Paul S. Appelbaum, M.D., 129th President, 2002–2003

Last winter when Paul Appelbaum, the 129th President of APA, asked me to introduce him today, I was proud and delighted. But I was dismayed when the organizers of this opening session informed me that I have only 5 minutes to do so. I will conform to that official request.

I first met Paul in 1980. He was fresh from his psychiatric residency at the Massachusetts Mental Health Center and already making important empirical and analytic observations on patient competency and the right to refuse treatment. Paul joined our Law and Psychiatry Program at the University of Pittsburgh. It was soon apparent to all in the program that he was something very special, gifted, a keen observer, an excellent writer and speaker, direct and honest, professional, and dedicated to psychiatry and its patients in all ways. He had a twinkle in his eye. And he was efficient. As the months went by I rapidly realized that in recruiting Paul we had struck gold. He was Mozart, we were Salieri. We would do best to further his genius so that all might advance.

Now it is 23 years later, and I am pleased to introduce him today to be recognized and listened to by all of American psychiatry, including forensic psychiatry. We have profited considerably from Paul’s highly original intellectual contributions to law and psychiatry, his organizational leadership in the most important professional forums, including APA, and his advocacy for patients and our profession in these challenging times in the halls of Congress and extensively within other fields of medicine, including his efforts regarding how best to conduct scientific research with human subjects.

As a graduate of Columbia College and Harvard Medical School and as the A.F. Zeleznik Professor of Psychiatry, Director of the Law and Psychiatry Program, and chairperson of the Department of Psychiatry at the University of Massachusetts Medical School, Paul is known to us all—not only as our feisty and highly competent President of APA, but also through his two decades of informative writing in The American Journal of Psychiatry and Psychiatric Services. He has been the author or coauthor of 13 books—four of which were distinguished by APA as the year’s outstanding book in law and psychiatry (1–4)—and hundreds of papers and chapters, the leader of influential commissions, and the recipient of prestigious awards; there is no area of general psychiatry and forensic psychiatry where Paul’s voice has been silent. As pertains to the logic and practice of informed consent (5), psychiatric ethics, especially in forensic psychiatry (6), the understanding of the influence of law on psychiatry (7), and the prediction of dangerousness (4) so as to better guide psychiatric practice, our President is simply “the best.” His textbook with Tom Gutheil set the standard in the field for the practicing clinician (7). His original work with Tom Grisso in the assessment of patient competency has had and will have broad influence in our field for decades to come, for research and better treatment of both civil and criminal patients (3).

Predictably, Paul has had a great Presidential year. As is only fair, and required in business circles, Paul’s recent APA achievements can and should be judged by the objectives he delineated to us in the pre-election debates. For example, did Paul advocate this year in powerful ways to increase access to psychiatric care for patients, despite the negativity of local and national funding policies? Yes, as exemplified by his work with the President’s Commission on Mental Health.

Did Paul’s Presidency affect the APA organization in helpful ways? Yes, through his knowledge and contributions to the budgetary process, through his assistance in reorganization of the Central Office, through his present projects in revising and updating the APA ethics guidelines, and through his organizational mandate to psychiatry and APA to delineate now the essential characteristics of a caring and effective mental health system—to name only a few.

When Paul promises, he delivers. We are a better APA because of Paul’s tenure as President. And Paul has consistently delivered emotionally and otherwise for his accomplished and very close family. Paul and Dede, his wife of 29 years, herself an accomplished author on social and environmental history, are the parents of Binyamin, a reporter; Yoni, who this week graduates from Columbia University, and Avigail, in her second year at Barnard.

For those of you who do not know Paul, I recommend that you read him carefully, apply what he teaches, and more important, consider the character and integrity of the man behind the words. Leaders lead by having vision, by informing and motivating others to do what they do best, and by raising our spirits through their own hard work and excellence of product. Paul, the scholar and thinker, is such a leader.

Let us listen then to this everywhere-acknowledged major figure in American psychiatry, to his insights and recommendations for psychiatry, patient care, and the formulation of public policy. And let us all subsequently act to help him to achieve this challenging vision for the good of our craft and our patients.

Dr. Roth is Associate Senior Vice Chancellor of Health Sciences, Professor of Psychiatry, and Professor of Health Policy and Management, University of Pittsburgh, and Senior Vice President of Medical Services, University of Pittsburgh Medical Center. Address reprint requests to Dr. Roth, University of Pittsburgh Medical Center, Suite 11016, Forbes Tower, 200 Lothrop St., Pittsburgh, PA 15213; [email protected] (e-mail).