Several weeks ago, I heard a talk by my good friend Joel Yager on the topic of legacies. He delivered it to a large group of psychiatric leaders who were in their 70s and 80s and might be concerned about how they will be remembered.
As I looked around the room, I realized that almost all present had some thoughts about this topic, and I got the impression that many of them had not resolved this problem within their own minds. However, it was clear that they all had struggled with this question. My impressions were confirmed by the tenor of the question-and-answer period that followed the presentation.
This month, I will be 80 years old. My father died when he was 70, so I consider my longevity to be quite an achievement. But clearly, longevity and legacy are very different. We have to have a methodology for figuring out what our legacy will be. Those of us who are really serious about trying to work this out must sit down and begin to make a list of what we’ve done, what counts, and what is important.
First of all, we have to look at the question from a personal point of view. I am proud of my sons and my daughter. As I’ve mentioned before, my oldest son is a psychiatrist – and I might have had something to do with his choice of a career. My other two sons – and my daughter – have chosen other paths to fulfillment, and I salute them for that.
When I think about the crowning part of my career, I might say, "I chaired three departments of psychiatry." Somehow, saying this doesn’t sound particularly impressive.
Joel asks us to respond to the question: "What are you most proud of?" I immediately responded by saying "being elected president of the APA," yet there are so many greater presidents who served than I. As a young psychiatrist, I met a few great psychiatrists who served as American Psychiatric Association president, including Francis Braceland, Karl Menninger, and Henry Brosin – men who had something to say and said it with their strength, stamina, and productivity. One interesting moment occurred when I was sent by the National Institute of Mental Health to do an evaluation of the programs at the Menninger Clinic in Topeka, Kan. It was freezing out, and I was being driven from one building to another when I saw a large man in a fur-collared coat emerge from one of the buildings, and my driver said: "That’s Dr. Karl out for his daily walk." For me, that is part of his legacy.
In thinking about our legacies, how do our writings, books, papers, articles, and essays figure into the picture? Certainly, the writing we do as part of our contribution to the field often helps to define our legacies. I’ve written one article that helped my career and our field, "The Enigma of Stigma," (Psychiatr. Ann. 1983;669-90). I delivered this article as a talk in 1982 at a meeting of the American College of Psychiatrists, and then I used the theme of defeating stigma during my tenure as APA president that same year. Out of the 270 articles I’ve written, that is the one I value the most.
I am also hoping that my work with medical students also will be part of my legacy.
At this point, I am asking myself: Should I focus on putting my life in order? Or should I keep plugging along and continue fighting against stigma on behalf of people with mental illness so that my kids will be able to say with pride: "He was my Dad"?
I think I’ll do both.
Dr. Fink is a psychiatrist and consultant in Philadelphia and professor of psychiatry at Temple University.