May 7, 1999

BY DIANA DELL, M.D.M

In my waning time on the APA Board of Trustees, I see this final column as a place for observations, a place for closure, and a place to say thank you to some special people.

Ingmar Bergmann, the great movie director, said that getting older was like climbing a mountain: the higher you get, the more tired you become - but the more panoramic the view. Perhaps that has been my personal experience on the APA Board of Trustees - I am older than the usual member-in-training (MIT) but have a more comprehensive view and a deeper level of understanding, built on many previous years in medical association activity and medical politics.

APA seems to be struggling with changing times - just as other associations are doing - with declining membership and rising expenses. It is luckier than many membership groups, having stable resources at present.

As an organization, I think we need to work on gender, race, and generational issues at every level. Men's voices still dominate the upper levels of leadership, where most of the decisions are actually made in spite of the large number of women members. Racially charged tensions have marked several Board discussions during my tenure, although I have never observed discriminatory practices. The tensions between "old docs" and "young docs" are no greater here than I have seen in other organizations, although some members-in-training and early career psychiatrists seem to feel it is greater.

At the Board of Trustees level, Rodrigo Muņoz, M.D., APA president, has provided wonderful leadership this year. I have admired and respected him even when I did not share his opinion on an issue. The Board is embroiled in its own debate about changing its composition, although it is possible that no change at all will occur. I agree with those who think the Board might function more efficiently if it were smaller and met more frequently, even if I never get to cast that vote.

The Board has gotten very powerful and out of balance with the Assembly. So it is hard to say which body speaks for psychiatrists when the two bodies disagree. In contrast, my limited experience in the Assembly makes me think that even its members have stopped taking themselves seriously at times.

Without these two years on the Board, I would not have known Dr. Derek Puddester or shared his friendship and holiday household. I would not have taken a year for women's health research or enjoyed the great mentorship of Dr. Donna Stewart. I would have missed watching leaders like Drs. Donna Norris, Carol Bernstein, Nada Stotland, Carol Nadelson, and Mary Jane England working in this organization. I would not have giggled over government jokes with Jay Cutler, been awed by the insightful speeches of Dr. Paul Appelbaum, or gotten my political lessons from Drs. Joe English and Harold Eist. I would not have seen Dr. Jim Krajeski move into the job of editor in chief of Psychiatric News - argued with him, agreed with him, encouraged him, or seen his great potential for putting the newspaper back into the "readership" position it deserves. And a most special thanks to Cathy Brown, who has sensed my vulnerability as a writer, shared my surprise when simple opinion pieces generated big waves, tolerated my tardiness on deadlines, and made me feel like the column was worthwhile and fun.

And thanks to all of you. It's been a great ride.

Dr. Dell is the APA member-in-training trustee.