Medicine and Creativity: Interview with Richard M. Berlin in The Lancet

This interview on Medicine and Creativity originally appeared in The Lancet, Medicine and Creativity Vol 368 December 2006 2006 in a special issue focusing on creative physicians.  The Lancet is a British medical journal and is considered one of the world’s “high impact” medical publications along with the Journal of the American Medical Association and the New England Journal of Medicine.  Here is the text from the article (some of the spellings look odd – they are in “English”):

 

Richard Berlin is a poet and psychiatrist who practises in a small town in the Berkshire hills of Massachusetts, USA. Current projects include a second book of poetry, Secret Wounds, and editing a collection of essays by 23 contemporary poets describing how their own psychiatric treatment influenced their creativity.

Which research paper has had most effect on your work, and why?

The paper “Hidden conceptual models in clinical psychiatry” by Aaron Lazare (N Engl J Med 1973; 288: 345-51), because the author makes explicit the hidden psychological, behavioural, social, and biomedical models that underlie psychiatric assessment and treatment.

What do you think is the greatest political danger to the medical/scientific profession?

The corporatisation of medical care and research.

What part of your work gives you the most pleasure?

My relationship with my patients.

What part of your work gives you the least pleasure?

Serving on committees, where my mind tends to drift to the Leonard Cohen song, First We Take Manhattan, which begins with the line, They sentenced me to 20 years of boredom, for trying to change the system from within”.

Who was your most influential teacher, and why?

Miss Athey, my tenth grade English teacher. Her goal was to convey her love of literature to her students, and she succeeded. Without her influence, I would never have become a poet. Garrison Keilor dedicates his anthology Good Poems to English teachers everywhere, “especially the great ones”. Miss Athey was one of the great ones.

What would be your advice to a newly qualified doctor?

No matter how much you know, no matter your level of technical expertise, all your patients will die, so first be sure you do everything possible to relieve their suffering.

What is the best piece of advice you have received, and from whom?

On my first day of psychiatry training, my supervisor, Dr Tan told me that patients would approach me on the locked inpatient unit to ask questions about medications, discharge, unit rules, etc. His advice was to respond to all questions I couldn’t answer easily by saying, “I’ll have to think about that”. I am happy to report this response has continued to work well for me in a variety of professional and personal situations.

Do you believe there is an afterlife?

Only in the way we live on in other people.

What is your favourite book and why?

The Catcher in the Rye by J D Salinger. I have read this book countless times, and for years I identified completely with Holden Caulfield and his adolescent world view. But on my most recent reading, I realised I had finally grown up; now I responded to Holden with parental feelings of worry and concern, and imagined how l would treat him if I were his psychiatrist. How had I always missed the fact that he is writing from a mental hospital? Since I couldn’t reach Holden any other way, I wrote him a poem.

What would be your advice to a newly qualified doctor?

No matter how much you know, no matter your level of technical expertise, all your patients will die, so first be sure you do everything possible to relieve their suffering.

What items do you always carry with you?

My sense of humour and a few clean jokes I can tell to my teenaged patients. And I also believe every doctor carries a black bag filled with the poetry of medical practice.

Do politics, spirituality, or religion play an important part in your life?

My wife is a physician and health-care reform activist. My main political activity is to support her efforts as she works to create a universal, affordable, Canadian-style single-payer health-care system in the state of Massachusetts.

Describe your ethical outlook

My stepbrother Jernigan Pontiac (his pen name) has written about his life as a taxi cab driver. In the introduction to his second book Hackie 2 he quotes Philo of Alexandria who said, “Be kind, for everyone you meet is fighting a great battle”. I continue to try to make kindness my ethical outlook.