June 2003
Volume 16, Number 6
Frank Winn is the distance learning coordinator and admissions director in the department of physician assistant studies at East Carolina University. He received his PhD in 1977 from Texas Technical University. His research interests are in the areas of ergnomics and aging.
Who am I? That was the opening question for a popular 1950s TV show, "What's My Line?" I sometimes feel like a contestant on that show when asked to describe my training and career as a psychologist.
I have been called a physical therapist, an occupational therapist, an engineer, as well as a member of several other disciplines. I have received praise for my clinical acumen as well as praise for my research. Colleagues have told me that I would never enjoy leaving a clinical position for one in research. Other colleagues in research positions wonder how I ever functioned as a clinician. I am a professional who has left people with their mouths agape, after a lecture on the pathophysiology of carpal tunnel syndrome. Who am I, or better yet what am I? I am a psychologist with a very interesting background. Am I unique? Not by a long shot.
From the first class I took in psychology, in 1965, I knew it was the field in which I wanted to be. What I did not expect was that I would be an active participant in many of the areas surveyed in my introductory course. When I graduated with a bachelor's degree from Michigan State University in 1968, I thought my career would be in clinical psychology. The United States Army, however, had a different career path in mind. The U.S. Army sent me for training as a preventive medicine specialist and assigned me to Fort Bragg, North Carolina. I was upset that the Army would take an individual trained in psychology and provide them with training in an entirely different discipline, while taking someone with no interest in the field and training them as a psychological specialist.
I was rescued from this military career track by none other than Johnny Carson. One evening on his show, Carson joked about the cause of recent casualties in the 72nd Airborne Division, alluding to the 82nd Airborne Division garrisoned at Fort Bragg. According to those who heard the show, Carson alleged that the division suffered 80 percent casualties from needle punctures when they made a jump. He was, of course, referring to the drug use that was rampant among all military services during the Vietnam crisis. The military brass was not amused by the comment and Lt.Gen. John Tolson, Commander of the 18th Airborne Corps at Fort Bragg, was told to solve the problem in his command. His response was to set up the first stateside drug abuse screening and treatment facility which was called Operation Awareness.
The program treated soldiers who were medically evacuated from Vietnam for drug use as well as those soldiers screened and treated who were assigned to Fort Bragg. At Operation Awareness, I maintained a small caseload and was responsible for program evaluation. Even back then the government wanted to make sure that the money spent for treatment was used effectively. That was my first contact with data, and the impact that data could have on funding decisions, and it fascinated me.
I left the Army in January 1972, not sure if I wanted to be a clinician or a researcher. After three years away from academia, my advisor at Central Michigan University decided to help me determine if I was graduate material. He had me enroll in three statistics classes and a course in physiological psychology in my first semester of graduate work, under the assumption that it would break or make me. I found the challenge daunting but exhilarating, and obviously I survived. I found the course in physiological psychology extremely interesting and it led to a master's thesis on chemical stimulation of the brain. This training, in an area that we now refer to as neuroscience, provided me with additional skills that would be beneficial later in my career. The most immediate impact of this master=s level training, however, was a decision to select a different area in which to complete my doctoral training. Physiological psychology, while fascinating, was not a cost-effective area in which to conduct a dissertation. Eight months of seven-day weeks and 10-hour days cannulating rats and collecting data was a sobering experience.
As a result of the lessons learned completing my master's degree, I decided to pursue an interest in developmental psychology, specifically how pathology develops during adolescence and how people respond to the pathology during senescence. This interest area emerged as a result of treating drug dependent soldiers and wondering what the impact of their use would be as they got older. Because of the perceived costs of doctoral training I headed west where it was cheaper to attend school as an out-of-state student than it was to further my education in Michigan as an in-state student. My journey led me to the University of Oklahoma at Norman, where my expectations for a training program in life-span developmental psychology turned out to be something far different. The training offered at the time was in experimental child psychology which included a good dose of Hull-Spence S-R theory and hard-nosed training in basic research skills. Because of this emphasis I left the training program after a year and kept heading west to Texas.
Texas Tech University, in Lubbock, was the final step on my training odyssey. At Tech I was fortunate enough to associate with a life-span developmental psychologist who allowed me the freedom to do research in areas I found interesting as well as take the courses that I needed to complete the training emphasis I wanted in life-span development. I completed additional research studies dealing with chemical stimulation of the brain as well as research in cognitive aging, and completing the coursework leading to the completion of my dissertation. I successfully defended as a major area, life-span development, as well as completing comprehensive exams in clinical psychology and statistics.
I was awarded the PhD in 1977 and landed a position as a visiting assistant professor at the University of Texas at El Paso, where I learned a valuable lesson. Unless you have another income stream, an academic posting is not that lucrative. After a year I left academia and accepted a commission as a lieutenant with the commissioned corps of the U.S. Public Health Service detailed to the U.S. Coast Guard. The individual who recruited me told me that I would be expected to conduct personnel research and when necessary, do some light counseling similar to what I had done with the Army. When I reported for duty at the U.S. Coast Guard Support Center on Governors Island, New York, I felt confident in my abilities to succeed. My misplaced confidence was based on prior experience with clinical responsibilities in a military environment, my experience conducting program evaluation work in the military (that resulted in a publication), plus my classroom work in clinical psychology, and a strong graduate level background in statistics and research design. None of these experiences mattered, however, since the individual who recruited me took liberties in describing the position I was to fill. What this position would do, however, was teach me to be adaptable, and to draw on a personal skill set that I had been taught in my graduate training, but not recognized until then: problem-solving.
Reporting to the senior medical officer at Governors Island, I was informed that my job title was chief of the psychiatric service and in addition to that, I would be responsible for establishing and operating a psychiatric screening service that would include in its catchment area Coast Guard assets in 40 States and Europe. Obviously, I was dumbfounded and voiced the ethical concerns that I had in fitting my training to the requirements of the position that I was expected to fill.
The Captain was very understanding of my position and gave me the option of resigning my commission on the spot, and funding my own way back to Texas, or filling the position, with him working with me to supplement any deficiencies that I felt needed to be addressed. I accepted his generous offer. The Captain was true to his word and I was able to finish post doctoral training at the Paine-Whitney Clinic at the Cornell Medical Center, at the Creedmore Psychiatric Hospital, and at the Bellevue Hospital Center. After five years in the position at Governors Island, I was transferred to the U.S. Coast Guard Training Center at Cape May, New Jersey, to do personnel and recruit selection research.
After eight years with the Coast Guard I found that I still had a professional interest in the field of aging. In the mid 80s a new area of study called ergonomics was in its infancy and the National Institute for Occupational Safety and Health was interested in me because of my background in aging. As a commissioned officer with U.S. Public Health Service, I accepted a transfer from the Coast Guard to the psychophysiology and biomechanics section of the applied psychology and ergonomics branch of the division of biomedical and behavioral sciences at NIOSH, a component of the CDC.
I quickly discovered that my training in physiological psychology and research design were important to success in this developing area. What was surprising was that theoretically, the constructs underlying the field of life-span development and the constructs underlying the study of cumulative trauma disorders, an outcome of poor ergonomic design, were almost identical. Adapting to the theoretical framework of this new area was as comfortable as putting on an old pair of shoes.
The area of research that I quickly adopted at NIOSH was carpal tunnel syndrome.
The syndrome has special relevance to older cohorts since in severe cases sufferers lose fine motor coordination in their hands, lose grip strength, and can develop accompanying Raynauds syndrome. These problems have a direct effect on activities of daily living and, with the death of a caretaker, can prevent an individual from living alone. Investigators in Europe and Asia have been aware of the problem but it has not attracted much interest in the United States. The area of study dealing with the older worker is a research area I have continued, often in collaboration with foreign colleagues I met while at NIOSH.
Funding cutbacks, and a decision to de-emphasize research on the older worker, led me to transfer to the National Institute on Drug Abuse in the early 90s. My new office was responsible for conducting policy-oriented research in response to requests from the Office of National Drug Control Policy (ONDCP) which is administratively located under the president.
It was fascinating conducting policy oriented research that required quick turn around. What was even better was the fact that the group had a generous operating budget to finance its operations. All good things must end and this assignment ended with the ADAMHA reorganization. I was subsequently assigned to the office of applied studies located in the Substance Abuse and Mental Health Services Administration. I think it ironic that I started my federal career working in a drug abuse clinic and conducting program evaluation functions for the Army and ended up retiring from federal service with a job classification of health statistician conducting program evaluation activities for the center for substance abuse prevention.
What do I do now? I retired from active duty because of a contact I made at the Coast Guard base on Governors Island. The physician assistant profession, a new field established in the mid 60s, was quickly developed in the military medical system. I became good friends with a physician assistant while stationed at Governors Island and we kept in contact over the years.
When he assumed the chair of a new physician assistant program at East Carolina University, he asked if I would join him. He said he needed a faculty member who was adaptable who was willing to mentor clinicians in research and someone who could teach behavioral medicine, public health, and how to read a research article. I opted to leave federal service because I found this new challenge very appealing. Since my arrival six years ago, the department of physician studies has created a distance learning program and graduated successful practitioners from the first primary care training program that offers the didactic phase of training in an asynchronous format.
So, what am I? I am a psychologist by training who has managed to benefit from the quantitative and research training I received and from the approach to problem solving that all psychologists learn and internalize. What does the future have in store for me? Hopefully, continued challenges and problems to solve. It does not matter if I am mistaken for an engineer, a physical therapist, or a member of any number of other disciplines. My training has allowed me to approach my professional life as if it were a big sandbox in which to play. I can try whatever I want and build anything I can conceive, and I am not alone in the approach that I have been taught to take. There are many others in the sandbox with me.
