By Gerald D. Klee, MD
[Winter 2005; Vol. 31, No. 2; Pg 12, 18-19]
An updated version of this article is available at http://www.finesinger.com/
After Doctor Finesinger’s premature death in 1959 most of the records pertaining to him were lost by the University of Maryland (UM) Department of Psychiatry. The following article summarizes the information I have gathered about his career and about the early years of the UM Psychiatric Institute (UMPI).
The University Of Maryland (UM) School of Medicine, founded in 1807, is one of the oldest medical schools in the US. It took the school 143 years to found a department of psychiatry, but when they got around to it they did it right by appointing Jacob “Jake” Finesinger, one of the country’s most outstanding psychiatrists, to build and direct it.
The two major forces behind the creation of the Psychiatric Institute were Dr. Maurice C. Pincoffs, the influential professor and chief of medicine at the UM school of Medicine, and Governor William Preston Lane. Pincoffs wanted to improve patient care and teaching in University Hospital and the Governor saw a university department of psychiatry as an adjunct to his plan to improve patient care in state mental hospitals. In 1947 the state allocated twenty-five million dollars to upgrade state mental hospitals with about three million dollars of the total set aside to found a UM psychiatry department. In 1949 the public was alerted to the need for such improvements by a series of “Maryland’s Shame” articles in the Baltimore Sun that described the “snake pit” conditions in state hospitals.
Psychiatry was a small, part-time operation under the department of medicine and Pincoffs wanted it to be an independent full-time psychiatric department. Finesinger’s teaching and research orientation in psychosomatic medicine made him an ideal candidate for the job.
Born in 1902, Jake grew up in Pennsylvania, but after he completed High School his family moved to Baltimore when his father was appointed Rabbi at Shaarei Zion Synagogue. Finesinger attended Johns Hopkins, where he earned his Bachelor’s and Masters (in zoology) and graduated from the medical school in 1929. While a medical student, Finesinger became imbued with Adolf Meyer’s psychobiological approach to psychiatry.
Upon his graduation from medical school Jake went to the Harvard Service of Boston City Hospital, where he did his internship and a neurology residency. After his residency, a Commonwealth fellowship enabled him to travel to Europe for several years for further training. He studied conditioned reflexes with Pavlov in Leningrad and also had a training analysis in Vienna with Anna Freud before returning to Boston. There he entered psychiatric training at the Boston Psychopathic Hospital (now called the Massachusetts Mental Health Center). He also trained at the Boston Psychoanalytic Institute.
In 1938 Professor Stanley Cobb invited Jake to join him at Harvard’s Massachusetts General Hospital (MGH) to help build and run the psychiatry department that Cobb had recently founded. Cobb had trained at Hopkins with Adolf Meyer and other neurobiologists before returning to Harvard. Jake had trained under Cobb at Boston City Hospital. As a Harvard Medical student, I was taught by Cobb and by Finesinger before Finesinger left for Maryland in 1950.
Cobb, whose major interests were in research, left most of the administration and teaching to Jake, who had a charismatic personality and abundant energy. Students and house officers loved him as a teacher. Other departments in the hospital valued him as a consultant. He ran the Pavlovian laboratory for the department. His chief research interests were in psychosomatic medicine and neurophysiology, leading to numerous publications and international recognition. He left MGH for Maryland in 1950. To this day a photo of him hangs in MGH department headquarters, where his memory is revered.
A sample of his many appointments at the time he came to UM in 1950 gives some idea of his breadth and energy. He was chairman of the research committees of both the American Psychiatric Association and the Group for the Advancement of Psychiatry and he was also president of the Boston Society of Psychiatry and Neurology.
Although he had no building for the department when he started, Finesinger wasted no time in recruiting staff and residents. In 1950 he was joined by Robert Grenell, PhD, an accomplished neurophysiologist from Johns Hopkins who was soon followed by philosopher John Reid, PhD, whom he recruited from Harvard (MGH). Before becoming a professor at Harvard, Reid had been a Professor and Department Chair in philosophy at Stanford. Reid’s title at Maryland was Professor of Philosophy in Psychiatry. According to Grenell, “this was the first such appointment ever, anywhere.”
The new department started with only two psychiatric residents; Enoch Callaway, a young research psychiatrist, and William Fitzpatrick, who had trained in internal medicine and psychosomatic medicine before coming to Maryland in 1950. Others came soon after. Salaries were low. Bill Fitzpatrick recalls starting out at $2000 per year. Despite the low pay, many of the psychiatrists in training underwent psychoanalysis after coming to Baltimore, since that was considered an essential part of psychiatric training.
With no building and no psychiatric beds, the young psychiatrists under Finesinger kept busy doing consultations on the medical wards and conveying psychiatric concepts to medical house officers and students. They also saw patients in a psychosomatic outpatient clinic catering to multiproblem medical patients whose conditions had emotional components. Teaching was done by Finesinger and by volunteers from the psychiatric community.
The building housing the UM Psychiatric Institute (UMPI) was completed and ready to receive staff and patients in late 1952, over two years after Finesinger arrived. (1)
Senior psychiatric staff recruited in the early 1950s included professors Maurice Greenhill and Klaus Berblinger. Both came to UM from Duke in 1952. Before going to Duke, Greenhill had been with Finesinger at MGH. Greenhill was responsible for residency training and Berblinger was in charge of the Outpatient Service. Dr. H. Whitman Newell was the director of the Child Psychiatry Service under Dr. Finesinger until his death around 1956. Callaway received one of the first NIMH five year career investigator grants in 1954. He credits Finesinger for helping him get it.
Finesinger strongly promoted the integration of clinical experience and research in the training of psychiatrists, because he believed that clinicians should think like researchers. For example, he recruited me to the department in 1956 to do research in psychopharmacology with Callaway, and made me director of the psychiatric outpatient service before his death in 1959. Similarly, in 1957, he recruited Walter Weintraub to work with me and Callaway in psychopharmacology and appointed him director of the inpatient service in 1959.
Under Finesinger’s direction the department grew rapidly and it quickly gained wide recognition. Unfortunately, he wasn’t able to enjoy it for long because of his untimely death. He continues to live in the hearts and minds of those like me who knew him and learned from him. He was the most inspiring and influential of my mentors.
Jake was a renaissance man who applied the full range of art, science and humanism to the study of man and the healing process. Along with his vast erudition he was witty and down to earth. You knew he thought something was unethical or unscientific when he said, “It ain’t kosher!” Although he was no longer attached to formal religion, he certainly remained “kosher” to the very end.
(1) More extensive information is available on a Website devoted to Finesinger. http://www.finesinger.com/ The webpage, which is still under construction, will soon have a more user friendly design. I wish to thank Professor Anthony Lehman , MD, M.S.P.H. Chairman of the UM Department of Psychiatry and UM Psychiatry Professor John Talbott, MD for encouraging me to work on this project. Gerald D. Klee, MD.