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Saturday, 06.03.2021

Martin Kassell: One af a Kind of Psychiatrist by Barry Blackwell

William R. Dubin’s comment

 

            Thank you for the invitation to contribute my thoughts and memories about Dr. Kassell’s extraordinary biographical sketch. What follows are several early memories of Martin’s impact upon my professional life in psychiatry.

            I first met Dr. Martin Kassell as a fourth-year medical student from the Medical University of South Carolina. I left my home in South Carolina to come to Philadelphia for an elective rotation in psychiatry because I was hoping to ultimately undertake my residency training in psychiatry in “Philly.”  My mother was born and raised in Philadelphia and she was the youngest of nine children, so I had a large family in the city that I wanted to be near.

            When I arrived at Jefferson Medical College in 1973 for an elective course, the psychiatry training director told me that I should contact Dr. Kassell who would be my supervisor for the four weeks of my elective.  When I went to my first supervision session I was somewhat nervous not knowing what to expect nor did I know what supervision actually was. Within five minutes of meeting Dr. Kassell I knew that I was going to have an exceptional training experience. Dr. Kassell greeted me warmly and wanted to know about my background and interests. He explained the process of supervision and told me that he was always available to meet if I had clinical issues to discuss. He treated me like a friend and colleague and had warmth that drew me to him; this was the foundation of a lifelong relationship. 

            As a supervisor he was demanding but never demeaning.  He had a teaching style of discussing psychiatry in a very lucid, organized manner. He was able to take diverse information and organize it in meaningful way.  He was a psychoanalytically-oriented psychodynamic therapist and this was the psychotherapy approach taught at Jefferson. Psychoanalysts were the majority of the faculty.  Their approach was a very rigid orthodox analytic interpretation of behavior.  When I went to my first lecture on Manic Depressive illness the lecturer did not mention phenomenology, lithium or biology. Instead he lectured on the psychodynamics of mania being “a wish to devour” and it only went downhill from there.

            At that time Philadelphia and Jefferson were dominated by this analytic orientation.  Even in my naiveté and lack of knowledge about psychodynamics this type of formulation never made sense to me and had no clinical usefulness.  I struggled, not only as a medical student but also as a first year resident, to understand how to find meaning of this thinking process. Thank goodness for Dr. Kassell. He took the analytic concepts, stripped away the jargon and presented the concepts in a practical and useful way.  As a resident in supervision with him he taught me to think about psychodynamics in a more practical and useful way. He also taught me to be systematic in my thinking and how to categorize problems. In that era it was psychosis, neurosis and organic causes and how to work through a differential in each category.

            Dr. Kassell was a demanding supervisor but reciprocated my efforts with kindness, humor and an interest in me.  He invited me to his home for meals, introduced me to his family and was always willing to listen to me when I had issues that troubled me. One anecdote that speaks to his openness and willingness to allow me to see him as a “regular guy” is the time when I went in for my weekly supervision. He apologized and stated that he had to go to Camden, NJ, and my supervision hour was the only time that he could go. He had to pick up his car which was having new tires installed.  He asked if I wanted to ride along with him. As a result, my supervision hour ended up being a trip together to Camden to pick up his car and talk about cars and life.

            To this day I pass on to residents Dr. Kassell’s wisdom.  As a resident I was making no progress with a patient who was minimizing and rationalizing his problems. Dr. Kassell told me how I should confront this type of patient. He said to me: “Sometimes Billy you have to give the patient a zinger.”  Over the years I have given this helpful advice to residents who I supervise.  He also imparted to me the skill of having patience in a therapy session by teaching me that often the most significant moments in a therapy session last only five or six minutes and all else is white noise. Again I have passed this wisdom on to residents which has ultimately made them better psychiatrists. One of my supervisors once told me that we choose to teach because it is a way to gain immortality.  By this he meant that our teaching is often passed on to future generations of physicians. If this is the case then Dr. Kassell has gained immortality; he was an inspirational educator who cared about his students and residents. More than anyone else he taught me how to think like a physician and a psychiatrist. I have and will always remember his wisdom

 

April 25, 2019