A Surgeon’s Legacy to Psychiatry
“How could I possibly turn down an opportunity to speak at the annual meeting of APA? I’m responding as fast as I can, before you change your mind.” This is the email I received from Dr. Sherwin Nuland when I invited him to give a keynote lecture at the APA annual meeting in Philadelphia in May 2012.
Humility and understated humor were emblematic of this talented, wise, accomplished, and renowned surgeon, writer, and ethicist. As the title of his address—“The Goodness of the Physician: From Hippocrates to High-Tech”—suggests, his words were far-ranging and full of resonance for the audience that ranged from members-in-training to APA Lifers.
Sherwin “Shep” Nuland, who died March 3, at age 83, was a great friend of American psychiatry. I was first “introduced” to him in 1994 when I devoured his groundbreaking book, How We Die: Reflections of Life’s Final Chapter, which won the National Book Award that year and was a finalist for the Pulitzer Prize in 1995. His thesis was that modern medicine was becoming antithetical to the notion of having a “good death,” that our heroic and well-intentioned life-sustaining efforts were preventing many of us from dying with dignity.
Death was very much on my mind in those days, as many of my patients were dying of AIDS and I was attending far too many funerals. Further, at the APA annual meeting in 1994, I had shown my second videotaped interview with a 35-year-old physician who spoke to me about living with and dying of this relentless and incurable disease six weeks before he died. This documentary videotape and sections of Shep’s book became companion pieces in my teaching of medical students and residents over the next several years. They both served to highlight and honor the humaneness in the everyday practice of medicine.
Shep and I finally met in person in 2003 when I attended a lecture that he gave in New York City on the life and work of Semmelweis. He had just released another book, his memoir, Lost in America: A Journey With My Father, about the very complicated relationship with his father Meyer Nudelman. In the canon of in-depth, dynamic studies of the father-son dyad, this volume is a classic. But Lost in America is also about Dr. Nuland’s year-long hospitalization in the 1970s for an implacable obsessional disorder and depression.
I invited him to give a keynote address at the next International Conference on Physician Health, which was held in Chicago in 2004. His passionate and heartfelt personal account was the highlight of the three-day meeting. Seized with emotion as he relived that painful period of his life, Shep paused to regain his composure and said, “I apologize. I think I’m going to have to read the rest of my story from my notes.”
This lecture and an earlier TED Talks presentation in 2001 in which he described receiving ECT are two further examples of Shep’s gift to psychiatry. As a grateful patient, he has joined us in our battle to fight stigma—both by educating the public about the illness of depression and by promoting the life-saving benefits of ECT. A recipient of many awards, he was most proud of being granted the Ken Book Award from the National Alliance on Mental Illness in 2004.
As a specialist in physician health, I have one final salute to this great man. Shep has helped countless doctors who, because of internalized stigma, are living in fear and silence with untreated mental illness. His words and actions have comforted many of them as they pick up the phone and reach out to us for treatment. I am so grateful that I got the chance to tell him that over breakfast in Philadelphia.
May his memory be a blessing. ■
