‘There’s nothing magical about’ psychiatry, Carle Dr. Arthur Traugott says as he heads off into retirement. ‘It’s listening.’
URBANA — Carle’s first staff psychiatrist, hired in 1972, will see his last patient today, after 51 years on the job.
Born in 1940 in Junction City, Kan., Dr. Arthur Traugott knew he wanted to be a physician as early as seventh grade — though his father wanted him to be a minister like him and others in the family.
After graduating from the University of Kansas with honors — “I was there at a time when the athletic stars were Wilt Chamberlain, Gale Sayers and Jim Ryan, who was the mile record setter” — Traugott stayed on for medical school before heading to Cleveland Clinic for residency, where he realized he wanted to specialize in psychiatry.
He and wife Shirley chose Champaign-Urbana to call home, where they raised their two children, who now have children of their own. Shirley has “been wanting me to retire for a while now,” Traugott said about the love of his life.
The American Psychiatric Association distinguished life fellow will miss “working with patients” more than anything else.
Before his last day, the grandfather of five and classical music aficionado took time out to answer questions about what it is like to be a psychiatrist — then and now.
How did a Kansan end up in C-U?
I think I went on 13 job interviews but ended up looking at largely college communities and multispecialty clinics. This was one of the last interviews I went on.
It was a bleak November day, all the leaves were off the trees. It was a gray sky, all the crops had been harvested — it was just kind of a dark, barren land at the time. On the flight out here, Shirley said, “Why are we going to Champaign-Urbana?”
I said, “Because they invited us.” We didn’t know much about Champaign-Urbana at the time. But we just utterly enjoyed the community.
It just struck us here that people here were on the move — they were going to Chicago, St. Louis and occasionally Indianapolis. The other thing I realized afterward, is that the questions I asked in my interview at the clinic — it seemed like I was getting straightforward answers.
I had to wrestle with my insecurity of being the first psychiatrist at any place — but there were many other things that attracted us here, and we are glad that we have been here for 51 years.
When did you gravitate toward psychiatry?
I went to Cleveland Clinic to do my internship and was accepted there for an internal medicine residency. Near the end of my internship, I had a rotation in psychiatry, which at first I didn’t care for — and then I realized that psychiatry was a medical specialty and I belonged there.
What was important to me was being a physician — and psychiatry there was treated as a medical specialty. I could see how it worked together with other practices of medicine.
At the end of that internship, I approached the chairman of the psychiatry department and told him I would like to participate in their residency. He said, “I’m sorry, this year is all filled, but I’ll put you on the books for the beginning of next year.”
So I spent a year in internal medicine — which was one of the best years I spent because the pressure was off of being competitive, of one-upping your colleagues and just learning clinical medicine. That has served me well throughout my career.
I have always emphasized that first of all we are physicians — and our specialty is psychiatry.
American psychiatry had really fallen head over heels with Freud. In the early ‘70s, Freud and what was said to be Freudian was beginning to be questioned. It was no longer necessary go through psychoanalytic training to be a psychiatrist.
The program I was in emphasized both the medical aspect and the psychotherapeutic aspects of psychiatry and that’s what we are continuing here in the way the Carle residency program has been set up.
What additional challenges did you face as the first psychiatrist at Carle?
First, I was dealing with people’s perceptions of psychiatry. I had to deal with the perception that psychiatrists were strange people.
One of the common things when we were out and I would meet people and it came out that I was a psychiatrist, people would ask, “You aren’t psychoanalyzing me, are you?”
I said, “I only work in the office.”
When we moved here, the Realtor showed us Devonshire, and there were a number of doctors who lived there. I told the Realtor and my wife, “I don’t want to go from work back to work.”
We chose a neighborhood where our children could be exposed to an educational experience neither one of us had. I wanted that because of the racial diversity of the school for my kids.
Dr. Arthur Traugott, Carle’s first staff psychiatrist, hired in 1972, will see his last patient before retirement today.
How often were you on call back then?
When I was first here, it was 24/7. That went on for several years.
What is the one technology you wish would be reimagined or even never invented?
Electronic medical records.
What are psychiatrists experts in?
They should be experts in listening to patients. As you get to know people, and what their wavelength is — you can tune in on that. You can join them on that wavelength.
If you don’t let someone tell their story, you don’t connect with them. And that’s a feature that the current conditions are really driving out of the practice of medicine. I call it “big box medicine.” And the other thing that’s happened is that we have this American belief — I call it “better living through chemistry” — there ought to be a pill for it. And many times, there isn’t.
I made a vow that if I got involved with any medical organization and was on any active committee or council that I needed to continue keeping my foot in medicine, because I have seen what happens when you take doctors off the call schedule — and then also when they get totally removed from practice. They don’t think like the doctors they were before, so that’s why I continued to work half-time here. I remained loyal to my roots.
There is a nationwide shortage of psychiatrists, as there are in a number of other specialties. And that led to the starting of our residency program here. It was established because we needed more psychiatrists. And also realizing that if they didn’t stay with us, maybe they would stay right in the region and we could help that way.
That program has been going now for I believe seven years, and we have hired four out of those classes to be part of our active staff here.
I would also argue that a psychiatrist has to be extremely patient in dealing with certain patients who want me to do the work for them. You just have to be willing to keep hearing the same thing and put it back in their court and say, “What can you do about this?”
It’s urging patients to do something — otherwise, you are just closing doors rather than opening them.
What’s changed the most over your five-plus decades as a psychiatrist?
Psychiatry has evolved. One of the confusing issues about psychiatry is that we have no true test that can confirm a diagnosis. It’s based on clinical history — just as medicine was in the Oslerian era — it’s what the patients tell you.
There’s nothing magical about it.
It’s listening — trying to understand the patient’s worldview through their eyes and not your own and recognizing when you find yourself conflicted over that because you see things differently.
When I was doing a lot more verbal psychotherapy, I would begin by telling people that my job is to become obsolete. I may be able to help you learn how to better define what you consider to be your problems, to look at what your strengths are and also to identify areas where you might try some different behaviors.
The answer that they are searching for, they probably already know but it’s just helping them to more clearly see what that is.
Managed care also changed things. My professional organization, the American Psychiatric Association, did not do a good job of rising to the challenge. They hid behind the cloak of absolute confidentiality.
The MBA bean counters took over and figured out how to do it cheaper and cheaper and dumbed it down to where at a time psychiatrists are seen as only writing prescriptions. And that’s also part of why I stayed involved with the American Medical Association.
It’s hard to put a value on talk therapy. The problem is really that it’s a process that’s slow to evolve. How can you say what one particular moment is worth? I have become much more sensitive to that in preparing for retirement here.
It’s hard to understand how a single appointment with a psychiatrist is really that valuable. And a single appointment isn’t that valuable — it’s a series and continuing over time.
What are you looking forward to after retirement?
I will still be involved with Carle’s residency program.
I will have more time to take in any number of musical venues available in our community. Krannert Center for the Performing Arts is already like a second home to us.
I will be able to do some recreational reading that I haven’t been able to do that much of, and be willing to try new things. If there is something I haven’t tried, I’m willing to give it a try and see what’s there. I won’t be closing off those doorways.
Do you have any book recommendations?
“A Fever in the Heartland,” by Timothy Egan. Parts of it are utterly disgusting about how corruptible we humans are.
What worries you about the future in terms of the field of psychiatry?
That we become more constrained time-wise.
I became nostalgic. It’s amazing what memories have started resurfacing. I became aware that I lived a very busy life, and looking at things, I realize that all things do come to an end.
As my career has been close to an end, I have found that disengagement is more difficult than I anticipated and that the connections I would have liked to continue have to come to an end, but I still have the memories.