July 06, 2001|By Arthur Hirsch | Arthur Hirsch,SUN STAFF
Dr. Paul R. McHugh is still on duty at the Johns Hopkins School of Medicine, where he's been director of psychiatry for 26 years, but he's already been transfigured on canvas - captured in oil, framed in carved wood and soon to be hung in a library annex. Generations to come will see a man in a white coat, eyeglasses in his left hand, his congenial face open to possibilities, perched on a chair as if impatient with sitting.
The official portrait is part of the retirement package, although McHugh is not exactly retired, which only makes the painted image seem that much more apropos. Here's a fellow who resists sitting back in his chair, much less fading away.
Technically, as of this week, McHugh retired as Hopkins' director of psychiatry and behavioral sciences. As a practical matter, however, he will remain interim director until a successor is named. After that, he will work as a clinician and researcher, devoting more time to writing, through which he established a national reputation for chastising his own profession. Psychiatry has moved from one epoch to another since McHugh arrived in Baltimore, and much of the change has affirmed his convictions. But McHugh figures he still has a role to play in the profession's evolution.
"I felt that the only things that I could do now would be to spend more time on my own writing, and that I didn't want to go when people were saying `Gee, he's lost a step,' " McHugh says. "I love it, going out the way I'm going, people saying `How will we replace him?' and all of that. Well, in two or three years you'll know how to replace me."
A committee searching since fall for McHugh's successor recently recommended a candidate, says Dr. Solomon H. Snyder, committee co-chairman. The candidate's name has been passed along in confidence to Edward Miller, chief executive officer of Johns Hopkins Medicine, and no information will be released until Miller's office announces the next chief of psychiatry and behavioral sciences, Snyder says.
McHugh, a Massachusetts native who came to Baltimore from the University of Oregon, says he agreed two years ago with Miller that he would retire soon after he turned 70 in May 2001.
"Seventy is a good age, wouldn't you say?" he says.
It appears so for McHugh, who seems to have Prozac flowing naturally in his veins. At a recent testimonial dinner given in McHugh's honor, Dr. Richard S. Ross, dean emeritus of the School of Medicine, joked that when embroiled in difficult departmental matters, "I felt so much better after talking with Paul McHugh that I sometimes wondered if he understood the problem."
That would be the McHugh personal style, the backslapping, Massachusetts-accented bonhomie one might associate with someone running for mayor of Boston. The voice that emerges in his writing, and by all accounts in his teaching, is another matter.
That would be not the schmoozer but the stickler for intellectual rigor. McHugh as psychiatric guru would give his disciples this mantra for lifetime repetition: How do I know this?
It's a simple enough question that McHugh has wielded like a scalpel. Over the years in his writings in the American Scholar, Commentary, the Weekly Standard and more specialized scholarly journals, McHugh has dissected what he considers psychiatry's tendency to fall in love with culturally fashionable theories. Says McHugh, who came to psychiatry from a medical residency in neurology: Where's the evidence? How do you know that?
Edward Shorter, who published "A History of Psychiatry" in 1997, says McHugh has "led the assault on political correctness in psychiatry," adding that "it took some courage to go against the tide" at the time McHugh published some of his toughest articles in the early 1990s.
McHugh is probably best known for his critique of recovered memory syndrome and the related psychiatric diagnosis of multiple-personality disorder. McHugh rejected both notions, saying therapists were putting these ideas into their patients' heads. Shorter, a professor at the University of Toronto, says that since McHugh wrote about it, recovered memory, which typically involved unearthed recollections of childhood sexual abuse, has been "entirely discredited in psychiatry."
He has questioned the rationale for physician-assisted suicide and the sanity of its best-known champion, Dr. Jack Kevorkian; he has challenged the evidence for post-traumatic stress disorder and assailed the psychiatric bible, the Diagnostic and Statistical Manual (DSM), for its proliferation of diagnostic categories insufficiently supported by clinical research. McHugh compares much of the DSM to the sort of appearance-based diagnostics practiced in general medicine in the mid-19th century.
