• JA. And I got ears full of that EAR That's another stor;w. It went throw CouncU••• with some disa.ster••• Abouit JA cent J2 EAR this point, I was about to come up to Council, How many of the Council meetings did you attend? Did you hav·e a feel for the Council meetings at all? JA Ya. I went to all of them during the two and a half, three yea.rs that I was there. EA.R Was tha.t at the time that :n.e turned the Grants part of the program ov·er to me, ortha.t was already JA Well, I think that was done during that time because he clearly didn't like to maid.le with it. EAR No, you see that's just pure routine, that's detail that he doesn't feel he wants t0 do. In addition, he just doesn't like to officialte in that kind of meeting •••·behind the scenes, beforehand•••• JA There was one other issue that I think was also at the of it, and that is that there was a v·e-ry very different point of v'iew between, at lea.st some of the people on Council and Stan as to what their role was. I member a a number of settings in which he said quite directly, "You arre advisory with respect te policy. You are mandated to appreve the grants, but what we do is up to us". And that did not set •ell, at all, with the likes of Josh Leierburg and others, Jolly West , and I think, Stan wasn't particularly interested in sitting up there and ta.king the flack on that there eithe:xr. He said, that's the way its• going to be, a.mli screw you. And the Councils a.gain were clearly not pi>iicy ma.king, or real.ly even policy discussing for him. Important issues came up there, no question, about that, and I think they were very skillfully handlei but in terms of one role that tke Council could hav·e serv·ed., which was a major input role, 1 t didn •t. EAR Ya. It's very interesting because the problem of the strain, so to speak, between Council and the Director existed with Bob Felix teo, but in different ways. Bob's style was to be there, and in a sense, to turn the discussion or the tone a.round somewhat, and in a very corny kind of way, his style was on many occasions, I saw him do this, they'd get into a. big disaassion about JA JJ EAR ce>nt. something. Instead of responding to the discussion, instead of sa;w:1.ng, this is rea.lly what we would not do, he would say, Now this is,,,JOU people are now ea.ming your keep. This is exa.eitly wha.t we need the Council for. Well, lovely, lov·ely, but what about the answer to the question that they a.re raising. And he w0uld j'USt go on. JA Reinforce the process••• EAR iZa.ctly, exactly, and he would just go on (Whereas Stan, this was the ca.se we·ere Stan somehow, tumed tails on his feet, and didn't wa.nt to sit up there because he didn't know how todeal. with it V'erba.l.l.y. But I think it's also true that part of the other phenomenon that we ta.lkei about was operational there ev·en with the people of the caliber of Josh Lederburg, Stan felt that his thought process around these issues was superior to theirs. He didn't want to waste his time with this, and go through this. It was an interesting or pa.rad.ox -f,~t-f,/i,"/J./4/J/~/4/J a.t lea.st a kind of contradiction in equality, because with people coming up, he can be ino:cdinately patient, which is what he did with his special assi5 tants and he lov·es to bring people along, he leves to have people learn from him, so to speak, and while he can be harsh, in terms of getting things done, as you mentiona:1., with people in that kind of lea.ming 8 situation he really can be v·ery warm and very permissive in a sense, but when 1 it's a matter ef interaction with peers , or superiors, right, then there's another problem. One other part of this that's V'ery importa.ilt, and tha.t is, and you alluded to it fairly on., Stan was rea.lly not a charter member of the psychiatry community the way Bob Felix was. Stan, I think, will nev·er be , whereas Bob Felix obviously came up with all of those people, Frank Braceland, John Roma.no, they started together, they worked things through together. He was a member of that community, an intimate member.. of that community. Stan., was in a. sense, and still is, to some extent, •• ••. a kind of an outsider to those people, so that when they ca.me out of Council, whether it JA cont 34 EAR was Jack Ewald, or wh0ev·er it was, I think most of them were bright enough and honest enough to admire his competence, even a Josh Lederburg, but they didn • t feel the sense of camaraderie. JA It wasn't an Old Boys Club, with him as a member of it. EAR Exactl;w, of course, •••• JA To some degree, you see, that's another piece of it. To some degree, you see, I think there was a.nd is an incredible arrogance on the part of the field, because I think, in one sense or another a lot of those people wbuld have felt that Stan wG>rked for them, and the Institute should be an agent of the interests of psychiatry, specifically, and the fact that Stan had some very different views about that, that he genuimely believed in interdisciplinary tinds of things. I remember his great pride in speaking of the first community mental health center with a lay director and of what a great step forward he felt this was. He didn't have to have a da.11t;,ned MD to be the director of a community mental health center and how proud he was of that. And that wrankled. And there was another shift there too and that had to d'1> with this I think • You may ev·en have gotten caught in some of this one. The way in which the field was treated by financially, by the training branch a.nd the fact that with, I' guess, Bob Felix's total blessing Vertermark, I didn't Imow him, but he was a Johnny Appleseed and he simple went around the country helping set up departments. He was a collaborator, he was a friend, helper, you could call Vesty and get what you needed. If JOU need.Ed another grant, he would taake ca.re of i£. It was very significant, to me that the psychiatry training branch, at least up to and including tne time that I was in that division, as a sort of director, so I think that this whole business of Stan's relationship with the field of psychiatry was often a less than smooth one, though having to do with I think things on both sides. I think Stan, at is core, is, IHm being interpretive here, but I think he has some questions. He would ha.ve liked to have trained in the main line JA cont 35 and they felt they ought to own him a.nd run him and if he weren't part of the club, then at lea.st he ought to work for us, a.nd Stan doesn't work for anybody. That's another characteristic of Stan. He does not work for a.nybociy. But I don't think I ever heard Stan say a sort ef unqulifie:lly good thing about any other people, sort of up the ladder from where he was. He certainly had friction with Shannon of NIH and he certainly did'nt care much for, it was strange, because I guess he'd had a previous good re­ lationship with Irv, ( EAR ob yes) what• s his name? EAR I don't remember. Obviousl;w that secretary has got AJ who then became EAR He works at NYU. I 1mow who you mean. JA NotPhillips ••• EAR Oh, no, it's a Jewish name, Mike Laza.mo?, I don't know JA Wasn't he involved in the Adamha thing early on? Then he was director of Adamha., wasnt • he? EAR Ya, and also, well, it really all began with Wilbur Cohen,· who eventually may be the compromise fa.ct in the title. But that was another••• Wluriiuexxu KU:xiDR JA Whether or not Stan wa.s going to be made associate administrator of ADAM.HA for Mental Health,(which is the EAR Which is the model Bob Felix had had for NIH, you see, Bob Felix had been Associate Director for Mental Heal.th within HilOf NIH, that had happenErl long a.go with Jim Shannen. Well, it's very interesting. You never sa.w him in.interaction with Jim Shannon. Now, you se,, Jim Shannon, of course, had long since made his relationship to NIMH through his relation­ ship with Bob Felix. There too, the problems were, r.elationships, net problems, they were, I think, between two peerrs, and while they went a.t it cats and dogs quite often they had mutual respect for ea.ch other. When Stan came in, I think that the lack of cordiality and the lack of regard was mutual. I think that Stan admired Shannon's ability, but I think he had n0 JA J6 II& EAR CONT pers(l)nal rega:r:d for him at all and that was recipricatei in spades by Shannon. He really thought that Stan was Johnny come J:ately to l>egin with and He, Sb.um.on, should.n • t ha.ve to tolerate him, and yet there was no way te get around that. JA I think there were some Y'e?:y basic philosophical differences too. Because Stan was absolutely committed in part I think because of the empire thing, but I think for other reasons too, to, having, again, a 'case where the grand scheme made very good sense but where in practice it just didn't work out quite that wa.y, in terms of having service, research and training a.11 within one estab­ lishment setting••••• EAR Absolutely, well we had fought that fight, you see, long before you ca.me and after it was separa.tei f:r:om NIH in a different department•• but you toucaed on something that I rea.lly want to get on the reco:cd a little earlier on because one of the ways in which Stan has mot been giv·en his just due is precisely in his willingness to go beyond the psychiatric community for leadarship, and there's another pa.rt of that, which bas to do with the Intramural program, which we hav·en•t talked about at a.11, and that is that, you see, there was a long standing enmity en the part of the key people in the Intramural program, because of their own early dispute with Bob Felix, and so Bohn Eberhardg, Loren, and Bob Cohen, not very mucl!l because he just doesn• t have a jea.l.ous bc>ne in his bod.y, but some of the other people at the Intramural program really felt, epitomized by Eberhardt, tha.t Stan was selling the Intramural program down the riv,er because it was then in the Intramural program, never realized llow many times he went to bad for tl!lem, how mueh he feels, ud he still expresses it to this v·ery day, that a great part of his career has been dev,oted to pro­ tection of the scientist and the support of the scientist. He sees himself as the administrator par excellence wbo has done a tremendous a.mount to nurture and protest these scientists, who are v·ery bright but have no sense JA 37 EAR cont · ··a.bout politics and really need to be led. like children for their own protection , so that his willingness to put me in, for example, a$ the first non psycb.iaitric h.e.c¼.;{ for the training bnnch, a.n.d theD the Division, and his willingness to do other things that incurred. the wra.th of the pslJChia.trie cemmunity beca.us e he was willing to go beyond that, and ev·en ironically, and I'm not sure that this happened before you ca.m,, either, but the psychologists were up in arms beoaus e they thought the original regulations for the cOJlllllunity mental health centers did not permit non MD directors and he said, that's wrong, but the reulations were nene the less chang83. a little bit to pacify, and to make it ;more clear that there could be non-psychiatric ~ ~ c\ d~ Psychologists never believ·ed , never hav·e rea.lly acceptEd the fact, that Stan wa.swUling to go beyond the socalled. medical model. JA Nor for that matter, I"m sad to say, ha.v·e a large number ef the research community ev·ery appreciated the degree to which he did in fact fight for their interests• . EAR Danny Friedman is the classic example. JA He is still pushing like hell to get it broken up a.nd send the research ba.ek .t'""i NI~, and that may well happen, that may well happen now. EAR Well, I talkai te Bud Bussey not to long ago, who you know is on the .Biomedical \ , recently, and Bud .Bussey, I don't know how well you kn0w, is an interesting man. I had not known him that well (J.A. he's not easy to lmow) I'm sur.,:e he's not easy, but he plays his cards very close to his chest. And incidentally, this little procedure is, in it's own way an interesting clinical !Ool, if you will, and so you get tG know people, much better than you thought you did, after ye>u get finished with all this. But, Bussey, I think is in the same ea.mp as Dan Frie.imam in that NIMH somehow didn't do do right by•• research••• JA Even Da.ve Hamburg ••• EAR Oh yes, now, now••• JA cont 38 JA I think he had his questions before, but he knew which side his bread was buttered on and he liked v·ery much being part of Stan• s extramural consultative apparatus. It's v·ery clear that they did consult. EAR Well, you know, aore than tha.t. Yc,u know, Dave played. a very peculiar unusual role with Stan. Stan went out to Stanford every once in. a while to consult on whatever was going on with Dave because he had. a. lot of respect for him and I think Dave, v·ery uiquely, played that role with Stan in a way that almost nobody else did. I think Stan respects Dave's ability. To Stan's everlaatiag credit, when he does see someone who is competent, he's willing to giv·e him credit for .fut;~~and well, he respects good people, and of course, Dav·i:nl a very extra.o:cdimary man J.A Dav·e &l.so had a. real ta.lent though in knowing when to keep his mouth shut. with Stan, which someene like Danny Friedman obviously didn't. He would pop off about ev·erything. EAR Well, I hope I can get to see Dave. I know he is so damn busy. I was going to inv·erview him early o:n, and then he got involved. in a let of things , the Africa. thing ca.me a.long, and then this thing came a.long. Incidentally, I saw Jetty in Boston not too long ago. The other thing a.bout Dave, and this is not as incidental a.s it may sound, because I think he's pla.y,ed. a role at NIMH that's important now, I think, to some extent, p.robably still a will, but Dav,e is playing, veey clearly, the Kingmaker in Washington. JA You• re telling me • " EAR And behind the scenes, every once in a while, it surfaces, but those of us who have been a.round, can tell the signs. ja Here and there, and this is another real change for Dav·e, at least, in some settings. He's not at all candid about that. He said. te me, I talked to him the day before yesterday, and he said to me over the phone. He said, e>f course, I either suggest it or approve of every single health person who's entire been appointed. in this/administration beginning with Califano, right straight en down. He mea.ns it In the way that he played with Terry •• • •••• JA cont 39 #( EAR Well, that goes ba.ck quite a bit. That•s another story. JA That's another story. I'll tell you one thing right now, Eli, absolutely right nGw, that I weuld li>e willing to preiict, and this is no reflection on you or on the project, but I will be willing to predict, he will 'be too busy to talk to you, if he does, he will not be candid. No W&F" will be be candid now. Five years from now, wherever he is, ma.lfbe. EAR>f-;H It's too bad. Well, he's cut some people off, including Alberta for other more complicat.i.·reasons. JA Much more complieatErl. reasons. He's cut me off too, EAR It's a sad part of what happens in a person's life cycle and sometimes, some eitherfor situation and we cant..... Well, lilt's get back to NIMH. Is th.ere a.nything, as we were talking, any large issue that comes to mind, that I'v·e left out or that you•v·e left out, which is t10re important than what I'v·e left out? ja. Well, in terms of the substantiv·e things that were going on while I was there. The various mev·es eitaer, to increase the domain and how tb.ose came a.boat and we talked about that. The i:mense amount of energy that got devoted to internal, by internal I mean within the goverment political struggles and an awful lot of Stan's tiae went to doing battle with those up the ladder, really, a tr•endeus a.mount•• ear I want to ask you a slightly different question, 'before it gets away from me. You ca.me here early on in yourcareer, so you didn't, although it is true that you had seen comparable things and I think you v·e-ry hicJuy pointed out that yeb. had comparable kinds of responsibilities with the••• JA Oh, but not eeally. EAR Well, in a sense, I mea.n process-wise • So th.at having that early on in JOUl" ca.reer:ryou don't ciuite hav·e th.e opportunity to see your NIMH stint in a pers­ pectiv·e as it might compare and contrast with other agencies, but I ion•t think that• s a serious problem. What I really want to ask you is ..What was your JA cont 40 EAR general evaluation of the people there a.nd tne manner in which they worked. You talked a little bit al)out the rivalries, some of the internal politics, the way Stan tended to compartmentalize people, but you interacted with a lot of people. What was your overall- evaluation of the operation as such, in terms of competence of the people, wap of working toether, or whatev·er? Was it a. series of fiefdoms? JA Yes, to some degree, it clearly was a. series of fiefdoms and some of that was Sta.n's doing. Tha.t;s the way he set it up, that's one of the things that comes of that kind of multiple unilateral nela.tionship, namely, in the decision of whether or not to develop a. special mental health division it was not discussed in Sma.11· Staff and decided there, it was decided quite otherwise. In general, certainly, the people who were in the leadership positions, see, one of the funny things about my position there was that I had vastly more to do at that stage of the game with the dozen people in the top of the scheme than I did with those well down in the system. At the next step, when I became Associate Director of Mental Health training, I had a v·ery different kind of experience down in the bowels of the thing, which was a fascinating shift of gears for me. But, in generral, a superbly competent bunch of people, none I think without flaws, if you will, all of them very much eaptiv·e to the Zeitgeist that was • Those }fho couldn't function within that system be it Don Oken, or George Hamm, got out. They were not tolerated. Interestingly enough, the one person amongst that group whom I never, ev·er, could get close to, and I'm sure you can guess who that is, (EAR-Phil, Mort) Oh, Mort, Oh, I actually got quite close to Phil, nev·er intimate with him, but I could talk With Phil. With Mort, Never. And I think there may hav·e been a. number of things that related to that, I think, EAR But the ,nost a.bv·ious is the ;most important. He didn• t want to feed ba.ck to Stan. JA Because he knew , he wa.s the onl:w one who really Imew what the role was. JA cont 41 JA The seeond thing aas, that I think in some wa.ys, I mean, this is purely speculativ·e, I think Mort was a little jealous. You know, he had supplanted in one part of the role. The second thing/; was, that by GGd., he wanted to work directly with Stan. Some· people whom I have just inc:mdible sespect for, Phil certainly did an amazing job in a v·ery quiet, but super effective way in the congressional. affair. I think Sherm, what a phenomenal guy, just incredibllf solid, hard-working, would take on the tough ones kind of a. guy •• Certainly your role as being, in a v·ery effectiv·e wayj. the kind of gad-fly in the system and you were the one per;son who could sort of get away with saying, Yeah, but what a.bout this way of looking at ii,and I don•t altogether understand of how and why Stan tole:rated that, Stan and the others tolerated that, but it was a terribly important role that you played there. I did hav·e, and still have, the most inct:edible respect for Lou, who was able in the face of all sorts of onslaughts, I mea;., the easiest thing in the world would have been for Lou to stir up the research community against Stan, to be a.n undermining, neve:ir, he may have disagreed. with Stan, and Lou is certainly very conservative, for Loll it is resaa.rch uber alles , he certainly was not supportive of setting up that special division, he saw it as a. rape, he sa.w it as a. perversion of the things tha.t , ncb question a.bout it, but by God he worked at it, he worked hard at it, a.nd I think he deserves a. hell of a lot· of credit for actually keeping a very high standa.:rd within NIMH. Betty Pickett was another unsung sort of hero for a long time who did an awful lot-of the hard work. I also was very close to, for a.ll of his rigidity, to Bert Boothe. He and Stan certainly disagreed v·iolently on man~ things. Bert was certainly one who hued to the old line, but again he gets an awful lot of credit. Stan would probably not va~ue Bert•s contribution in al.l that hiring(?) I may be wrong. EAR In one sense b.e would, but he sees. he would see Bert as being a. somewhat more pedestrian kind of guy than he raally was. He wa.sn • t that all pedestrian. JA cont 42 EAR And Bert Boothe's dislike of Stan was a personal dislike based on a very emotional attribute. He just didn't feel, that Stan, and this is where he was wrong, that Sta.n va.luEd human dignity and that he was willing to tolerate the human condition in the way one :needed to. Bert was an absolutely thorough-going gentleman and he didn • t think Stan was, and I think, as simple a.s that and as complicated as that, let alone the fact that he couldn't tolerate what Stan did to what he 1rhought was his program. So, it,s a.11 very compliea.tEd, and yet it's terribly important to hderstand. Someone has already tc,ld me, a.md I hope they're wrong, that this may be very interesting to those of as. who were involve! in this but it really isn't v·ery interesting to anybody on the outside. I rea.lly hope to be able to do it in such a way that it's illustrative of the way an organization oftan works and very important because this was one of the most successful national. federal. heal.th progrus with a creativity, with inventiv·eness, with a. cadre of people, with an impact on its own field that I think in some respects is almost unequal.lei. So I th.ink it's a very important story and I think the story is essentially the people, and is I 1 v·e said to individuals, My God. if a story about the National Institute of Mental Health can't talk about behavior and dynamic processes, which one can? JA Now, as particularly as I shifted over into the Ma.np0wer and Training and sort of got more down into the bowels of it, that was a storm:,- time for me too, because, in a way, you see, the training area was one in many ways I think it was the area that Stan· had the least impact on for a variety of reasons. Maybe he calculated that he didn't want to attack that one head on it would hav·e required a head on assault, he approached. the resea.reh issue in terms of trying to hav·e at least a. eompom.ent of research that was more targete:1 than the•• he did it by sidestepping the dirt. He simply set up another one and went that way • There wasn • t any conv·enient way to do that with respect to training, it would ha.ve taken a head-on assault, and he clearly JA cont 4J JA intended that Tom Plaut and I do that W'ell, it's ver:y strange, I remain on v,ery close personal terms with Tom, but there is noone with whom I disagree more totally in terms of many of the issues that Tom stands for. I think Tom is absolutely irresponsible in terms of some of the things that he proposes to do, and more impertantly, the way that he proposes to go about doing them. Tom tauts.: himself on being such an egalitarian, in. fa.et Tom is the most dan­ gerously dictatorial person that I think I've .,,,er run into, and he will sidestep anything to get dom what bethinks he, he really d.oesnt listen., and goes about it as ne da.Jm well pleases. His latest white paper on that five year plan, is a sort of ultimate example of that, so I very s~on had my falling out •1th Tom and I found. myself in a very awkwa:cd pesition down there because I was Tom's, in some ways, in a little different version of the Bert-Stan thing, in that ev·e:rybody, particularly people like Bert, Bert Boothe and Stan Shneider and Milt Witman and ev,erybody, you lmow, were coming to me to protect them against this thing. I hfpe I nev,er undermined. Tom on that but what became clear after a year at it was that I could .not, ;in conscience, stay on and do that. EAR Was Jerry Ostterwild at the time there? JA Jerry was there, and Jerry is a classic example of one cf the sort of tragedies of the system. Jerry and Steve Goldstein. is another one and sev·eral people like that. And that was what I was going to say. At the 9 working lev·el within the Institute there were, well, it was obviously a gradation, but the level of quality was much less uniform than at the top. And wh&t ~u bad there, ill my view, was some very v·ery .good people, maybe , a bit narrow, maybe a bit captive with things., but first class people. Bert Boothe, Elma.gen, and I lmow he again has lovers and detractors, but man, did he do a job. Milt Witman, in terms of what he did with respect to social work, Bal.ph Simon in terms of fighting terrible odds in terms going of getting some things rimm ailei started JA CONT 44 EAR By that time, I didnt even know the nurses v·ery well JA Yeah, they werre aJ.l in transit when I was there and well, I alwaysliked, but as not impressed with the wisdom and vision of Stan and some of the people in psychology. They did a job. On the other hand, there were within the lower echelons of the some of the saddest people I'v·e ever seen, pe0ple who dev·elopei wha.t I, for want of a better term, sort of call institutional paranoia, and they were professionals who were de facto ex-some­ things. They had been psychologists or psychiatrists, or social workers er something else. They ld. let themselv·es get terribly far from the roots of, where they had become bureaucrats, and there were still terribly concerned with and proud of being Dr. this and Dr. th.at. They had lest the ties with where they were and what came of t:tlat. I thin:i, was a rigidity and a protect­ ionism. Now, I ha.v·e to sort this out. You see, I guess, and maybe I'm captiv·e of some ef this. I really think that Bert Boothe was being protective because he had something pretty good, a.nd not perfect by ;a.n.y means. There were certainl;w some a.buses of that. · It was something that really needed to be protected.. But there was a.nether whole area. where it was a. matter of ••my program•• to be defeaded against anything, whether it was good, bad, or indifferent, and people who genuinely beeame more interested in and rewa.xded. by the accolades of the field and everything else. Now I think if there was a problem with Stan's style , not just Stan, but the ambia.nce, it was that it· wa.s not particularly supportive of the troops in the trenches, and much more often the message would come down farom the 14th floor "You• re not doing it right. Why the hell don.•t you do this? rather than a supporttv·e, nurturing kind of ••• that might ha'V'e produced some identification with the tasks of the Institute, so the result was that those who had any gumption at all sought and they 1 their ego rewal.'ds from the field/became really eaptiv·es of the field rather than leaders of it and developed this kinds of very :tigid, ud tended to be, al and Osterwild' s a sad classic/axa.mple ·, that they tended to be unhappy depressed, discouraged., bitter, nitpicking , some of them pompous, you Imow, JA cont 45 JA oJerblown sense of their own worth and importance and discouraged because they weren't being offered chairmanships of :major departments everywhere, and so on. Those were sad people, and I must say that it was partly seeing that tha.t the forty )ear old depressEd bureaucrat who was also so locked into the f edera.l retirement s;p5tem and their salaries had often gotten up to the point where they were not going to get the same thing outside, who one of the things that mad e me decide tha.t I didn't want to , at that stage, of tne ga.m~ at least, that I wanted. to get out, ba.ek into academic, so one sort of final pitcti may be .the best 0f all worlds it would have been awfully nice i think if some scheme could have been worked out to allow more real kind of interchange between those not necessarily in the top leadership positions, but sort of at the exec. sec. level within the variou s units , some interchange between academia and the Institute, so that there could ha:v·e been more sharing of the • I guess one sort of last thing. If I had to cat:egorize the toes of my life that had been most clearly important, whea the sort of learning density ha.s been highest, it would be clearly my last two yea.rs at Swarthmore, in the honor's program there, the first year and a half a.t Stanfo:rd and absolutely these years at NIMH. It.twas the most phenomenal, and that was particularly unusual because it was not in the omerai sequence of things to hav·e had the chance, a.t =that really ~.erribly green stage, to b e part of all of t:nat, to watch it work, to learn from the likes of Stan and you and Sherm and Mort, and all of that crowd, simply unparalleled, just un.paraJ.lel.lei, in terms of that kind of experience and it has stood me in phenomenally good stead at , that many many times since, there are litera.lly times when faced with a decision, usually when it has a political component to it, which now more and more mine do, would say, you know, "How would Stan handle this? and. I also think , how would Dav·e Hamburg handle this , andthey were two, in some ways v·ery similar, in other ways vastly different peeple, so I had two strikiingly different models and I , you Im.ow, incorporate pieces and things. There was a able v-aJ.ueiJJis experience , I made one professional career error in my life. JA cont 46 I go for gra.n.diose statements. like the man who said , I ain't ma.de one gram.matica.l mistake in my life and I took that back as soon as I seen it. When I left NIMH, I should not have gone directly back to, well, a.) I Probably should not have gone back to Stanfo:rd, though that's ha.xd to sort out, but I certainly should not have gone directly back to a. fa.culty position at least not c,o one that got me again so quickly embroiled. in administrative things. I should have, maybe, used my contacts that I made in, by the way, that's one other terribly imp9mta.nt component of that, is tna.t it let me meet and get to Imow at a very early age an awful lot of people who otherwise I still might not know. People like Dan Fried.man and others, that I am really now on a v·ery good relatienship with, not all the time, but, you know, I met them. Otherwise, I w0ul.d:n •t have met all this sort. What I should hav·e done was to go and get the v·ecy v·ery best research post-doc for two or three yea.rs that I could possible have found, because the one flaw, for me right now, is that I really don't hav·e the background, the real full background. I know what good research is, I can dabble in it, I can probably facilitate it in somewhat the way that Stan did, but I feel a. little uncomfortable about not not having got it yet. In that respect, had.I in some way or other gone the clinical associate route, I would ha.v·e got that, but I would not hav·e got the other, so you pay your moneYf and take••• I should have done both, that's what I should have done. I should have delayed gratification a little bit longer and spent two jea.rs with that, although th.at preba.bly wouldn't hav·e had much impact on ~hat) where I a.m now. EAR I would suspect that , I remember when you left, and we chatted for a while as you were leaving, I suspect it's easier ,to say now that what WCi>uld have been then. I think you would ha.v·e found it v·ery difficult to go back to well, a research post'doc after having been in that ••• JA I think so too. But you see I had the illusion , don •t delusion, that that's what was going to pappem at Stanford, but through a variety of JA cont 47 things .taa.t were partly out of eit.her Dav·e• s or my control, partly within our control, too, I mean, I could have said no to Dave, I suppose, but I went ba.ck to, I really in a sense went more back to administrative things than I had come from them, so it was really a But, I jast, you know, summing it ap, I just view myself as having been phenomenally fortunate , just plain lucky, to hav·e had that cha.nee and par­ ticularly a.t that time, it would be v·ery different now. I don't think I'd want any part of it. I've lin fa.ct had a ;couple of feelers abeut, you know, in no way a.m I interested. come EAR Though, you did HUX exa.ctl:w lOIUXi at the right time. Had it been some- what earlier it might not hav·e been quite as good. Had it been any later it certainly wouldn•t have been as good. You had the best dif both worlds, so to speak. When Mort came a.long there wasn't quite as much going on. Stan hadn't rally set himself up as extensively, so that Mort had a different responsiY>ility, aJ.though he too sees it as an important part of his experience. JA Have JOU interv'iewed Mort? EAR No, I've carefully stayed away from the pEOple that I , well, except for Stan, and I'v·e a.lrea.dy done some work with ·stan, but I hav·en't talked to I . . Sherm, I hav·en•t talked to Mort and I've also stayed away from the people who are still at NIMH, except for one hour with Bert, which was very unsatisfactory. The phone kept on ringing, a.nd Bert, as I am sure you a.re aware, is V'ery difficult to pin down. I think it was as dd: difficult for him to talk to me as I'm sure Dav·e H:tamburg, if he would even allow me to come and see him, so that's too bad because Dave's input in many ways is terribly important and while I know a lot about it, by inference and by interaction myself with Dave, I really would have liked to ha.ve gotten in to bim. But, listen, let me stop at this point and let me thank you again so much for this. You know, with everybody, it's so interesting to hear. NLM NOTE: Interview tape ends abruptly here