Dr. Lawrence Kolb August 11, 1976 Albany, New York LK How far have you've gone with it? EAR Well I have gone quite a bit, but not as far as I'd like to. Let me tell you what I have been doing. For the past year I have been interviewing a number of people and collecting information. I started really more than a year ago talking to Stan who obviously is a., captive audience. And then last April, a year ago this past April I went to see Bob Felix and spent 2 full days with him. I have about 7 hours worth of tape with him which is very interesting beginning way back from his early days on through when he actually left. And then I have done a hour or so with Phil Sapir, I have done a hour or so with John Eberhart, Bob Cohen. I did a hour with Bert Brown. But all of this really is rather intimate and sparatic. Except that it is very useful because it really goes to the heart of what I am trying to do. Namely, to really talk to people who have been involved at various important points and get their perspective on what were the attributes, what were the characteristics what were the events that helped really shape the decision making process. I do not want - and dontt feel I could ·even,if I wanted to-write a traditional kind of history with very meticulous examination of all the important documents and chronological presentation of everything. Which I think, frankly, would be deadly dull. LK When I gave my 25 year address, whether you read it •• EAR Yes, I did. LK I made a most ••. and I had quite a correspondence with John Eberhart and whoever · - was/!edi:t;i,ng.;. - I: said, "you know I wrote about people" and then they wanted to edit all that and I said, "I won't have that, that is what is wrong with history". EAR It is silly. And I really think the thing that has provoked my doing this in the first place is really two aspects of the same issue. I think in many 2. EAR(cont) respects NIMH was and still is a unique federal health agency. But it was that not only because of the nature of the area, we had often said when I was in training with Veste and after with Ray Feldman. Many of the arguments we use to make about why the training program could not be split between service training and research training for example. Or why research per say could not be split off from training and serivce per say was because in the mental health field you are always dealing with the whole person and in that sense you,have to think of all aspects of what it is you are doing with the individual, the research, the service, the training, all important parts of those things. LK Some perculiar splits did occur. EAR Yes, unfortunately. But from in many instances, I think, pressures from the outside. Not the least of which at one time either the head of NIH or the Surgeon General at that particular time. So I think that there were obviously people in various key positions at every point in time who had their own very unique input into what was going on. From your father through Bob Felix, all the rest of you who were there in the early days and even on and up to .... Incidentally, I am cutting this off at the 25th. anniversary. In other words, this is a story of the first 25 years. I think the most recent past is a different kettle of fish in many respects and I think were you then to go up to today it seems to me you would have to be much more concerned with a lot of outside pressures, a lot of outside influences which to be perfectly fair may well have resulted at least partially from the development of the first 25 years and the way mental health was viewed. But cer~ainly those first 25 years are a kind of growth and development that have almost an organic kind of look to them. And, as I say I would like to illuminate if I could possibly do it is how the key decisions were made. Who was involved, Bob, obviously, played a very important role for the first 15 years. And, what I have on tape from him I think is very helpful. You 3. EAR(cont) were there in the early days and it would be very helpful also, as you suggested.5,in your letter to know about the role that your father played. When I got to know him at the end all I knew about him was that he was a poker player. And that was as-~~I came along much later. LK The role my father played started before World War II because he actually did all the ground work for this and had to get together that advisory committee. I can ''t remember whether I can comment on that advisory committee and that paper ••• EAR I don't think so. LK The members of that advisory committee were extraordinarily important. EAR Alan Gregg was on it. LK Alan Gregg was on it. EAR David Levy. LK No, no. EAR No, that came later. LK That was before that. I think Ed Strecker was on it. I think Nolan Lewis was on it. Henry Waltman of the Mayo Clinic was on it. EAR Was Charlie Slacker involved at that point? LK No. He didntt come into the !icture until much later. Long after my time. There were 6 or 7 people and he had them together before the war broke out. When he left Lexington he was already thinking of this. I didn't know, you know, until I came to New York that my father was an aluminist of the N.Y. State Psychiatric Institute. He was sent up to N.Y. as one of the two psychiatrist, he and Walter Treadway to get psychiatric training-at that time the Psychiatric Institute was forming as the first multi-disciplinary Institute - Psychiatric Institute in the world. It is the first medical multi-disciplinary Institute of this kind. Did I sendyou a copy of my paper on the Institute? EAR Yes, I have that. LK What I think that first Institute did and also I think they went further, well, 4. LK(cont) I think the first Council went further. I thought the Council expanded the and role beyond perhaps the concepts that my father had that first Advisory Committee had setting up all the grant programs, expanding for the support across the country to the grant methodology. I think that was probably Alan Gregg's great influence that did that. But the first Council was important because they actually brought the concept of the Institute to the attention of :lhe·major professional bodies .. EAR And this was 1945-46? LK No, this was back in. EAR Oh, you mean very early. LK No, this was way back in '41. EAR -Right, Right, OK. LK t 4L It is in the minutes so you will find it in the minutes of the American Neurological, the American Psychiatric and the AMA. Now the American Neurological there wasn't a ••• what is the other one called the Neurological Association of something. The American Neurological was a small group of persons very influencial. The American Neurological approved it and I think Henry Waltman was probably the leader there and there may have been someone else in the group perhaps Strecker. The American Psychiatric appnpved it. The AMA turned down the concept and my father, I remember, he was in an absolute rage and never had any sense of respect for the AMA for that reason. But at any rate, before the war the approval was already gained by the major speciality professional~associations and I don •·t think at that time they were thinking beyond the field of medicine and psychiatry they weren't considering the other mental health professions... Of course, with the development of the Council it was broadened. One of the matters that I thought the grave mistakes the Council made .at the very beginning or perhaps it was the training committee was to produce the split between the disciplines. So that each of the disciplines 5. LK(cont) was trained separately rather than people who were going to work with the area of psycho-pathology being trained in similar environments. I thought that was a .• I don't know that at that particular moment I perceived the ultimate consequences of it. EAR Let me interject a point there. When you were first involved in training before Veste came along, do you recall how or what percipitated the idea on the very points that you are making about the separation of disciplines of the very famous 40~20-20-20 split of funding among the 4 disciplines? Do you recall .... LK NO. Because actually Veste came in just before the first meeting of the Committees. EAR So he was already involved._ LK So that he took over my job at that time was to sort of organize the procedural aspects of the office. On the other hand working on the research side I was working both policy wise and procedural wise. We were waiting for Veste to get there. I actually developed the first training forms before Veste got there. But he was in on that first meeting and I was not a part of that discussion so I really can't make a contribution to that. EAR That continued to be a thorn in the side of so many people for years and years and years. LK Yes, in different ways. EAR In different ways, yes. No one was satisfied with it, it really was funny. And, of course, by the time that Ray and I came along it was modified to some extent except that the original division just from sheer enertia and the build up of existing grants remained as a kind of influence on the distribution of monies. But it by the early 1960's it had long since been shipped, to Well, I'm sorry I didn't mean to interrupt you. But that ••• I am trying to track that point down and I can't get it. 6. LK That one I think you would have to go to some member of the original training committee or surviving members of the first Council. They might be able to discuss it. EAR Incidentally, I have all the Council minutes. So that is very valuable. LK I can't even remember who the members of the first Council were. There might be a few around. EAR I am sure there are. LK John Romano was chairman of the Research Committee. He and I worked very closely together. EAR I have to see John. I got a very nice note from him and then he called me on the phone to say that he didn't want to write anything down he would rather I came up. Bo I need to talk to him. Well, OK your father's involvement then certainly played a very important role even before the Institute •••• LK I think he got his ideas from his experiences with the N.Y. program. Even at that time it was a multi-disciplinary operation with Atern Laboratory which you know. I don't think he really himself, I don't know I never really talked to him about it, conceptualized the broad expanse that the Institute took in supporting training and research across the country, through the grant projects.. But by the time the Council had met and had 'its first meeting and well, whoever pulled that law together, the people who were involved in developing the law. There were several Council meetings different small meetings with various groups that lead to the clauses supporting research and training and grants. And they had the model-the Cancer Institute to work on which undoubtedly influenced the development of the 1946 bill. You would have to get that from the people who actually sat on that operation. There aren't many of them around now. EAR There are a few. LK Who are they? 7. EAR I should have brought the paper with me- Frank Braceland came slightly later on. LK He wasn't in on any of that. No, he wasn't in on any of that. EAR No, he came along later •. 1K His teacher Strecker was heavily involved. EAR That's right and John was on the research Romano was on research. LK Yes, he wasn't on the Council. EAR Margaret Meade was on the first Council. LK No she wasn't. EAR No. ,LK You should look at the list of the first and I'll have to hand this to John Romano. You should look at the list of the first Research ADvisory Committee. It was a remarkable Committee. Margaret Mead was on that. David Levy, Rappaport, Radel a Columbia sociologist Kingsley Davis, Merritt, Wexler, Grinker, the neurophysiologist from Hopkins, Bard. Some of the keenist minds in the country were on tha.t~group an9- some of them moved on later to become members of the Council. EAR Yes, r have the list. I haventt looked at it for some time. tK It was a great educational experience for me but I'm not suppose to be talking about the experience. EAR No, I think actually one of the points that really needs to be stressed is that not only was there a very important interaction between staff and Council and staff and Committee but I think the story that has not been sufficiently told but has been touched on many times in papers here and there but that the hold idea:: of committees and Council served as an incredibly important communication network among people in the disciplines and in the entire mental health field. And as you well know, nothing was more coveted as a kind of indication of your position and status in your field than to serve on one of the committees and of course, the highest 8. EAR(cont) accomplishment was to serve on Council. I think that anyone who served on the NIMH Council was automatically viewed as being one of the senior and important people in their field. No it worked both ways. You didn't get to be on Council before you got that kind of recognition but that really set the mark on you and for psychologists I think for even more than psychiatrists it was viewed as a very, very important compliment to their status in their field. And all of the interaction took place at the various meetings the dozens and dozens of committee meetings that I attended it was so clear that as good a job as they were doing in the review of the various applications what was going on is an important side effect was the development of this communication., I really think that did as much for the peer reviewas did anything else that took place and it wasn't intended as such. LK No. EAR I don't think it was ever consciously viewed in that sense. That is a very important part of the whole peer review system. Well, you came in exactly when in the terms of your official position? LK I came in right, let's see just after the war, 1946. I suppose I was the Dale Cameron and Bobbitt were there and I was the next one on the board aside from those in the public health service who were working in the office with Bob. Dale was acting as Deputy, Bobbitt was •• held sort of a staff position. And I was there before I can't recollect whether Jim Loury arrived after Veste, I think he did. I am not sure. EAR It was very close in time. LK It was very close in time. I recruited Phil Sapir. I knew •• in getting my analytic training in Washington and because of Sullivan's interest and friendship with Sapir I was very immediately strucked by this young man's background and what he might bring to it. And he came into the office 9. LK (cont) actually through public relations. At that time, what is her name •• the gal that runs the mental health movie program •. Alberta Jacoby EAR Alberta Jacoby. LK Alberta was running that and she found Phil and I got to know Phil and eventually got himto cross the isle in the old T bldg. and become the number two person in research section. So I quess he was there when John Eberhart<~took over for me. Some of the interesting things that came up in the research study section initially perhaps because of my previous training in neurology perhaps because also of the interest of certain neurologists like Houston Meritt and Sam Wortis, one of these •. ! think either the first or the second meeting I got on the agenda. At that time the secretary had an enormous amount of power. Orr.:maybe he took it I don't know which. In the sense that you really could formulate the agenda evening the chairman wasn't around very much and didn't know what was coming in. And, the other thing that I did was to commence the business of abstracting all of the research grants and sending the abstracts out to the members and getting them to vote on the operation beforehand and that was remarkably interesting to see-to get a preliminary vote and then see the changes in positions that took place following the interactions at the meeting. There weren't many many changes and one of the most powerful person in speaking for projects happened to be Margaret Meade. She was terrific~ But anyway one of the very first questions that came up was whether there should be a separate section dealing with the neurology or neurobiology as against the psychology or the social sciences. Well, that was voted down at that time but I am sure the discussions at that meeting and the subsequent meeting really established the nucleous that lead to the •• pushed by the neurologist to set up the Institute for neurological disease and blindness which came on about 3 years later. EAR Actually the blindness part didn't come in until later. LK But I am sure the origins of that probably were well obscured by the neurologist but the beginning through what the neurologist learned in the NIMH. EAR That incidentally, in another interesting aspect of NIMH in that while it is true that the general model was taken from the Cancer Institute once NIMH began to flourish a lot of the things that we did at NIMH were looked on partially and copied by some of the later Institutes. There were a number of things, the small grants program, for example, which really began at NIMH was taken on elsewhere and, of course, now all the other institutes are a lot more interested in applied research and service programs and so forth. Which in the early days as you well know made us a kind of a odd duck. LK The institute was thought to be very peculiar, very loose. EAR D6 you recall that when you first came on board there was any real incling of where the NIMH was going to go in years in terms of the extension and the increased funding arid all the rest of it? Was that even consciously a part of the expectations? LK My belief was that we were so pressed and so involved in establishing the procedures that were necessary in order to immediately meet the many many requests that flow through the institution that there ••• ! can tell you Bob Felix, to my knowledge, never had a single senior staff meeting without a group. That left each of the section chiefs very very free. And I dare say if you spoke to Jim Loury or to Vest or if you spoke to John you would find that they spent most of their time working with the committee chairman. And I don't believe anyone conceptualize the range of efforts that would be made or the eventual size of the program. The committee either requested or I did a summary after a year or two on the varieties of areas in which we were making grants. However, the committee really made those decisions without really having established priorities that merely examined the incoming request and attempted to provide a judgment on the bases of merit. But there weren't 11. LK (cont) any at that time any pre-conceptions as far as I could see. If there were any kind of high level judgments being made it did not occur in the early office there. EAR I know from what you are saying no real sense of history was developing at that timei LK Just EAR Yes, right. How did you see Joe Bobbitt's role. You know, of course, he and Bob Felix had been friends in the Coast Guard and had worked together even before they came together there. And now that was an unusual relationship. LK It was an unusual relationship -:and perhaps for some of us it was sort of irritating. EAR Really? LK Well Joe was very bright and he had a lot of ideas but I sometimes felt he was rather impractical and quite obsessive. And he had a way of seeming to delay the activities that one wanted to get along with. Probably because Bob often discussed it with him. EAR What was his official role. He didn't become Assistant Director until sometime later on. LK Oh, many years later. EAR And he was just called a staff advisor or did he have an official title at that time? LK He did have a title but I have forgotten what it was. He wasn't tunning one of the Divisions. EAR No he got involved •••• LK He would probably be what we might call a Senior Program Analyst or something like that these days. It really is sort ,of a staff position. EAR I had, incidentially, as a ••• 12. LK He might have had an awful lot of influence on the way the training committee went though. That is very possible that he had had a lot into that and brought about the multi-disciplinary sport. EAR But I think once Veste really came on board then Bob really looked to Veste rather extensively for his leadership in that field. But it is a sad/ incident that I had actually,: c·~lmed.Joe Bobbitt oh, about 6 or 8 weeks be£6re he died last year and I said I wanted to come in and talk to him. He wasn't feeling well at the time, he hesitated and he said yes, and then he phoned me back a couple of weeks later and said no. And I said I was going to be in Washington on the last couple of weeks after that and I would give him a call when I came into Washington if he would see me and in the interim he died. So that I never did get a chance to talk to him and I am not sure that at his state of mind at the last few months whether he wanted to talk, he wasn't feeling well.for a number of reasons but physically I think and mentally I think he felt that he had come to a kind of dead end. LK Was he still attached to the Institute then? EAR No he was with the Child-Health Institute and had been there for some time after he had been the Executive Sec. of the Commission for Child Mental Health. He then went back to NIH in Child Health as an Assistant Director for Behavioral Sciences. And that didn't work out well. I think the point you made and also a number of people made he wasn't really a good administrator. He::,was a very bright man, lovely sense of humor, very verbal and I think very insightful about a lot of things but his strength I think really was in a staff position rather than a line position. And I think both in the Child Mental Health Commission for one where he was kind of the Executive Sec. and then when he came back to Child health it just wasn't his cup of tea. LK That is interesting that you say that. Because I think that is the way that I perceive that. 13. EAR Yes; '_I think that is true. But those people play, very important roles if they are given the right responsibilities. And he was. I knew him very well. He was a delightful person but always from the standpoint of someone that you could turn to to get some interpretation of things or to give him a fairly clear-cut job to do which he could do extraordinarily well or to give you some analysis of a larger picture of what program analysis •••well. Who were some of the pthet ':..people there during, it was obviously a very small staff. Milt Whitman came in about that time. LK He came in about the time I was leaving. EAR And Ester Garrison about the same time. LK Now letts see what about the social worker that went out to Chicago. He came on about that time too. EAR Oh yes, Dan not Dan Flynn •• LK Irish name though. EAR I know who you mean and he went to Chicago •• LK Then we had the famous old psychiatrist who was once a Director of a State Hospital who was doing some of the, I quess, the Division was still concerned with inspecting hospitals or inspecting states. Oh, what was his name? EAR I should have ,brought my notes with me because I am sure that I have it. He was in Washington? LK He was in Washington with the Department, he wore a little goatee and looked a little like Adolph Meyer. I should have my notes too, but I don't. EAR Did you or your father have any files of personal materials? LK I'll tell you what happened with all my father's files. I had my father give them to the National Library of Medicine. EAR Oh really? LK They are all there. I went through the files and I kept those that I thought were relevant. I think there was a fellow by the name something like Losinsky who was responsible for putting them in order. There were several Universities 14. LK(cont) trying to get them. Most of the stuff that was continued there really related more to his work in the drug abuse field then to the division of mental healt~ as it was called and I mean the Surgeon General. But that material should be there if you want to look at it. EAR I will and Ilh~ve to spend some time in '!,.,.~~- What I have not done for a v,riety of reasons was with the exception of John Eberhart and Bob CohenI and Dave Shakow, I have not spbke to the people who are still at the InstiJute. I thought I'd much?:ather ••• i I LK Now the business officer there went on to become one of th~ senior people. I Sort of a hedvy I fellow and I think he just retired. He might be an interesting Juy to talk to~ I EAR Yes, I know ~ho you mean there to. Hyman Moore. i I and LK No, his predeicessor. He was the auditor the business officer I when we firstiI went in there. I could see his face. As a matter of fact ! I pulled for IDr. Martin down at NI •• Lexington .. I just went through some old I ! photographs dnd sent him some photographs of my father and this mans picture I i was on it. His impression of what went on might be of some interest. I ! I don't know, but it possibly could. i EAR WEll, obviouJly, the more people you talk to the more things fit together I . I and also the~e are some contradictions in perceptions that you have to ! reconcile hete and there. Bob's recollection of the National Mental Health I I Act is that ~ctually he had that idea about a year or so before he had I i written out ~hen he was still in Colorado and I am sure, he obviously did I I talk about yqur father a great deal but I think his feeling was that broad 1, outline of t~e mental health act was something he had kind of worked up and other pe1ple have other points-of viewas to how that all developed as is the case ~lso with individual programs. Phil Sapir, for example, i doesn't know ihow he got selected to be the head of the program and Bob ! Felix told m~ that he had been reluctant to fulfill it since Phil didn't I I 15. EAR(cont) have the advanced degree but that Alan Gregg had taken Phil to dinner one night and had been very impressed with him and recommended him to Bob. Are you familiar with that story? LK No. EAR And recommended to Bob that he •• LK Take over. EAR Which really worked out beautifully. LK Yes it did. EAR He did an extraordinarily good job. LK He did a wonderful job. EAR What •• from your recollection what do you think were some of the things that happened early on aside from the rather unusual caliber of the people that were brought in. LK Yes, I thought it was an extraordinarygroup of people that were gathered for the Committees and those of the group that Bob was able to get there at that particular moment. That may have been an expression\ot the time because we were just coming out of the end of World War II. People were restless. EAR But I think one of the unusual characteristics and attributes that Bob had and I guess to some extent still has is his ability to pick good people and give them a chance to do the job as they see it. Everyone said that to me in one way or another that he somehow had the sense for a kind of person who might be suited for a particular position. And, of course, his extreme affability and his ability to get along with people. LK That was wonderful. One of the matters that I recollect with a certain amount of distress and pain was the planning for the mental health section of the National Institute. I got involved in that as part of the research section of it and as a matter of fact, I went:-atound and visited all of 16. LK(cont) then existing Institutes and I had seen some before hand because I had worked at Hopkins in research. We • • My feeling was . . if:· they were going to do clinical research there,,they were going to have to in some way modify the plan they had for that structure so that you could bring in patients and keep them if you want to ·do studies for it for a considerable amount of time. And I couldn't see the way the structure was originally designed a block of wards right in that center section was the appropriate place. Well we argued at,,;-very great length that they should give the NIMH a L shaped corner on a wing so that they could have an outside area and an outside recreational and other kinds of areas for their patients who were going to be ambulatory, most of them and you could set it up something like a psychiatric hospital on a couple of floors. That was defeated by Mizour the first Director of the NIMH •. EAR Of the NIH .. Jack Mizour was the head of NIH clinical center. LK Uack didn~t know anything about this field at all and he had rather fixed ideas for reasons that I never clearly understood why Bob and the Institute excepted the determination to get the space they did and then had to start askint for moni~s to build their children's section somewhere else, etc., etc. What happened I don't know. The head of the research grant program at that time was a very, very helpful person. He and his second in command whose names escape me at this particular moment but might come back at some time. Because we called upon them to study their procedures and to get slants from them about the problems they had run into in the grant programs. These were valuable both to myself and Veste. Alan was one of them. EAR First Alan. LK And the chief, I can see him now. Handsome little guy with a mustache, looked like an Army Colonel. I was going to say O'Donnell but that isn't right. Well anyway, it is in the records but th~y were very, very helpful in starting the grant program and we collaborated very well with that(} 17. EAR Did you have a feeling early on that it was already the beginning of a kind of tension between NIMH and the rest of NIH? No there wasn't? LK No there wasn't. I think it that early stage everyone was enthusiastically moving forward with their own programs and I don't think anyone perceived the fact that this new Institute was likely to become and grow into a frame that was not quite similar to the rest of the medical model. EAR Right, right. LK And had to such extensive fingers all over the country and be so involved with service programs. Or to become so powerful. EAR Right. The relationship with the regional office begun early on. LK Well, when Jim came in, he commenced that relationship. My impression was that it was very tenuous, initially. And, I don't think it became strong for many years later. You probably have a better idea than that. EAR Later on it did. Especially when Stan came on board. Alan and Stan worked very closely together in'that development but that was in the very late 1950's or late 1960's. Well, were there any particular, I know it is difficult to kind of single things out, where there any particular incidents that you · especially recall as a kind of marked, in one sense or the other, as a turning point? You mentioned one in a sense, that is what happened at the clinical center and I think that was probably an important point. LK The other one, I suppose, was the decision made by the training committee to split up the disciplines. I thought that that put a stamp on the whole training of mental health professionals that made an enormous difference and also led to much of the inter-disciplinary tensions over these many many years. I thought that was a very significant one. EAR Do you recall ••••• LK The next one that I think occurred after I left. I wonder whether one 18. LK(cont) couldn't point to the inclusion of non-professionals on the Advisory Committees and some significance whether you could trace a chain in the methods of providing judgments and whether this had really been useful or not useful for the field. EAR Depends on who you talk to. I think by and large people would say it was useful and I think there perhaps the saving grace is that in many instances, certainly not in all, but in many instances, the lay members of the Council were fairly good. Now there was some total disasters, people who sat there literaly for 4 years and never knew, even at the very end, what had gone on. The most famous example of all. •• I have to tell this to you as a kind of a partial payment fo you for taking your time because I know you'll enjoy this. We had a women from Philadelphia who was the wife of a fairly well-known businessman in Philadelphia. Her name was Mrs. Rose .. A very pleasant lady and she was going off the Council the first year I was there '58-'59, I quess. And at the end of the 4 years Bob as he always did thanked the Council members who were going off and he said, ''Mrs. Rose I want to publically announce that 1':this is your las,t Council meeting"I Of course, we all greatly appreciate your participation in the Council for this 4 years" ••• and the usual kind of empty commendation that he made which in her case was empty because she practically never opened up her mouth. "I wonder if on this very last meeting there is something that you might want to say?'' And she said, "Well Dr. Felix there is something that I would like to say, ever since I have been on the Council I really wanted to know what is the difference between a psychiatrist and a psychologist?" And the place almost fell apart. Noone laughed, of course. You could just feel the absolute stupefaction., Bob handled it very well. He didn't make a change of face, he just very gently told her. But after 4 years to have served on the Council in that body and then on the last day to come up with a comment like that. That was the worse. But there were some very good ones. 19. LK I have met· Charlie Slaper since I have come up here to New York because he is the President of the Research Health Facllities Corp., and I am now on the Board of Directors. He must have been a very lively ~ximber: EAR Well he thinks that the NIMH was his production. LK He does. EAR He thinks that there would not be a National Institute of Mental Health without him. LK Well I don't think, maybe the :etpansiveness of it later on had much to do with him, but, of course, he was not there when the generative act took place. EAR He thinks, I can tell you ••• when the 25 anniversary was put tog@ther md I was very actively involved in behind the scenes organization of it and so as you well know just X-numbers of invitations were made and X:7"numbers of people that we could ask to deliver a presentation. And I think we did reasonably well. We had the most important people to make the appropriate comments and to invite the people we ought to invite .. And to give the awards to the people that we thought should get the awards, that was the most difficult of all. But he called me one day and somehow found out that I was the guy involved behind the scenes. And he wanted to know 1) why he hadn't been invited to give a talk, he hadn't even been invited to come, why he hadri't been invited to give a talk and why he wasn't getting an award because if it were not for him, this obviously, is confidential, that if it were not for him there wouldn't have been any NIMH. And so I made the appropriate clucking sounds over the phone and assured him that we certianly did want him to come but unfortunately it was a limited meeting and we just couldn't accommodate everybody who mi.ght make a presentation and we left the awards to a committee decision and that was not my responsibility. He was very angry, very angry. Apparently he must have been a very lively man. LK Oh, he is. He is sort of a hypomatic fellow. EAR And that came through. 20. LK And,·~ I think he probably had the voice •• the ear of many people. The extent to which they listened to him I don't know. EAR Well, I'm sure he must have had an influential role. I think ••• LK Was he one of the first of the non-professional people who was appointed to the Council. EAR Yes, I think so. Yes, I think he was, he was among the very first.. But that is an interesting point that you raise. Acutally, I think I am correct, that is written into the regulations for the Council that there would be 12 members and half be lay-members. Now, how that was originally written in I don't know. I am not sure •• that somewhere anong the line in the development of the actual legislation and all the laws and regulations that developed •••• LK I don't think it came out of the Institute. I think it came from the legislation. EAR It probably did and I am trying to recall whether the Cancer Institute had the same proviso. I suspect it may have. LK Do they all have that ,now? EAR Yes. LK They do. I am not sure it did. It would be interesting. EAR Yes. Were you involved? ••••• LK I have just been sitting here this morning with a head of a hospital, one of.:our Where western cities.1'He is confronted with being executive officer of the board of trustees mental health center, which happens to be a psychiatric service hospital that has to work with the federal government, the state government, and the county government. The federal government demands that the mental health center has an advisory board. And if you don't think this hasn't produced complexities in a relati-onship with the board of trustees with a hospital and medical school, oh, gee. EAR Well, but there is a kind of phrase that has been used many times before but a kind of creative tension develops when you have this kind of ••••• LK Sometimes it can be destructive. 21. EAR Yes, it can and her is where, for example, Bob really did a superb job ~f chairing the Council meetings. I think that in my day when something occurred under less deft control might have created a real split in the group. He would always, it was almost a stock phrase, he would come out and say now, "this is what the Council is all about", you know the idea that there are two different point of view and let's hear the different points .... I am not going to stand on this myself. "You are suppose to advise me and let's discuss it .1-f And so he Side put it in a more positive tone and so that worked out •••••• 21_..,. EAR o/ ' What year was it? LK '49. EAR It was the middle of '49. So you had been there not quite 3 years. LK Have you talked to Dale Cameron? EAR No, I really have to talk to Dale. LK And EAR I really have to talk to both of them. Did you have any feeling, talking about Dale reminds me, did you have any feeling when you left that Bob even in those early days was looking to someone who eventually might take his place. Or at least really would be more a First Lieut. than Joe Bobbitt was? I don't think Joe was every seriously considered as a possibility. LK Well, Dale was really the acting deputy. He was there all the time and I think all of the decision making was made by Dale. Dale was •• he had not trouble making decisions. They were very generally very firm ones, they didn't adhere always to people. Bob you know had to carry on all the ceremonial activities and made all the external contacts and did all of that. Dale wasn't involved he worked effectively with not only the people in the PHS and the department but also with the legislator. I don't think that Bob had any ideas at that time he was so hepped up and so active, interested and engrossed in his ••what was going on I think he was engaged in the leadership position fully and completely m.d wasn't 22. LK(cont) thinking at all of successors or making any recommendations about successors. Maybe so, but I wouldn't have thought so., EAR No, I think your right but what he in effect said to me was that in his consideration of who to give responsibilities to it was sometimes with the thought that well, would this be the kind of person who might indeed take my position if I were to leave. Which might them provide for him a criteria for deciding whether or not to give certain responsibility. An~ I think somewhere anong the line he decided it was not going to be Dale. That is undoubtedly after you left and I quess I have forgotten the exact sequence but shortly after that Dale also left. And then I don't know what the sequence was. I think for a while Bob didn't think of anybody. And then I think perhaps in the back of his mind was perhaps Alan Loury and then, of course, that was changed the year Alan was in England and then when Stan came along a number of people had recommended Stan to him and then when Stan began to work it was almost totally different than anyone who had worked for him. And he came in at a point in time when Bob was thinking about his turning it over. One of the interesting aspects of NIMH I think9 is of the 3 people who have been the Directors .. Bert has been minimally involved. But I think Bob could not probably had not done the job that Stan did and Stan could never have done the job that Bob did .. Stan is not that kind of out-going individual. I think Bob was at the right place at the right time to bring people in and Bob for all of his administrative ability and ability to pick people out and keep people enthusiastic and to to through all the ceremonial procedures as well as he did, probably is not as good an overall organizer and administrator as Stan is in a larger kind of operation, so what Stan missess ••.•• LK Well I can tell you that perhaps one of the reasons I left was I wasn't exactly pleased with his administrative skills. Perhaps I am a little tighter on certain things than he is. He tends, you know, to seemingly make 23. LK (cont) a decision and then the next thing you find your on a slippery rock or something. It has disappeared. Of course, the major reason was I thought I had something more interesting to do at that particular moment.. I know that I felt some concerns about that during those 3 or 3 and one half years., EAR And yet he really did an extraordinary job. LK Oh, he did. EAR Absolute e~traordinary job. And as you well know when Stan came in one of the serious problems he had was that he wasn't Bob Felix as far as the old-­ timers were concerned. LK That's right. He couldn't give them what they wanted, what Bob game them~ EAR He couldn" t give them the milk of human kindness the way Bob did and they· di.dn' t recognize the strengths which took the place of that. Once you have been fed that it is hard •••• ha? •• LK The strengths were internal. EAR Yes, right. But by the same token, again, on a much smaller scale Bert probably was good. I think Bert has some of the strengths of Stan and Bob and many of the weaknesses in both of them, all in one person., It is a very unusual kind of combination he is of the two. And of course, he has had problems that neither of them had in terms of all the major changes that have occured in the past few years. But it is interesting, there only been 3, infact, literally for the twenty-five years two. And in all that time they have provided a very unusual leadership level. And •.•• LK To go back I will say ·this:;. [ .know my father had decided that he was going to recommend and it was quite clear. EAR I know, Bob had mentioned that. Ok, I started to ask you a few moments ago were there any other kind of highlight'incidents that come to mind that will help a little. Actually, from what you saying really it_was so much of an on going sort of thing. it is hard to pH:!k out •••• LK The process was hectic and rapid. 24. EAR Do you have any recollection. Well let me mention. 2 names::.A:m you, one is Jim Birren, did you ever interact with Jim Birren? He was there in the early days. It was in the Intramural program. I think he may have come on after you left. The>other is the, I blocked out his name myself, ••• the sociologist who is now out in California, who was then~. early on too in the Intramural program. LK I know who you mean. I recruited John Clausen. EAR That is the one I mean. LK I recruited Cummings that did the work and started the farm, at 1-1'IWI, you know on territorial rights for animals~ John Clausen was there. John was a grea,t infleunce immediately. He was highly respected and his input was· very significant. EAR Do you recall how he came on board? Was that a Joe Bobbitt acquisition? LK I don't know whether it was Joe Bobbitt or whether it was John Ebe:r;hart. EAR It could be either one. LK One or the other or both. EAR Now let me ask you on that very point. Do you have any recollection very early on that I mentioned before wasn't any sense of history, and obviously, there really ••• things were as I ,:wo-wh·hhave anticipated, things were really moving too fast for anyone to look at a long perspective. But was there any kind of feeling of self-awareness that would have lead to Bob or someone else thinking about keeping some kind of record of what was going on. Did that ever come up? LK Well, off and on since I left the NIMH there had been attempts to write a record. I had some correspondence, it probably is locked up in some file down at the Psychiatric Institute. EAR Richard Williams? LK It wasn't Richard Williams, it was a woman. EAR A woman? LK Was she in the Research Division of NIMH? 25. EAR Jeanne Brand? LK Yes, Jeanne Brand. EAR Well, that was some time ago. She is now with the National Library of Medicine. LK She pulled some stuff together. EAR Right, she did and she wrote a paper. LK I never saw it. EAR I'll send you a copy., LK I'd love to have it. EAR I'll send you a copy. LK Jeanne Brand was the only ••• EAR What she wrote down was a history of the mental health act. I}l,l duplicate a copy. LK I'd love to have it .. EAR She is a historian by training. LK She is? EAR Yes. LK I didn't know how far she went with it.. All I knew is that she stopped. EAR But that is many years ago. LK That is many years ago. EAR It is a very nice little paper. And ...but it is a historical paper-? wh:i,ch is as I say not what I want. LK a lot of historical papers .. EAR Right .. LK Just a little dull. EAR Yes, right. LK I don't know of any others actively engaged in that task or even considering it. 26. EAR Well you say Richard Williams paper didn't you, Perspectives on Mental Health? Which came out a couple of year ago. LK I am not sure that I saw that, where is that? EAR That is an NIMH publication and I don't have an extra copy but let me send you the identification number and you can get a copy of it. In one sense that is better than Jeanne's mainly because it is larger and later. It really is all about NIMH. What happened was that just about the time Stan left and when Bert took over. Bert had a feeling it would be nicer if someone did a history of NIMH. And Richard who as you know had been with NIMH for some time and had written a number of other works was in a sense commissioned to collect information and he went around and interviewed everyone and went through a lot of material. And then he put together, again, a history from the standpoint of the growth and development and its components. That is a very difficult thing to do and I don't need to tell you that if you don't, in full it will be a 500 page volume which noone would read. And so his is a condensation of that. And in that sense I don't think anyone was terribly satisfied with it. Infact, this was going on at some length when I was there and there were some thoughts well, maybe we won't even publish the thing because its earlier versions were not satisfactory to anybody. But then after a number of revisions and some agonyzing judgments and Bert very much wanted to see the thing in print. It was published, it is not too bad. I think it is a handy reference, especially for someone who doesn't know the Institute. But what I am trying to do if possible, is really to give some light to some of the key things that happened. The Joint Commission is a terribly important development in the early 1950's which I think played a key role in the whole development of NIMH. All the people involved in the various programs, Veste played a critical role 27. EAR(cont) in the trainin,g program. Bill played a critical role in the· rese.arch program.. Even some of the things that went on early on in the various special programs... There were early development, juvenile deliquency, aging, a number of things that went on. LK I knew about but I never met him. Was he over in Baltimore at that time? EAR With Schock? I don't think so .. I think he was at the Institute all the time and then he was at the Clinical Center when that was set up. He may have even spent some time in T-6, early on. I think he actually worked with Joe Bobbitt when Joe had that special section in the early 1950's. So there are a lot of things that went on at NIMH and I think, not the least, of course, it was a fascinating story of its own is the relationship, unusual relationship that Bob both and Stan had with various Congressional figures, Fogerty and Hill for one • .And Stan had some realtionship with their successors which just as NIH with Jim Shannon enjoyed a special relationship with Hill and Fogerty and with Mary Lasker for example. So that all of those things are very critical. LK I think Charlie Schlacker and maybe Mary Lasker while they were associated together they may have been a little competitive of each other. EAR I suppose. LK Just from passing aside. EAR She was on one of the early Councils. LK I think so. It was interests brought out beyond the field. was more interested. EAR A guy who has a story to tell, unfortunately he and I are not on the best of terms anymore is Mike Gorman, who was very much involved as 28. EAR (cont) Mary Lasker. LK Mike has withdrawn from this field hasn't he? EAR Well not altogether I don't think. LK What is he doing? EAR Well I've seen he has written, he was at one of the APA conventions. He was at some mental health meeting and gave a talk • But he was another person who was upset that he hadn't won one of the awards at the 25th. anniversary. That he hadn't been given the of an award. And that troubled him very much and I think there was some justification on his part. I think he really did an extraordinary job of the lay members on Council he really was very, very productive. He knew the field as well as any of the professionals did and most articulate in a group session. That Irish verbalazation of his he would start to talk and it was almost as if his own words kind of caught him up and they took off on their own and he would maHe an impassion speech about something or other. Aside from the fact that he was thel"e qui.te often with all kinds of agenda on people who had been in touch with him before and that was useful. It was brought into play the very important pressures. I think I am just trying to emphasize as you well know how important some of the key people were and how I think it would be terribly important 'to tell the story from that point of view and to go through some kind of chronological point of view. LK Don 1 t you think he would talk to you? EAR I am sure he would. I had written him one of the same letters that I had · written to you. I mus.t have had a bad address because it caine back and I have been saving him because I don't want to talk to him until I got everything all together. He has such a personalized point of view like so many things that I am sure •••• LK Is he still working with Mary Lasker? 29. EAR I think he is. I haven't been in touch with him in some years. LK I thought I heard something that made me wonder. EAR Really. LK Irving Bloomberg, of course, does the work here in New York State. EAR He may really ••• LK I thought Irving said something to me. EAR Recently? It could well be. LK He is living in Washington isn't he? EAR Yes, as far as I know.he is still living there. And he lost his wife a couple of year ago and I think he was •• he is a very volatile guy anyway. I think he was somewhat depressed. On occasion he drinks a little more than he should probably. So all of these things can effect. Well, I am pleased about the lead to go to the library of medicine and look at your father's papers. I think that is very useful. LK I sent Brand the references to the stuff- the pre-war stuff. EAR 'She probably has it. LK And the minutes of the meetings of those several associations. She may or may not have them but they are readily available and you the journals. And the meetings in which the proposed Institute was discussed and approved. EAR I suspect she does. It is a kind of ironic turn of events that she is now at the National Library of Medicine and last year I put in a proposal for supportof this project asking primarily not for any funds for myself, obviously, but for travel funds and for someone to transcribe all these tapes and for some funds to interview by phone perhaps 100 people beyond 50 or so that I want to interview in person. And then for some of my •• for publication of this because, 30. EAR(cont) unfortunately these kinds of things take a subvention"'"' not likely to be a best seller. And so if a University Press were to do it or a Commercial House were to do it they would do it only on the availability of the printing costs which these days are very considerable. Unfortunately, the application went through Jeanne and the application was turned down. They sent me the pink sheet on it and they just misconstrued what I wanted to do. Of course, the criticism was as if I said that I was going to do a formal traditional, historical documented study. And I made it quite clear in the application that this was not what I intended to do. :C donit know if you eve:i; read a book called the Politics of the Budgetary Process. Have you ever seen that? LK No I haven't seen that. EAR It is a book by~ •• LK I should I'fu living in it now••• EAR Well you might, if you had some free time I can give you the reference. It is called the Politics of the Budgetary Process and the author is a man called Wildawsky. He is a political scientist, Erin Wildawsky. LK Wil. •• EAR daws1:ey, Erin. He is the Dean in the School of Government and Public Policy, I think at Berkeley. The book was published in the late 1960's. It is a very, very insightful description of what goes on in Washington bureaus and agencies from the standpoint of what the program managers have to do in terms of the annual defense of their various bidgets. And he points out a clearly and I think a very appropriately that a great deal of the skill and competence of a program manager people like Bob Felix and even above that. A great deal of their skill and competence is tested in the manner in which they defend and develop their annual program budget. That really is the critical point of interaction EAR(cont) between themselves and their resources. And it is beautifully done if you have had any involvement in the budgetary process. It evokes all kinds of ••• LK Reflections and emotions. EAR Right, yeah. Let me turn this thing off ••••••