These days when I receive my complimentary copy of the Archives of General Psychiatry, published by the American Medical Association, I often throw it out without bothering to look past the table of contents. There is seldom anything of use to the clinician. The great majority of the contributions are at the level of basic science, of a preliminary or tentative nature, and bear absolutely no relation to clinical practice at the present time. It is good to know that there are people pursuing such studies. I believe Francis Bacon would classify them as experimenta lucifera. Eventually, it is to be hoped, some of the data will come together and form experimenta fructifera, another Baconian term, this one signifying useful or fruitful investigations. Who can say in the short run which is which? Bacon was right that much progress in science results from the patient, systematic, even plodding investigation of natural phenomena by individuals who need not be particularly distinguished individually. It is a collective effort, something one can scarcely fail to miss when examining reports that list as many as fifteen supposed contributors. Some of this is perhaps resume padding by aspirants eager, indeed obliged to establish a publications paper trail. Many such articles are of questionable value, concluding with the familiar “more investigation is needed” meme.
It was not always thus. Back in 1968, where our depressed anti-psychiatry senior medical student is still waiting outside J. Willis Hurst, M.D.’s office for his internship interview, the Archives of General Psychiatry was more interesting – and more useful. It remained so for a number of years, a decade or more thereafter. The contents reflected what the title promised. They were of interest and potential use to the general, clinical psychiatrist. Gradually, as the Decade of the Brain dragged on and became the Century of the Brain, that began to change. Current editions of the Archives are virtually unreadable and are certainly incomprehensible by the generalist. Without extensive training in biochemistry, brain imaging, and most of all, statistics, one has to take the reports on faith or not at all. The change in the editorial policy of this supposedly general psychiatry journal is indicative of the change in the field of psychiatry itself. The human, personal, psychological dimension has contracted –shriveled might be more precise- to a mere dot. The inhuman, material, objective side has swollen to take up all of the available space. The brain has vanquished the mind. All of this was well under way before it even occurred to me to become a psychiatrist. It was not what attracted me to the profession, whose rank materialism has long since become onerous and sinister. Vladimir Lenin, who graces the cover of the latest issue of the Archives of General Psychiatry, would have approved.