A Short History: Interview With The Geezer

As the 100th year anniversary of the University of Iowa Department of Psychiatry approaches in 2019, I find myself wondering how my personal history intersects with it since I’ll be retired in 2020 after being on faculty for about 22 years and associated with the College of Medicine and the Psychiatry Residency for 30 years. Construction of the Psychopathic Hospital began roughly around 1919, which is about the time construction began on me–in a way. My parents were born in that era. Mom was white and Dad was black.

It was still against anti-miscegenation laws in many states for a black man to marry a white woman around the time of my conception. Iowa was the third state in the union to reject the law banning interracial marriage and it did so in 1879. Several states did not until 1967 when the U.S. Supreme Court struck down all such laws in Loving v Virginia.

Mom died of complications of dementia shortly after I was forced to do something she made me promise I would never do—move her into a nursing home. You’ll never know.  I wrote her obituary:

In early life, she worked as a waitress. She often spoke with great pride of her ability to carry more hot dishes bare-handed from kitchen to table than anyone else she knew. She was an avid card player. If you couldn’t remember what tricks were played in a game of 500—Ruby had you for lunch. She lived in the heart of the downtown area on Federal Avenue for decades—and loved every minute of it. She enjoyed the noise of the traffic, the city waking up, the city eating lunch, and the city having a hard time going to sleep at night. She lived high above the street, and didn’t mind the stairs at all, even late into her seventies. Ruby loved going out for coffee. She was a great talker, and thoroughly enjoyed hearing a good joke. She knew that sharing troubles and laughter were both healing.

I like to hear a good joke, too. One of my colleagues in the surgery department almost always breaks me up because he tells me one whenever we meet in the hallway.

Dad died in 2002. He probably died of alcoholic liver disease and its complications, including dementia. I did not write his obituary:

John “Johnny Hots” Amos: While in the 11th grade, John enlisted in the United States Navy to fight for his country in World War II. He was stationed in the Pacific. He received an honorable discharge after serving four years. John was happiest when he kept busy. He had a passion for working crossword puzzles, especially the Sunday Crossword in the Des Moines Register. John liked to walk, visit friends and enjoy a cup of coffee at the Casey’s up the street from his apartment. All those that knew and loved him will sadly miss him.

I missed Dad’s funeral mostly because I missed his presence while growing up. You’ll never know. I like to walk as my trainees know as we hike all over the hospital on the psychiatry consultation-liaison service. I like crossword puzzles too.

My younger brother died in his early 40’s from squamous cell carcinoma of the larynx. He was a heavy drinker and a heavy smoker. I wrote his obituary:

Remember

Randy will always be fondly remembered for his generosity, his kindness and his infectious sense of humor. His family and his friends cherish his raw, honest passion. We treasure everything he gave to us. Even the courageous and peaceful way he finally let go of his life was a gift to us. He died as he lived—in the arms of the people who loved him. 

A year prior to his death in 2000, through a quirk of fate and a puzzling judgment by my department leaders about what was appropriate regarding physicians acting as doctors for their own family members, I was his inpatient psychiatric physician on the Medical-Psychiatry Unit where he was transferred in our hospital after he’d presumably accidentally overdosed on narcotics and became delirious. He recovered then. A year later, at Hospice of North Iowa I barely took my eyes from him during the terminal delirium of his last moments. Then a couple of his friends dropped by and we got to talking about him so I turned from his bed and listened. They spoke of how much he had meant to them. I lost track of time. When they paused, I turned back to him and he was gone. That day I learned that being with someone who is dying is not about being on death watch, but about being a witness to who and what was important to him in life. You’ll never know.

That was 18 years ago, which was about the time I was asked to write a book review in the American Journal of Psychiatry. The book was Being Black in American Today: A Multiperspective Review of the Problem, by Dr. Norman Q. Brill, MD (“Being Black in America Today: A Multiperspective Review of the Problem.” American Journal of Psychiatry, 157(5), pp. 845–846).

I had by then been on faculty in the University of Iowa Department of Psychiatry since 1996. In my review of Dr. Brill’s book, I mentioned my undergraduate experience at Huston-Tillotson College (the college of “predominantly black enrollment,” now Huston-Tillotson University) in Austin, Texas back in the 1970s. The excerpt follows:

Dr. Brill’s appraisal of many black leaders in chapters such as “Black Leaders in the Black Movement” and “Black Anti-Semitism” may be refreshingly frank in the opinion of some. He tailors his prose so as not to denounce openly those whom many would describe as demagogues. At the same time, it is apparent that his underlying message is that a substantial number of them are not only out of touch with mainstream black America but may even mislead black people into adopting ideological positions that impede rather than foster progress. Dr. Brill’s description of the issue reminded me of my own experience with this phenomenon as a freshman in the mid-1970s at a college of predominantly black enrollment in the southern United States. A guest lecturer (who, as I recall, had also written a book about being black in America) told us that the white man would never allow a black man to be a man in America. He had only three choices: he could be a clown, an athlete, or a noble savage. These corresponded to the prominent and often stereotyped roles that blacks typically held in entertainment, sports, and black churches.

I remember asking the lecturer if those were the only choices, which one I should pick. He replied, “Be a clown.” I thought he was the clown.

There were a number of guest lecturers who gave that message to students, and I was not comfortable with it. I had grown up in Iowa and, while I had experienced racism, I had also known kindness, generosity, and understanding.

I got my first real job with a consulting engineer firm, Wallace Holland Kastler Schmitz and Co, during which my real life actually began. That’s where I first learned my work ethic.

I spent a couple of years at Huston-Tillotson, then transferred back up to Iowa to finish my undergraduate career at Iowa State University. I eventually entered medical school at The University of Iowa in 1988.

I began with several other largely African American and Hispanic students in a summer enrichment program designed to help students of color from disadvantaged backgrounds to be competitive and successful in their careers in medicine.

One of our group decided to forego that experience, saying “I’ll see you all in the fall.” At the time, some of our classmates, both majority and minority,  were concerned that the affirmative action structure of the enrichment program gave minority students an unfair advantage.

The curriculum was extremely challenging and at several points during my medical school career, I considered quitting, despite my so-called advantage. I’m the only member of my family of origin to go to college, much less go to medical school.

And as far as I know, I might be the only African-American faculty member in the history of the Department of Psychiatry at The University of Iowa. The 2017 Greater Iowa African American Resource Guide published annually by the Iowa Accountability Program lists only a couple of other psychiatrists besides me.

And I’m in phased retirement.

I used to wonder how I ever decided to choose psychiatry as a career. I guess it’s not such a mystery. This has been a short history but a long post. I think that’s enough punishment for now. My wife would probably agree.

List of Resources:

The University of Iowa Department of Psychiatry History Page

University of Iowa Hospitals and Clinics Department of Psychiatry Physician Profile, James J. Amos, MD

A Timeline of Iowa’s Civil Rights History

African Americans in Iowa 1838-2005 Iowa Public Television