What inspired you to become a psychologist?
I was always intrigued by the paradox of addiction. I was always drawn to trying to understand why behaviors that so often result in suffering are so hard to change. I grew up in the 70s in Brooklyn, New York, and many of my friends did drugs. Some are now doctors and lawyers, some are cops and firemen, and some are dead (of addiction). All did the same drugs. Why were some able to stop and others not? I had great mentors in college who helped me to nurture my curiosity.
Why did you focus on pain management?
I had finished a partial fellowship in addiction when my first girlfriend died of cancer. I then decided to become a psychologist who worked with people with cancer and did a fellowship in psycho-oncology at Memorial Sloan Kettering Cancer Center. It was 1987, the height of the AIDS epidemic in New York City, and someone was needed to work with people dying of AIDS and who also had addiction issues. I then met Russ Portenoy and Bill Breitbart and the rest is history. I never saw such compassion and expertise so easily and seamlessly interwoven as when watching them work. I wanted to be the psychologist version of them!
Who were your mentors?
his one is easy: Russ Portenoy, Jimmie Holland, Bill Breitbart, Kathy Foley, Perry Fine, and Ray Houde. (May Ray rest in peace. He understood the interface of pain and addiction better than anyone of his generation.) All taught me everything I know about pain and encouraged and supported me long before I had any idea of what I was talking about. I try to be as generous to my mentees as my mentors were to me. Ken Kirsh was once my mentee. He is such a genius. He turned the tables and mentors me as my main collaborator over 20+ years.
If you weren’t a healthcare provider, what would you be?
I wanted to play for the Knicks but I couldn’t go to my left so I am not really sure. I play bass guitar so I'd like to say I’d be a paunchy middle-aged Hebraic rock star. Or a sushi chef. Or a professional horse racing handicapper. It’s hard to say. I graduated college at 20 and already knew I wanted to go in the direction I went in. I even had to stop playing in bands so I could get out of graduate school and finish my internships.
Why did you leave academia for the commercial arena?
I felt that the only way to continue to contribute to the research database on risk management in a meaningful way was to leave academia and take the extraordinary opportunity that Millennium offered me. I work with some of my best friends and people I admire, love, and respect every day. I wrote my first paper on urine drug testing 2 decades ago. I have always believed in it and other tools that would make practitioners good enough at recognizing and responding to concerns about addiction that they would treat pain comfortably, safely, and aggressively. I wanted to continue to contribute to the science in this area but in academia found it becoming too difficult to conduct studies. I was so busy working clinically that I no longer had the time to be in the research and education realms. I realize there is a certain irony in that. I often semi-joke that I left academia to get some academic work done.
What is your most marked characteristic?
When I was in graduate school and training to be a psychologist I had to go for my own psychodynamically oriented psychotherapy. I did the horizontal bop (psychoanalysis) lying on the couch suffering myself, as they say, 3 times per week for 5 years. I learned that my favorite emotion is righteous indignation. I gravitated to the right fields because I get to feel it every day! I work in areas that feel important, ARE important, and in which there is complexity and it is never justified to feel too comfortable or complacent. The desire to help people with pain, cancer, and psychological problems related to them, etc, is something I feel every day. I feel they deserve better than they get and that is where the righteous indignation comes in.
What do you consider your greatest achievement?
The publishing of the Pain and Chemical Dependency textbook with Howard Smith. It was a mountain of work, a great achievement, and I think it sold 450 copies and my mother bought 448 of them. But that aside, to edit such a book and to do it with such a wonderful co-editor makes me and my parents very proud.
If you had to choose one book, one film, and one piece of music to take into space for an undetermined amount of time, what would they be?
Book: Catcher in the Rye. This book resonated with me as an angry young man and made me realize you could go crazy about the hypocrisy in the world or you could channel such feelings into doing something for the good of others rather than be consumed by it. I just wish it had come with instructions on how not to become the crotchety old guy.
Film: Annie Hall. It helped me understand how to be a Brooklyn Jewish Boy and live in the world.
Music: Anything by Stevie Ray Vaughan. Anything.
What would you like your legacy to be?
I would like to be remembered as someone who thought first about what was good for patients and didn’t think of simple solutions to their complex problems. Someone who could advocate for AND against opioids as needed, who cared about and tried to prevent addiction while trying to make sure that people in pain had everything available to them that might help. I wouldn't mind being thought of as an iconoclast and as anti-dogma. Oh, and an addicted horse player. (If the shoe fits.)
What is your motto?
My motto was something I first read many years ago when I was tearing through all of James Kirkwood’s books—and I don’t mean P.S. Your Cat is Dead, though that has always resonated with me, ie, when you think a situation has bottomed out, never fear things can get worse! One of his other works, There Must Be a Pony, mentioned the story of the narcissistic and entitled person who was unsatisfied with a roomful of riches. His “dumber” sibling, meanwhile, is delighted to receive a roomful of horse manure. When asked why he is so happy, the sibling says, “With all of this manure there must be a pony.” Despite my inclination towards righteous indignation I am an optimist at heart and believe the best trait a human being can cultivate is gratitude.