Wall space is hard to come by in Dr. Jerald Kay’s office, and he likes it that way.
Seemingly every square inch of vertical real estate is covered in large photos that Kay has taken from his world travels, a cadre of visual stimuli that wraps visitors in a cocoon of color and contrast, and raises questions about where and when the photos were taken. Put simply, he’s a shutterbug who enjoys sharing his treasures.
Inviting and warm, the office features a leather couch that the average NBA center would feel comfortable lounging on, a large wooden desk and a small library where you’re just as likely to pull a periodical about jazz or photography as you are to handle a hardcover about the integrated treatment of psychiatric disorders.
A Renaissance man if there ever was one, Kay, the professor and chair of the Wright State University Boonshoft School of Medicine’s Department of Psychiatry, is a fountain of fast-flowing wisdom within his field. But to know him is to realize, in the beginning, he never truly intended to be here.
“I came to psychiatry through my experience in classics,” said Kay, who was named Frederick A. White Distinguished Professor of Professional Service by Wright State in 2011.
Kay grew up in Maryland in a home where the pressure to migrate to medicine was palpable. His father, unable to pursue his dream of becoming a doctor, wanted it for Kay and his brother even worse.
“‘My son the doctor,’ I grew up hearing that,” said Kay.
At first, Kay deftly bucked the pressure and sought a degree in religious studies at Washington University in Saint Louis, Mo. While there, he connected with an influential professor. “I must have taken six courses with him,” said Kay. Through intimate study of Greek mythology, the professor piqued Kay’s curiosity. “The Greek tragedies and some other major works really opened my mind in understanding why people do what they do and what some of the universal themes were about,” said Kay. “He kind of opened my eyes.”
The experience changed his life
In the summer of 1967, the so-called Summer of Love, Kay was a regular in the Haight-Ashbury district of San Francisco. Though his heart was with getting a Ph.D. in comparative religious studies, his head and trusted mentors were urging him to explore his growing interest in human behavior instead of being forced to explore the jungles of Vietnam.
“To then enter medical school in the fall of ’67 and plunge into all the memorization and regimentation was a culture shock to say the least,” said Kay. But it was a culture he would learn to enjoy. In his surgery clerkship, he found working with people pre-operatively and post-operatively far more intriguing than anything involving a scalpel. Despite his enjoyment fixing cars, he never really developed an interest in the operating room. He preferred the patient contact. Interestingly, he became the psychiatrist to the cardiac transplant team at his former university years later.
Keeping an open mind
In medical school Kay discovered his passion for clinical work, and it has remained a bedrock of his career ever since.
“To this day every patient has taught me something, and in that sense psychiatry is one of the most gratifying specialties to be in,” said Kay. “If you keep your mind open and don’t let your brain turn to scrambled eggs, patients will teach you an enormous amount.”
That open-mindedness is one of the most emphasized values Kay impresses upon young medical students at Wright State, as well as those at other universities who have read any of his books on psychiatry.
Over the last 30 years, Kay’s approach has been to embrace the challenge of becoming the very best clinician he could be, which he said has given him a solid foundation to learn about new areas of study in American psychiatry. Take for example his interest a couple years ago in learning more about the current state of mental health among college students.
“I went looking for a book about it and couldn’t find one, so with considerable help from leaders in the field across the country, I wrote it,” said Kay. The book, Mental Health Care in the College Community, has recently helped raise Kay’s public profile, but he readily admits he’s no expert in the area. He might, however, be an expert in synthesizing his and others work in the field as evidenced by the more than 35 psychiatry books he’s authored or coauthored.
In recent years, his prevailing interest in the field has led him back to some of the science themes that he typically resisted learning much about as a medical student.
A new love for neuroscience
Recent discoveries in psychiatry, cognitive psychology, and neuroscience show that psychotherapy works not only on a clinical level but is actually a biological treatment. Psychotherapy sessions can change brain structure and brain function as repeatedly evidenced through neuroimaging studies.
“I’ve fallen in love with neuroscience in a way I hadn’t in medical school,” said Kay. “How words, learning, and memory, and the power of the doctor-patient relationship affect the chemistry of the brain.”
Kay said he finds it particularly intriguing because staying informed involves keeping up with a science that changes virtually every week and has, with greater regularity, been taking him around the world with speaking engagements on the subject. Kay said the integration of the biological and the psychological is what is driving a new level of excitement in American psychiatry.
Early in his career, Kay conducted psychoanalysis (he’s a graduate of a psychoanalytic institute), but now he’s focusing much more on psychoanalytically informed psychotherapy with adults, teens, and occasionally children (he’s also completed a fellowship in child and adolescent psychiatry) and believes deeply that his department should strive for excellence in psychotherapy training with patients of all ages.
“Of the people who come to our program for residency, a large number of them come for that kind of training, which is becoming more rare, but it’s what I believe in,” said Kay.
That being said, in Kay’s estimation a focus of all medical education will shift to teaching students how to more effectively interact with and listen to patients.
“It’s very clear that educating medical students will emphasize more behavioral science, professionalism, and the ability to relate to one’s patients,” said Kay.
Body and soul
Whether the focus is bedside manner, advocacy, professionalism, or ethics, Kay predicts demand for teaching and learning these these attitudes and skills will go up. “By virtue of our training, we spend a lot of time as psychiatrists already doing this, so our skills are going to be more relevant to the training and education of all physicians,” said Kay.
A jazz buff who plays drums with a quartet and tuba in a large wind ensemble weekly, Kay approaches his hobbies of music, photography, and travel as aggressively as he does his profession. It’s all or nothing. Wright State has received his all, and he’s built a program with an excellent reputation in psychotherapy training because of it.
“Coming to Wright State was the best thing that ever happened to me,” said Kay. “It turned out to be perfect. When I got here there was almost no one in the Department of Psychiatry. Very few people get that kind of opportunity to build a department de novo,” said Kay. He has also enjoyed working closely with the dean of the medical school, Howard Part, M.D., who has supported every effort he has undertaken, according to Kay.
For more than 20 years, Wright State’s Boonshoft School of Medicine has benefited from Kay’s equal desire to teach, write, and conduct research. “I’ve never been someone who could spend an entire day in an office doing only one activity,” said Kay. “I see a small number of patients, write, develop new programs, teach my residents and medical students, and, of course, work collaboratively with my colleagues in other departments and hospitals.” Kay is equally proud of the department’s well-recognized programs in public-sector psychiatry in the Dayton region that care for those child, adolescent, and adult patients with severe and chronic mental illness and intellectual disabilities.
His enormous appetite to learn more about the latest areas of study in his field, and his vigilant pursuit of staying sharp in its most basic disciplines, like clinical work, have made him a leader in his field and an invaluable asset to the school.
“In my field, the most talented psychotherapists are people my age because they get better and better and better if they keep their minds open,” said Kay. “And now, I, too, am doing the best and most rewarding clinical work of my life, which in turn, makes me a more effective teacher.”