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The Rickels Standard

In the forthcoming issue of Penn Medicine (Summer 2012), I devote my editor’s note to a memoir published last year by Karl Rickels, MD, the Stuart and Emily B. H. Mudd Professor of Human Behavior and professor of psychiatry in the Perelman School of Medicine. A Serendipitous Life: From German POW to American Psychiatrist vividly tells his story, shedding light on his path to becoming one of the world’s leading experts in treating anxiety disorders with medication. But even as the magazine was on its way to the printer, Rickels garnered yet another honor: the 2012 Pioneers in Psychopharmacology Award from the International College of Neuropsychopharmacology (CINP). According to the college, the contributions of the honorees “must be internationally recognized as significant to the growth of the field.”

The honor no doubt has a special significance for Rickels, a founding member of the college, who devoted some pages in his memoir to its creation and to the celebration of its 50th anniversary in 2008. As he writes about the latter event, “Since I was one of the original clinicians who demonstrated the excellent anti-anxiety effects of the benzodiazepines, such as Librium and Valium, I was honored and thrilled to chair a scientific symposium entitled ‘The Role of the Benzodiazepines in the 21st Century.’”

But Rickels is not one to sit on his laurels. He concludes that chapter by citing the task ahead in psychopharmacology: “We need new and better ways to treat our patients, not just ‘me, too’ medications. We need new and daring approaches. Our patients deserve it!”

Rickels has always had such a concern for his patients. In a profile in the Fall 1988 issue of Penn Medicine, he said, “The human being is not a machine, a black box that you throw a pill into, and some response comes on. Drugs are not given in a vacuum but are given within a therapeutic relationship.” In his view, the patient should become “a participant in therapy. . . . We do things together as a team. I think the doctor who does this would have good success.”

As his memoir makes clear, Rickels did not hold such an elevated position when he arrived in the United States. His first stay in the country, in fact, was as a young German prisoner of war, captured in North Africa in 1943 and later shipped to the United States. Once there, he and the rest of the prisoners went through a delousing station, where they were stripped and sprayed with DDT. His prospects seemed dim indeed.

But Rickels was not one to give in to despair. He knew more English than the other prisoners and did his best to improve his language skills. He was a hard worker, no matter what the task, and he was able to make himself a dependable –- sometimes indispensable -– prisoner. After the war, he returned to Germany to earn his medical degree and do his internships. But he leaped at a chance to return to the United States.  Soon after returning, Rickels applied to be a psychiatric resident at Penn. After joining the faculty in 1957, he went on to found the Mood and Anxiety Disorders section of the Department of Psychiatry. In 2008, Rickels received the William Osler Patient-Oriented Research Award, one of Awards of Excellence that are the highest honors the medical school bestows to its faculty members. Along the way, he gained a reputation as a superb researcher who was never beholden to the pharmaceutical firms whose products he tested.

Near the end of his memoir, Rickels states that, in 2011, the Food and Drug Administration approved vilazodone for treatment of adult depression. Its decision was based “on a pivotal study to which my group significantly contributed.” The Rickels standard was clearly still in place.


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