Joel T. Braslow, MD, PhD

Interviewd Spring 2000

Archived Profiles

Dr. Joel T. Braslow is an assistant professor in both the departments of History and Psychiatry and Behavioral Sciences at UCLA and a member of the Health Services Unit of our MIRECC. Born and raised in Los Angeles, California, Dr. Braslow received his B.S. in biology from Stanford University, His M.D. from Loma Linda University School of Medicine and his Ph.D. in history from UCLA. Dr. Braslow lives in the Los Angeles area with his wife, two children, dog, cat, rabbit, frogs and salamander.

How did you became interested in the history of psychiatry?

I was drawn toward history because of the insights such a perspective could shed on contemporary psychiatry. A common idea is that history is a collection of curious, though dusty, old facts that may be interesting but of little immediate value. I think this view short-changes the large amount of clinically and scientifically relevant knowledge that can be gleaned from an historical approach. Far from being simply cataloguing "just one thing after the next," historians are primarily interested in understanding why and how things change, asking quite fundamental questions about the nature of people, culture, society, institutions, and science. What propelled me towards graduate school in history was this potential to ask really exciting questions about the present-day nature of psychiatric practice and science.

Your first book, Mental Ills and Bodily Cures, was on the history of psychiatric treatments used from the 1900s to the 1950s. Why did you choose that particular topic?

To understand the nature of modern biological psychiatry. I felt that starting with the major somatic treatments of the twentieth century was a good entrée into probing the clinical and scientific context of what was then (1990s) the "decade of the brain." I also believed that this epoch was greatly misunderstood, leading to fundamental errors in conceptualizing past and present-day psychiatrists and the basic dilemmas of caring for patients with chronic mental illness.

As with any project one is highly committed towards, the personal also plays a big role. A memory that periodically resurfaced throughout medical school and my residency helps explain some of my personal motivation for studying obscure doctors at California state hospitals. My father, a surgeon, served a brief stint at Camarillo State Hospital in the 1950s. Clearly committed to his calling—for he genuinely believed that there could be no higher form of humanitarian service than treating the sick—he often recounted his surgical feats, some of which came from his experiences at this hospital. One of his favorite stories, perhaps because of his brush with fame, recounted Walter Freeman teaching him how to perform a transorbital lobotomy. With a certain amount of flair and drama, he described the procedure: "One takes a thing that looks just like an ice-pick and positions it right above the eye. Using a hammer, the pick is pounded into the skull. Then ping!!! the bone breaks enough to let the ice-pick slide easily into the patient's brain. You then swing the pick back and forth, cutting the nerves that connect to the front of the brain. That's it."

For my father, this memory and its recitation reaffirmed his skills as a surgeon and his belief in himself as a healer; even in spite of lobotomy's infamous history, he tells the story with pride. For myself, the story was more ambiguous. On the one hand, I found myself wanting to identify with him as a physician, and, later on, my decision to become a doctor was motivated by a positive identification with him. On the other hand, the tale increasingly perplexed me; I wondered how my father's desire to heal coexisted with his performance of this seemingly mutilating operation. My book aimed at understanding this contradiction. In the very human and often tragic dramas in that story, I tried to give voice to both doctors and patients in order to comprehend the meaning of often seemingly incomprehensible acts.

What is your current project?

I am currently working on a history of anti-psychotic drugs from 1950 to the early 1990s. In many ways, this is a much more complex undertaking (and, perhaps, even more fascinating) than my previous work. On the one hand, I'm looking at the development of clinical trials and how culture and science have shaped this evolution. On the other hand, I'm exploring how physicians in a number of very diverse settings used (or didn't, as the case may be) this knowledge in their every day practices. What I hope to show is the ways in which culture, science, and institutional context mold how we treat and understand severe mental illness.