From mind to brain: new emphases on psychiatric education.

I cannot be in the company of still active Yale colleagues without having far too many memories. To suffer reminiscences, Freud noted, is to suffer neurosis, and this should probably not be inflicted-even on deserving friends! Nor has Fritz Redlich done anything so drastic, in spite of being busted in bronze and hung in portraits, for us not to celebrate his astonishingly productive present. I first encountered Redlich's openness to innovation and search in World War II. Later, almost exactly 30 years ago, as a psychologist studying medicine, I enjoyed sharing the excitement of learning at Yale about human biology and about both the depths of the brain and depth psychology. With a provocative dubiety, Milton Winternitz, the founder of the "Yale system," would challenge students-in his view, machined products fit only to grind out A's and B's-to think and dare to investigate. Ideas at Yale were to be actively pursued in the best company available-a range of experts in every department who were curious and willing to lend a hand in developing and transferring technologies and science information in what then were the hardly promising pursuits of the application of biology to psychiatry. The professorial names ranged from Fulton, MacLean, Livingston, Long, Burr, Pribram, Gardner, German, Peters, Powers, Jackson, Darrow, Yannet, Hitchcock, Dollard, Janis, Miller, Delgado, to Barnett, Welch, J. White and-of enormous personal meaning-Giarman; and so many others. Learning from one's peers as a Yale student, and from the vantage of a professor-the peerless, regenerating flow of Yale students, are hallmarks of a Yale education and its science environment. The inventive and determined nurturance of this richly evolving climate of opportunity is what indelibly marks Dr. Redlich's long transit at Yale. We have moved far from that time when-beyond the limits to consciousness and coma set by energy metabolism-there was no vital chemical link of brain to behavior, let alone to the psychoses. Today we know brain as a highly differentiated and specific endocrine and information-generating organ, and of biochemical and macromolecular sequences in brain function relevant to the pathophysiology of psychotic states. Yet from an era of innocence, we have arrived at a more consequential ignorance. Like general medicine, we now possess a range of potent therapies that can be all too rapidly and mindlessly implemented, and the biobehavioral infra-