As this is our 50^th anniversary, I would like to make some remarks about psychiatry in general, and what makes us want to give our time and be a part of the Maryland Psychiatric Society.

Psychiatry has come a long way since the APA was founded by Dr. Benjamin Rush in 1844. In a 1827 edition of The Diseases of the Mind, Dr. Rush wrote with authority on the remedies for general mania. “The first remedy should be blood-letting. This grade of madness being an arterial disease of great morbid excitement or inflammation of the brain." Rush recommended, "20 to 40 ounces, unless fainting occurs first,” and attests that “the effects of this copious bleeding are wonderful in calming mad people.”

Fifty years ago when the MPS was founded, chlorpromazine was synthesized to be an antihistamine. In 1952, after French anesthesiologist-surgeon Henri Laborit had noted its sedative properties, it was tried for schizophrenia. This ushered in the beginning of psychiatrists’ truly effective use of medications.

But never has psychiatry been as intellectually exciting as it is in the present. The two great forces in psychiatry, psychoanalysis and biological psychiatry, may be on the threshold of being joined. Eric Kandel in his 1998 article, “A New Intellectual Framework for Psychiatry”, began to tackle the question of genes and the environment. He wrote that the ability of a given gene to directly manufacture specific proteins is highly regulated and that this regulation is responsive to environmental factors.

In a recent Psychiatric News article, Dr. Dennis Charney was quoted as reporting that severe stress changes brain anatomy.

It is incredible to witness the advances in our field and to participate in its discoveries.

I, like most of you, chose psychiatry because I love it. I was drawn to this field as it offers an opportunity to try to understand the human condition. To examine the brain, the mind, and to have someone share their very soul in psychotherapy makes this work a true privilege. When bogged down with managed care or reimbursement issues, it is often important to recall what draws us to the work in the first place.

When I was a young child, my grandmother would tell me bedtime stories about growing up in rural Arkansas. Her grandfather was a country doctor. He tended to the sick, traveling in a horse and buggy to make house calls at neighboring farms. As one can imagine, being a country doctor in rural Arkansas didn’t pay too much. My grandmother would describe how he was paid in chickens, vegetables or shoes. For better or worse, reimbursement has come a long way in the past hundred years.

I have always cherished that image of my great-great-grandfather’s autonomy and freedom in his practice. Regardless of the age in which we practice, certain fundamental principles and values have remained. The autonomy of the physician is key: the ability to master a field of knowledge, to talk with and examine a patient, to have adequate time to render a diagnosis and to formulate a treatment plan, and to respect the patient’s right to privacy and confidentiality. The physician must have control over the decisions regarding the treatment of the patient. These statements appear so basic that it is hard to believe that they would need to be fought for to be preserved.

The MPS is an organization run by psychiatrists. It exists outside the boundaries of managed care, insurance companies, the legislature and the mental health network. It allows one to be a psychiatrist first, with an individual professional identity. Regardless of one’s career path, this identity stays.

Tonight, we share in the celebration of 50 years as a society. The camaraderie that we have, and the bonds that we share with members across the city and state, show in this evening and event. I am deeply honored to be this year’s President of the MPS and will do my best to serve you.