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IN MEMORIAM: LEST WE FORGET

Joel Elkes - November 12, 2013 – October 30, 2015

A Personal Recollection by Barry Blackwell

 

As a young resident in 1962, at the Maudsley Hospital in London, I knew of Joel Elkes by name and reputation only but in 1970 we met in person when he gave the opening talk at the first Taylor Manor Awards Conference in Baltimore, organized by Frank Ayd and me. His topic, “Psychopharmacology: On Beginning a New Science”, (Elkes, 1971), was a tour de force of personal recollections on his role in launching the discipline of psychopharmacology from his first meeting with Alistair Frazer as a medical student in 1934, over tea and anchovy toast, until he became the First President of the new American College of Neurosychopharmacology (ACNP) in 1960.

       The peroration to this spellbinding talk was a reflection on the role of psychopharmacology as a science. He begins …

       “I know of no other branch of science which, like a good plough on a spring day, has tilled as many areas in Neurobiology.” Joel then itemizes them …

       “Synaptic transmission in the central nervous system … regionalization of chemical process in the brain…the interaction of hormones and chemical process in the brain … tools for the study of the chemical basis of learning… dependence of pharmacologic response on situational and social setting… a hard look at the semantics of psychiatric diagnosis … to have resuscitated the oldest of remedies, the placebo response for careful scrutiny … to have encouraged the Biochemist, the Physiologist, Clinician, the Mathematician and Communication Engineer to join forces at the bench level is no mean achievement for a young science.”

       Elkes ends with a paragraph that emphasizes how psychopharmacology is “compelling the physical and chemical sciences to look behavior in the face.”  The sentiments he next expresses epitomize Joel’s unique capacity to integrate disparate themes.

       “There is no conflict between understanding the way things are and the way people are, between the pursuit of science and the giving of service. Where does one find a field as rich and powerful as ours?”

      Joel spoke these words when he was midway through his tenure as Chair at Johns Hopkins.

       I did not fully understand the meaning behind these words until I met Joel again almost half a century later. In 2015 Tom Ban suggested I write a biography of Joel Elkes, a process that involved reading much of his writing, talking to him by phone and eventually meeting face to face when, with his wife Sally, he moved to their summer residence north of Chicago, only an hour’s drive from my home in Milwaukee.

       When Joel spoke in 1970 his focus was shifting from the science of psychopharmacology to

its broader behavioral implications in medical education, medical practice, and an inner understanding of the self. Behind him were the early years of neuroscience and mostly bench research in Birmingham UK, when he picked up where Thudichum left off; moving from the anatomical structure and basic chemical composition of the brain to an understanding of its physical function and neurochemistry. This was followed by Joel’s Camelot years as Chief of the NIMH research program at Saint Elizabeth’s Hospital in Washington DC where his talents as a nurturing overseer of both basic and clinical research were highly productive.

       His next move to a pre-eminent medical school with prestigious faculty in all the clinical disciplines broadened Joel’s palate bringing novel opportunities and challenges. The shift in Joel’s interests that underlay this move may well have been completion of the psychoanalysis begun as a medical student, disrupted by the Second World War and not accomplished until a quarter century later in Washington DC. Once again he was highly successful in building a program he named the Department of Psychiatry and Behavioral Sciences, a prescient appellation that was quickly copied across the nation. It was replete with one of the first MD-PhD programs, attracting stellar residents, as well as other innovative programs described in the biography. But the time and environment presented problems. This was on the cusp between psychoanalytic hegemony over academic psychiatry and the burgeoning dominance of neuroscience pioneers. Joel’s efforts to integrate these poles were vigorous but perhaps under appreciated by leadership devoted to preserving the integrity and dominance of their own domains. Certainly the environment was less compatible and more challenging to someone who, like his physician father, was not adept at administering a complex and hostile environment.

       Having accomplished what he could Joel moved on to the final phase of his academic career, a six year respite for reflection and incubating fresh ideas, filling a named Chair at McMaster University in Canada. Although these years were fallow in terms of research and publications he emerged with renewed vigor as Emeritus Professor of Psychiatry at Louisville University where he undertook to “humanize medical education”, developing innovative programs that integrated the twin cultures of Art and Medicine with success.

       When the time came to retire from teaching Joel settled into a contented life in Sarasota living with his talented wife Sally, an idyllic relationship bonded by shared interest and enthusiasms in art, education, mindfulness and social justice.

       As one surveys the panorama of Joel’s life and accomplishments one perceives core characteristics identified by sociologist Robert Merton and others in creative scientists. These are an ability to see analogies, to view parts in relation to the whole and pursue original, integrative solutions. In Joel’s case this yielded a lifetime of successful and evolving innovation against a changing Zeitgeist. One wonders if it has received the merit deserved. As the field of neuroscience has become more complex and unyielding there may be a tendency to regard the original discoveries as simplistic. Joel’s constantly evolving and innovative accomplishments may attract less approval than those of scientists who persist in a single area of endeavor. History will be the judge. Thudichum, also a man of multiple talents, underwent a long period of competitive disparagement before his contributions were eventually accorded the universal praise they deserved.

At our meeting a few months ago with Joel and Sally we found Joel engrossed with a painting in progress, the walls of their house hung with his completed art of high caliber. After a delightful lunch and informative conversation Sally invited us to attend a showing of his most recent work in Sarasota timed to celebrate Joel’s 102nd birthday on November 12th.

       Later, we wrote to accept the invitation but two weeks before the event Sally phoned from a hospital to say that Joel was admitted with a syncopal episode or a small heart attack. She handed the phone to Joel who sounded optimistic so I wished him a speedy recovery and looked forward to seeing him at the art exhibition. On October 30th Sally phoned again, this time with the sad news that Joel’s cardiorespiratory function had rapidly failed leading to his death.  Conscious till close to the end he was holding her hand. Sally has decided to turn the Art show into a celebration of Joel’s life and we shall be there. Before she hung up Sally told me Joel called her “The Oracle of Delphi, well of my being, compass of my life.” What a sentient human being; and talented scientist to boot. What a creative pioneer; a role model for aspiring neuroscientists.

References:

Elkes J. On beginning of a new science; Personal recollections in Discoveries in Biological Psychiatry, Eds. Ayd FJ, Blackwell,B. Philadelphia: Lippincott JB, 1971.

Blackwell B. Joel Elkes: An integrative life. On INHN.org in Biographies. 8.20.2015

 

Barry Blackwell

November 12, 2015