Wounded Souls, a Broken System and Me

I became a psychologist because I wanted to be a healer.

At twenty-five, I believed I could save lives through therapy alone—reach into the chaos of psychosis, pull people back with presence and insight and bring them home to themselves. Not with medication. Not with systems. Just one mind in conversation with another. I’d read the stories—Frieda Fromm-Reichmann, Harold Searles, Otto Will. I believed in that kind of power.

Thirty years later, in 1998, I emerged from a Christmas party on Lafayette Street, blinking in the cold, the voices of managed-care executives echoing in my ears.

“We’re improving outcomes.” ”We’re making care more accessible.” ”This is the future.”

Inside, I’d shaken hands and sipped wine alongside people who would decide how mental-health care was delivered in New York—what treatments were funded, which outcomes counted, which lives were worth saving.

Outside, I suddenly didn’t recognize what I’d become.

I had spent decades building treatment systems, designing programs, running a major nonprofit. But in that moment, under the sharp winter sky, it felt like I’d traded something essential for something that was no longer me. I was part of an effort to implement government mandates designed to cut costs, based upon an approach to restructuring that I’d never found persuasive—one that claimed it would not only save money but also improve outcomes and patient satisfaction. I wasn’t sure I could still claim the mantle of healer. I wasn’t sure I’d earned it.

I started walking, eventually passing Cooper Union—my old school. The Foundation Building still stood, but everything around it had changed. Starbucks cups had replaced the brown paper bags of my student days. The Bowery, once a corridor of discarded men and cheap liquor, now pulsed with boutiques and condos.

In the early Sixties, I was a suburban kid commuting to Cooper from Long Island. I’d arrived there dreaming of rockets and steel, hoping to shape the future through engineering. Eventually, I convinced my parents to let me move closer, into a crumbling Puerto Rican neighborhood I shared with classmates. That apartment gave me my first taste of independence—and of urban strangeness, fear and excitement.

But the dream of engineering didn’t last. I lacked the kind of mind that found clarity in equations or poetry in trajectories. My classmates lit up over elegant theorems; I didn’t. What moved me wasn’t symmetry—it was suffering. The unpredictable rhythms of human behavior.

At first, I worried this meant I wasn’t smart enough. But it wasn’t about intelligence. It was about passion.

And then Jon died.

I was twenty, walking out of metallurgy class, when a friend stopped me.

“Did you hear about Jon?”

“No.”

“He hanged himself last night.”

Jon had been brilliant, well-liked. Just days earlier, he’d borrowed my apartment to be alone with his girlfriend. He’d seemed fine. Months before, he’d mentioned seeing a psychologist. No sign of desperation—just a passing comment.

And now he was gone.

There were no equations for that. But psychology might offer answers. That summer, I enrolled in a local college to test the waters. After three classes, I knew I was ready.

At first, it felt like coming out—naming something essential about myself. I worried people would think I’d failed. But many respected the choice. I had named something they hadn’t. I wanted to understand suffering. I wanted to help.

I trained as a clinical psychologist and began work at an outpatient clinic in Brooklyn, part of a new state psychiatric center. It followed a community mental-health model focused on prevention and continuity of care.

Many of my patients had recently been discharged from long-term hospitals. Most lived in custodial settings—large minimalist halfway houses. Thousands were admitted, and few were ever discharged to regular community housing.

I was drawn to the patients others avoided—those with severe, persistent conditions. They weren’t just dealing with symptoms; they’d lost the basic confidence and skills for daily life. Some couldn’t grocery shop or walk outside without panic. They weren’t ready to ask Who am I? They were still trying to feel safe.

Still, I believed I could reach them. If I stayed present, if I asked the right questions, I could do what the legends had done—pull someone back from psychosis through relationship alone.

But week after week, patients I cared about made modest progress, then stalled or slipped back. One man—bright, newly stabilized—confided that the Church of Scientology was controlling his mind. L. Ron Hubbard, he said, was sending signals from London. Minutes later, he was shouting, pacing, overturning a lamp. He needed hospitalization. My presence wasn’t enough.

After three years, my dream of the lone therapist-healer began to fade. Neither state funding nor insurance covered the kind of care these patients needed. Even when we found ways to offer it, traditional therapy often didn’t fit. Eventually, a thought I’d once considered blasphemous took hold: Maybe these treatments aren’t the right tools. Recovery—not cure—became the goal. And recovery required a team.

Still, I honored my dream of being a healer, even as I shifted toward what no one else seemed to be doing in New York: designing programs that worked.

Over the decades, I helped build supported-housing models grounded in behavioral psychology. I moved into administration and consulting. I cofounded a nonprofit and served as its first executive director. Our mission was to take practices that had worked in the state system and elsewhere and disseminate them in the broader community.

We created integrated systems of care: housing with onsite supports tailored to need, crisis teams, outpatient services combining therapy, medication, vocational support, outreach, peer advocacy. Some programs were under one roof; others required coordination across sites.

These weren’t just ideas—they were places where people could build their lives. And they worked. People who once cycled in and out of hospitals found rhythm, purpose and community. I was good at the work—strategic, realistic, driven. Recognition came. The models were replicated across the state. Some gained national and even international attention.

In a strange way, I’d become an engineer after all. Not of rockets or machines, but of systems for human care. But I never cured anyone.

That night in 1998, standing before the statue of Peter Cooper, I asked myself: Have I created any lasting innovations? Or just rearranged the parts of a broken system?

The city moved around me, fast and indifferent. No revelation came. Just the awareness that time was running out.

Somewhere in the back of my mind, a childhood rhyme surfaced:

Tick-tock, tick-tock. Soon we’ll all be dead.

And then it came—the pressure in the throat. Not nostalgia. Not regret. Something deeper. A swallowed Munch-like scream of frustration mixed with disappointment.

A few passersby glanced at me—just long enough to make me wonder what they saw. I exhaled sharply, stepped into the uptown subway and rode home to the suburbs.

The questions stayed with me. Not just Have I done enough? but Was what I gave the right thing to give?

A few months ago, my old fraternity held a reunion call. I watched the familiar faces talking about careers, families, retirements. Most had stayed in engineering. Some had taught, others had built companies—accomplishments worth being proud of. Although the old competitiveness stirred in me, I felt I’d measured up to their standard. But they seemed more content with their achievements than I did.

Now, at eighty-one, this is where I’ve landed. Not with peace, exactly—but with proportion.

I gave myself to the work. I helped build something that mattered. And still, I sometimes feel that I received more than I gave. Maybe that feeling never goes away. But I know this: I gave all I could, within my capacity.

I tried to direct my energy where it mattered. The work gave me purpose—and joy.

The hoped-for sense of accomplishment never fully followed. Still, it was enough to keep going.

Enough to keep asking what it means to try—really try—in a world where suffering never waits its turn, and we all owe humankind our best.