9/26/2016
Musings:
‘You Can’t Always Be Right,
But You Can Always Be Kind’
University of Rochester
Department of Neurology
50th Anniversary Celebration
September 23, 2016
Ira Shoulson MD
Professor of Neurology, Pharmacology & Human Science
Center for Regulatory Science & Medicine
FDA Center for Regulatory Science & Innovation (CERSI)
Georgetown University Medical Center
Washington, DC
http://regulatoryscience.georgetown.edu [email protected]
Musings
thinking, reflection, meditation, abstraction,
contemplation, introspection, reverie, dreaming, daydreaming, rumination, navel gazing, absent-mindedness,
cogitation, cerebration
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9/26/2016
Limitations and Biases
• Restricted to first 40 years (1966-2006)
 1966-1975 (Medical School, Formative
Education and Training)
 1975-1990 (Faculty, Clinical Care, Mentoring)
 1990-2006 (Reverse Mentoring, Clinical
Research, Encore Careers)
• Perspective biased by personal interests,
point of view, and proximity
• No apparent COI
‘You Can’t Always Be Right,
But You Can Always Be Kind’
Robert J. Joynt, MD, PhD (1925‐2012)
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‘You Can’t Always Be Right,
But You Can Always Be Kind’
Kind (caring, nice, sympathetic, empathetic, generous, gentle, thoughtful, compassionate, benevolent, humane, considerate, concerned, helpful, gentle, charitable, kindred)
Right (correct, true, accurate, exact, precise, factual, successful) – (antonym = wrong)
‘You Can’t Always Be Right,
But You Can Always Be Kind’
“Be kind, for everyone you meet is
fighting a harder battle.”
― Plato
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‘You Can’t Always Be Right,
But You Can Always Be Kind’
Kind (caring, nice, sympathetic, empathetic, generous, gentle, thoughtful, compassionate, benevolent, humane, considerate, concerned, helpful, gentle, charitable, kindred)
Right (correct, true, accurate, exact, precise, factual, successful) – (antonym = wrong)
Success – (antonym = failure)
Mentoring & Reverse Mentoring
The First 40 years (1966-2006)
• 1966-1975 (Medical School, Formative
Education and Training)
1966-67: UR Interviews and Visits
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Robert Joynt MD
George Engel MD
William Morgan MD
John Romano MD
Robert Joynt MD
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9/26/2016
George L. Engel MD (1913‐1999)
George L. Engel MD
• The Boot-Elective (1967-1971)
• The Bio-Psycho-Social Model of Medicine
(Science, Apr 1977): interactions between
biological, psychological, and social factors
determine the cause, manifestation, and
outcome of wellness and disease.
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9/26/2016
John Romano MD (1908‐1994)
Engel & Romano
•
•
•
•
•
Nitrogen Narcosis (the ‘Bends’)
Delirium vs Dementia (EEG correlates)
Biopyschosocial Model of Medicine
Conversion Reactions vs Malingering
Psychosomatic Medicine
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Romano and Engel
William Morgan MD
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9/26/2016
Morgan & Engel
The Clinical Approach to the Patient by William L.
Morgan and George L. Engel, Published May 1,
1969
The First 40 years (1966-2006)
• 1966-1975 (Medical School, Formative
Education and Training)
1966-67: UR Interviews and Visits
1968-75: Milieu Counts
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David Goldblatt, MD (1930-2007)
Richard Satran, MD (1929-2014)
The First 40 years (1966-2006)
• 1975-1990 (Faculty, Clinical Care,
Mentoring)
Faculty Leadership (Joynt, Griggs)
Faculty Colleagues
Cross-Mentoring
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Robert C Griggs MD
Richard T Moxley MD
Ralph F Josefowicz MD
Charles A Thornton, MD
Robert C. Griggs MD
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Richard T. Moxley MD
Ralph F. Jozefowicz MD
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Charles A Thorton, MD
The First 40 years (1966-2006)
• 1975-1990 (Faculty, Clinical Care,
Mentoring)
Faculty Colleagues
Mentoring and Reverse Mentoring
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Reverse‐Mentoring
‘Searching for a Young Mentor: What Could I Possibly Learn from a Mentor Half My Age? Plenty’
Phyllis Korkki, age 55, NYT Assignment Editor
New York Times, Sunday Business, Sept 11, 2016
Snapchat
Reverse Mentorship
• ‘Young Mentors (Millennials) Are Natural Consultants’– They operate horizontally rather than vertically (hierarchically)
• ‘Baby boomers tend to have a hierarchical view of the workplace – an ‘org‐chart’ mindset that imagines power filtering down from the top.‘ • Millennials, by contrast, may see work as more of a horizontal network
• ‘Each age group has untapped resources that can benefit others at a different stage of life.’
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Reverse‐Mentoring
• As we age, our dendrites begin to shrink (particularly in the prefrontal cortex, which helps us to focus, stay on task and maintain bandwidth).
• Older people tend to be more disciplined and diligent, thereby compensating for learning deficits…and are also very good in putting ideas and thoughts into categories.
• The older brain is a wiser brain, but can get into a rut because of its lack of plasticity.
• ‘You can teach old dogs new tricks. You just can’t teach them as fast.’
Reverse Mentoring
‘Our mentorship provided me with something unexpected: a chance to take what amounts to a leadership position I had not seen coming. As a relatively young professional, I was usually the one taking the advice, not doling it out. The role reversal was jarring.’
Talya Minsberg, age 27, NYT Social Strategy Editor
New York Times, Sunday Business, Sept 11, 2016
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Roger M Kurlan MD
Karl D Kieburtz MD MPH Robert G Holloway MD MPH E Ray Dorsey MD, MBA
Roger M. Kurlan MD
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Karl D. Kieburtz MD, MPH
Robert G. Holloway MD, MPH
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9/26/2016
E. Ray Dorsey, MD, MBA
Peter Como PhD
Kevin Biglan MD MPH
Bernard Ravina MD MS
Samuel Frank MD
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University of Rochester Medical Center
1925-1975
Edward C. Atwater and John Romano
“To Each His Farthest Star”
“To Each Her Farthest Star”
‘You Can’t Always Be Right,
But You Can Always Be Kind’
Charlyne Miller Hickey RN
Irenita Gardiner RN
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Char and Nita
• Clinical care is the underpinning of clinical research.
• Whether you are innately kind or not, patient interaction and care will make you kinder… and a better clinician and care provider.
Alice Rudolph PhD
Cornelia Kamp MBA
Elise Kayson MS RNC
Lisa deBlieck MPA CCRC
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Denny O Day RN MSPH
Aileen Shinaman JD
Cindy Casaceli MBA
Shari Kinel JD
Mary Slough
Ruth Nobel
Mary, Ira, Ruth
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Margaret Joynt
Rose Holloway
Roslyn Griggs
Josie Shoulson
1990-2006 (Reverse Mentoring, Clinical
Research, Encore Careers)
Parkinson Study Group (PSG), Huntington
Study Group (HSG), American Society
Experimental Neurotherapeutics (ASENT)
Encore Careers (Reinventing Oneself) and
More Reverse Mentoring
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Parkinson Study Group 2010
Huntington Study Group 2010
Baltimore, Maryland
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Noah Shoulson
Robert Joynt MD
Robert Joynt MD
Emma Shoulson
Noah Shoulson
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Joynt sayings…a sampling
“Even a blind hog gets an acorn some time;”
“I know there is a God when I have a martini in my hand;”
“The only thing harder than being a saint is living with one;”
“If you are going to teach a dog a new trick, you have to
know more than the dog;”
“Sincerity is the most important thing about being dean;
once you’ve learned to fake that, the rest is easy;”
“If you have 10 minutes to spend with a patient, spend 9 on
the history;”
“The problem with trouble is that it usually starts out as
fun;”
“I’d rather have a drink on the rocks than be on the rocks in
the drink;”
“Fanfare and gloating are the stuff that starts revolutions;”
“To a man with a big hammer, every problem looks like a
nail.”
And his favorite,
“You can’t always be right, but you can always be kind.
There is no limit to kindness.”
In Memoriam: Robert J. Joynt, MD, PhD
(1925-2012)
ARCH NEUROL/VOL 69 (NO. 11), NOV 2012
Ira Shoulson MD
For all his accomplishments, ability, and wisdom, Bob
Joynt stayed conspicuously modest and remarkably
kind—a person the Irish call salt of the earth and many
others call a real mensch—a good, kind, decent, and
honorable human being.
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‘You Can’t Always be Right, But You Can Always be Kind’
‘Let’s Make America Kind Again’
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