Dr. Nathan Schnaper dies at 92

Psychiatrist was renown for his tough-love support for cancer patients and their families

August 26, 2010|By Frederick N. Rasmussen, The Baltimore Sun

Dr. Nathan Schnaper, an eminent psychiatrist who was known for his work with patients and their families at the Greenebaum Cancer Center, died Monday in his sleep at Gilchrist Hospice Care.

The longtime Sudbrook Park resident was 92.

"He had been rapidly failing over the last several weeks," said his son-in-law, Dr. James M. Carlton, a Baltimore hand surgeon.

"On Monday, he had eaten a lunch of a corned beef sandwich, potato chips, an Entemann's chocolate doughnut and some Gatorade," Dr. Carlton said. "He then closed his eyes and drifted away."

With Dr. Schnaper's death, "an era has passed," said Dr. Kevin J. Cullen, director of the University of Maryland Marlene and Stewart Greenebaum Cancer Center and a professor of medicine at the medical school. The psychiatrist was the longest-living faculty member of the UM School of Medicine.

"Nate was an icon and a father figure to all who worked at the cancer center. He was the perfect combination of friend, adviser and institutional memory. He was universally loved," Dr. Cullen said. "He was remarkable, and his longevity goes back to the early days of this institution and what it has since become."

With his omnipresent red socks, matching hand-tied red bow tie and irascible demeanor, Dr. Schnaper was "inextricably woven into the fabric of this place," Dr. Cullen said.

Dr. Schnaper, the son of Russian Jewish immigrant parents, was born in a second-floor apartment above his father's East Baltimore shoe store, and in 1925 moved with his family to a home near Pimlico racetrack.

After graduating from Polytechnic Institute in 1936, he enrolled at Washington College, where he earned a bachelor's degree in 1940.

Even though he had been accepted as a student at the UM School of Medicine, Dr. Schapner didn't have the tuition money, so in 1940 he enlisted in the Army instead.

He served five years with the Johns Hopkins-staffed 118th General Hospital's psychiatric unit in the Pacific.

"It was like an apprenticeship to medical school," Dr. Schnaper told The Baltimore Sun in a 2003 interview, and it helped him decide to become a psychiatrist.

After the war, he entered the UM School of Medicine, where he earned his medical degree in 1949. He completed his internship at the old U.S. Public Health Hospital in Wyman Park, and his psychiatric residency at Sheppard & Enoch Pratt Hospital.

Otherwise, Dr. Schnaper's home for his entire career was the UM medical school hospital, where he taught medical students and worked with Dr. R Adams Cowley — the cantankerous founder of the hospital's shock trauma unit that bears his name — as chief of the psychiatric branch from 1970 to 1977.

From 1974 until his retirement in 1996, Dr. Schnaper was chief of psychosocial services at the UM Cancer Center.

He became fascinated with how cancer patients dealt with their diagnosis and how in many cases they faced the end of their lives.

He had noticed that doctors after surgically treating cancer patients really didn't want to have much more to do with them beyond pain management.

"I conjectured," he told the newspaper in the 2003 interview, "that it was not only a threat to their omnipotence, but to their mortality."

He made a commitment to his cancer patients and reassured them that he would never abandon them and would be there until the very end helping them and their families.

Dr. Schnaper had given up psychoanalysis in 1970, explaining in The Sun interview that he didn't "have that much time" and neither did a terminally ill patient.

With a combination of pep talks and being able to confront emotions and fears, he was able to reach into a patient's heart and mind.

If the situation called for it, Dr. Schnaper lapsed into a patois that was laced with expletives, doing whatever he had to do to get through with the message of "don't give up."

"It was tough love, his brand, and he got right down to the problem," said Dr. Stephen C. Schimpf, who had been director of the UM Cancer Center, and later was CEO of the Medical Center, until retiring five years ago.

"But his approach was a very practical one, an approach that helped patients cope with their illnesses, their anxieties, their threat of death and indeed their death," he said.

"He also helped residents and oncology fellows cope with the issues of an intense training program, but also with their insecurities of entering a field where success is often measured in reducing pain and suffering rather than cure," he said.

Dr. Schimpf said his old friend and colleague didn't mince words.

"He cut through all the crap and would tell them, 'This is what you're going to have to do. Life is tough. You may not make it. What's important is what you do with the time you have left,' " he said. "He was direct and very effective. The patients loved him."

Dr. Cullen recalled the time a VIP patient who had complications from a malignancy had become despondent and withdrawn from his family and nurses. Dr. Schnaper was summoned to evaluate the patient.

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