{"id":64944,"date":"2016-04-30T14:52:36","date_gmt":"2016-04-30T18:52:36","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=64944"},"modified":"2016-04-30T15:56:52","modified_gmt":"2016-04-30T19:56:52","slug":"the-chemistry-of-paint","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2016\/04\/30\/the-chemistry-of-paint\/","title":{"rendered":"the chemistry of paint…"},"content":{"rendered":"\n

Dr. Insel’s selection as Director of the NIMH in 2002 was a surprise<\/font><\/em> choice. After losing his position in the NIMH Intramural program, he came to Atlanta to head the Yerkes Primate Center. After one term, he was not reappointed [the scuttle-but – too controlling<\/font><\/em>] and then became Director of a Translational Center, a research consortium of the area Universities put together by Emory Chairman, Charlie Nemeroff. It was a time when Dr. Nemeroff was known as boss-of-bosses<\/font><\/em> with influence felt far and wide, and locally we assumed that Nemeroff had a lot to do with Dr. Insel’s surprise appointment at the NIMH. Years later, after Dr. Nemeroff’s fall from grace, Dr. Insel presumably returned the favor by helping Nemeroff secure another Chairmanship in Miami.<\/p>\n

I heard him speak several times in his Atlanta days. He was interesting, knowledgable, enthusiastic, personally humble [unlike his boss]. He struck me as more like an academic biologist than a physician. During his long tenure at the NIMH, it seemed to me that he has come in three distinct flavors over the years:<\/div>\n
    <\/p>\n
  1. \n
    Clinical Neuroscience:<\/font><\/strong><\/em> That was a surprise – his becoming a champion for making a dramatic change in a clinical specialty. He wasn’t a clinician himself, and for the NIMH to set the direction for a medical specialty [and even try to change how that specialty approaches diagnosis] is unprecedented. But that’s what happened [fulfilling the scuttle-but – too controlling<\/font><\/em>]. Admittedly, it was a time when biological psychiatry and psychopharmacology were in their ascendency, but Dr. Insel catapulted brain science to an almost exclusive centrality. His enthusiasm for neuroscience breakthroughs was in every talk, every blog post, almost every call for proposals. By natural selection, the NIMH iterated towards becoming the National Institute of Brain Science – at least that’s how it looked to me. And while he often talked about public health statistics, the growing menace of depression, and the need for more treatments, the research was heavily weighted towards basic neuroscience – brain circuitry<\/a>…<\/div>\n<\/li>\n
  2. \n
    Blaming:<\/font><\/strong><\/em> In the summer of 2011, it became apparent that the pharmaceutical industry was fleeing CNS drug development like rats from a sinking ship. After twenty-five years of variations on a couple of simple themes, they ran out of molecules, and were under siege for overplaying their hands in almost every dimension. Dr. Insel changed. He seemed disgruntled, angry, blaming. He talked of our current treatments as inadequate and seemed to be trying to gear up the NIMH to do something about that through a series of policy changes: RDoC, short trials, accessing industry’s discarded molecules. He was becoming even more controlling<\/font><\/em> than before. It was as if he’d suddenly noticed that the NIMH was out of the loop with treatment research and he was frantically trying to catch up.<\/div>\n
    I expect that I’m not the only person who saw those Suicide Statistics as an indictment of our mental health systems and the NIMH directions. And while we’ll probably never know the story, I would expect that those numbers along with other disheartening indicators probably had something to do with Dr. Insel’s surprise<\/font><\/em> exit as Director of the NIMH. I suspect it was a suggested exit. It’s apparent in the things he’s said since announcing his retirement that he’s in the blaming mode<\/a>:<\/div>\n