Surrogate: How a Woman Named Sandra Made Me a Mother

Chance can change a life and it certainly changed mine. As a third-year undergraduate at Harvard I overheard a conversation about a college volunteer program in the local state mental hospital and for the next two years I volunteered on the back wards of the hospital. Each week I would talk with Mary a gray-haired tired woman who had been sitting quietly in a corner for three years. Over the academic year that we talked she regained enough function to leave the hospital and I believe our conversations were part of what made that happen. My experience with Mary would prove to change the course of my life.After graduating from college I went on to graduate study in academic psychology but I changed direction as I realized how much I missed the experience with Mary and other patients. I went on to medical school and from there to psychiatry. Now more than fifty years later I have two stories to tell: my own and how psychiatry changed during my working lifetime.I spent my career as an academic psychiatrist working in a public hospital where I taught young physicians and other trainees to take care of sick poor people while also caring for patients myself. I loved my work; but at the same time I saw how psychiatry was changing and I was troubled by what I saw. When I trained in the 1960s psychiatrists cared for patients as individuals. Now they push pills and promise more than they can deliver. In this book I describe that change and I offer a proposal for a different and better psychiatry-one that returns psychiatry to its roots and is more helpful to patients and more fulfilling for psychiatrists.