DR., JOHN ROMANO 11/14/77 EAR You go ahead as you see fit from how you see it so many years subsequent· to our point of departure. JR Well" Eli, as I indicated earlier in my letters·and other·mitterial I sent ,. to you,· perhaps the ·most striking thing to me was the exeit~/~m.t··-and the enthusiasm of those who took part in ·the inftiatfo:a of this, venture·. rt ·was, as you know, the first·majorventure of the nation in terms of suppoy;t of mental health~ mental illness, with the exception, of eoursa:, ·the origin:... of St. Elizabeth's Hospital some yea.Ps be~ore t·hat and alsa ;: · I tld:n~, what preceded it may have been ··some.·of·C,the nar-cot~c hesp!:tal plans at Lexington, and I think later· at<Fort Worth.· However, I· wa:s:.·1I1.uch.. impressed with Thomas Perriri, as·the Surgeon General who was influential in directing the first days of this movement. I don't know enough of·the role o-f Lister Hill and of -others in the Set'lat~ who brought about the legislati:on. I think Larry Cobb ':s father ·playeq some part in helping to design that~.- I think Sam Wortis may have played- a part in that ·and whether Ed.Strecker an.d others did I dont··t know,. but someone:must have played a part in helping t() design and to help direct- the fo,rces toward- the· enactment of tb:is:- le.gislat:f.onc of the 79th Congress· ·and you can imagine I was pleasantly· surprised and' honored to learn that I was appointed. as· one of. the founding members· .of the :fi:rst Council together with Bill Menninger for a three year ·period, I' t·hink there was Tallman, Strecker and Levy for a two year.period andTal.lm.an and~eorge Stevenson, I believe for a one yeaT. period- I had WJr'itten to-you· eariler about the,first meeti that was convened.and how Albert Deutsch· reported this ,II) 7 {Ip \d't(/'V • event and inasmuch apparently inadvertently or vertently spoke·about an atomic pile that took the headline off the first meeting, I think in the American 1 - 2 - JR(continaed) Red Cro.ss Building some time.in. the summer of 1946~ .It was as you say a total medical group,. all the ·members of the Council were M,_-D~ 's and at that time, 3 of us were chosen to chatr the Committeei~ to ser_ve the Council. Strecker in training, and I believe it was StepJenson- ·fn the community resources and myself in research and. I was-. al~o .impressed and really ~elt highly respons~ ible because I was given really free r,eign in the ehoice.0f thos-ewho would participate with-us in the first.research stµdy· section and:-we tried to choose people who were outstanding-in their fields in the social sciences like Margaret Mead and Kingsley Davis and in psychology, like Curt Lewin and Rappaport, David ,ltt ' -~ !?.--~ .,,n;,1...,-~,.,,J\/s,'il'· ,,,.{:,, -Rappaft,rt and Dick Whent and then~ of course, in i~or't:hologf. and anatomy and physiology and other fields relevant to our·concerns we tried to appoint the outstand·ing scholars and scientists in those discipltnes~- Larry Cobb was .the Executive Secretary, r- remember vividly, the- meetings-, - the preparation. that · Larry and I would make:. the night" bei:ore - these were two to three day meetings ~­ the two of us together wi.th one·'~or-: more of· those valiant: and- COlllpetent ~ecre~ taries - we would work all night long and try to- prepare an agenda for the following day. The number of projects f<!>r us to m.ake decfsions,about were still very limited and as I rememb-er in the first year, something like $300,000 .was expended and much of that· f.or· Neural- Science other than ..psychiatry •' ·However, during that time we tried to set the stage in an ethical or a mcrral···sense as well as in a scholarly sense, we tried:to: pass judgement on the nature of· the investigator,. what was the. nature of the: (J_uestions he was posing to be answered, lh-ef' - what was the research project, did ittlend itself, did the q9estion itself to answers, what were the populations to be studied, what were the methods to be used, instruments.to be used .and we were more interested in those matters fundamentally than we were in terms of seeding or pump priming for Alabama JR(con.t:.:inned) or for California or for North Dakota-, whatever the case may be, although these matters did come up but they never,came up verrstrenuously .. On one o-r- two occasions, -Vesty-would mention to us· that thf-s· or that Congressman was especially intere-sted in the acceptance of this or that project and as I remember it, connnents like that led.us all-to·becom.e increasingly critical if- anything about the project and' we tried not to be dis$ua:ded pr diverted from our primary set of criteria, which had to de with meritorium n ~..,, , we- also tried- to identify bright young minds without as yet a history or record of.productive research,hopefully that­ we would help to stimulate them and nourish them in terms of their pursuit of new knowledge.. I rernember that. the_ participation- of. the Committee members and the discussion was very full- and free and all of us found it sort of a Ve?+J exciting ecumenical affair that we would listen -to with respect the responses of Davis and Mead in terms of the social sciences.- · W-e would listen Abner Wolfe, we listened-- to Haroid-·Wolfe, we listened to. Huston'.·Merritt, we listened ·to Davi:d Levy, we listen~d- to ~a great number of others, you -know, who were in a position to guide us concermtng the merits o·f>the research involved and I think also we_ tri ed _to. be· like_ Caesar "s wife above reproach and if anyone 1 of us were, evenly distantly related to the investigative.work that is being considered we absented ourselves and we excused .ourselves~ and re·turned later~ However, we also. felt that such persons could be asked-.questions and th~se questions were asked of -them,.wh±le they were away. and then they -came back t0 discuss it after. some judgement. had. been made--.. We tried to maintain that posture of objectivity in terms of the. wo:r:-,R. I think as I look back on it it seemed to me then, and· it does- now·, too, that-,I.·, thought it ·was the U'nited States of America ·at its best, .namely a citizen government of persons like myself and others, not employed by th~ G-over~nt, who would come to JR (continued) Washington at times at considerable personal loss to themselves in terms of .the·ridiculous perdiem of the day and the fact that I was able to stay at the Cosmos Club I think helped me but we made it in some way, what with travel and a day or two stay in a hotel or at the club we were able to make it but it seems to me that there was a genuine feeling on the part of all of us that there was this exciting and e~traordinarily mportant venture of our Government now introducing itself to supporting the pursuit of new knowledge in a field which even today does not. have any clear idea of the basic causes of mental disease together with identifying young people of promise and nourishing them for the future just as later on we help to nourish those who became the career investigators in the field. These were the exciting things together with the fact that we were also helping to train and educate young psychiatrists.. I think we forget that in my salad,. days when I finished my residency at Colorado an extraordinary small number of persons, I think in·.. the.nature of 3600 or 3000 even less than that and then later on even when I came to Rochester in 1946, the membership of the American Psychiatric was less than 4000 or about 4000 and today as I am told there are over 27,000 psychiatrists and that we now outnumber pediatricians and obst~ti.eians in nU1Uber and also that we have become., very-- .. s:r11,A\.io.,k.c:i,.l.:t,;J;R..:«:c~1 (.' diverse as compared to our earlier days when we were more of -~lism, that all of this in some way stennned, I think, I cantt think of any single event more important in the development of american psychiatry since World War II than the 79th Congress passing the National Mental Health Law. EAR Did you have the feeling then, I know you were so terribly busy just doing the things you men.tioned all of this feeling of eEcitement and being a pioneer and getting involved in this important development, did you have .... 5 .,.. EAR(continued} a feeling then at all about where this would lead in terms of scope and breadth, did you have any expectation that it would really grow to the extent that it did grow over the following decade or were you too busy with the daily activities to worry about that long-range problem? JR That is a difficult question. to ask because even though perhaps several of us were contemplative or tried to be contemplative about it, and also as young men we dreamed young men ts dreams but r don't think that any of our dreams much less our day dream fantasy,_,,s would encompass- what has happened ~~"} t .l1 JA,/,, ,~ iJ•l"«,€:.~"il'\<d"\r-"L,;'t.("' since then. Ls.peak particularly for example, the /' l increase in "Ir'. ·J'J ,€;,y /;.iJr7.._.L,'¥'.l.r¼'L~•f' the number of psychiatrists and the comparable · · v · ·. · _ increase of the mnnber of psychologists, social workers, nurses and also many other now paraprofessional groups. The fact that there are thousands and thousands of people now currently ~ngaged in either in certain aspects of prevention, but mostly in treatment programs and in research is far beyond any fantasy. I should say that one of my disappointments run this whole matter has been in spite of the record reported by Booth and others of the current inves·tigative program in reviewing recently those studies in our nation engaged in studies of the antecedents of schizophrenia, the so-called long term views, prospective views of the schizophrenic patient and his families and so on, I am impressed with how few of them have clinical psychiatrist as principal investigators. Now most ·of them are psychologists, clinical psychologists -and experimental psychologists and in no way deriding or denigrating the tremendous contribu­ tion psychologists made E .mt;tsl! say I am personally disappointed and those of our hopes when we helped to launch the career investigative program that there are not more psychiatrists engaged full-.time in clinical researches at this time. Now, I think they can be numbered in the hundreds out of 27,000, let's - 6 - JR(continued) say psychiatrists and I think that there a number of reasons for this, One is that there have been fewer models, the second is that we may draw to psychiatry people who are more humanistically inclined than those interested in let's say the pursuit of certain kind 0-f rigor in scientific investigation and there are other reasons as well, but I am personally dis­ appointed that there aren't as many people involved full-time in clinical psychiatric research. EAR Well, wasn't there a dilemma. in this sense that the program began at a point in time when the needs were so enormous in so many different directions,. researc5 training, connnunity services, clinical services.. -0£.::various kinds and I know for example having been involved in the training program for so many years that the expectation·,,was that we would produce a sizeable number of psychiatrists who would provide clinical service. Now, what happened was, lam now talking about the early and the mid fifties as well as into the sixties that in proclucing these people for service responsibilities inevitabl~~~ou then tended to push people away from research by this kind of emphasis and even more importantly because we got criticized for this later on the economics of it was such··that .> a lot of people went into private practice in psychiatry. Now, it is only because progrllltls like the 4~]lti~l:'-iJ:'':f investigative program came along that we··: - • ,· I were able to do what we were able to do in the field of psychiatry. psychology, as you just pointed out, I think very aptly already had models for research,..,> you didn't have it in psychiatry, s.o maybe your criticism is justified in terms of the facts but the circumstances were such that you could almost have predicted this is the way it would have gone and without the,C~reer Investiga­ tors f-rogram :things would probably be even worse than they are right now, I L ... 7 ... EAR(col!ltinued) which leads m~ to the next question because you were very intimately involved with eareer Investigator;;prog:r:anK'and I wonder if you would say a few words about how you saw that beginning and your relationship to Bert Booth and all the other things part of which,. of course, is in the book that you wrote that very lovely foreword for, but nonetheless your own personal feelings about that program. JR Well, in the first place, a number of us had thought aboutlli.is idea for some time before it was establisned and I drew attention to a nmnber of people, the models of the American Heart Association wiich.at that time had just enacted the life­ time career award, plus the Markle Foundation Medical Scholarship Funds, which enabled bright young people to be appointed for a five-year period to give support for their scholarly eal!'eers, princibly in research but also in education, so we had these two as a model before us and· as a matter of fact, the Markle Foundation also had used the device which I later used for the first time at Atden Hou~e, that is to convene all those, all the Care:er Investigators at that time in order that they would get to know ·each other and perhaps create a new core of people who had interests in common. What we had before us .was . ~thi:s..,) . that an earlier model of the psychiatr~sts and in no way is this pejorative it is historical and there were top-drawer people, first great~ model was the sophisticated administrator of a large mental hospital back from the colonial days up until the 20th Century and many of these were very capable clinici.ans, people of great community interest¢' and compassion, through the moral revolution of the 19th Century on to the 20th Century, on to the crowded hospitals and son.on, so this was a model, this was one of the goals which the young psychiatrist could aspire, if he wished to.. A second fitJ.J' was eventually because - 8 - JR(continued) of the impact of psychoanalytic psychology on the whole notion of psychotherapy and the whole opening up of the notion that certain kinds of mental illnesses, particularly with neuroses, lend themselves to certain kinds of psychotherapeutic approaches that the next model became .the pschotherapist clinician, the private psychotherapist clincian, often times a psychoanalyst psychotherapist practicing clinician. So we thought would it be possible in some way to create a third model and that is the model of the psychiatrists as scientific investigators and there were very few models - in ~y salad days there were very very few available to us. In New Haven, Ed Gilday did some studies with blood lipets in terms of body types and also made some observations of behavior of persons awaiting surgery and other matters. I learned about post-cataract panic in other matters, from him and others at that time. However, the greatest thrust was on education and on service to the sick so there were very few investigators, so we thoaght would it be possible one day to select some young people, men and women, who are psychiatrists an.d to help them develop as investigators, not as social scientists, not as psychologists, but as psychiatrists in their own right and to c-reate a new kind of a scholarship in terms of the rigorous scientific investigation of clinical matters and so on. This was the objective. Now for the first four years or so, Allen Gregg· chaired the career investigator selection committee and I was asked to chair it following his retirement from the chairmanship and I must say it was an extraordinarily exciting time - very able people, the committee was very small. I think there ·i'lv- -- were four, five or six of us attbhat most and the number of applicants as yet was small so that each of us could take upon ourselves site visits, detailed r - 9 - JR(continued) site visits to see one or two people. I remember seeing Danny Friedman, I remember seeing a great number of others at that time and then to come back and report on.our findings and also making a rather selected judgment for the future. Phil Sapir was by far the outstanding person in all of this,_ his scholarship, his background helped to develop this and then Bert Booth came to replace and to help Sapir in this matter and so he worked intimately with both over the years. I chaired for three years and then was abroad in Europe on a Sabbatical - 59 to 60, and came back for another year to continue chairing from 60 to 61 and Larry Cobb spelled me for that year that I was away~ This too was a very exciting thing. However, during my time, we were hung up at times with a few matters, one was psychoanalytic training, so regardless of who the person was many of them also wanted to have psychoanalytic training, the point is not necessarily for future psycho .... analytic· treatment purposes and so on:;.but as a backdrop in terms of their scholarship, but it mean't at times they were socially paralyzed, socially and physically paralyzed because they had to stay some where, you see, in order to be analyzed, it also meant a considerable number of hours,· sometimes ten, tweleve, fifteen, twenty haurs a week devoted to the analysis moving back and forth and the seminars and so on. This was a problem as to how often should we do this, how often sh9uld we supp9rt this~ The second was that at that time, there were ae17tain fads, one was separation, sequestration and depriva- . . . ~ tion studies, social deprivation studies and so we were hung between arranging deprivation studies and also arranging for psychoanalytic treatment and all kinds of matters about extra money for this for that, for tuition and all kinds of other things and I am sure that my mind is still muddlgd by some of - 10 - JR(cantinued) those administrative problems that we had to deal with and so on, .but that doesn't in any way reduce the significance of the time of trying to find young men and women with promise with some kind of excitement in them, with some kind of internal itch that had to be scratched, some curiosity that we hoped would direct them into one area or the other of the field which was so broad and needed so many people to follow its directions and so on. EAR In retrospect,:. because you have raised a very important underlining current I think about this issue of psychoanalysis, if you had to do it all over again do you think you would have a different perspective on whether or not analytic training really should or can serve as an important adjunct ta the complete training of an investigator who comes from a psychiatric background? JR Well, let me say that I have many more reservations today than I had ten years ago, twenty years ago9 thirty years ago, and so on .., I had the privilege together with GeflJrge Gardiner and Charles Brenner, ,to be appointed the first Sigmund Freud fellows in p-sychanalysis at the Boston Institute, 1939, and ,I, Jf\,,~p'V) -· there is no question that I learned a great deal, not only ~or my pensonal analysis but from the c_pmpanionship and the scholarship of people like Helena Deutsch, the Bebrings, Jenny V.elder, Robert Velder, a number of others who were there, John Murray, Moe Kaufman, others at that time and also from those who were my peers, Vandler and Brennel'r·and Gardiner and a few others. There were very few of us at that time and I am sure that it stretched my mind and helped me to understand people better, but as time goes on, well in the first place, I have been very much upset by the politicizing of the analytic movement, the fact that it remained for the most part a night school, almost in a talmudic ~j,-.J sense the lack of examination of essential points of developments,.¥ they - 11.., JR(continued) got intellectually stuck I thought without any movement and for that reason I had serious question about it.- Also, it did not enter the community, the market place of the University in terms of challenge to its ideas and methods as freely as some other points of view have and I think unfortunately what happened is that in the American scene that behavior at times was interpreted reduction~istically almost ·exclusively in terms of conflict of opposing forces or the resolution of such and so on and the paradigm of the unconscious conflict became an explanation for almost all of deviant behavior, and I regret this, because in contrast to some of my colleagues who scold the physician and the biologist for reductionism at the biological level saying that · 7.n 1,,(1., !#vfjl,,\,/ that they explained behavior in terms of the molecule atd:the micular level or ~ii,!~ in biophysical terms alone, I would also counter that we have been equally, if not more reductionistic in terms of explaining behavior almost exclusively in terms of the paradigm of unconscious conflict so that I think that has beeen unfortunate. Furthermore, I think that the psychoanalytic movement lend itself to a certain slovenliness in psychotherapeutic techniques in spite of its supposed rigor and again it did not examine or look for that which was baste and essential in a psychotherapeutic encounter and a number of non-analysts, regardless of how one looks at them, Carl Rogers and others, particularly Frank and those who tried at least to find out what is there that is in common with this extraordinarily important experience of patient and physician and physician's family in terms of trying to resolve distress and reduce pain, so r:think that looking at it today when young men or women come to me, I say,• well it all depends on what you wish to do. If you wish to pursue personal analysis and then go through the whole shakes at the Analytical Institate that's up to you to do,. the only thing is so long as you do it with your eyes open, it does f:ake amount of time, amount of ... 12 - JR(continued) money, the point is what would you be doing with that time or money if you were doing something else, whether you are in the gross of academe or something else. I think hhat at the moment we look at psycho­ analysis- in terms of its body of knowledge as well as its therapeutic method and so on more critically, you see then we did ten, twenty, thirty, fourty years ago and I also think that many modern Departments of Psychiatry give ample opportunity for the· young resident and the young studen-t whatever he may be to learn something of the basic postulates of psychoanalysis .. I should e2eplain my position. I believe that psychoanalysis is addedc'.immeasurably to having to understand people. I don't think that it has any significant efffect on the incidence or providence of madness, nor do I think it has e~ any appreciably,effect on therapeutic efficacy compared to other method with a neurotic and with less effect on the psychotic.- EAR I thin:k you rc)ise a very important general point that I have to be very sensitive to and which threads through a lot of what you are saying namely,_ the following - that it is terribly important to view these developments in the context of the time in which they flourished so that I think that it is perfectly understandable, indeed,. justified to see the emphasis that wes placed on psychoanalysis in the early days of NIMH that it did stretch the indidvidual's mind to have to engage in this kind of personal examination but that I think I hear you saying perhaps psychoanalysis itself as a mode of investigation did not grow as rapidly with the times as it should have and so that perhaps at the present time we find people engaged in primarily psychoanalytic approaches doing things which are, maybe it is a little harsh to say outmoded, but they dontt take as much advantage- of new knowledge that is available today as they might have and so that perhaps if I am hearing you correctly, you are saying that the - 13 - EAR(continued) basic process of psychoanalysis has added very importantly to an understanding of people but that's what they d'id years ~d years ago, what are they now doing beyond that that really is keeping up with all this new information, penhaps they are not doing enought:in that direction. That's very important because I am sensi,tive to what you said a few minutes ago about l~;.l\,tt,1-J , the concern that people had in terms of the training of the curia investig@tor tZ_._,___..~·· to make su~e that these people were fully prepared to serve as a whole person and herEKwas ·one way of adding to their personal understanding, their personal competence in some way that better understanding of self would make them a better scientist. _,,.In .those days I think it was an understandable argument - today you might have some question whether it's that important anymore. JR In some ways I think that the pschoanalytic experience later on was a deterrent and suppressive, particularly to curiosity and to examining different points of view. I think that unfortunately this comes under I suppose the general notion.of indoctrination and certain general ideas were accepted and without much challenge to them, that why, if r may return for a moment to another subject, it is the subject which I have found in my professional life the most challenging experience I've had is the teaching of undergraduate medical students. I think it is because being younger, their minds are as yet not overcluttered and they ask by far the most searching questions and they get directly to the meat of the matter •. The resident and older students have in some way or other made their peace with ambiguity and they accept our ignorance as much more tolerantly than do the younger. The younger also are more , .,J'},.L,i• l= -:1,,'t Pl rt 'lif"411(.-~-,i_: =..... · Cl! r f' .,,..~,.,...:::f' JV,,,,,.,.,. t•' . daring because they have as yet to face consequences, therefore they can be, /) - 14 - ~\ JR(continued) ~ore ~~enturesome with their notions and ideas but over the years one of the most stimulating things to me and Gae which l devoted a great part of my life to was the teaching o-f undergraduate medical students and I may say, incidentally, that of all the contributions that psychiatry h.as made to medicine in my view, I would put the teaching of the unde!Tgraduate medical student as first. I think that to what degree we have been successful, to what degree we have failed, that at least we have brought to the attention of every Doctor in this country in the· past 25, 30years, some notion of man in a psycho­ social system as well as in a biological system and it seems to me as, and Leon Eisenberg·agrees;, withlJle, that even it seems outlandish for us to say this ti'ih1,/(!, li t/' for a discipline~~) so few successes, still I think that psychiatry at its best is an excellent paradigm for the general practice of medicine in terms of being aware, let's say, of the psychological and social aspects of humanitY, of ,,:JI man in human terms rather than infrahuman biological terms and this is I think the goal of the undergraduate·teaching and I think that there too, we come back to the impact of NIMH. I've said before that in terms of psychiatry the single most impor·tan,t act, I think, to bring about a cnange in psychiatry was the 79th Congress, passing the National Mental Health Law. It not only led, as we mentioned before this, to tremendous increase in the numbers of psychiatrists, but also led together with .the Hill-Burton Act, together with some liberalization of insurance even thirty years ago or 25 years ago, to the psychiatric unit in the general hospital, to the fact that the medical student now could see psychiatric patients in the same place that he saw obstetrical, medical,,surgical, pediatric patients, the fact that he was not in the nut houser,or mad house so many miles away from the main stream and that he could see dt first hand the fact that there was no myth to mental illness - there are peoplel\t,ho are really - 15 - JR(continued) sick, people who are about to cut their throats, pe&ple who are deluded, people who are unhappy, people who are distorted in their thinking and feeling and acting - that these are no myths, these are really disturbed, upset, distraught human beings and he gets to see ±f first hand,what it means to understand a person who is depressed and wants to kill himself and· so, on,- s-o I think that he gets to know something of the whole sweep of the growth and decline of man and woman in our society and he gets to see something of the ~ ., impact of social systems and that man is a political animal, a social animal, and that we rediscoverJthe human family, rediscover:);the human comm.unity, all ;' this now can be communicated to the medical student today and of tomorrow a~d I think that point in this contribution may be increasingly important as the present government has in mind spending more and more money to support the primary care providers, pediatricians, general pract-itien:ei-s ,- ·~gen~ral - -• in-terriists, family medicine practi.tioners to help them care for people, their patients who are mentally sick ) and I think that how better can we do this by insuring an ade.quate preparation in the undergraduate period because nothing beyond that compares in importance to the backdrop. EAR I think that is a very important point. You said in passing though, i:t is interesting the analogy may be made :Ln a sense, if I can interpret one of the points you made a moment ago, that as we get older the search for security becomes more important to each of us, so we are less willing to take chances than we were as younger people and isn't that partly true also of organizations and might it not be that the sorts of things that yo~ did at NIMH initially were pioneering chance-taking experimental efforts which as the NIMH got older and more established so to s.peak, it became less and less willing to do - did you sense that at all in the long period of time that you have been affiliated - 16 - EAR(continued)w:i;th:NIMH or do you think they maintained that experimental attitude for all of the period you were involved with? JR Well, Eli, it is difficult to answer that because I am apt to project from where I am now and it may :ld!?lChat· I am now more experienced and more reflective than I was then but there has been a change but you are right: first of all about organizations. When we in-itiated the Stage Coach Club in Rochester in 1953, we invited the Chairman of Western Reserve, Dogil!as Bong, Pittsburgh,- Henry Brosen, George Ham at North Carolina, Maury Levine who succeeded me at Cincinnati and Herbert Gaskill, who just left Indiana to g0 to Colorado. These were five departments, six with us at Rochester, no, five with us at Rochester because a few years· later we invited Milton Rosenbaum at Einstein. Number one we had ne known each other for ten to fifteen years before we started this in 1953. Number two,. we had worked and studied together, servet\together on various ¢'01Illllittee's and so on. Humber \V' three most of ·A,had background in medicine., neurology,. psychiatry and psycho­ analysis and we would meet each year, we started in Rochester and-we arranged so that the Chairman and one other person would be invited from each place to come to visit us here. The agenda was determined by the -Host::'iDepartment, there were no notes kept, no minutes, no agenda, ne-mftttt:es, the agenda was prepared by the Host Department and no officers were elected, no dues, no money, each had to spend his own money to come, and after we wined and dined ' ., 0ur guests tjt.e?§~rst time in 53 we took them in Rochester ·to the Dryden Theatre· part of the Eastman House and showed them John Ford ':s epic movie "Stagecoach" so after that the club was called the Stagecoach Club and like a stagecoach every year it moved from place to place, second year was Cleveland, the third - 17 - JR(continued) year was Pittsburgh, and so on. Chairman and one or two other members of the Department and when we came toa Department, of course, the whole Department attended, the Host Department. We discussed matters central and relevant to University Departments - teaching,undergraduate students, graduate students, the nurses, running a..;_hospital, 1 ----to community, pscyhology, social work, all matters related to th,e University and we thought that we could do it better this-way small and intimate rather than at huge meetings where we could never see each other. Well, this club, was so successful that Vesty suggested that if we were to add some people we could apply for a grant and of course, not since George Washington left his high office did this happen, we refused. We thought if we had a grant we would have to have minutes, protocol$~ reports and so on and we said no, let others develop their own groups. Well, as a result, of course, the·Northeastern, the South, the Midwest and the far west professors were organt"fe<J6i modeled on the Stagecoach. Now we went through the first six years or seven years, and then we went tqrough five years of the next year - it was seven and then five more years and we reached Colora:1to ·on ·;the second turn in 1965, 12 years later, George Ham was about to resign,, someone else ·was about to resign - it was really a priv~te club of Chairmen, so we suggested that we discontinue the club for three reasons, one was that we didn't want to impose this unnecessarily on the Department because it was our private Chairman Club, number two, these other g,r.oups are being organized by Vesty and others and number three, we ::·wanted to belong to something 0 which had ended, we had never belonged to anything whic·h had ended and so everybody thought that was great except one person, whose name I won't tell you, who became very sentimental about the Stagecoach Club that we had to continue until I .... 18 . .,.,. JR(contdnued) ltad secretly kept a record of attendance and he had attended the least, you see, so he lost his argument .. What happened to it I don't know. Shaw once said every profession is a conspiracy against society, whether you believe it or ;not, I think he meant that as professions','get organized they become more and more sealed off in the terms of the society which they serve. More and more concerned with their own identity, -.:own~-progresp;"~own re-rd, own enrichment and so on and they forget at times what their purpose is in society, so I have always been suspect of entrenched organizations, unless there is, for example, the young Turk m0vement in psychiatry, the GAP movement was founded by a number of us meeting in Bill Mem1inger I s room one day - have you read about Albert Deutsch writing about the meeting and what happened since then., but essentially it was a meeting to sort of criticize the APA, to introduce ideas which we thought were too rockbound, they were too inert for a long time and then probably served a purpose, now the GAP ;;:f~l:hillk, :has outlived its usefulness, you see, and I think there should be a sort of a life span as there is for dogs,men, women or bui'ldings, I think some institutions should stop and· they should try other things or do other things. Now, to come back to - what was the other question part of that besides the organ½zation? EAR Whether you saw JR Oh, yes, I did see of late, probably because again of the times, just as you say, you have got to project this in the historical time. With increasing politicization of tremendous amounts of money now for health services and ·-~o(l.:;__ knows how much of the overall gross national product is being spent now·in terms of health services and health education and so on, there came a claim that we will now solve some of the great problems, alcohol, retardation, addiction, aging, the criminal and so on and there, I think, that as a profession, you see, we were not ri~ t only too humble but too t!ftSequious, too weak and we bowed down in obej~ance, let's - 19 - JR(continued) say to say Oh yes, we will solve these problems A,B.C.D.E. you see without adequate system and trial. Now, I applaud the community mental health movement for a great number of reasons. I deplore the way it was organized, } I deplore, letls say, it'~• starting out evangelically without due regard to the real problems of caring for chronically ill people. No nation, so far as I know, in the history of man'rhas solved appropriately and fully the problem of the chronically ill, whether or not in ancient societies they were abandoned on the ice floes or starved to death or killed outright or burned, or whatever· it.may be, or whether or not they were put on-the ship of fools and sent down the river to some other place, chronic illness has been a problem and a tremendous problem to all societies-. In ancient societies, it eouldn_1't be tolerated because they were nomadic and migrant and couldn"t handle them. In our society we rub them, we push them under the rug of our collected shame and guilt and supposed to forget them and so on. Now, this movement will sl:i.y all of a sudden hospitals aredbad places, we shouldn't get into them, if you get into them, you should get out immediately, you should be out in the community and led as you know to those jungles in New York City, Chicago, Los Angeles and ,so 9~li-~,!1f~nic psychotic patients t<1A,.,-,..,,#/i"'iri''-'t,1ft,(.f-✓ 8 with no socia:t skills either ever acquired or lost sent out in the community in these high-rise jungles so bad that the rooms have to be hosed down and ·be cleaned they are out on the street hallucinated,. eating garbage, their checks are being stolen by addicts - isn't it wonderful the mad are no longer in the mad house, they are in the connnunity with the rest of us and as you know,, there was a big fight between Rockefeller at the State and Lindsey at the City about who takes up the -check and these patients were caterpulted out the back·wards of the hospitals surrounding New York City into the eonnn.unity, into the Manhattan jungle, so that I think what happened was that a certain kind of evangelical fervor and a certain - 20 - JR(continued) kind of assuming that we had the answers to things which we do not hmie the answers to, play the part. Now, are their good things of community mental health, there are many good things to it. You drew attention to warehousing~ you drew attention to the fact that some people should leave the hospital and return into society as soon as possible, but much of this was done with the medication as well as with an increasing tolerance for deviance in communities. I think they played a part as well in whatever successes there have been. EAR You remind me of another point when you talked about the Stagecoach club which incidentally, is a· story I have not heard before, so I am very'.''lhappy to 'ge,tFiit but::I have said a number of times to people that it seemed to me, obvious to you and some others, that perhaps one of the most important beneficial side effects of the whole NIMH program was precisely the kind of communication that occurred in the various committee meetings, the interactions that ·occurred,_ the national source of communication which was inherent in the op~ration of these committees•, the National Advisory Mental Health Council for one, but perhaps on even more limited substantive basis, the various Peer Review Committee meetings where all sorts of things took place above and beyond the sheer review of the indidvidual applications, which every member of the Committee took home with him then as a new apperceptive mass-to add to everything else we:J;~C§Jfs:and so your Stagecoach Club was a:Llovely way of this kind of interaction and by the same token that took-place in all these Committee meetings three or four times a year as the case might be. Was that early on in your recollection, a conscious aspect or were you so involved in substantive issues that you really didn't think about this added overtone to what was going on nationally as a function of the operation. JR I think that is a good point and again I am not sure how conscious we?:were then at that time but I do remember the richness at times of the discussion between - 21, ~ JR(continued) members of the study section because,\! le£t the Council and after I left the Research S_tudy Section I also served on the Training Section and others and also on Ad Hoc Committee:!rs, one tMBg that Bob Felix which I think I wrote about with Don Marquess and someone· else in terms of- examining Ken Appel's proposal with the Joint Commission idea. My-own education was tremendously extended, my mind was really ~tretched by comments of people who were older and wiser or younger and brighter or others w'J,e with whom I sat listened and som on and sometimes debated and incidentally, my memory of this if it is reliable was that much of it was done, in fact all of it was done with grace. I don't remember much being strident or harsh. I don't think there was much adhominem. I think people r·eaH:y tried to keep to issues as carefully as possible. At times I would be disappoii;ited. For exqmplt;! fl l-A 4?,,•~.-ttt~,4 ll<; ; remember when·I staunchly defended supporting some <Sf the fact out of the ~....:in., =~~~..,.'i'l!'im:o,,;,,,1,1~l.l;:;wm,::,.,_1i1.1ti,l,(~r,;:- 1 _ _..,..__ Institutes' and I found that people who were involved in the analytic movement more than I was didn't speak at all and I spoke because I thought that certainly they needed money at that time to support their studies: and to support their growth and son on even thought later on I was disappointed that not more thingsdhappened. SIDE 2 JR Alexander and French EAR That would be fine,yes please. JR As I was saying the Chicago Institute to me particularly under the leadership of Franz Alexander-and Thomas French who incidentally, were both on the original Research Study Section. I thought and incidentally, I think were\.lbenefited by being on that Committee. I think that that Institute promised more in terms of engagement and research and showed it too regardless of what happened to Alexander's earlier notions o-f specificity and psychosomatic diseases there was a curiosity and a restlessness .in that group different than the more JR(continued) trunkated and set views of the New York Group and so·on; I think. EAR I am very interested in your comment a moment ago that there was little abrasive interaction among the members because you were repeating what a number of people have said about the ep:~ration of the Committee·'s, it was rich experience and I think that to some extent it's extraordinary compliment to the membership itself but also the important positive input that occurred because you were all concerned collaboratively· on this· effort to move the entire field forward and it is a happy accident really that so many good people got together on these Connnittee's that the best of each could be excited so to speak by these kinds of interchanges.,... I spoke last week with someone who had served on the Training Committee in Psychology, you probably don't know him because it was in the mid 60's but he said that the experiences he had with his Committee was among the most rewarding portions of his entire responsibility because it was an intellectual delight as well as a professional challenge and satisfaction to be involved in these meetings, the level of interchange, the level of intercourse was such that · ,·everyone was stimulated to produce at their very >:,best and I think this is terribly important, not only for the primary purpose of the meetings per se, but because of the point I made a moment ago that this then sent you a-11 home, so· to speak, that much w:tser, that much more stimulated, that much more competent then to continue your day to day responsibilit~ JR I think that's so, I think what it did really in a sense it reduced parochialism, it reduced chauvinism, it gave us other· people's points of view, we listened to these people with respect and interest - also there are two other thingsfhere ~ one is Bob Felix's administrative ability of not being intrusive; that was one thing - and also, I remember how much impressed I was with the staff, you see. :t realize~ you know that, many were paid very modest orc;negligible salaries and worked very hard and were very devoted - I could recite a whole number of - 23 - JR(continued) people who impressed me, not only the professional staff but the secretarial staff - all those young secEetaries who.did so much. EAR I think you are absolutely right, we had a very dedicated group of secretaries, Doris Smith, Hattie Arnold, Aggie Cosgrove, a whole bunbh of people. JR The one who married Bob Cohen; what was her name? EAR Oh, yesi I have forgotten her name, I know who you mean. JR Hattie Arnold was there for years and years - away even before that Larry Cobb and I had, whose names I have forgotten, I regret to say, but so devoted and I think there was the excitement and I think also in a way the excitement of the Comm.itteef"'s, this was a new thing, too. See, since then we have become a bit jaded, you see, it's not only that since then our Committee's.have multiplied into a thick forest and within schools, within our own sohools,in communitiesJat the State level, Nat'ional level, we are beset, we are surrounded by forests of Committeets and in those days, you see, this was it ) so that you could really devote yourself to it. EAR OK, well, you are absolutely right, I think that was new and innovative has now become somewhat mundane, but I have to tell you that some years ago George Sazlow, who was on the Training Committee in psychiatry and who I: got to know fairly well said to me "Eli, some day you will have to write a novel about the NIMH Training Committee's or all of the Committee's because there is such a rich story to tell." Now, I am not prepared to write a novel, I ,.J¼~ ,,. ,r don't think but I really do want t~ illuminate that part of the story as much as I can and I wonder whether you can recall any particular incidents in the course of your function.ing on these various comm.itteet-s that come to mind as a vivid example of the sort of interchange that took place - are there any specific incidents that you can particularly recall? JR It is difficult for me - I remember, r may have menti()ned this earlier, Vesty coming in one time and mentioning ,)that one or the other Congressman wanted - 24 - JR(continued) special attention to be directed towards '.:,a :, project and that led the Committee to examine the project even more carefully but also -(sandy, Just·a m-inute, I wanted to ask you to do something - hold on a:::moment; just leave it off for a while I just want to thinkthrough a little bit ) / EAR r do want to add a connnent about the point that·you jg:,st mentioned because I think this feeling of fiErce independence that the Connnittee•·s had that their responsibilities were not to the political pressures, theiE responsibliites were not to matters beyond the individual project, per se and the role it played in iilieir total responsibility to do the best they could with developing the field in that particular area and so that quite often that kind of input really backfired and I had seen it happen so many times, in fact as you well know, even the issue"of funding, per se, so far as the Collllllittee's were concerned was not supposed to be part of their concern,: you just approve as many projects that you feel are meritorious, the priority order- that you feel that they belong and never mind about worrying about whether there is not enough( money or too much money or whatever, we will take care of the money side of it you just do your job, which I think a lot of them did, although later on whenm.oney became tight and there were concerns about the distribution 0£ £unds, they were somewhat more concerned about this .., Let me ask you another question. JR Let me spea,k for a moment about that be·cause that is a point, I think. I think in those early days, number one, the Connnittee felt that they were making- judgments on merit, the scientific merit, this is the Research Study Section, most of them in training at the moment and I think that they tried to keep to that and they did not, it was the arithmentic of how much money was there was not in our minds, we just said that these are projects or programs that we think deserve support and we knew then that this would go to the Council and the Council would have the power, the power to a.ct on it, that the Committee's action - 25 - JR)continued) was advisory, the Council at least in the beginning had the power to accept or .decline-the Committee's.report and then beyond that it would go to the Surgeon General and if there was money he was obliged to· pay it, but if there was no money, of course he couldn''t pay it.. That's how the system was, then I think what happened later on was that a number of people, a number of my colleagues began to become political persons, they began to say t well~ given so much money we will say we should do this or do that or do the other, rather than objectively making some sort: of a hierarchical order on a merit basis and I deplore that~ Naw about theJother matter of the political urgencies, alcohol, addiction, aged, criminal,. retarded, etc .. , not for a moment do I minimize the significance of that, socially, intellectually, politically, economically, medically, and so on, they ar~ the great problems and the great unsolved problems, what I was sad about was that it was assumed let"s say, like with fme a.tomic bomb business that if you Just pour money into that, that would solve it," rather than a long period of pr~pa:ratiJttt of investigators, trial and error experiments over a period of time and sor1on towards those goals. That was my complaill-t.►. EAR Th~t' s a very good point. Let me take you back for a moment to something I just briefly alluded to at the very beginning about the strong medical character of the Council and bring up an issue which I think came up in those early days and that you may recall and that was the concerns so far as training funds were involved with makmng some kind of an appropriate distribution among the so-called four key disciplines, psychiatry, psychology, social work and nursing •. You may recall that a formula was developed early on which was known as the 40:....20-20-20 distribution, namely that 40% of the training funds would go to psychiatry, 20% to each of the other three disciplines,. do you recall anything about, that early development, does that ring a bell at all? - 26 - JR1contin~ed)- · I just· know of it, you see I was in those early days I was on the arrangement and so I think it was because of the urgent need for more psychiatrists and as you say urgent need for psychiatrists almost immediately in the service almost first aid function and so on, I do remember that one. I did visit - I served on both the Research and Training and at times on the Training Section I would also visit social work, nursing, psychology and so on it. EAR In the early days, as you well know, the Council members did serve on those other Committee's, after awhile the Comm.ittee•·s became completely autonomQus from the Council, the Council functioned completely separate1, I raise the point not only in its own right because I think it is an interesting part of the whole history because one of the things I need to be concerned about is the manner in which, again perhaps nn a political level, each of the disciplines looked at each other and I should tell you that I became sensitized to this because ultimately I had the position that Vesty originally had, I was in charge of the Training Program after Ray Feldman left and moved upstairs and I kind of followed Ray Feldman along and as a psychologist I was seen by my fellow psychologists in the Training Program as an apologist for the psychiatrists when I would say for example "look, you really have to be sensitive to the politics in this whole situation so far as Congress is concerned this really is a medical program, you may not like it but that's the truth''and I think that to the extent of the other three disciplines at the receiving funds has been partially a function of the fact that we are seen as a piece of the whole but as a piece of the whole the extent that psychiatry is visibly supported above what it was before, so too will the other disciplines be supported beyond where they were supported before and you may dislike that and you may feel that it. is professionally - 27 - EAR(continued) inappropr.fate to make that kind of relationship but that's the reality of the politics and so when Mike Gorman came along for example and had the general practioner program added to to the total support of psychiatry it J ,t,•d~JL},tf t·b 1 ' inevitably redourlfad ·H tto the other disciplines because all of NI?-1H got more money 1 ,t A by virtue of his very aggressive political posturing.· I think that's a reality. I think the internal struggle among the disciplines was also reality and I want to make the appropriate balance between those and I frankly have not been able I suspect it is somehwere in the record, but I have not been able to find the true origin of that 40-20-20-20 approach. I asked Bob Felix about it and he had a vague recollection of it. JR Mine is vague, too. EAR And I think it is there somewhere. Incidentally,. t:his book I should tell you I do have among the written documents, this is a complete official set of minutes of all the National Advisory Mental Health Council meetings from 1946 through 1971 so that. I have that and ,of course, a lot of other documentation a~ailable to make sure I put personalirecollections in appropriate juxtaposition(I what the facts were. JR I think you are right though, psychiatry was looked upon as premum interpares that was the objective of the legislation, you see, and also it was the objectives of those early days. Now, as you know, there has been a rev.ersal in the past number of years of what kind of·research has been supported the biomedical was two to one, and now, psychosocial is two to one, there has been a complete reversal and I think because of the alcohol and addiction and other problems of the day. EAR If what I am about to ask you, you would rather not do, please don't hesitate to say so but you had such close connections with so many of the key people - 2 8 - EAR{continued) early on. that if you weuld be willing to make SO'Dle comments about any or all of them that would be very helpful. Bob Felix, I know. JR May I look at that EAR Sure, this is the very first one but I will mentien some names. Bob Felix; I think is pre~ty well delineated but how much interaction did you have with Joe Bobbitt and let me preface my question with the following connnent - I knew Joe quite ~ell at NIMH. AND AT the time I was about to begin this work I wrote to Joe as I wrote-to everyone else and I said to him that I wanted to come.to Washington to chat with him about this: book I was hoping to put together, he was at that time no longer with the. NIMH, he was with the. National Iristltu~1~~af Child Heaith-:at1~ HtVaan,iBevelopment · and I don't know whether you had been in touch with 0 him at all in the last period before he died, but he was not a happy man at ~that time and I think he had had a number of personal disappointments; in any case, after reluctantly saying that he would see me, he called me back a couple of weeks later and he said he would prefer not to do it and I was not aware of why but her ally was quite depressed at the time and very shortly thereafter he died of a .;,::massive heart attack. I am very sorry that I didn':t get Joe's input because in cirtain ways he was a unique member of Felix's early team,as you know he and Bob lelix were together at the Co;ist G;µa~d, before Bob came to NIMH and I think that Joe and Vesty and Bo~a ~~;~:~o to speak, served initially as the thre key people. ·JR Who as the third one? EAR Vest. Joe Bobbitt, Vesty and Bob Felix,. now~ of course,, that's not to ignore peop e like Dale Cameron and Jim Lowery and Larry Cobb and a whole host of others, but lo you have any recollection at all of Joe Bobbitt, and if so, what is it? I . - 29 - JR At first I was somewhat deceived by him. I didn't recognize the positive aspects of him as I did later on, but later on I got to know him better, he was immensely:inform.ed, tremendously loyal to the group there, devoted and I saw all good things~_Jjefore .that I don't know whether maybe a certain kind of anxiety on his part deceived m~ or he looked unsure of himself or at times he i). {1 ~.,,~t Url)t~~trr---•{< . . .1', J> ¼'. •~;"··•·· '"''"i ,, ,..,,p, "'l;,,,- f.. Jj' $' v o/ seemed a bit ol,Jsequi'tusf) and to others, maybe( that distorted my earlier view,\ but as time went on I got to know him better and had admiration for him and affection - those are my memories of Joe Bobbitt. EAR And, how about Dale Cameron and Jim Lowery. e JR Well, Dale I knew and I thought was top-drawer, he was ablej he was affective, \:t.rr.::e:: he related well to people and so on. Jim I knew less well.. I think Jim had been at Colorado either with me or shortly after, as you know for a long time there before NIMH was conceived, Dr. Treadway would send the USPH Fellows to Denver for a year or two, that's where I met Vesty and E·dgar Finley, John Cronin, Victor Vogel, Terrell Dav·is and then there were others who followed I think Loweryfollowed them and there were some others, too that I remember were therel so I knew them a little bit in one way or the other and I also knew them then on the Committee's and so I knew Lowery less well. He was to me more taciturn, more difficult to know, not withdrawn but sort of quiet and held things the others. EAR Do you recall having any feeling whatsoever within Bob Felix's early staff ~tF organization as to who was seen as his right hand or should such -an occasion arise who might take Bob"s place should he decide to leave or .retire or whatever obviously I am not talking about the very early days of NIMH, but later on when things were fairly well developed, was there any clear indication among the people who were not in the immediate family as to whether there was a kind of hierarchy of individuals. JR I don't think I was aware of that. I gather in those very very early ~ays Dale was there and Bobbitt was there, those two and I dontt remember many ·others, who were there besides those two? EAR Well,_ very shortly after they came some of the other people, Vesty, of course, came, lesier Garrison, Milt Whitman, Phil was there, Earry Cobb was there JR Larry Cobb was at the beginning, too. EAR And then when the intet:'1Ilural program was developed, Seymour Ketty came, Dave Shakow came, Bob Cohen came early on, those weee all people early on. Incidentally, I am inevitably going to have to give much less space and attentio,p. to. J;he intermu!-"al program than it deserves, because I think that; !!t,•1t· " ¥,,,~.,'',,j ~- . :r; ,,,.,., ,ir· . ¼f,e1l"«"'t,,-\,/ll_",,_'i,,sl,.•,,,,i;,,A;,,· Ji ·'"-it @-- :,,, 4,..,Jj:_,,·!¥ "·•;>-'•-"'' '~ 1<' A the Intermural Program developed a life of its own with John Eberhardt and Bob Cohen, w;ho were there, Seymore Ketty was there for a short while. Now, how about Bob Himself, do you recall any particular incidents that helped you illuminate his character for you? JR Well, I remember- first of all that Perrin introduced him to us at that first meeting and I remember one felt that this was Perrin's choice, that he wanted Bob and we were all so eager to help BOB, I mean he brought out sort of mothering and fabhering in us, at least I felt that way, I wanteed I to do everything I could to help him in terms of his service and so on .. EAR Yes, you were saying mothering and fathering .. JR We all wanted to help him. Well, then later on I was really, I think I indicated to you in the· letter ,and I am sure you will deal with this ~ith discretion, I was never_·impressed with Bob as a scholar or as a scientist:t in any way, rather, but for the most part I think he made very good judgments and had an ambience of trust which extended down to the-Universities as well as inside and there was a trust matter which I think and ~is sort of irrepressible spontaneity and effusiveness, this bubblyness of Bob I think JR(continued) lent itself to that particular phase. Now others criticized him· because they say he promised too much, he promised too many rose gardens in terms of the mental hospital movement getting rid of those and so on, but if it started with Bob or not, I don't know, I think i.t did, didn't it? EAR Yes. JR Whether or not he got sold on that and didn't realize clinically what the problems were and so on, that's been a criticism of Bob's, the rose garden business, but I wasn't aware of it at that -time, this was an earlier time. I enjoyed meeting with him, he supported us, I invited him when I would chair The Career Investigator Selection Program and invite himE~ back, he is in that pieture I sent you. Mine, were iositiV'e tJ1ings, but I n·ev:er felt that Bob was, ~~ li$-t'·'-t,Jb'l> lJ!.i~ile'.\iP..' ef:&,.-,.,,fl},t' ,!JA:tO"" .1U,..~ 1 I saw him withl\Committee' s at tim~and I thought he handled himself well there, I thought he adapted to the set, you see, and I think it would have been dlifficult to find someone like him. I remember I once spoke to David Levy, I was somewhat critical of Bob, and Levey said, don't underestimate him, he said he is just the· right man at this time, he is doing a wonderful job and he began to point out to me what he was doing and I felt a little bit ashamed but I felt corrected,. too. I think Levey was right. EAR I do too, and actually one of the anderlying themes that I hope to be able to justify in the way I present this is that, indeed, Bob was just .the right man at the right time and to some extent so was Stan Yolles for the '.fime that he·was l>~ Director because by the time Stan came in 1964, the Institute had grown to a point 1 . 1' "'~ · where it was so complex, there were so many :vO~U\tt~t.f 4V'"'~ parts that Bob no f) f longer had the opportunity to use his personal approach as effectively as he done in the early days and Stan is an administrative genius in that sense and so where -- 32 - EAR(continued) Stan is a much less pe.i;sona.l;o.1;\_c;}.'lersonable indb~idual than Bob Felix was,at the time he came in he was able to handle the new dimensions of NUm much better than Bob. Stan really is the person who developed the whole i'h<t· §QqJ, ~/Tl ., Connnunity Health Centers picture,.Bob was involved and I think that Bob probably feels that it is lilis baby, but the facts I suspect or show that it was much more Stan's input than Bob's input in terms of the actual organizational structure as such and all the work that went into it and then by the same token in a much smaller way since I am not going to deal with it at all, I think that all of the political problems that Bert Brown has faced,. he is probably more able to handle that than either Bob or Stan would have bee/; although I don't think anybody could have done a truly satisfactory job under these circumstances, I think the situation is overwhelmingly against doing an effective Job because of all the political pressures at the present time. JR I see O'Keefe's name here, 3, too. EAR Yes, Dan O'Keefe was there JR I reniember him.. In fact I :remember all of' them. I· re~ell\ber· Sam H~ilton •. EAR Does the name Charlie Shlafer ring a bell with you at all. JR He came after me. I had nothing to do with him. EAR Tell me something about Mary Lasker because she certainly was there at the very beginning and what were your impressions of her .. JR Well, she was supposed to have been not of very grey eminence, much more vivid than grey and she was supposed to be there because of the wealth and all the rest some direct influence on monies and so~ron and she was supposed to be the Queen Mother who directed the destiny of this or that program and I had met with her, I think I wrote you once, at that time with Hovland and all the others when they wanted to have adrena1·cortica1· extract solve everything about schizophrenia with the Louisville mayor with the string tie, you know and so on, and which I objected, I would not testify and they misquoted -·33 ~ JR(continued) by saying we have got to be together, we have to have a united front and so on, and so that was my only really direct experience with her.· I looked upon her as someone who wanted to do good in this whole thing, but a fairly narcissistic pe:rzson, who also enjoyed every minute of the power operation.- EAR Very bright woman, though. JR I am sure she is. EAR Is there anything that I have left out JR I am trying to think through lte!rf!:,:about. I did share with you that thing about Strecher and the Training Connnittee in the letter., You have that? EAR Yes JR That brought about a major change in the whole organization and Gregg and 1 Perrin supported me on that. EAR Tell me something about Allen Gregg, you had a number of interactions with him and he played a very key role in those early days.~ JR I knew him for a long long time before this and also I have known him through the years until his death. He was a man of considerable ability. He became , tl;:,,,t-,!i' t,,lr:l"fii' f{ he told me later on almost somewhat ~·"1 ,~he became a professional wise man. ' He was called upon at all times to utter great sayings and he reminded me a little bit of what Hutchins once said when Hutchins left Chicago to go to that fun~ for the Republic the foundation, somebody asked him, Well; Mr. Hutchins, how do you like it? He said "you meet so many interested people.'-' Gregg once told me that he found it difficult to know who was his friend ever because of the people would identify him, you see. Remember in Aesop '·s fable when the flea sets on the wheel of the chariot and says "lo, see the dust I raised 11 it happens to what is called a philanthrapoints in Foundation work, they all of a sudden they are the money and I have known some other people who - we had one person JR(continued) come here from another Foundation, gave a small amount of mon.ey for some things we needed and then came here and proceeded to tell me how to spend \"t'-lv it, dollar by dollar, so I said "I am sorry that 1he couldn't do that'' he would have to go home again and alU:kinds of ominous things were said by this person, but I told, it happened to be a woman, the story of the boy who bought his girl at that time a five cent coca cola and then spent the rest of the evening squeezing it out of her. She never came back but she let us have the money. Those are the problems,. EAR Incidentally, you remind me Bob Felix was very sensitive to that issue and I mentioned to you that when I was hired by Vesty I was interviewed by Bob and I have very vivid recollection both of his warmth and charm, but also his saying to me "Now, I want you to know, Eli, that when you come to work with us, and at ~'i;tJ\,;' that time I wasn't sure I was going to be hired, ~ he said ''when you come to work with us that you have to recognize that because we have provided monies to the Universities for these training programs, that does not mean that-we own those Universities, and the funds that we provide them are for programs, that they are to run and that we are not to run, and I was constantly sensitive afterwards that someone who went visiting of the need to be aware that, inevitably everyone would look on you with great favor and whatever you said was instantly wise because you were the person with the dollars and you had to remain almost cynical to that kind of embellishment that people were trying really to seduce you 1 because you had the money to give away and Bob was very sensitive to that problem and I think he told everybody when they first came in to be concerned about it, aware of that possibility. This is refreshing some memories for you JR I just saw Mary Switzer's name, who I rem.ember very vividly, she was one of the - 35 - JR(continued) first persons to come visit us when we finished --------- and also Fremont Smith. Fremont Smith was at times he reminded me of the Holy Ghost, it seems to me he was always with us, but unlike him you could see him and hear him. I thought he was at times a busybody, but he later went into the Macy thimg and was able to satisfy his needs by having all those small meetings. EAR Mary Switzer was a very formidable lady. JR She was able,. and she had this tremendous background in rehabilitation, I think it was. Those are the. /, BAR Well, any last thoughts? JR I remember one thing - this was a Council, I may have touched upon it, Carl Borman, at that time I think he was on the Council, yes he was>objected very strenuously to any monies being given to the Analytical Institutes at that time ( which I defended for the reasons I stated, but what surprised me however, was that people like Bartemeyer ·and Menninger were still on the Connnittee didntt respond and it sort of shocked me because they were clear_ly the·· pro;t:agonists ) and I wasn't, but I defended it on the basis of the prineiple that these were groups of people involved in very important matters and that they should give them an opportunity to pursue them with support and in putting their house in order and so on, even. though later on I felt that they were not as fruitful as I would have liked. Isn't this interesting to look back on this? It really is •. EAR Well, you were on for the first three years which I really think obviously the formative years of the Institute. JR No one - is anyone else living? Menninger is dead, George Stevenson EAR I think he died a couple of years ago. JR Strecher died, ~eiman Tallman? ..., 36 - RAR I don't know JR BT¼dDavid Levey died. EAR Yes, he died JR I may be the only one left EAR I didn't want you to think about it that way JR I have thought aboµ.t it some tim~s. Another person I should tell you about who impressed me very much in terms of his wisdom John Whitehorn. EAR Yes - JR John Whitehorn was a jewel in the, he was wi~e, he was learned, he was thoughtful, very sober and times a little bit boring but still I g~t to know him, of course, before that because during the war years when the State Department asked Carl Menninger, Hubie Whitehorn, :Bartemeyer and myself on that expedition to the European Theatre, f spent most of my time with Jahn and we went to see the grave of ,his boy who·~as killed:Lin the Bulge. I got to know him over the years. In fact be:60-re he died he caine up here to receive an honorary degree together with Dave Shakow·;;' EAR He was a very serious man, he rarely joked JR I loved him dearly and he was a very fine·man, he played a very important part in thos early days in terms of judgment. EAR When he was on the Conncil in late 1950's and early 60's he was always looked upon, he didn't speak up as much as some other more volufble people did but (01:.e:,~lt( when he spoke everyone listened to him and Jackie ..,,:;;;= Wo!f_ was on at that time .. Eli Ginsberg was on, Mike Gorman was on that time, John Benjamin was on at that time. I think the membership of the Council the ·first decade and a half was just absolutely superb people - it was a total delight to sit in on those meetings, listening to the interchange. JR I agree with you EAR It was actually intellectually stimulating and the only really sad memory I - 37 - EAR(continued) have which is very vivid in my mind is we had a National Advisory Mental Health Council meeting on the day that President Kennedy was assassinated. we were literally meeting at the time and Bob with tears in his eyes and a quaver in his voice adjourned the meeting that Friday, just after lunch when it,was announced that the President was dead and as everyone remembers where they were that aftern.oon, but that was the only really sad note that I can remember of Council meetings or happened during Council meetings, but the interchanges were <;)~t,,~~u{ just spectacular. You still hear Jackie ..... ~ Wal,.t everyonce in a while saying he always began his most pointed criticism by saying-· "I would like to tell my brothers around the Council table'' and then bang he would whack at something and Mike Gorman - did you neve-efty-t:1,4:ng--- much interaction with Mike Gorman. JR No, but I knew him. His brother has been here in town, a social worker. EAR I didn't know that. Mike with a real irish gift of gab would begin talking, you could tell that as he talked, he literally fed himself by virtue of the word that came out, it just spun out, but he was very very knowledgeable, as much and some times more so than the profes·sional members of the Council about what was going on, where, substantively knowledgeable about what was going on. JR Let me not forget to mention Fogarty you know from Rhode Island. I was very much impressed with him. I thought he was informed, he listened and a very genuine devotion to the cause. EAR An.d so did Senator Hill. JR Rill I knew less well, but I am told that was so. EAR Absolutely. JR Those two probably were the stars. EAR They were the key~ they were the Congressional key. JR Eli~ I think - I wish you every good fortune in this RAR Well, as I tell people at this point S - 38 - JR urgency of the problem from the very beginning that was the thing and the spirit, you see the spirit of the interest of the people,their. enthusiasm, their unselfishness, I thought,the grace, the good humor, the fact that we learned so much from each other in those early days and also I think there was very little factionalism,. even then there was. sort of an ecumenical· pluralism, realizing that there are many psychopathology survives regretfully under many flags and that·we must examine all those areas relevant to our concerns, that was there I think from the beginning. EAR And I think it continued for quite some time. Well, I thank you so much for your time and patience on· this. It'"s most helpful