From Generation to Generation: Reflections on My Recent Activities
June 2012
Cynthia R. Pfeffer, M.D.

"To every thing there is a season, and a time to every purpose...." This Biblical statement highlights that reflections on one's activities highlight changes in a person's life that occur at different stages. I am reminded that my current activities have a significant link to my past. I have reached a new stage of life where I am now a member of the American Academy of Child and Adolescent Psychiatry's (AACAP's) Life Members circle, a special group of colleagues and mentors. This group of AACAP aims to provide a valued collegial enclave and forum within AACAP..... I am now one of them.

I joined AACAP when I was just out of my child and adolescent fellowship at Albert Einstein College of Medicine and within a few years presented papers at the AACAP Annual Meetings and published scientific papers in Journal of the American Academy of Child and Adolescent Psychiatry. This continuity of activities has been maintained, most recently, with my participation in the Wisdom Clinical Perspectives at the AACAP+ CACAP Joint Annual Meeting in October 2011 in Toronto, Canada. At that symposium, I focused on a retrospective view of my scientific research within the context of my own development as a child psychiatrist and the field of child and adolescent psychiatry at large. I realized also what a wonderfully special impetus the Wisdom symposium offered for the Life Members to provide support, mentoring, and insights to younger child psychiatrists. In this symposium, I aimed to describe my recent career activities by illustrating that through perseverance, objective observation, and analysis of my discoveries about children's development and psychopathology throughout my career, that I have achieved a personal sense of wisdom and that I hope to be able to pass that to others. My work involved discovery, definition and longitudinal contact with children and adolescents to identify predictors of mental health outcomes. Additionally, the consistency of my work lies in addressing new questions that arouse from past observations and that were tested in new controlled studies.

Certainly, I have gathered, as have other child psychiatrists who have been involved in conducting research, information that still requires understanding. Unfortunately, it has become more difficult to seek research funding because of the effects of tightened budgets of governmental, foundation, and private donors. As a result, I have refocused a significant portion of my efforts on clinical work involving patient care and teaching child psychiatry residents. However, my research "spark" has not been extinguished and I continue to write scientific papers on the accumulated data that can make contributions to our knowledge in child and adolescent psychiatry. My focus remains on understanding the role of stress on children's outcomes, such as suicidal behavior, anxiety and depression.

On a more personal note, I have gained extra time for renewal of "family ties." A number of years ago, my mother, due to her elderly age, came to live with me and this provided me with a special opportunity to experience her interactions that were refreshingly wise and caring for her family. I had time to discuss our family past and to learn new things about who we were and are. As time passed, however, her physical strength decreased and I learned what it is like to be a caretaker of an elder parent-hiring staff as companions, going on doctor's visits, managing decisions during recurrent hospitalizations as my mother became increasingly frail. Others praised me for what I was doing but to me it was "the right thing to do, without a doubt." My mother died in 2009 at the age of 96.

More recently, I have experienced a renewal of many aspects of family life and other interests. Last May, I travelled to Israel on an educational tour that focused on the current aspects and past history of life in Israel. It was amazing to realize that not only are there great concerns about international relations in the Middle East but also there is such a diversity of social, cultural, and economic issues existing in Israel. It was inspiring to see how this "Start up Nation" has developed into a modern democratic state in such a relatively short historical time period. While on that trip, I also had the pleasure of seeing some of my child psychiatry colleagues.

Family growth has been a pleasure to experience. My brother, Bruce Pfeffer, a child psychiatrist in Potomac Maryland, was joined in his practice by his older daughter Lisa Pfeffer Jager, who completed her child and adolescent residency at George Washington University Medical School. I am very pleased that she has confidence in me to answer some of her occasional questions about patient care. Erin, who is Lisa's younger sister, now lives in New York City and has a two year old son. I see Erin and her family regularly and take great pleasure when she asks me to baby sit for her child. I am happy that she lives in New York! In fact, I wish that I could have more regular interactions with Lisa's two boys, who are 3 and 7 years old. I now miss seeing my brother's and sister-in-law's son, Brad, who had lived in New York City while he was a resident in internal medicine at Langone New York University Medical School but moved to Baltimore, Maryland to begin a cardiology fellowship this year. However, I am overcoming this issue by making more frequent visits to Maryland to see my family there.

I believe that being active is a most satisfying aspect of one's experiences. I have learned this by observing several of my friends, colleagues, and some of my patients who have developed creative endeavors as they are in the later phase of their professional activities. The AACAP Life Members Group illustrates this too and I cherish being able to continue acquaintances with those who have been important to my professional growth.