Our audience was so impressed with him. This is the kind of psychiatrist you want. Kind, caring, sense of humor. Looks you in the eye and discusses what you're going through.
At 92, (born in 1924), he doesn't see many patients anymore but does administrative work. And he travels around the world - recently to Vienna - to participate in psychopharm'y conferences.
He's received many grants from the NIMH - National Institute of Mental Health - whose requirements have changed over the years.
"The last grant I wrote was in 2009," he said. "Then I stopped. I'm too old."
He works out at a fitness center five days a week, plays golf, and meets for breakfast with friends.
Karl has been widowed twice. Both women died of cancer. A couple of nights ago on PBS, Frontline presented Being Mortal with the great writer/surgeon Atul Gawande. It's about telling your patients the prognosis is not very good. View info here.
When a patient learns he will probably die and the doctor begins explaining what's going on, the patient hears nothing except the death sentence.
When a psychiatric patient is told, as I once was, "You have manic-depression," - now called bipolar disorder - he or she may be relieved to know their odd behavior has a name. I, however, was so shocked I had an out-of-body experience.
Karl wrote a popular easy-to-read book A Serendipitous Life: From German POW to American Psychiatrist. The reviews on Amazon are very interesting. Friends and neighbors call him a "modest man" and had no idea whatsoever about his serving in the German army under Erwin Rommel, The Desert Fox.
When Rommel was implicated in a plot to kill Hitler, he was allowed to take cyanide to die and his family was spared being killed.
Young Karl was captured and brought to America as a POW. He knew he wanted to return some day.
He received his medical degree in Germany. His field of study was bacteriology. He was following his mentor and thought it a good career pathway.
Just discovered! A new antibiotic was just discovered at the Scripps Institute "that could eliminate the threat of antibiotic-resistant infections for years to come." Scott found this as he's interested in science.
This is also reminiscent of the discovery of new drugs for various mental health conditions.
After Karl graduated from med school he had to find a way to get to America.
A Swedish couple agreed to sponsor him for a year. He worked at Boston School of Public Health. Back then, primitive methods were used to control psychosis or aggressive behavior.
Lobotomy, insulin coma therapy.
Patients would sit in strait-jackets in state hospitals since no one knew what to do with these poor souls.
And then Thorazine - an effective antipsychotic - was discovered in 1950.
State hospitals emptied out, though of course patients returned as mental disorders usually - though certainly not always - last a lifetime.
The great writer Virginia Woolf sadly drowned herself as she didn't wanna experience another bout of mental illness. She died in 1941, nine years before the advent of Thorazine.
They wanted him to be a researcher, which was his forte. He mentioned there were no drugs at the time for TB and if you could see the lung, it had holes in it.
Was wracking my brain to remember which of the German writer Thomas Mann's novels dealt with TB.
The Magic Mountain, of course. Thomas Mann left Germany before the Nazis got a stronghold there.The Franz Kafka family were killed in concentation camps.
Read my fictional story "Kafka's Other Woman" here.
Karl was instrumental in the development and testing of many of our earliest drugs such as the above imipramine.
Then he mentioned John Cade of Australia and lithium. Read my lithium blog here.
Karl's favorite med for depression is Effexor. My friend was on Effexor for many years and when she weaned off, she got flu-like symptoms.
Now she's off all meds, like me.
I asked Karl if he believes it's possible to get off meds for good.
He mentioned Dr Laslzo Gyulai who has many of his bipolar patients go off meds. He makes sure, though, they check in frequently with him.
If a patient has trouble sleeping, that's a symptom that perhaps the bipolar is coming back.
Read about Laszlo Gyulai, originally from Hungary, here.
We had him on the cover of the Compass years ago.
What people go through!
See the white-haired woman on the left?
I gave her a poster about Dr Rickel's presentation when we both attended The Upper Moreland Historical Presentation by Jason Sherman. He'd made a film about The King's Highway.
Doris brought a friend with her.
Whoop-de-doo! All those handouts finally paid off.
It wasn't until the Estes Kefauver Hearings in the U S Congress - Kefauver was a liberal senator from Tennessee - that the FDA was required to list both the efficacy (how well the drug worked) and safety of the drug.
To wit:
One result of his efforts was the Kefauver-Harris Drug Control Act (1962), which, though weaker than the proposed legislation initially introduced by Kefauver, imposed such federal controls on the sale of dangerous drugs as requiring substantial evidence that a drug be both effective and safe as prerequisite to licensing, generic names on drug products, and mandatory disclosure to physicians of information about the effectiveness and side effects of prescription drugs.
Read about it here.
Karl mentioned that drug studies are either paid for by the government or by the drug industry. The latter, of course, are biased. Drug companies ignored information about bad side effects or the high drop-out rate of study subjects.
In time, studies were double-blind - neither the drug administrator nor patient knew if the drug was real or a placebo.
When imipramine - brand name Tofranil - and other early antidepressants were first developed, the patient had to take the drug four times a day.
In time a slow-acting or extended release pill could be taken once a day.
Major problem with these tricyclics, as they're called, was DRY MOUTH. Karl gave the best description of dry mouth I've ever heard.
There was such little saliva that a person could not speak!
Karl mentioned that drug studies are either paid for by the government or by the drug industry. The latter, of course, are biased. Drug companies ignored information about bad side effects or the high drop-out rate of study subjects.
In time, studies were double-blind - neither the drug administrator nor patient knew if the drug was real or a placebo.
When imipramine - brand name Tofranil - and other early antidepressants were first developed, the patient had to take the drug four times a day.
In time, a slow-acting or extended release pill could be taken once a day.
Stay on your medication and if it's not working, take something else.
Ada mentioned that some people in our group are on as many as eight different meds.
"This is terrible!" said Karl. He's had patients like this and carefully weans them off to determine what works and what doesn't.
The person feels so terrible they have no impetus to work.
He's also very interested in panic disorder.
Karl was always interested in ANXIETY. Benzos to treat anxiety were the first developed. Librium.
A man couldn't drive, so his wife drove him everywhere. He sat next to her in the car.
Karl advised the man to change places with his wife. He assured him he would be fine.
As we know, the best results are to have both meds and talk therapy.
Although Karl would see a patient for one of those ridiculous 15-minute med checks, he would speak to a patient in such a caring way, it served as quid pro quo psychotherapy. (I have no idea what that Latin word - or could it be Etruscan? -word means.)
I MUST CONFESS that I took a little nap, started a Part Two, but lost my way. The damn thing wouldn't publish b/c I put a photo on there that Blogface couldn't publish.
Just proves that if you think you have only one more hour to go, that figure will be tripled due to the laws of the universe.
Thanks, Robin and Sandie, for the great party spread! We had plenty of plastic bags - thank you Torrance - to put leftovers in. The zipper skin tangerines are delicious!
Above are Ritz Crisps which I'd never tasted before. And hopefully never will again.
Anthony and Ellen came in late. He sat next to me and shook my hand.
Hi, I said. Did you bring your wife with you?
I thought it was Moe and his wife Terry.
"We all look alike," he said with a smile.
People asked loads of questions.
He sent me a thank-you note before I got home. He lives in Gladwyne and took the turnpike over.
Ruth,
Thank you for inviting me to meet with your fantastic group. I really enjoyed it. Your group was most attentive and enthusiastic. But you did not have to give me a gift. Nevertheless I enjoyed the socks and look forward to reading the book.
By the way my book is not for sale BUT free. Please have anyone who wants a book e-mail me name and address and my assistant will mail the book. I still have 15 samples to mail as gifts.
Have a great week-end!
Karl
Many thanks Ruth for this afternoon,
ReplyDeleteI learnt such a lot that for me it was a worthwhile afternoon . I have to commend you for all your efforts in helping people in such dire straits.
I am in the process of reading your magazine and I know that the information in it will help me to deal with friends of mine that have mental issues and disorders. I was telling Lynn that I think one of my friends has bi polar and hasn't told us . I now know what is happening in her life. I will definitely be showing her more patience.
Once again thanks,
Regards,
Ina.