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t m c » p u l s e | d e c e m b e r 2 0 1 4 16 My most recent book, 'Fatal Pauses,' is about people who get stuck in life and are terribly unhappy. Examples include people in dysfunctional relationships; and those with problems of overeating and obesity; with alcohol and substance abuse; with wasting time surfing the Internet or playing video games; with eating disorders; with over-pleasing others, etc. Finally, I will probably be remem- bered for helping—along with many, many others—to spearhead the move of the legendary Menninger Clinic from Topeka, Kansas, to Houston. Prior to their move, Menninger had flourished in Kansas for over 75 years. However, about 15 years ago, Menninger realized that they needed to transition to a new, much larger city in order to be affiliated with a great research-oriented medical school and an outstanding teaching general hospital. Many other cities, medical schools and hospitals actively sought to recruit Menninger; but the Houston Community, Baylor College of Medicine, the Houston Methodist Hospital and the Texas Medical Center prevailed. We all believe that Menninger's move here is working well, as the Menninger Clinic continues to offer outstanding care to patients regionally and around the nation. On this very day, Menninger Clinic's beds are full with long waiting lists on each service. Additionally, the teaching and research at the Menninger Clinic are excellent. As a result, Menninger has returned to being ranked among the nation's top five psychiatric hospitals, and is blessed with a beautiful new facility near the Texas Medical Center. Q | How have you seen things change through your career in terms of patient diagnoses and treatment today versus 20 or 30 years ago? A | Very similar to many other types of medical illnesses like hyperten- sion, diabetes and seizure disorders, most psychiatric illnesses are chronic conditions that must be managed over a lifetime. That being said, now that psychiatry has returned to its roots in medicine and neurobiology, the advances over the past several decades in our ability to treat the symptoms and reduce the suffering of those among us with mental illnesses have been revo- lutionary. Accordingly, the pervasive stigma that has historically been associ- ated with having a psychiatric disorder is also reduced. This means that people are much more willing to trust psy- chiatrists and other behavioral health professionals. Over the past decades, we have been working much more effectively as multi-disciplined teams in our care for people with mental illnesses. Although we have a very long way to go in this regard, diagnosis and treatment are far more evidence-based. This will dramatically improve in the future when we discover valid and sensitive biological markers for psychiatric disorders and as we learn more about the genetic bases for these conditions. We shouldn't guess as much as we do now when we, for example, choose a medication to treat depression. We now involve families in our care, and that's been a change. Prior to the 1970s, there was widespread belief that parents and spouses were responsible for many mental illnesses, and that they should be excluded from the psychiatric care of their family members or loved ones who are ill. As a field, we could not have been more wrong. Most often, families are loving and want to participate in and facilitate the care and recovery of their loved ones with mental illnesses. We must work in partnership with fam- ilies to provide optimal care of people with psychiatric disorders. Another major change is the rise of advocacy groups—largely comprised of people with mental illnesses and their families—who work in tandem with In college I had several excellent teachers who, to my great surprise, determined that I was a good writer. They went so far as to encourage me to become a writer instead of a physician.