Sarah Lisanby Interview

Interview

Interviewee: Sarah “Holly” Lisanby
Interviewer: Jessica Roseberry
Date: January 19, 2011
Place: Dr. Lisanby’s office

Jessica Roseberry: This is Jessica Roseberry. I’m here with Dr. Sarah Lisanby. She’s chair of the Department of Psychiatry and Behavioral Sciences. It’s January 19, 2011, and we’re here in her office in Duke South, and I want to thank you very much, Dr. Lisanby, for agreeing to be interviewed today; I appreciate that.

Sarah Lisanby: You’re very welcome. Thank you for having me.

Roseberry: I wanted to first ask you, if it’s all right, just a little bit of kind of your background at Duke. I know you were here previously, and I wanted to ask you what the Department of Psychiatry looked like at that time.

Lisanby: Sure. So I was here on the campus spanning my years as an undergraduate medical student and resident, so that was during the period from ’83 to ’95, and I came to know about the Department of Psychiatry from different perspectives as a student and trainee going through that process. So my memory of the department at that time was that it was a very exciting place. I started volunteering in the medical center as an undergraduate. I was a premed major, majoring in psychology and math. And wanted to enter the hospital, learn about what being a doctor was like and what are the differences between being—going to medical school versus going to graduate school, because I was trying to make that decision at that time. So my first experience of the hospital was as a student volunteering in different units. Then of course as a medical student rotating on the different clinical services I got a med student’s view of what working here was like, and I learned about taking call and sleeping in the hospital and working in exciting places like labor and delivery, in the emergency room and surgical wards. And then of course psychiatry, which really fascinated me: getting to meet people who were dealing with major psychiatric illnesses, learning their stories, beginning to understand what brain disorders are about and how they affect people’s lives and learning about the effective treatments that were available and also the limits of those treatments. I was just fascinated. And then of course those influences led me to choose psychiatry for my residency, and then I experienced the Duke Psychiatry Department as a resident where taking call took on a whole new meaning, because I was actually the doctor that had to be responsible for when emergencies occurred. And of course I had an attending, but that transition from being the student doctor to the actual doctor is a very substantial one. So as a resident I had a wonderful experience here in the Psychiatry Department learning the full spectrum of psychiatric services from psychotherapy, different forms of psychotherapy, group therapy, family therapy, also learning about medication treatments, psychopharmacology. And then learning about electroconvulsive therapy, or ECT, which was the somatic, nonpharmacological treatment which I had first encountered as a medical student seeing—having patients have ECT and seeing the near-miraculous recovery that these patients had for their severe illnesses. As a resident it was just a wonderful experience. I gained a lot of clinical exposure on the inpatient side, outpatient side—not just Duke Psychiatry but also the affiliated institutions like the Veterans Administration Hospital which is right across Erwin Road. And at that time it was John Umstead Hospital in Butner, North Carolina, that’s the state hospital; now it’s Central Regional Hospital. Those experiences were really wonderful aspects of my training. And I also got to learn about the department through the research lens because as a—actually as a medical student I had a whole year for research which I did in an area that was related to psychiatry, the interface between the brain and the body called psychoimmunology, the effect of stress on the immune system. And so I spent a year in a psychoimmunology lab learning about the basic neuroscience of that brain-body interaction. And then as a resident there was some elective time that I used to learn about clinical research. So to answer your question in a fairly long-winded way, I had a fantastic experience of the department throughout those twelve years at Duke.

Roseberry: Was Duke fairly strong in ECT at that time, would you say?

Lisanby: Oh, yes. Duke has been—historically has been a leader in the field of electroconvulsive therapy or ECT. And some of the individuals that taught me how to do ECT are still here in the department, like Dr. Richard Weiner—who’s been a wonderful colleague and friend over the years and is still a member of the department—has played a major role in educating literally now decades of doctors on how to perform state-of-the-art ECT and has also made major contributions to research that has modernized the treatment. So then as now the department has always been quite strong in ECT, and the medical students and residents have the opportunity to gain significant hands-on training to learn about state-of-the-art ECT practice.

Roseberry: What were some of the other strengths of the department, perhaps?

Lisanby: Well, there are many. How long do you have? (laughter) Reflecting on my training, what I now with the perspective of time view as strengths are the diversity of the training that I received. So psychiatry is a field that has different components to it. There are different ways of understanding brain-based disorders—from the molecular to the genetic to the environmental, social, neurobiological, the molecular biology of it, the physiology of it, and the behavioral aspects. It’s really fascinating. And the training that I received here as a student and resident introduced me to that spectrum, and I felt like I received balanced training addressing the—what was then called the biopsychosocial model of psychiatric illness, so the biological basis, the sociological influences, and the psychological influences. So there are strengths across that spectrum then as now in the department.

Roseberry: So it sounds like the department has been able to work, maybe, with other departments, with other medical departments, to take an interdisciplinary approach? Is that fairly accurate?

Lisanby: Well, interdisciplinary collaboration has been a notable strength of the Duke Psychiatry Department, and I can give a few examples. So we have a medicine psychiatry program; we call it med-psych for short. And this is a program that provides dual training in medicine and psychiatry. So the residents who graduate from this program are eligible to be board certified in both specialties of medicine and psychiatry. And this is a joint training effort between the Departments of Medicine and Psychiatry. Not only is it a wonderful training experience, but it prepares clinicians who have this unique set of skills to address the whole person, to look at the brain in the context of the body, to understand the interplay between medical and psychiatric disorders. There’s so many ways in which they interface. There are also the effects of treatments. So some of our psychiatric treatments have medical side effects, and so having dual training from both perspectives is a big help. This clinical and training program also dovetails with some of our research strengths that are interdisciplinary, spanning Medicine and Psychiatry. So if we think about the—well, of course there’s comorbidity, so people can have both psychiatric and medical disorders, but there’s an interplay there. So we know that for example depression is one of the leading risk factors for heart disease, and there you see in evidence the mind-heart connection or the brain-cardiology connection. That depression could be a risk factor for heart disease is important for understanding the etiology of heart disease and also for intervening and treating, suggesting that interventions to treat depression and stress and anxiety and other related conditions can actually improve medical outcomes. And indeed this is so. There are behavioral interventions for treating hypertension, for example, or high blood pressure, which is one of the leading risk factors for heart disease and for stroke. So the medical, psychiatric, and behavioral interventions to improve health in general—not just mental health but physical health, that’s a—that represents a strength of some of the research going on in the Duke Department of Psychiatry, and that interplay between stress and heart disease and in general the mind-body connection has been part of the fabric of the department ever since I’ve known about it and continues to be an important strength.

Roseberry: So it sounds like that’s a strength that you will continue to carry forward as chair of the department?

Lisanby: Absolutely.

Roseberry: (laughs) So tell me a little bit about your own work. I know that you have specialized in the area of brain stimulation. Tell me a little bit about that.

Lisanby: You’re asking me about my favorite topic. So brain stimulation is exciting and stimulating for a number of reasons. First of all, what do I mean by brain stimulation? Well, we already talked about one form of brain stimulation which is electroconvulsive therapy, or ECT, which is our most effective and rapidly acting treatment that we have available today for severe depression. And ECT, we continue to do it because it continues to be necessary for treating severe illness. But what’s new in the field of brain stimulation today is that we have not just ECT but we have a growing family of new interventions that provide us new and less invasive and different ways to stimulate the brain. For example, transcranial magnetic stimulation, or TMS, uses magnetic fields to stimulate the brain. And this is done in a—usually it’s done in a fashion that’s below the threshold for causing a seizure. So whereas with ECT a stronger electrical field is used, and that induces a seizure, in the case of TMS or magnetic stimulation, a weaker electric field is induced in the brain by the magnetic field, and that weaker electric field stimulates the brain at a level usually below that which causes a seizure. But this subconvulsive stimulation actually changes the functioning of the brain and represents really a breakthrough in neuroscience as a tool for studying brain function. The difference between brain stimulation and brain imaging—which probably a lot of people have heard about brain imaging or magnetic resonance imaging or positron emission tomography imaging—these imaging techniques allow us to visualize the structure of the brain or watch the brain in action. What brain stimulation does that’s different from brain imaging is that it’s not a passive listening device like a tape recorder that we have here on the table; brain stimulation is an active intervention. It actually changes brain function. So this has therapeutic potential in a way that just getting a brain scan does not. It also—as an intervention, because it can change brain function, it allows us to push the science further than brain imaging alone could allow us to do. Well, how would that happen? Well, in science we like to be able to test hypotheses. You want to form a hypothesis and design an experiment where you test whether that hypothesis is true, and in the case of brain imaging you can only get so far as correlation. So you can see a particular illness and look at what the brain scans look like, or you can see a particular dysfunction of cognition, say, and say, Well, for most people who have this disorder, this is what their brains look like. But that doesn’t mean that the way the brain looks caused the disorder. You’d like to really know, Is there a causal relationship, rather than just a correlational relationship? And that’s where brain stimulation comes in, because it can test cause and relationship. So you go in and stimulate an area of the brain and see what effect that has on function, on behavior, on cognition, on memory, on movement; or just about anything the brain does you can study it by using brain stimulation. And because brain stimulation is a way of intervening, if we’re smart enough as a field we maybe—may have the chance of figuring out how to use it as a treatment, and that has already happened today. So transcranial magnetic stimulation is an approved treatment now, approved by the Food and Drug Administration, for the treatment of depression. Deep brain stimulation is another new member of this brain stimulation family where the electrodes are actually implanted deeper in the brain so that you can reach deeper targets than magnetic fields can reach. And this is an approved treatment for Parkinson’s disease and movement disorders, and it is now FDA approved—well, it has a humanitarian-use exemption for treatment of severe obsessive-compulsive disorder. It used to be if you had severe obsessive-compulsive disorder, or OCD, and medications weren’t working and behavioral therapy wasn’t working, your only hope was to have brain surgery where an area of the brain, a small area, was actually lesioned or cut. Deep brain stimulation is less invasive. There’s no lesion induced by deep brain stimulation. What it is, it’s a thin wire that allows electricity to be deposited to a very precise area of the brain to stimulate it, so it’s a less invasive option now for people with severe obsessive-compulsive disorder so they don’t have to have a lesion surgery; they can have deep brain stimulation. And deep brain stimulation or DBS is also being studied for the treatment of depression. So I mean, I can go on and on. I give lectures on this topic, but these are just some examples of ways of using brain stimulation to study and ultimately treat the brain. So that’s the area that I work in. And I do have to say that Duke had a big influence on my following this path, because as a medical student I remember very clearly having a patient with catatonia, which is a very severe condition where you are mute and you can’t move. And this severe catatonia was treated very effectively with electroconvulsive therapy or ECT. So I saw this patient immediately before and then on the afternoon after her ECT, and she was talking after one treatment. And I thought, That is amazing. I’ve got to find out what’s going on; how does that work? And so that motivated me for a number of reasons: one because it was so powerfully effective and the change was so rapid, but also because when I began to delve into, well, how does it work, and I realized there’s actually a lot that’s not known about how ECT works, that was motivating to me, too, because I had a research bent. And I thought, Wow, if we could study this and understand its essence—what is the active ingredient, how does it work?—then not only could that be a major contribution, but that might help refine the treatment, to make it safer, to make it more effective. And so that’s what led me to my individual research project which is magnetic seizure therapy which I’m also happy to talk about, where we use magnetic fields to induce more focal or targeted seizures as a way of capitalizing upon what’s good about ECT, which is that it works for most people; it’s very effective, but try to—but using magnetic fields, the benefit of magnetic fields are that they are safer, they’re more easily targeted, they’re less invasive. So if we could do—have the efficacy of ECT without some of the side effects by using magnetic fields to be more precise in how that seizure’s induced, that has a potential of making this often-lifesaving treatment available to more people and more tolerable, and so that became my project when I left Duke to go to Columbia for a postdoctoral fellowship. My project was to develop magnetic seizure therapy and to take it through the different stages of preclinical and eventually clinical development, so that basically explains how I wound up in the field of brain stimulation. And it’s really exciting to work in this area, because it really represents a paradigm shift for a field of psychiatry. As I explained, when I was a student here, and there were the biopsychosocial model, and we had psychotherapy and we had psychopharmacology, and then we had ECT which was sort of this outlier different thing than the other two interventions. Now we’ve got three families of interventions: we have psychotherapy, we have psychopharmacology, and we have brain stimulation—where ECT continues to be an important part, but now we have a plethora of new interventions and new ways of interacting with the brain using very carefully applied electricity to achieve that which the other two treatments alone, psychotherapy and medications, could not. So the future’s really bright, I think, for people with brain-based disorders both in neurology and psychiatry, because we’re using these tools to better understand how the illnesses come about, and we’re using these tools to provide treatment where previously there was no hope.

Roseberry: That’s great. (Lisanby laughs) Can you talk a little bit more about your own work with MST? You mentioned that, but just maybe elaborate a little bit more on what you’ve done.

Lisanby: Sure. So as a postdoctoral fellow, as I said my project was to develop magnetic seizure therapy. And this was really starting from the basics—having to work with an industry provider that made magnetic stimulators, to modify it to the requirements that we thought would be necessary for inducing a seizure under anesthesia, which is a challenge because anesthesia raises the threshold for inducing a seizure and so the magnetic stimulator had to be powerful enough to overcome that. And this took years of preclinical development—testing prototypes, doing basic research to develop a paradigm and a system that would be effective in inducing seizures, and then testing its safety. And this is where I really cut my teeth, you would say, learning research as a postdoctoral fellow—designing experiments, running experiments, learning how to publish results, present at scientific meetings, and then compete for grants to fund the work. And so the work on magnetic seizure therapy was funded by grants from the National Institute of Mental Health and also foundations that have focused on mental health like NARSAD which is the National Alliance for Research on Schizophrenia and Depression and the Stanley Medical Research Foundation. These were major contributors that helped me and continue to develop the technology. And I will say it is—it was a very exciting project because I was very passionate about it, having the clinical motivation to find better, more effective treatments and also the scientific opportunity to contribute by developing a new intervention. And it really—it was a lot of fun, an adventure. To give one example, the first person to ever receive magnetic seizure therapy, the first patient in an approved research study on this, but the first human being in the world we treated in Switzerland. This was a collaboration with a colleague that I had met at a scientific meeting, Thomas Schlaepfer. And he had convinced me that, well, when you start a new treatment it’s often easier to get to the stage of human trials when you do international studies, because in the US there’s regulations that—through the FDA, which are important regulations, but you have to go through these regulations before you are allowed to test—do human trials in the US. So I thought this made sense, and so we decided to work together on a research project, to do the first patient in his hospital in Switzerland. And so this meant I had to go to Switzerland; it was in Bern, Switzerland, to do the first patient. And a first milestone was getting the approval from the ethics committee, which we got, and then the next milestone was recruiting the patient, which he did, and then she was being admitted to the hospital on a certain date, and that coincided with my plane ticket to fly out, to be present and train the team and participate in the first treatment. And so of course that meant we had to ship the device out to Bern, Switzerland to get it set up so that it would be ready for her treatment. And I remember very vividly the day that I got the phone call from Thomas to say, “Holly, I’ve got good news and bad news—” and mind you, this is the week before I was supposed to fly out for the first treatment. He said, “The good news is the device arrived; the bad news is it’s in a million pieces.” And I thought, Oh no, this is horrible. Not only is a young woman in the hospital about to not get the treatment that she’s supposed to get, but all this buildup of setting up for the first MST for just this anticlimactic thing. And then it dawned on me, Well, no, we’re going to make this happen. And so we scrambled, and I ended up taking parts of the MST prototype that I had in my own lab. So we disassembled parts of it. It fit into three large suitcases, and there were a few additional parts which I was able to get shipped from the supplier in Wales shipped directly to Switzerland. So I had pieces of magnetic stimulator in three big suitcases, and I had an oscilloscope in my carryon along with a magnetic coil which looks like a strange-looking electronic device. So I was carrying that on, I was going through Customs, and I had typed myself up a letter to explain what it was so— (laughs) in case I was questioned, What is that in your suitcase? I will tell you, this was before 9/11, so the level of security—I actually wasn’t questioned. I guess they thought I just had lots of shoes. I don’t know what they thought, but I was able to get this through in my luggage and set up the equipment, and we did the first treatment. And the important news is that she had a wonderful recovery from her depression, and we published the results. She actually was interviewed on the Swiss TV talking about her experience having magnetic seizure therapy. I watched the interview. It was in Swiss German, so I didn’t understand it, but Thomas (laughs) said that she spoke favorably of the experience, him being fluent in Swiss German, but that’s an example of the type of adventure that science can be. And it’s been a wonderful privilege to be able to have wonderful colleagues to work with, people who are really suffering from these primary psychiatric disorders who are willing to participate in research studies like that. I mean, can you imagine being told, Well, we’ve never done this before on anyone in the world; are you willing to be our first subject? The courage that she had to do that and that the second patient or the third patient or the fourth patient had, I mean, it’s a tremendous amount of courage. So it—and that’s also really thrilling to be part of that, so—.

Roseberry: And it sounds like it’s been effective.

Lisanby: The treatment you mean?

Roseberry: Yeah.

Lisanby: Yeah, so we’re at the stage now of clinical trials; we’ve published several of these. We’re doing some international collaborations now. MST is being done in several countries now. I mentioned Switzerland—there are also several programs in Germany, in the United States now, Australia, Canada. I believe others may be up and running soon, but those are just a few that are doing trials. It’s not FDA approved at the current phase; we’re still at the phase of trials.

Roseberry: Well, can you tell me about the chair of the Department of Psychiatry, becoming the chair of the Department of Psychiatry and Behavioral Sciences.

Lisanby: Right. Yes, I can hardly believe here I am sitting behind the desk that I used to sit in front of. (laughter) It’s really thrilling; it absolutely is. I’m very excited about being in this position, because it’s Duke, and it’s Duke psychiatry. I love this department and what it stands for and its mission, and to have the opportunity to be in this role at this time is really thrilling. You know, I was very happy at Columbia. I was running a division on brain stimulation and doing research and teaching and clinical work in that area, and it was very—it was a thriving program, and I really enjoyed it. And I wasn’t thinking about being a chair. I wasn’t one of those people that decided, I want to be a chair, let me find where I can find one. I was real engaged in what I was doing. And then I got a call from a member of the Duke Psychiatry chair search committee saying that the position was open and would I be interested. And I remember that call very vividly, sitting in that little office at Columbia. And it took me about a heartbeat, and I was like, Well, sure, of course I (laughs) would be. And that’s when it really clicked. I realized this is what I wanted to do. And I’m grateful that the search process worked out and that I was ultimately selected and have this great opportunity. I mean, it’s a very exciting time for the field of psychiatry with the maturation of the science behind brain-based disorders. I’ve talked some about brain stimulation, but there are other very important breakthroughs in our understanding in terms of neuroscience and the molecular biology and genetic contributors to these disorders that I think are going to lead to the next breakthrough. And so chairing a psychiatry department at this point of our—the development and evolution of our field is a wonderful opportunity to help participate in shaping that future.

Roseberry: How does one do that? How does one sit as a chair of a department and nurture those goals?

Lisanby: Well, I can tell you, you don’t do it alone, and you certainly don’t do it from behind the door of this office, so those two elements of being part of a leadership team, forming a leadership team, working with leaders within the department. And I actually think that everyone is a leader in their way, in their own particular domain, so I’ve made it my business to hear from the members of the department wherever they are. And in our department we’re very geographically spread out. So it’s meant getting in the car and driving out to Butner, North Carolina and driving out to the different affiliated institutions where Duke Psychiatry is spread across to meet and learn about what the different components of the department are doing. So the outreach has been an important first step, and so that means walking out of this door and interacting with the department, engaging the department to participate in the leadership process, because without their input I’m just going to make a bunch of mistakes. I need (laughs) to know from the department so that I can help make the right decisions for leading the future. And you know we have three important missions which are interrelated having to do with clinical services, research, and education. So I’ve been very actively involved in recruiting and interacting with the residents, because they are our future. We are Department of Psychiatry and Behavioral Sciences, so we also have trainees from other disciplines like psychology interns, so we—our education mission is a little bit different from other medical clinical departments where it’s mostly MDs. We actually are almost half PhD’s in our department. And so the clinical psychologist, the experimental psychologist, the neuroscientist, neurotoxicologist, all various forms of specialties that converge on brain-based disorders are a part of the fabric of the department.

Roseberry: Do you think the role of the chair has changed since Dr. Frances was chair? I believe he was the chair when you were here as—.

Lisanby: Allen Frances was indeed the chair when I was a resident. However, the first chair that I met was Keith Brodie, who, when I was an undergraduate was the president of the university, formerly the chair of this department. And I remember taking a seminar that he taught in the Allen Building and on campus about psychobiology and—actually I think it was called psychopathology. That’s where I first learned what psychiatrists did and learned about schizophrenia and what those disorders were about. But yes, I think that the role of being a chair of an academic clinical department has changed. Some of the components are basically the same; we have the same missions. But the world has changed around us, and the way that those missions are executed has had to be responsive to the changes. Some of these changes have to do with healthcare reform and the way healthcare is financed and the way our education mission is financed and so on. There are levels of regulation that we have to meet, accreditation standards, and levels of documentation. You know, here’s a big computer sitting on my desk. (laughs) We’ve gone electric. That’s another big change, electronic medical records, the way that clinical care is delivered and documented, all of these things have changed. So yes, I do think that the role of the chair, or rather the challenges in fulfilling the role, have constantly been morphing as the—as healthcare in the nation has changed. Also the science has evolved, which has been a very exciting change. But the fundamental components of being a leader in a medical system—being able to inspire others to have a vision for the future, I think those basic elements have remained the same.

Roseberry: Let me ask you about women in leadership at Duke. There have been several new department chairs who are women including yourself as the most recent, and I wonder if you can kind of talk a little bit about kind of the atmosphere maybe for women in leadership at Duke.

Lisanby: Well, that is obviously something I looked very carefully at when considering the position, and Nancy Andrews is a really inspiring role model. From the first time that I met her, I thought, This is phenomenal. This is a wonderful thing for Duke, and what a great time to join Duke again, to rejoin Duke. So I think that there’s— what I have encountered personally is a great deal of support, enthusiasm about women in leadership, support for myself in this new role from the dean’s office and throughout the hospital administration, and that has been very welcome and makes me feel like there’s a great opportunity to fulfill the vision, to be able to participate and take the department that next step, because there is such a great level of support. Having other new chairs that are also women is also very inspiring when we think about who are our role models and having a community of women in academic leadership. One of the things that helped me was my participation in an organization called ELAM, which is Executive Leadership in Academic Medicine. It’s a leadership training program for women in academic medicine. And women that have gone through the program are called ELUMs, and actually Mary Klotman, who’s the chair of Medicine is also an ELUM, and there are other connections of ELUM. Nancy Andrews has been a big support of the ELAM program and continues to send women from Duke to participate in the ELAM program. So I think that it’s really been a wonderful and an inspiring experience.

Roseberry: Were there women who were as you were here the first time—were there women that you saw in the medical center or maybe in the field of psychiatry that were able to—?

Lisanby: You know, there certainly were; I think they were fewer. And that’s changing now. And I’m pausing to think that most of the mentors that I’ve had in my own career have been men, actually. I haven’t had a female mentor. I’m thinking as I’m talking. Actually, high school. So I went to National Cathedral School for girls in Washington, DC, which is an all-girls high school. I loved it there. And I remember my—most of the teachers there were women, and that’s where I came to like math and science, from my math and science teachers there, so they were female role models to me. And now I’m happy to be in that position for the future, for the students that I’ve interacted with.

Roseberry: Would you like to talk about some of those mentors as well? You mentioned that many of them are men, but are there any mentors that stand out to you that you’d like to talk about?

Lisanby: Sure. I think—well, starting on the Duke campus Greg Lockhead, who was in the Psychology Department here at Duke—and I had done a two-year independent study, research elective with him. And he now that I think about it had a really profound effect on my career; I should tell him that sometime. I understand he’s not that long ago retired. In a couple of ways he impacted me. One is the decision to go into medicine. At that time I was trying to decide should I go into psychology or should I become a psychiatrist: now, what’s the difference between the MD and PhD? And I didn’t really know. And he was a PhD, an experimental psychologist, and his advice to me was, Well, why don’t you get a card in both clubs? Why don’t you go for the MD-PhD? And I didn’t take his advice. I took half of his advice. I thought, Well, let me do the MD first, because that seems like a really long training, and let me just get that started, and then I’ll see how it goes if I do the PhD. So that actually was my thought process when I was applying to med school. I never got the PhD, but the research fellowship played a very important role in teaching me how to do research. So that’s one impact. He encouraged me that—his advice to me was that having the MD would probably make a difference in my ability to fulfill my interest in studying psychiatric disorders. Now the field has changed such that, as I just mentioned, almost half of our department are PhD’s and there’s more access and ability for PhD’s to be principal investigators and to participate in the study of these conditions than perhaps there was at the time that I was doing that training, but it did encourage me that, med school, yeah, I could probably do that. The other way that he influenced me was the concept of being an active learner, that going to school is not about being spoon fed information because that’s not how you really learn. And I remember some of the first meetings I had with him where we’d sit down, and he’d say, “Well, what are you going to teach me today?” And I thought, Wow! That’s an amazing approach for a teacher to take, what is a student going to teach him today? And that’s when I began to identify with what being—actually what being a researcher is about, because if I’m going to teach him something I’ve got to find out something. I’ve got to learn something new that he didn’t know, and that’s where research comes in and that’s the joy of science is that there’s an unending number of things that we don’t know. Thank goodness for our ignorance because we can be constantly fascinated. So he’s one that comes to mind.

Roseberry: Well, are there any questions that I didn’t ask you as kind of look at a little bit about the department and your perspective? Are there any questions that I failed to ask you that I should have asked you to get that, another piece that I missed?

Lisanby: Well, let me think about that. I think that you’ve asked some great questions. I can’t think of any particular areas. I would just say that I really do encourage people to pursue medicine, to pursue academic research, to pursue psychiatry in particular. I think this is a great field for everyone, especially women who are interested in a great adventure, because it certainly has been.

Roseberry: Thank you very much; I appreciate it.

(end of interview)