I’ve been thinking a lot about George Saslow since I came south to take a timeout and think. I miss him. A lot. Dr. George Saslow was my guiding light after I moved to Oregon in the middle of residency training and became lost.
I came to his door referred by an old friend of his, my neurology mentor at Tulane. I knocked one afternoon and said, “Dr. Sam Trufant sent me.” These were the magic words. George Saslow smiled and opened his office door. I had found the guide I sought for the remainder of my training years.
Dr. Saslow was an amazing physician. When he was forced to retire at sixty-five by federal mandatory retirement laws, he went off and started a new department of psychiatry in Oregon where there had been none. When the people working on the Manhattan Project started having “stress issues” while developing the atomic bomb, George was the guy they called in to help sort things out. By the time we met, he was professor emeritus and active on the Psychiatric Security Review Board. He provided me an anchor from which to navigate the second half of my psychiatry training.
Sometimes I imagine that George would know what to do if he were still alive today. Then I remember what he thought about the changes that were happening, even back then, in the mid-eighties.
I talked to him about the changes he and I saw; the replacement of psychiatry education with psychopharmacology training, the infiltration of “prescribing” as a substitute for medical care, the loss of public funding of the state medical school and hospital and subsequent privatization, the closure of state hospitals and the first waves of patients abandoned to live “under the bridge”.
“Things are not going to get any better,” he told me. Back then, I wondered if he might just be a crabby old man. But now, having lived the past 25 years since our regular meetings, I see that he was the voice of experience and history, a skeptical enquirer, a lifelong student of human behavior and a talented visionary. Or maybe I’m just a crabby old woman now.
I often wonder what he would think about it all today, what he would do about the condition of the practice of medicine. More than anything, I long for leadership and guidance. I keep looking around, but see no one who’s in the position to provide this. My colleagues are head-down, occupied in the trenches, bailing the ocean with their teaspoons. They are caught up shoveling pills at patients as fast as they can in an effort to stay ahead of the time choppers nipping at their professional livelihoods. The younger ones have no idea that things were ever any different. The older ones take their marbles and leave.
What would George do? Every day I wonder. Then I remind myself of a favorite saying of mine: “If you ever need a helping hand, there’s one on the end of each of your arms.”
Dr. Saslow was a cognitive and behavioral therapist by inclination, so by professional heredity, I am also one. He believed in the miracle of changing one’s life for the better, one behavior at a time. He understood the power of words to create the world.
So, I take out my laptop and write again.
I’ve been sending my email missives out to a slowly growing group of friends and professional colleagues since I left Portland last fall. I’ve sent travel logs, personal updates, thoughts and feelings and the occasional professional rant. I am certain there are email boxes that have a special spam filter with my name on it by now.
I have had professional rants for years, but usually just talking rants during the slow spells of crisis work and rants when I walk in the mornings with my quiet-natured husband. I’ve always been prone to doing research projects when I’m perplexed, all the way back to medical school. Whenever I’m bothered by the idea of this medical treatment, that nutritional hoax or this social condition, I bury myself in the books. I get excited when I do research. I tell anyone and everyone that will sit still for five minutes what I think this week. I would probably hate someone else for doing this.
Now I’ve been given a great gift, the gift of a wider audience. In the past week I’ve had more different people read me than I’ve ever had in my life. I’m exceedingly grateful for this opportunity. Now, when I sit down to think and write, I know that there are a few more people at the other end of my pipeline.
Even though I still feel lost and leaderless in an overwhelmingly broken medical system, I am reassured when I see that there are others who have noticed that all is not well in our first world paradise of high-profit, “evidence-based” pharmaceutical products.
This endless flood of overpriced pills is poisoning our patients, busting our healthcare budgets and killing the practice of medicine.
And, like George, I fear it’s not going to get better soon.