1 JACK D. BARCHAS Interviewed by Stanley J. Watson Boca Raton, Florida, December 10, 2007 SW: Hello and good morning. I am Stanley Watson, professor at the University of Michigan of the Department of Psychiatry and today I am interviewing Jack Barchas, who is the Chairman of Psychiatry at Cornell University Medical School. This is one of a continuing series of archival interviews of the American College of Neuropsychopharmacology. We are now in Boca Raton at the Annual Meeting of the ACNP, and today, is December 10, 2007. These interviews cover a wide range of areas and may be you could tell us first about your background and training JB: I would be very happy to. First of all, there is no one I would rather be interviewed by than Stan Watson, because he is somebody very special to me, I have enjoyed working with him and he has been important in my life for decades. My career really was predetermined by my parents and my family. I lived most of my life in California and my mother and her parents had lived in California for many years. My parents were profoundly influenced by the Holocaust. I am one of eight children and my parents were very concerned with issues of education, fairness, and social justice. My father was a person who I never heard to make a discriminatory statement towards anyone. He was a man of enormous intelligence who graduated from college at eighteen, became a very good trial lawyer. His absolute love was the history of science and of ideas. It was something my mother shared with him; she was a housewife but would have loved to have been a medical researcher. When I was very young she would read me stories of people who had done medical research and about progress in medicine. I knew from an early age I wanted to be a doctor. I was always curious about how things worked and when I was four years old I took apart my grandfather’s violin and tried to figure out where the sound was coming from. I remember my mother’s look of concern but I explained what I was doing and she felt it was fine, that it was very important to figure out how things work. I had profound dyslexia as a child and when I told my teacher that I wanted to be a doctor, she said I would never be able to do anything in medicine, my Jack D. Barchas was born in Los Angeles, California in 1933. 2 intelligence wouldn’t permit it. But I heard my father tell her, “my son can do whatever it is he wants to do”. Both father and mother took my interest in medicine very seriously and when I was eight years old my father took me to a medical supply store and bought me a stethoscope. When I was eleven or so I told my mother I had decided when I grew up I wanted to study the brain. She turned to me and said that would be a wonderful thing. She still remembers having said that to me. When I was about thirteen, there was a spare room in our house my parents permitted me to turn into a laboratory. I got a used microtome and did paraffin preparations of plants and other things; I made slides, stained and studied them. I worked briefly in a pathologist’s laboratory when I was in junior high school, until my mother found out there might be samples with syphilis. In high school, I worked cleaning glassware for a laboratory that studied thyroid; that was a very important experience because the glassware had to be scrupulously clean. I have had an appreciation of glassware washers ever since, in terms of what they do. I knew early on I was interested in psychiatry and my father introduced me to psychiatrists in West Los Angeles. They were, of course, all analysts, but were very nice to me and encouraging. Shortly after turning seventeen, I went to Pomona College. It didn’t have much in the way of scientific research capacity but, otherwise, it was very nice. The first hour of the first day there, I met Patricia Courbet and fell immediately in love. She had an incredible impact on my scientific career and also became involved in the study of science. I have also always been appreciative towards my brothers and sisters for their patience with my intense involvement in science and my parents’ commitment to that. I started scientific work very early on. At Pomona it wasn’t possible to do much but I did dissect six cats for the anatomy lab and wrote a manual for the dissection of cats that was used for many years at the college. That experience had one negative impact; after Pat and I got married when I took my anatomy exam, I gave the professor at Yale medical school the feline names for parts of the human head and neck so he thought I was sassing him. He was the editor of Grey’s Anatomy and took this so seriously he brought me up on charges before the committee on promotions. I had done very well in physiology and biochemistry so I was passed on to the next year, despite what he felt had been intentional high level sassing of a senior professor. I knew I still wanted to study the brain and went to the nearby UCLA Medical School, which had a new Brain Research Institute of which 3 Doctor Horace Magoun was the first Director. He was in a kwanset hut because the Institute had not been built yet and had made it clear to his assistant she was not to allow any undergraduate students to meet with him. So I kept coming back once a month and just chatted with her. Finally she said, I’m going to let you meet Doctor Magoun. After that he agreed to let me spend time during the summer working in his lab. He assigned me to work with Carmen Clamente who had me tracing sections of cat brains from text books so he could use them in his research. Shortly after, I was assigned to work with a new faculty member named James Olds. James was very young but already had a paper in Science. He was an absolutely remarkable man. He had trained in social relations at Harvard with Talcott Parsons and the first thing he had me do was index his book with Talcott Parsons, which was a very difficult book to understand. Olds was not trained in physiology, anatomy, biochemistry or neurophysiology, but he had an extremely inventive mind. He decided it would be interesting to study the brain, so he went to McGill and learned how to do implant electrodes in rat brains. He put electrodes in different areas of the brain and watched them as they woke up. What he noticed, which was simply brilliant, was if he stimulated the animal and woke it up the animal would walk around and return to exactly the place he had awakened it. So he thought perhaps the animal liked what he was doing. Then he took a Skinner box, which had never been used for this purpose, with a bar the rat could press to get an electrical stimulation. He found the animal learned to stimulate itself very quickly and would do it thousands of times an hour. On the basis of observations in one animal he wrote a paper he immediately sent off to Science, knowing it would be rejected. But during the interim he repeated the experiments and, then had the paper accepted. He was then hired to come to UCLA and was set up in the animal facilities area. So, here was this extraordinarily intelligent man, working in a two-room laboratory, one to house the animals, and the other where I would implant the electrodes. I was his first research assistant at UCLA and I would implant the animal while he was pacing back and forth, expounding theories about what a reward system might mean. I loved working with him and the environment at UCLA was remarkably stimulating. I decided to leave Pomona after three years when I had enough credits to graduate. In addition, Pat and I had a calm but very serious disagreement with the President of the University. We had gone to protest the college 4 was not admitting minorities. He told us that if the college admitted them it would cut the number of deserving majority people so the policy should be continued even if the minorities excluded were of equal or greater talent. Based on that, we felt we couldn’t stay there, so I then ended up spending only a year with Olds, who had a profound impact on me. He and I used to discuss the possibility there could be many neurotransmitters when, in those days, only a couple were known. I might add that Olds was a very significant mentor. We did studies, looking at bar pressing and rewarding, over the entire twenty-four hour cycle. Animals would bar press over eating, over sex, over anything else and would bar press to exhaustion depending on the area of the brain involved. Olds was both creative and very demanding in terms of the rigor of the work. Doctor Magoun, who I talked to episodically, also proved to be a very important mentor. One hallway conversation, that lasted about a minute and a half, convinced me one can be a significant mentor in very little time. I was twenty or so and asked him should I get a PhD.or an MD, and he said he had a PhD but there were times he wished he had an MD; since there weren’t many people doing our type of work anyway, why didn’t I get an MD. Then he added, “Maybe you should go to Yale, because they are very strong in neuroscience..And, by the way Barchas, it’s very hard to find anybody interested in chemistry to work at the Brain Research Institute so why don’t you study neurochemistry?” That conversation took less time than it does to tell. I did all three things with very profound gratitude in terms of my career and my future. SW: Very nice! What was your first research project? And, how do you think that early period influenced you, in terms of themes and observations? JB: That is a very important question. I asked Olds, what would be the effect of morphine on bar pressing and, as it worked out, that was a very important question. The answer was we could give low doses of morphine, which didn’t effect the animal except to decrease the amount of bar pressing and neither of us could figure out what it meant. When I went to Yale, I plunged into finding appropriate mentors and people to work with. During the first week, when people were going to orientation, socializing and getting to know each other in class, I was off meeting every neuroscientist at Yale. Very early on I met Daniel X. Freedman. Freedman, at that point, was a beginning instructor.. He had an office in the basement of the Yale psychiatric institute at 333 Cedar Street, 5 which was one of the great centers for severely ill patients. They hadn’t much in the way of office space, so they gave him one that had been a padded cell for patients who needed seclusion. He kept everything in piles on the floor, so you had to walk carefully around them. He was working on a book on psychiatry, From Theory to Practice, with Frederick Redlich, which became a superb text, and he was also doing research with a man named Nicholas Giarman in the Department of Pharmacology. The Department of Psychiatry at Yale, which is now a powerhouse, had no laboratories at the time and the only assays for studying neurochemistry were bioassays that Giarman had. I proposed to Freedman that behavior might change neurotransmitters so we should study that, and he liked that idea tremendously. The assays we had were very poor at that time so he suggested I go to the Department of Biochemistry and ask for a pH meter. The Chair of our Chemistry Department was a famous biochemist, a man interested in the history of science, who had written a leading textbook of biochemistry. I had been a student in his section and done extremely well so I told him I would like to get a PhD in biochemistry and he replied, “Barchas, a man has got to know what a man wants to do and you either want an MD or you want a PhD. You can’t do both; it makes no sense whatsoever.” But then, he aked, “What are you here for?” I told him I needed to borrow a pH meter because we wanted to study whether behavior or stress could change neurotransmitters. So then he said, “Barchas, it’s very straightforward; biochemistry is a locomotive and behavior is the wind and the wind does not change the locomotive. We have pH meters, but I’m not going to lend you one for an experiment like that!” We tried to set up the assay without a pH-meter but it proved to be extremely difficult. We were able to use the student labs on the top floor of the medical school building but it was hot and humid. Richard Shrombren a Harvard medicl student, who subsequently became a talented psychotherapist in the San Francisco area, worked with me. I would go home every night and explain to Pat, who was putting me through medical school, that the assay was not working. She would review the materials with me and at one point said maybe I should call the author. I said he is Swedish but she pointed out the paper was in English. So, I called the author and I talked to him across the Atlanic for about thirty minutes; that took two weeks of her salary which, in the late fifties, was one hundred and twenty dollars. He asked how we were measuring the pH, because it had to be 8.4 exactly. I replied, “Sir, we 6 are using the finest European pH paper”. I could hear him laugh over the phone! Exactly twenty years later I was running the Fourth International Catecholamine Meeting in Monte Ray with about eight hundred to a thousand people when Arvid Carlsson came up to me and said, Jack, I still remember our first discussion. So, that’s the story of the pH meter, SW: Very nice, very interesting! Can you describe what themes dominated your research and the observations that began to impact you after Yale? JB: Just one last thing about the Yale period; I took a year off to work with Aaron Lerner to do organic chemistry and later I was able to continue the study with Freedman, which, in some ways, was a very important study, because it was a fundamental theme through the rest of my career. How does behavior impact neurochemistry and how does neurochemistry influence behavior. What Freedman and I found was that neurotransmitters or neuroregulators, serotonin and norepinephrine were differentially affected by stress. Our paper which influenced many other investigators throughout the years became very important, and working with melatonin also became very important. So, going forward I worked at NIH with Sidney Udenfriend, Herbert Weissbach and Sidney Spector, learning to do just plain good basic biochemistry and enzymology. I had arranged to work with Udenfriend to study serotonin and other mechanisms. When you went to work in his lab he handed you the next file folder on his big desk, which happened to be related to actinomycin D. So, I said I thought I was coming to work on serotonin and he replied, “Someday, you’ll appreciate what I am having you work on”. That began work on peptides and led to a paper in the Journal of Biological Chemistry after which I moved on to biochemistry, working out the biosynthesis of Actinomycin D. When I went to Stanford, to Dave Hamburg’s department, it was an opportunity to learn psychiatry because I had considered, at one point, moving to pharmacology, instead. Hamburg was interested in basic science, but he had no space so the first facility he gave me was a dog lab with a table in a room filled with dogs for Shumway’s first study on heart transplantation. I went in and would have to waitt ten minutes for the dogs to stop barking and, then slowly, I could do a few things. I kept reporting progress and never complained about the facilities but one day he said, “Jack, there is only one lab in this entire medical school I can find for you and that happens to be my own”. He had 7 just obtained a big grant he was very proud of and he was going to give it to me. I have always been incredibly appreciative for what he did. It gave me a chance to start to study neurotransmitters and behavior. The first student I had was Roland Ciaranello. He was an incredibly talented, creative, bright, hardworking and disciplined man, who became a dear friend. The theme was to study behavior, but what we were finding was there was so little known about neurotransmitters. That’s why Roland and I began studying epinephrine formation, its’ metabolism, and the effects of drugs. That work won a Bennett award from the Society of Biological Psychiatry. At the time I was a Professor and Roland was still a medical student. Roland and I showed the synthesis of these neurotransmitters could be controlled genetically, a study Doctor Hamburg urged us to do. SW: Let me switch topics. Can you talk about your clinical operations and about your education in those areas? JB: That became very important in later parts of my life. I was very fortunate in having superb teachers of clinical psychiatry at Stanford. Dave Hamburg had arranged that the very best of the supervisors, who had psychodynamic perspectives, would work with me. I loved clinical work and it was great fun. I stopped doing it one day after I was seeing a graduate student, who was pouring out his psychosexual history, a troubled young man. He was telling me his girl friend and Mother were both bored by him and, in the middle of him saying all this, I suddenly had an idea for an assay I had been working on. I felt conflicted at what to do. I thought God had put this idea in my head, but what should I do with it; do I even write it down? I helped the young man through his difficulties but I realized there were about thirty thousand members of the American Psychiatric Association who could help him but only about a dozen people who can run my type of complex lab, so maybe I should stop that activity. However, it was very helpful, as Herb Yallum graciously said to me, that Dave Hamburg told him to make sure he trained me like a psychiatrist. After twenty five years at Stanford and four years at UCLA, Pat became so ill with a brain tumor I could no longer go back to the lab after dinner and I was asked to be the head of psychiatry at Cornell to help that great department move into neurobiology, imaging, genetics and developmental psychobiology while maintaining its 8 clinical strength. So I am very pleased to have had that set of earlier therapeutic experiences. At this point I would like to mention the transforming impact of mentee’s on mentors. I referred to it in terms of Roland, but I have had a series of incredibly bright and able people, who pushed and pulled with me, as we worked out projects. Probably no one had more impact on me than Roland Ciaranello and Stan Watson, because they so brilliantly encouraged turning towards peptides, making me think about a whole host of new issues. Together, we were able to show where those peptides were; they could be changed by stress and runners could have elevated endorphins, which led to a search with Chris Evans, Jim Eberwine, Eckard Weber and others for new peptides and new ways to study them. One of the things I have learned is that the mentor and the mentee relationship is a two way relationship which involves changes for both and, when handled correctly ends up as a hybrid between friend and family; I feel that towards the people I have been talking about. SW: Can you give us the sense of what you think the most important research contribution has been? What has made a difference? JB: The question is a very interesting one. The answer involves the whole area of the endorphins and the opioid peptides that are endogenous in the brain. We had a lab that ranged from molecular neurobiology, biochemical neuroanatomy, analytical neurochemistry, and behavioral capacities, with the ability to study clinical physiology and pharmacology. When the endorphins were first discovered, we stepped immediately into the area, used all of the tools we could and an enormous number of people became involved in the effort. For example, the very first demonstration that various endorphins were in different systems and parts of the brain was work done under the leadership of Stan Watson. Identifying those pathways and that work, published in Nature, was very important, because before that people thought they were all in the same location. We did the definitive study on the anatomy and, at the same time, we were studying the behavioral aspects of these substances. Huda Akil was able to demonstrate, with John Madden, that stress changed endorphin levels in the brain. In those earlier stress studies I described, the wind does change the biochemistry, and the pain threshold does change. This was the first mechanism by which one could explain stress induced analgesia. We 9 pushed ahead, also, on the biochemistry, doing studies on the breakdown of enkephalins and enkephalinase and developing the first compounds that block enkephalins and change pain thresholds. These are examples of things we are doing that are integrative. With a variety of other people, like Eckard, Weber, and Chris Evans, we are also studying what substances are actually present. We developed new ways of assaying. Chris Evans developed a universal opioid assay antibody to pick up new substances and Ijo Maven maximized the ability to measure these materials. In very low cncentrations, at the theoretical limit, we were able to show that BAM 18 was a new peptide. We were the first to identify metorphamide, the first amidated endorphin peptide. We highlighted dynorphin 1-8 and showed it was present in high levels and we showed that dynorphin 18 and alpha-endorphin are present in the same system, suggesting they might have, as was later found, the same precursor. These are examples of the things we were doing. We were also doing the behavioral studies. I described the stress induced analgesia studies, but we also were doing, with Richard Thompson and John Madden’s involvement, studies dealing with learned helplessness and the role opioid peptides have in that process and in certain types of conditioned learning. We were able to study the effects of naloxone and show it reduced some forms of hallucinations. Huda Akil, with a colleague at UCSF, was able to show endorphins are released into spinal and ventricular fluid under certain conditions. All of this constituted a large story about endorphins at the very start of the endorphin period. We had the ability to bring together multiple technologies, all from the same laboratory, in an over arching program that was one of the more powerful ones in the country, and was extraordinarily satisfying. We did other things that were very important in the educational realm. A group of us, Phil Berger, Glen Elliott, Roland Ciaranello and I did a Textbook of Psychopharmacology, which was very popular, and another group of us went ahead and wrote an invited essay, for Science magazine, titled Behavioral Neurochemistry, laying out our vision of the future based on studies of these neuroregulatory compounds which could be transmitters or modulators of neuronal activity and how there could be dozens and hundreds of these materials. In the longer term, it is essential to study them. We were having conferences about these different substances like neuroregulators and psychiatric disorders and took them very seriously; it was an important educational part of what we did. So, we’re involved in both doing 10 psychopharmacology and trying to advance it by developing people from multiple fields, who can enter into this wonderful and exciting discipline. That is the heart of what we are doing that will, hopefully, have an impressive, long term effect on the field. Showing the wind does change the locomotive was very important. When you realize the context in which that took place, it was a very important thing to do. And, then we were starting to think about the necessity of undertstanding regulation. That was something we pushed, and the fact that there could be families of peptides doing very dfferent things. One of our discoveries was BAM-18 which can oppose some of the actions of morphine. It’s an opiod peptide; here we have these great families of opiod peptides, a couple of them doing different things in different ways and antagonizing or being synergistic with each other. The fifty years I have been in this field have been thrilling and exciting and we knew we were after things that were important. But, this next fifty years is going to be unbelievable because we finally have real genetic tools, real imagining tools, and real biochemical tools to study the multitude of systems and neurotransmitter systems. The ways of thinking about these which have been pioneered by people like yourself will now be applicable to severe illness. We will stop thinking about depression as depression, just as we don’t think about pneumonia as pneumonia. So, at the end of the next fifty years we are going to see a true major revolution in our diagnostic abilities. And what we will find is what we know from epigenetics, the wind does change the locomotive and vice-a-versa. SW: So, something you started years ago has grown very fast and very large? JB: Sure. First of all the research funding is important; remember the Federal Government is a critical vehicle that should be encouraged. A lot of my effort has been focused getting the Federal Governmnet through my work on medicine. We had a doubling of the NIMH budget before a doubling took place for all the NIH budgets. Many people participated in that, including my fifteen year old son, Issac, who helped write part of that for the Institute of Medicine, But, it’s easy to forget the importance of the program officers within government, people like Earl Usdin, Steve Koslow and all the other people who have so profoundly impacted on the science and what can be done. The private sector is also important, it can be a tug boat that adds resources but it is one arena in which, as a field, perhaps we have not done enough. People tend to think immediately 11 about private donations in cancer, heart disease and other areas. But, that has been missing in neuropsychopharmacology. We were fortunate enough to encounter the Pritzker Family, early on, and their support came in the laboratory and the Chair; although, much of that was after I left. Out of those relationships, they decided to see how scientists could work together, how they could share and what types of things could be done working together. Jay was a remarkable man of enormous intelligence and high integrity directed to helping science and his children, Tom, GiGi and other members of the family; Penny, Mick and, earlier, John, Lisa and Bob all helped in various ways. But, Jay felt particularly strong about collaboration and that led to setting up the Pritzker Network for seeding young investigators, which included Stanford with Alan Schatzberg, and Michigan with Stanley Watson, Huda Akil, and myself. We would discuss the projects and help them get started. We had a few projects which went across institutions; that was great fun and led to the Pritzker Consortium, an effort that involves Biff Bunney, inspired by his important work in genetics and messengers in the brain, expressed in different diseases. These are very difficult studies and we don’t know if the effort is going to be successful, regardless of what lab is involved. I might add how extraordinarily satisfying it has been to see the lab I started at Stanford now under other leadership, first with Roland Ciaranello as the Director, until his tragic death from a heart attack, and now, in the brilliant leadership of Rob Malenka. He is doing important research with help from the private and public sectors, and also the Department of Psychiatry at Stanford, which thrives under Alan Schatzberg. It is pleasing to have woked in an Institution and see good things happen to it through the decades. SW: Thank you. One area that interested me was your outreach work through the Institute of Medicine, and also your publications and editorial work. Can you comment on those? JB: That’s my interest in social policy. Pavee was first started through my father. He believed in social justice, doing good and improving the world; trying to get people to collaborate, who would normally not work together. He was President of the Sixteenth Congressional District Democratic Party in California and would take me, as an eight year old, to their meetings and sit me beside him on the sofa. After the meeting he would say, let’s talk about what happened, who said what, why did they say it, what were they 12 trying to do? I had all this experience in thinking about those types of things. That education had many manifestations I’ve already told you about, like the experience with the President of my College, in terms of civil rights. As a medical student, I did a study of teaching rounds, showing that doctors did not talk to patients very much. A paper on that was published in the New England Journal of Medicine, and became a classic, because it was one of the first articles the Journal had done of that sort. David Hamburg was inspirational in terms of public policy. He and I had regular sessions while I was a resident, in which we would talk about his activities in the public sector. I became a member of the Institute of Medicine and I was asked to Chair its Board on Biobehavioral Health and Mental Disorders, which I did for twelve years. I would testify on behalf of those issues to Congress and that became very important to me. And after Daniel Freedman passed away, who had been editor of the Archives of General Psychiatry I was asked to take the role and loved doing that. When Pat died, I married Rosemary Stephens, who profoundly influenced me in all of these later activities. I would do the editing work on the train from New York to Philadelphia, since she was Dean of Arts and Sciences at the University of Pennsylvania. I believe, as responsible scientists, those of us who want to, should become part of the public arena. I spent five years as Chair of the Board of the New York Academy of Medicine, a group of twenty two hundred physicians. I am now chairing a part of the American Psychiatric Association, a group concerned with some of its’ educational functions, and in the past I chaired the Association for Research and Nervous and Mental Disorders Board. All of that I did out of concern for how to benefit those aspects of the field grow and how to help young people and seniors. You asked earlier about my hopes and concerns; one of my concerns is that, right now, it is much harder for young people to get started than it should be. We create processes, like obtaining a first grant, extraordinarily difficult with multiple revisions, some of which are trivial and might be better handled by a letter of stipulation; they shouldn’t have to resubmit the grant. I am also concerned we are not funding senior investigators throughout their careers so some programs have been dropped, which I think sends a bad message in a field that is incredibly exciting. People have to feel there is a true career path within it. We have got to fund and be prepared to continue to fund basic science, no matter what the science is; it can obviously be in neurobiology or 13 psychopharmacology, but also in psychosocial or social neuroscience areas. Out of that can come translational research. We, ourselves, have done a tremendous amount of translational research. You and I did studies on naloxone in hallucinating patients, showing that in some patients severe hallucinations were diminished with naloxone and that was a form of translational research; we did it when it was time and ready to be done. I am worried we are defining translational research in a way that may be inhibiting basic science. So, part of my becoming involved in these activities is out of a love for the field. That is one reason I so like ACNP as it brings together everyone who might be relevant in a way that encourages communication. It has done that the entire time I have known of it, and it was nice I could come back and tell you how excited I am about the ACNP meetings. I deeply appreciate that and the chance to have this discussion with you. SW: That’s very nice, Jack. Last question, do you want to add anything? Are you happy? Do you want to make any comments about where you think this is taking you? JB: That is a very interesting question. I tend to be a happy optimistic person and that may be genetic, because I have a mother who is bedridden, paralyzed and more or less blind but still optimistic, not about her condition, but about the world. Maybe I get my optimism in a basic genetic way. I do find I’m very happy and have experienced a level of happiness in my marriage to Rosemary I never expected, because you know how close Pat and I were. She, of course, was incredibly fond of you and Huda. I am also very happy about my son, my grandchildren and about our field. I feel that we are really making progress. SW: Thank you very much, Jack. JB: Thank you. SW: A real pleasure. JB: A wonderful pleasure, Stan.