The Librarians

Bank robbers go where the money is, and we bookworms and journal raccoons are found in libraries. At the New York State Psychiatric Institute, arguably the premier interdisciplinary psychiatry institute, the library has the honored position of a top floor location in the new Oldham Building, and it is my habitat, so much so that my Columbia University mail is sent there. The multitiered library in our old building had a cachet that the new one in a new computer-age building, reminiscent of the corridors and staterooms of the starship Enterprise, cannot quite replace. Nevertheless, the company of our librarians is rewarding. These devoted keepers of the literature, who have taken an oath of near silence, are themselves an underconsulted resource.

Our chief and our assistant librarian are David Lane and Luis Minaya, respectively. Luis is a computer expert, and David is a master wrangler of search engines. Both are imperially slim and slip easily between the movable and crank-operated stacks, which ever threaten to squeeze them even slimmer. Luis has a phenomenal memory for computer procedures and is known to wind up explaining things to instructors who arrive with new equipment. In his spare time, David indexes some of our finest psychiatric books. If you want to know whether a book provides fresh and detailed information and feels good in your hands, ask a librarian who is an indexer. If you just want to know what is being submitted to journals, ask your favorite editors. They know the supply side of psychiatric information. However, an observant librarian can tell you about the demand side. So if you want to multiply your publications for an academic progression committee that weighs your output in kilograms, ask your editor what to write. But if you care about communicating with someone, ask your librarian what is being read. It can save you a lot of work for very little trouble. What lessons can be learned from the perspectives of David and Luis?

First of all, unless you are a famous psychoanalyst—preferably dead—a statistician, or Glen Gabbard, you may not want to write a book. Books provide wonderful context and perspective on a subject before a search of the literature (1), as well as leisurely exposition and even speculation, but it is chastening to learn how few psychiatric books are read—I mean, at all. Exceptions are books that course directors force students to read, but this effect is notoriously local. The Annual Review; books on statistics, imaging, and the attachment of rat pups; and American Psychiatric Publishing textbooks get some attention. Famously unread are collections of papers from international conferences and single-author collections of loosely related papers by philosophically oriented thinkers who are not household names. Books are cumbersome in the age of information. They give you more than you asked for. Journal articles are specific, portable, well-summarized units of information that are easily copied.

Both of our librarians stand in awe of their predecessors. Jacob Shatsky read an offering in a bookseller’s catalog that “a nucleus of a library in neurology and psychiatry of a well-known collector is available in Vienna.” He bought it unseen for $900. It was Freud’s library, proved by his marginalia, and in the original library, the collection was given its own room with a leather door. Shatsky died on the job, and his famous last words to our chief of psychiatry, Joe Zubin, were “take care of the library.” Shatsky’s successor was James Montgomery, whose connoisseurship, panache, love of lavish new gadgets, and demand for nothing but the best, indulged by the patronage of Director Larry Kolb, made him a librarian in the grand manner. Montgomery had a sense of humor (as do David and Luis). I cast a Churchillian cigar in a block of plastic with the inscription, “Sometimes a cigar is only a cigar” (Zuweilen eine Zigarre ist nur eine Zigarre) in German in Freud’s Sütterlin script with his signature. James proudly displayed it on library tours as “Freud’s Last Cigar” until it was stolen, together with several of Freud’s books, by a gullible thief. Once while James was in Japan, another director, Edward Sachar, had the entire Freud collection moved to Columbia University’s then-new climate-controlled (give or take an occasional indoor rain shower from a roof leak) Hammer Medical Library across the street, and it is hardly visited now.

A few years ago, the library faced a crisis. I have never seen David Lane so distressed. Faxon, then a respected major agent for journal subscriptions, went out of business after having collected payment from the library for the coming volume of each of its journals. Recovering the money, if at all, could have been a drawn-out legal process, and meanwhile, there was no money to pay for the year’s journals. David and Luis faced the prospect, maximally disturbing to any librarian, of shelving and binding all of their journals with 1 year missing. Fortunately, the psychiatric residents had just rejected their pizza budget from the drug companies for fear of undue influence, and we were able to approach Forest Laboratories to divert some leftover budgeting for an unassailable contribution to start the recovery process.

The skies darkened and a rain-bearing wind howling down the Hudson River Valley buffeted the institute, a curved gray and green structure that seemed to shudder as if it were poised to rise aloft like a giant monowinged craft. Talk turned to the grave matter of library crime. Someone had been removing books from the library without checking them out, which reappeared after long periods, left casually on a table, defaced with penciled marginalia. The two librarians, employing the weapons of logical elimination, had identified the perpetrator, a slightly disheveled researcher (are there other kinds?). Together they confronted him one day with their certain knowledge of his culpability, without telling him how they knew. For the time being, they did not call upon the institute’s security guards to loom nearby, ready to take the culprit into custody. Keeping the library’s computers free of unauthorized and salacious uses is another of Luis’s concerns.

The biggest issue now in libraries is electronic journals (2, 3). With many journals available online, doctors can download them without visiting a library. Printouts that are better than photocopies, e-mail capability, portability, and the ability to search by subject are appealing advantages. This poses a quandary for librarians. Who will now come to the library? For which journals should they keep paper volumes? One problem with electronic subscriptions is that if the publisher goes out of business, access to past volumes can be lost. This happened with Twin Research. Another problem is that it is more difficult to browse on screen. These considerations pale beside the financial advantages of being online. It is 10%–20% cheaper, and binding, which costs $12 a volume, is unnecessary. But holding a journal in your hand gives a fuller sense of a profession. The American Journal of Psychiatry and the Archives of General Psychiatry will always be retained in paper. Even though those journals are widely subscribed to, doctors discard or lose them. Journals with a variety of features, such as Letters to the Editor, will be kept. Pure research journals and neuroscience and psychology journals that lack features and are not very browseable will be available online.

David Lane leaned back in his familiar pose with fingertips touching. With evident sadness, he reflected that he is “old school” and is attached to paper journals. He resisted the identity change for librarians implicit in computers replacing stacks. To be a librarian means that you have books and journals for current and historical caretaking, you find and bind, and you give tours and orientation to neophytes. The library, with its tangible books and journals, allows for a heuristic, exploratory sojourn and a collegiality between librarians and users that electronic information loses. And then there is that great aroma of a library, right up there with wines, perfumes, new cars—and money.

Address reprint requests to Dr. Forrest, 133 East 73rd St., Suite 211, New York, N.Y. 10021; [email protected] (e-mail).I thank our librarians—David Lane, Luis Minaya, and James W. Montgomery—for their suggestions, emendations, and indulgence.