Last updated September 2013.
When Ginger asked me to do this, I was a hesitant but agreed. Stephen Major (AACAP’s Development Coordinator) sent copies of newsletter articles by John Showalter and Martin Glasser. My only experience with the Life Member program had been at the dinner in San Francisco. It was there and in John’s article that I became aware term “owl” as a designation for a group member. That became the basis for the musings that follow.
It seems that I have been in training to be an owl for most of my life. Early experiences included being a camp counselor and a high school history teacher. Along the way, it seemed that people sought my advice and trusted my judgment. Children seemed to like me. I found such things rewarding and challenging and led me to decide to go to medical school with the goal of becoming a child psychiatrist. There was the grind of going back to school for pre-med and then medical school at the University of Minnesota – both experiences requiring more persistence than creativity.
The residency training at that time was two years of general psychiatry followed by two years of child fellowship. I did both programs at the University of Kansas in Kansas City. My mentors there were Paul Laybourne and Shirley Lansky. The consultation-liaison rotation in the general program caught my interest, especially as related to dialysis, and it seemed that I had a knack for it. One of the outcomes was that I served as an unofficial liaison to the nephrology department for three years – attending rounds, giving lectures, and following chronic patients in dialysis. The interest continued into my fellowship where Dr. Lansky was very involved with the pediatric oncology program. When it came time to look for a job, she introduced me to her friend, Larry Greenberg, who was the director of the child division at the University of Minnesota. He was looking for someone to start a consultation-liaison service there. There has been little contact between the disciplines up to that time. I relished the challenge.
My time at the University of Minnesota ran from July 1976 to January 1985. It was an intense and highly rewarding experience. I was able to work with the pediatric patients, their families, pediatric house staff and faculty, nurses and other ancillary groups involved with the running of a clinical service. I had a nurse clinician with me and offered rotations to medical students, pediatric residents and child psychiatry fellows. Our group provided consultations to all clinical services but was most involved with oncology and organ transplantation. We served in a liaison capacity with the bone marrow transplant program. I loved showing students and residents how they could communicate effectively with children and families. I loved working with nurses and faculty on psychological issues that had an impact on the care they were trying to provide. So I was happy with the clinical and educational aspects of my work. Unfortunately, research was not a strength or particular interest of mine. I was too absorbed in the daily tasks to make it a priority. I was not an academic at heart so knew that I needed to do something else. That turned out to be outpatient work in Fargo, ND.
I enjoyed the novelty of a regular outpatient practice. As you all remember, this was a time of change in the usage of psychotropic drugs and increasing relevance of DSM III. I worked very hard to catch up in both areas as they had not been central to my previous work. To maintain some level of C-L involvement, I did some team teaching with one of the pediatricians when he was attending on the inpatient service. He liked the biopsychosocial model and wanted that as part of the student experience in pediatrics. I gave lectures to medical students on the psychiatry rotation. This was not very rewarding as neither the students nor the course directors had any interest and I lost mine after six years of effort.
I left the group practice in 1995 for independent consultation work. That turned out to be directed mostly towards school questions and interventions although some consultation work with a few pediatricians continued with their outpatient practice. I was also a member of the ND Board of Medical Examiners for 10 years along the way. I have been fully retired for the past five years.
North Dakota is an interesting place to live. Prior to the oil boom, the population was about 600,000. The state has been in the black while others have struggled through the recession. Oil has brought lots of money and a fair amount of social dislocation, and some increased crime. Politically, it is conservative outside of the larger cities but probably wouldn’t tolerate fraud or ignoring state interests at the federal level. There are a limited number of child psychiatrists – most are in Fargo. Inpatient facilities for children are very limited. It has never been easy to recruit physicians here for any type of practice and psychiatry is no exception. Would I come here again? Absolutely! The people are honest and generous. It is a safe place to raise families and the schools provide good education. Winters can be long but handling snow and cold are familiar tasks – easily addressed. It is much easier to stay warm in winter than cool in summer. There are three colleges in the Fargo-Moorhead area so access to the arts and national speakers is convenient – with parking that is much easier and cheaper.