Professor Shorter
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Interview with Prof Ned Shorter
Sunday, 29 October 2006
By Bianca Felix
It is a hot and sunny afternoon, in Sydney. I am sitting on a hotel balcony with Coogee’s beach sparkling below. Opposite me is Professor Edward “Ned” Shorter, the eminent historian, who is enjoying his very first (very brief!) trip to Australia. We are attending the annual meeting of RANZCP’s Forensic Section and Prof. Shorter is one of the invited speakers.
Prof. Shorter is an eloquent speaker with a strong – almost strident – voice, which is pleasantly accented. He regularly interrupts his presentations to pursue a tangent; at these times he stands in front of the microphone, hands on hips. His manner is a mix of confident authority and genial old uncle.
Although a historian by training, it becomes clear throughout the conference that Prof. Shorter identifies with psychiatrists, consistently referring to “us” and “we” when discussing the profession. In fact, he attended medical school for several years to “learn the basics” and it was clear during the conference that he was comfortable with the clinical and technical jargon that forms the second language of doctors. While engaging in the clinical years of medical school, he has observed many interactions in the clinical setting to “get the gut feeling for what happens in the encounter between doctor and patient.” Prof. Shorter tells me that he feels very comfortable at conferences because he feels that he has something important to say to clinicians – that there is a message that history can provide to them.
Quite simply, Prof. Shorter is passionate about what history has to teach the discipline today to help it resolve its “current crisis”. Shorter believes that there have not been any truly new psychiatric medications for decades and, in addition, that there are no effective new treatments in the pipeline. He feels that the role of history is to “delve into the past” and find out what treatments are worth a second look. Indeed, which diagnoses are worth a second look! This view formed the basis of the first of his two lectures at the conference, and neatly dovetailed with the conference’s theme of “Epidemics in Psychiatry”.
I asked Prof. Shorter why he chose to pursue the history of Psychiatry, rather than any other branch of Medicine; he replied that it is the specialty that is most related to culture and, therefore, is for him the most interesting medical discipline. For example, understanding various models of how illnesses present and how treatments fit into the cultural milieu.
He urges training psychiatrists to be aware that official diagnoses are ‘riddled with artefacts” and that many drugs are “scarcely able to improve on placebo”. Not only that but we must not lose awareness of the side effects of many treatments. Finally, he told me that we should forget about psychoanalysis! That while the psychotherapies are “enormously useful”, depth psychiatry – as he called it - is not helpful at all, a message that is hard for older psychiatrists to accept.
During question time, Prof. Shorter would often joke with someone who had asked a question which he particularly liked, that they could discuss it further over a beer. But, when I asked Prof. Shorter which historical figure he would most like to have a beer with, he immediately launched into an appreciation of Emil Kraeplin as the most important figure in Psychiatry (who he feels surpasses Sigmund Freud). However, it soon became clear that Kraeplin was not someone to hang out with! He was an ascetic and a teetotaller, as well as being a fervent German nationalist.
So who would Prof. Shorter like to have a beer with? Alois Alzheimer - “a very jolly man” and the only one in Kraepelin’s circle who would not hide his steiner when Kraeplin walked into the room.
My career in interviewing for student newspapers commenced with an interview I conducted by post (email was a not as ubiquitous back then) with the WA historian and GP Jim Leavesley. Leavesley’s specialty is medical biography – or pathography – and I asked Shorter if he had heard of Leavesley (no) and what he thought of this pursuit. He felt it was a “valid parlour game” and speculated on the causes of George III’s madness, atopic that had been discussed in a presentation that morning. Prof. Shorter does not believe porphyria is the culprit but thinks that George III had a brain lesion or, even more likely, an affective disorder.
During Prof. Shorter’s opening lecture, I was struck by some of the material he quoted from which implied rather shady dealings had been conducted by some of the big Pharma companies. I asked him if, as a historian, he had far greater access to the archive of Pharma than a clinician or other members of the public. In fact, Prof. Shorter told me, the Pharma archives are closed to all because of fear of litigation. The incriminating material had come from a psychiatrist’s private papers. In the US, there are several archives that exist where the papers of individual physicians can be placed, after their death, for the interested historian to search through at some future time.
We ended the interview with Shorter exhorting all doctors – including the faithful Responder readers - to not throw anything out but place it in one of these repositories so that future researchers can have access to as much material as possible. With that, we left the hot balcony and went in search of some lunch and some air-conditioning. And a cold beer!