The excerpt below is taken from Fulfilling the dream: A history of the University of Washington, School of Medicine, 1946 to 1988 (pp. 68–69) written by C. A. Finch and published in 1990.
Psychiatry originally was organized under Frederick Lemere as a division of the Department of Medicine. A separate Department of Psychiatry was established in 1948, and the following year Herbert Ripley was appointed executive officer. Ripley had graduated from Harvard Medical School, interned at the University of Chicago, and obtained his psychiatric training at the Payne Whitney Clinic of Cornell-New York Hospital Medical Center. He also taught and received psychoanalytic training at Columbia.
Ripley believed that psychiatry should be taught through all four years of medical school, progressing from normal emotional development and doctor-patient relationships to an understanding of personality disturbances and their significance to disease processes. He encouraged his faculty to undertake research of a psychosomatic nature and to involve community organizations if possible.
Ripley’s first recruits, Thomas Holmes and Stephen Fleck, arrived that same year. The scope of the department was later expanded with the appointment of a sociologist and cultural anthropologist. Close relationships were established with the University’s psychology department and with the clinical departments of public health, medicine, and pediatrics.
Owing to the tight budget, departmental offices were initially furnished with army surplus desks and chairs. Departments were engaged in intense competition for space in the school’s early days; Ripley’s secretary once called him during an out-of-town trip to say, “Come home immediately! Hospital plans have been changed, putting psychiatry in the sub-basement.” While one to avoid confrontation, Ripley proved a competent negotiator, and the department stayed above ground. But other problems were of greater consequence. Faculty access to the fifth floor psychiatry ward run by the state at Harborview was permitted only after a Superior Court hearing.
Some of the department’s early research attracted national attention. Holmes’s studies of the emotion-induced reaction of the nasal mucosa provided dramatic evidence of the connections of the psyche with physiological processes. His studies at Firland Sanitorium of the relationship between life event stress and tuberculosis later led to the development of a quantitative index of stress events. Stephen Fleck studied psychosocial dynamics of unmarried mothers in the Florence Crittenden Home. Theodore Dorpat with Ripley investigated causes of suicide, while Joan Jackson undertook studies of alcoholism.
Teaching progressively expanded into these many areas of special interest, bolstered by a student summer research program. A residency program in psychiatry was initiated in 1951 at the VA Hospital, and in 1957 a formal training program began in clinical psychology with pre- and postdoctoral internships. By 1959 the department had 18 full-time academic and research faculty, including psychologists and sociologists as well as psychiatrists.
Training activities expanded further with the opening of the University Hospital. In 1961 a formal residency training program in child psychiatry was initiated, followed in 1967 by a four-year subspecialty fellowship in social and community psychiatry. Forty-eight residents were in training by 1969. More than two hundred physicians successfully fulfilled their postgraduate psychiatric training requirements during Ripley’s 20-year tenure. The number of students and faculty counseled by this modest and supportive man was far greater.
Ripley resigned in 1969, and three years passed with departmental members Cornelius Bakker and John Hampson as acting heads. During this time the Harborview Community Mental Health Center came “on line” as one of the department’s major facilities.
Carl Eisdorfer was appointed chairman in 1972. Eisdorfer had received his Ph.D. in psychology from New York University and his M.D. and psychiatric training from Duke. At the time of his appointment he was professor, head of the Division of Medical Psychology, and director of the Center for the Study of Aging and Human Development at Duke. Under his aggressive leadership, the UW Department of Psychiatry entered a period of expansion with new faculty and additional training and research programs. A new Division of Community Psychiatry developed liaisons with several mental health facilities throughout the WAMI region. A Geriatric Research Education and Clinical Center was funded in 1975 and encouraged collaboration between the psychiatry department and the Veterans Administration hospitals at Seattle and American Lake. When Eisdorfer left in 1981, the department totaled 115 full-time faculty members at the medical school, University Hospital, Harborview Medical Center, the Veterans Administration Medical Center, and Children’s Hospital and Medical Center.
John Carr, who had been at the UW since 1963, was appointed acting chairman, becoming only the second psychologist in the country to head a clinical psychiatry department. He had previous training in general, industrial, and clinical psychology. Almost at once a crisis arose, affecting
departmental support from federal and state sources. State budgetary problems had forced Governor Dixie Lee Ray to request return of previously allocated funds. Both federal aid and state support of the community and child psychiatry programs were severely cut or marked for elimination.
Conferences followed between the psychiatry department and the Mental Health Division of the state Department of Social and Health Services that eventually resulted in a more effective approach to public needs and that served as a national model for state-university collaboration. This partnership, backed by direct funding of departmental activities by the state legislature, included the development, production, and marketing of clinical services and technical assistance through a comprehensive statewide community mental health program.
Over the next few years it became evident that research interest in the field of psychiatry was turning toward a more biochemical orientation. The appointment of Cary Tucker as department head in 1985 anticipated this change. A graduate of Case Western Reserve University School of Medicine with psychiatry training at Yale, his interests centered on neuropsychiatry and psychophysiology. Prior to coming to Seattle, he headed the psychiatry department at Dartmouth Medical School.
By 1988 the department numbered about 125 full-time faculty, 300 clinical faculty, 50 residents, 12 interns, and 35 postdoctoral and psychiatric fellows. Inpatient and outpatient services included childhood, adolescent, and adult services, as well as addiction treatment. Departmental structure included divisions of psychotherapy, aging, neuropsychiatry, psychopharmacology,
behavioral medicine, community psychiatry, and crosscultural psychiatry.
The excerpt below is taken from Department histories published in 1991 by the University of Washington.
Psychiatry in Seattle before the School of Medicine
During the early earls of the century and indeed well into the 1940’s psychiatrists were in short supply in Seattle. Those known to have been practicing during those years were specialists in “Neurology and Nervous and Mental Diseases” but were colloquially known as “alienists.” They appear to have worked, in part, for the Court Sanity Commission examining psychiatric patients at Harborview. World War II saw a great resurgence of interest in emotional disorders and in psychiatry on the part of the medical profession. So it was inevitable that the planners of the new medical school at the University of Washington included a Department of Psychiatry in their gran plan even though there were less than a dozen psychiatrists in the whole Seattle area.
Psychiatry’s early years at the medical school – 1946-1948
At the time the School of Medicine opened in 1946, plans went forward for the development of instruction in the behavioral sciences and in clinical psychiatry. In the fall of 1945, Dr. Frederick Lemere, newly arrived in Seattle after psychiatry training in Denver and neurophysiology training in England, contacted the new Medical School Dean (Turner) asking if he could teach neurology in the medical school. Dean Turner is reported to have said, “No, but we could use your talent in psychiatry.” At that point in time psychiatry was organized as a Section under the Department of Medicine and did not officially become a separate Department until October 9, 1948. Dr. Lemere became the Acting Chairman of the Psychiatry Section in 1946, serving in an unpaid capacity with other unpaid faculty recruited from the local psychiatric community such as Drs. Edward Hoedemaker and William Y. Baker. The new first year class received an hour lecture on psychopathology during the first half of their year. Because the new school had no home of its own, lectures were given in Quonset huts located near Meany Hall or in various other campus buildings wherever space could be found. One of the more popular activities insofar as the students were concerned was the field trips to Western State Hospital to tour the facility and observe “real live patients” before embarking on their clinical years.
Concurrently, a search committee was looking for a permanent, full time chairman, finally persuading Dr. Herbert S. Ripley (who was at Cornell and on the verge of accepting a Chair at Tulane) to accept the job. It should be noted that Dr. Lemere continued to be an active member of the unpaid clinical faculty for many years after Dr. Ripley’s arrival.
The Ripley Years – 1948-1969
As mentioned earlier, the Psychiatry Section of the Department of Medicine officially became a Department, co-equal with the 0ther departments of the new Medical School on October 9, 1948, with the appointment of Dr. Herbert S. Ripley as its first Professor and Chairman. Dr. Ripley assumed his duties on April 1, 1949 and was joined later that year by Dr. Thomas H. Holmes and Dr. Stephen Fleck’ the latter on a half time basis. The department’s first psychologist, Caroline Preston, also part time, joined the faculty in the summer of 1949. The department’s first full-time Chief Psychologist, Dr. John L. Vogel arrived in 1959. In subsequent years, Dr. Nathanial Wagner (1962-1967), Dr. Joseph Becker (1967-1970), Dr. John E. Carr (1970-1977), Dr. Hans Doerr (1977-1980), and Dr. Hugh Armstrong (1980-1986) have filled that post. Reports are that the new Chairman and his staff made do for some time with Army surplus desks and chairs. The first staff conferences used a card table. Dr. Ripley and his family lived in the old Union Bay Village compound where many new faculty members lived, temporarily, on coming to Seattle.
Dr. Ripley was interested in having his new faculty become involved with community agencies. Dr. Holmes was very active at Firland Sanatorium, which was at that time a tuberculosis sanitarium, and it was there that he did much of his early research on stress and life events in relation to physical illness which led to his studies in the Artic and eventually to the studies on life events and disease with Dr. Minoru Masuda, a biophysiologist, who joined the department in 1951. Dr. Holmes worked with many residents, such as Dr. Richard Rahe, who went on to continue the studies in the Navy. In the same setting Dr. Donald Dudley studied respiratory problems and psychiatric illness. Drs. Theodore Dorpat, Neal Ely, and Joesph Verhey studied pain responses. Dr. Ripley’s interests turned to problems of suicide and he and Dr. Dorpat conducted landmark work on this problem.
Meanwhile, Dr. Joan Jackson, a sociologist, joined the department as a research assistant in 1952 and began her extensive studies in the field of alcoholism while Caroline Preston followed her Eskimo patients from Firland Sanatorium to the Alaska Coast to document the cultural problems of that group. Dr. Fleck chose the Florence Crittenden Home and learned much about the psycho- and socio-dynamics of middle class unmarried mothers. This was the beginning of a departmental relationship that would last until the closure of the Florence Crittenden Home in 1969.
Dr. Ripley redesigned the undergraduate lecture program in the first and second years. He instituted post-lecture ‘small group discussions’ though for some time-there was not enough faculty to divide the class into really “small” groups. Whereas the previous lectures had been largely phenomenological, Dr. Ripley introduced a much more psychodynamic slant, having himself been trained in psychoanalytic psychiatry at Columbia. In the post-graduate area, Dr. Ripley initiated psychiatric residency training on July 1, 1951 using the Seattle VA Hospital* as its chief training site. At the time it was the only approved 3-year training program for specialization in psychiatry in the entire Northwest. With the opening of University Hospital in 1959, facilities became available for a marked expansion of the residency program. The annual report for that year listed a faculty of eighteen full time academic and research staff and further noted that “the salary scale makes recruitment difficult.”
Child Psychiatry had its early departmental origins in September 1949 when a Division of Child Psychiatry was established along with a Psychiatric Clinic for Children located on the top floor of the Hall Student Health Center. Dr. S. Harvard Kaufman, who had come to Seattle in 1945 from his child psychiatry training in Philadelphia by way of Pittsburgh, became the Director. At first “the going was tough,” Dr. Kaufman recalls. Trainees came from Pediatrics, the School of Social Work and the Department of Psychology. Even so, they managed somehow to gather together a staff of 3 social workers, 2 psychologists, and eventually 2 more full time psychiatrists, Dr. Charles Mangham and Dr. Alan Leider. But with continuing funding problems the staff drifted away to private practice until by June 1955 only a part time child psychiatrist (Dr. Elwood Jones) remained. In 1959 the Division moved into University Hospital as the Child Psychiatry Outpatient Department with Dr. Jones remaining in charge until the coming of Dr. Raymond Sobel as the full time Director and Head of the Division in 1960.
Dr. Sobel started a subspecialty training program in Child Psychiatry in 196`1 and inaugurated the Department’s first program in family psychotherapy. He was succeeded by Dr. Irving N. Berlin who became head of the Division on April 1, 1965. Dr. Berlin’s interests were in social psychiatry and he expanded the trainee’s experience to include contact with community programs and agencies. Two years later, in 1967, Dr. E. Mansell Pattison inaugurated a full time 4th year subspecialty fellowship in Social and Community Psychiatry. During the Ripley Chairmanship, the number of residents in training expanded from 2 to 48; over 200 physicians successfully fulfilled their psychiatric training requirements during his tenure.
During Dr. Ripley’s chairmanship, the Department evolved from a difficult beginning in which the faculty utilized the Harborview Sanity Board Court for student teaching to the many clinical and educational programs that were in place at the time of Dr. Ripley’s retirement in 1969. At that point he could look back on successful post-graduate courses for non-psychiatric physicians, formal courses for up to 600 non-medical students each year, field work instruction for graduate students in psychology, sociology, social work nursing, internships in clinical psychology, a special training program for anthropology graduate students and a very successful experimental treatment program (The Adult Development Program under the direction of Dr. Cornelis Bakker) which utilized an educational model and received national attention. Dr. Ripley was especially proud of his summer research program for medical students, a pioneering enterprise that was successful for many years and inspired many of its participants to opt for a career in academic medicine.
Acting Chairs – 1969 – 1972
After Dr. Ripley’s retirement as Chair in 1969, Dr. Cornelis Bakker became Acting Char as the Medical School began a search for a new permanent chair. After one year of dealing with a department which was gradually realizing that the search was going to be an extended one, Dr. Bakker resigned as Acting Chairman and Dr. John Hampson became the Acting Chair for what eventually became two years. In spite of the problems what might be expected from the absence of a “Regular Chair,” the department was able to continue recruitment of faculty and residents and to develop a maturity about organization and function that would make the next interregnum a much less disorganized experience. This major contribution of Drs. Bakker and Hampson saw the department through the opening of Harborview Mental Health Center in 1970 and brought “on line” one of the last major sections of the department’s Seattle facilities.
This time period (1969-1972) marked a major change in the orientation of psychiatry and of the department in particular, from a basic psychodynamic framework to a community and cross cultural emphasis.
The Eisdorfer Years – 1972 – 1981
In September 1972, Dr. Carl Eisdorfer became the second Chair of the Department. Dr. Eisdorfer had obtained a Ph.D. in psychology from New York University and had received his M.D. and psychiatric training from Duke University. At the time of his appointment as Departmant Chairman, he had been a Professor of Psychiatry, head of the Division of Medical Psychology and Director of the Center for the Study of Aging and Human Development at Duke University. At the University of Washington, he became the Chairman of the Department of Psychiatry (which was soon designated the Department of Psychiatry and Behavioral Sciences) as well as an adjunct professor in the Department of Psychology.
Under Dr. Eisdorfer’s leadership, the department began another period of vigorous expansion. New faculty members were brought in and training and research programs expanded. The division of community psychiatry established liaison with mental health facilities throughout the WAMI Region with the most popular being a placement at Anchorage, Alaska, under the faculty supervision of Dr. Robert Kraus. After the arrival of Dr. Arthur Kleinman, faculty exchange with Human Medical College in Changsha, China began and has continued actively to the present time.
In 1975 the division of Geriatric Psychiatry had its first real base with the funding of The Geriatric Research Education and Clinical Center, at the VAMC in Seattle and American Lake. This program with Dr. Murray Raskind as its first full time Director has provided a focus for the care of aging patients and education of faculty, residents and students.
Dr. Eisdorfer stressed the need for increased national visibility and a major step in this direction occurred when the department joined other major west coast training centers as the host for the oral examinations for the ABPN for the first time in 1977.
In 1979, Dr. Eisdorfer left the Department on sabbatical and Dr. Robert Kraus served as Acting Chairman. When Dr. Eisdorfer left the Department in 1981, he left a department which had grown from 3 full time faculty in 1949 to 115 full time faculty members at the Medical School, University Hospital, Harborview Medical Center, The Veterans Administration Medical Center, and Children’s Orthopedic Hospital. It had established community psychiatry programs in Alaska and in mental health centers in Bellingham and Olympia as well as at HCMHC. This marked some contraction since the early years when there were faculty in the Trust Territories of the Pacific (Dr. Robert Fisher and Dr. Lawrence Wilson) and at the Maui (Hawaii) Mental Health Center.
The Acting Chairman – 1981 – 1985
The departure of Dr. Eisdorfer and the appointment of Dr. Kraus as Chairman of Psychiatry at the University of Louisville (Ky) found Dr. John E. Carr selected as Acting Chairman. This appointment had departmental support but proved to be an item of considerable note in the field because Dr. Carr was a psychologist, and a non-medical head of a department was unusual. The selection was a successful one, however, and the department, now much more sophisticated than in 1969 restructured itself under his leadership, and with commendable faculty effort a good working relationship was developed with State programs, the Community Psychiatry Program was reorganized, and a better working relationship with the County and its Task Force on Mental Health was established.
The search for a new Chairman again occurred at a time of change in the field of psychiatry as more biologic research and medical orientation began to take the place of the community psychiatry preoccupation that had marked the early 1970’s.
The Tucker Years 1985 –
Dr. Gary Tucker is a graduate of Western Reserve University, School of Medicine and did his psychiatry training at Yale. Prior to coming to the University of Washington he was Professor and Chairman in the Department of Psychiatry at Dartmouth Medical School. Dr. Tucker’s interests in neuropsychiatry and psychophysiology signal an increase in the departmental commitment to biologic psychiatry which in turn reflects the changes in American psychiatry in general.
Department histories. (1991). University of Washington.
