What do doctors actually do at the big psychiatric convention?
My patients are curious. Increasingly, so is the general public.It’s that time of year, the annual meeting of the American Psychiatric Association. The going assumption is that these affairs are boondoggles, big bashes sponsored by drug companies, private hospital chains, and other special interest groups. That perspective is not entirely wrong — for years, there’s been an embarrassing commercial cast to the central exhibition hall — but for the most part, it runs counter to the experience.I’ve attended “APA” faithfully for three decades, beginning in residency, when I had submitted a study about competency to stand trial. That year, in San Francisco, a few fellow trainees and I invited our favorite family therapy teacher to a dinner following the residency reception. The meal became a constant, the Monday night of every meeting. In time, our teacher begged off. By then, the dinner was a hot ticket. It attracted “young Turks” from public health psychiatry and the Federal government. The crowd aged. The numbers shrank. This year, we’ll be back to a small handful.This sort of tradition makes the meetings intimate. Attendees trade family news and academic gossip. We update each other on science and clinical lore. Overall, doctors divide into interest groups. The writers among us discuss writing: David Hellerstein, Bob Klitzman, Anna Fels, Keith Ablow.
There’s a certain amount of stargazing. I recall the thrill, early in my career, of meeting Otto Kernberg, the great psychoanalytic theorist. I don’t know whom residents watch out for in the pharmacologic era; for most of my career, therapists have been the heroes — Salvador Minuchin, Hyman Muslin, Aaron Beck, Jim Gustafson, the late Michael Basch, and Leston Havens. When the convention was held in New Orleans, I took a memorable walk with my old teacher, Robert Coles; he was visiting some of the girls, now women, he had written about during the school integration struggle. Another year, he introduced me to Ethel Kennedy, and we talked mental health politics.
Authors come speak. I wrote about Joyce Carol Oates’s presentation, in connection with her short story (later a novel), “Zombie,” built around the shameful history of lobotomy. My essay sparked a correspondence. I first met Judy Blume at APA, and Jamaica Kinkaid. I had crossed paths with William Styron in the ‘sixties, but we renewed our acquaintance at an APA meeting and stayed vaguely in touch. One year, I got to exchange a few words with Jorge Luis Borges. I held on to the posture I arrived with in the ‘seventies, admiring and wide-eyed, lucky to be there.
Over time, I did seek out medication research and picked up some genetics and physiology, mostly when I was researching a book. But the talks I recall were on other topics. A seminar on Hubertus Tellenbach led to an interest in German phenomenological psychology, a perspective that pops up now and then in my books, sometimes in hidden form. I’m a sucker for sessions on European philosophy and its relationship to the theory of psychotherapy or diagnosis. Often I brush up on the history of psychiatry. I’ll attend virtually any session on couple or family approaches. Some years, I squeeze in an hour on wonder drugs I’m too timid to prescribe, human growth hormone and DHEA. Back when I was doing reporting, I wrote about Ethel Person outlining her concept of love and Judd Marmor and Donald Klein debating ethical boundaries in treatment. My own presentations tend to be about writing or practicing, but I’ve spoken about the dilemmas of intimacy, mid-life crisis in film, the nature of advice, and reductionism in psychiatry.
Between lectures and seminars, I’ll walk through the “new research” poster hall to see what’s on the horizon, especially in the work of young colleagues. I browse in the bookstalls. I’ve used the APA’s facilities to tape public service spots on mental health topics. The organization’s working committees convene during the conference; some of my time goes to the routine business of position papers and resolutions.
Regarding elegance, it’s true that the drug company speakers travel by limo. I take the convention busses or go on foot. Except when I served in the government, in the Carter Administration, I have always gone on my own dime. I started out sharing hotel rooms with a residency-mate and later saw no reason to change habits. Some years, I did on-the-spot journalism to help pay my way, staying up into the wee hours to file stories. As for Big Pharma buying its way into doctors’ consciousnesses, I’ve never come home from a meeting with loot in excess of a tote bag and a pen.
So there it is, the squalor and the glamour: cramped quarters, long hours, and, with luck, renewed acquaintance, clinical pearls, research findings, quirky theories, and even literary inspiration.I don’t expect to post again until my return, toward week’s end.
No comments:
Post a Comment