What’s with the Jews of Winnipeg and psychiatry?

posner gerryBy GERRY POSNER As I was reading through the book “Healing Lives” by Eva Wiseman, one section grabbed my attention and indeed one line in particular on page 424. It seems that as many as 20 percent of the Jewish medical graduates from the Faculty of Medicine in Manitoba went into psychiatry. That means one out of every five chose this area to pursue a career. How unusual is that? Or is it?

 

What was the attraction of these students to psychiatry? What was wrong with cardiology, rheumatology, or any of the myriad of other “ologies” available? There had to be an explanation somewhere.

The first thing to do was to identify just who these people were.  In Eva’s book she lists the following names of those who qualified for inclusion in her book as they had practiced at least five years in the Province of Manitoba, categorizing them by gender: In no particular order, the males named were: Harvey Chochinov, Philip Katz, Bill Bebchuk, Harry Prosen, John Matas, Lawrence Katz, Will Fleisher, Murray Stein, Manny Matas, Neil Mowchun, Michael Eleff, Stanley Yaren, Dane Hershberg, Mark Lander, Fred Shane, Robert Steinberg, Murray Schacter, Gary Altman, Shalom Coodin, Mark Etkin, Daniel Globerman, Steven Kremer, Mathew Lander, Sam Lazareck, Louis Ludwig, Brian Malchy, Joshua Nepon, Eytan Perl, Jack Perlov, Mark Prober, Jeffrey Reiss, Jeremy Sawyer, Leonard Schwartz, Jose Stelzer, Max Sucharov, Simon Trepel, Eric Vickar, Jeff Waldman, Eric Vickar and Ken Zimmer.

The females were: Sheila Cantor, Marcia Fleisher, Adrian Kettner, Alla Kirshner, Cara Kroft, Gail Lavitt, Debra Lander, Mirtha Lopez-Fisher, Sara Rusen, Fran Steinberg, and Rivian Weinerman.

But then there are the many Jewish individuals who left Manitoba after graduating here and who entered the field of Psychiatry. Try these names out for size. In alphabetical order they are: Howard Book, Ron Braunstein, Ed Brown, Cliff Corman, Len Elkin, Richard Finkel, Paul Garfinkel, Richard Hershberg, Mayer Hoffer, David Klass, Molyn Leszcz, Len Leven, Morton Menuck, Sam Ozersky, Richard Popeski, Mel Prosen, Paul Remis, Barry Richmond, Gary Rodin, Richard Stall, Irv Tessler, and Sheldon Zipursky. There are no doubt more than that and I hope this article might draw some more names out. What all these names had in common was that they were Jewish men who graduated Medical School in Manitoba and who later entered Psychiatry. There had to be a reason for it or maybe more than one.

Of course, the usual line you hear is along the lines of “I could not stand the sight of blood so that eliminated most of the rest of the areas of medicine and thus psychiatry seemed clean and clear of that issue”. I pay little attention to that possibility. There may have been a handful like Morton Menuck who would say that psychiatry was his destiny. It seems doubtful to me that this was true for very many on this list of names. The best way to get an answer, if any, was to ask a bunch of them. And I did. The answers were all over the lot. I refer to some of these responses below.

For Harry Prosen, he made a kind of history as he was likely only the second Jew in Manitoba to become a psychiatrist, following in the footsteps of John Matas. And clearly he was a success at it, not for just himself, but in assisting others. For a few, psychiatry was not the first choice but always lingered in the background. That background was often highlighted by the presence of a mentor of sorts, the way Harry Prosen was for Mark Prober. Prober actually did a few years in internal medicine but Prosen’s “probing” and Mark’s wife, Marilyn’s pushing, ultimately tilted Mark Prober into psychiatry. He says it was the best move he made short of marrying Marilyn.

For David Klass, it was just this: “My reason: upon crossing the US-Canada border on my way to an internal medicine residency I heard something like a voice saying ‘you should be a psychiatrist’. Since I seem to be somewhat impressionable I took that directive and completed the first year of internal medicine and became a psychiatrist.“

There were some who said that it satisfied a parental inclination. Some parents and indeed some in this physician group were of the belief that psychiatrists and psychoanalyst were God-like figures whose abilities allowed them to help mankind. And then there were those that felt there was a deeper meaning in a behaviour or words, even from the most banal dinner conversation. Was that a Jewish quality per se? I doubt the answer can be known, but I would be willing to put some money on that desire to self- examine as being a particularly Jewish characteristic and a trigger for Jews to enter into psychiatry. Perhaps status had some influence on a few as there is an aura about the psychiatric field.

When I interviewed Molyn Leszcz recently for a previous article he provided me with some other possible reasons for the rush into psychiatry by Jewish boys. He wrote to me with the following possibilities:
• “Lots of immigrant children; some were children of survivors - hence an impetus for education and then medicine; psychiatry aligns with the Jewish tradition of applied wisdom to deepen understanding, recognizing the complexity of behaviour - viz. the Talmudic approach of “on the one hand and on the other”.
• Rabbis were the first psychiatrists and our tradition has long recognized the presence of depression and the need for support from the community - many rabbis are pastoral counsellors and many psychiatrists incorporate spiritual approaches - there is a long intertwining - I used to joke with my late father-in-law Rabbi Rappaport z”l that we would be happy to switch professions.
• Our Winnipeg communities were small and insular; you needed to belong/fit in and - hence the further interest in human behaviour.
• What is well documented at large is the pursuit of mental health training as a way to continue a healing process - at one end - Tikun Olam and at the other end, the “wounded Healer” whose work is to continue a reparative process from early life in an adaptive response to family illness, trauma and suffering - viz the immigrant/survivor story. “

Ron Charach offered that he was attracted to psychiatry from his own personal involvement with the late Dr. Philip Katz, of whom he spoke in glowing terms, even referring to him as the original Dr. Phil (although these days that might not be so complimentary). And he made this other salient observation:
“Whether or not we had Holocaust survivor parents, many of us had relatives with some degree of emotional disorder; often these were our favourite relatives! The very presence of such people in your family tree often bequeaths on to you a high level of sensitivity (as a psychiatrist/poet I have an unlisted-number amount of sensitivity,) which can make you very good at empathizing with the tsuris of others. It certainly heightens your awareness of other people’s emotional issues, just as you are all too aware of your own.”

Paul Remis observed that he entered medicine initially in part because of his close attachment to three friends: Morton Stall, Sam Corman and Arnold Popeski, all of whom along with Remis were to be in the same class in medicine at the University of Manitoba in the fall of 1963. Sadly, Corman and Stall were killed in a car accident in June of that year. Remis graduated, was uncertain where to go and ended up in Africa working there before concluding psychiatry was for him - a very personal choice and indeed almost in opposition to his family. What really struck home with Remis and linked him to his three buddies and psychiatry was that all three had younger brothers: Richard Popeski, Richard Stall and Cliff Corman, all of whom chose psychiatry as their specialty.

In the end, nobody knows for sure what made so many Winnipeg men pick psychiatry. Let’s be clear that there was nothing in the water in Winnipeg that caused it. But let’s also be clear that I could not write this same article about nephrology.