Dr. Serge Mosovich is an assistant clinical professor of psychiatry at Mount Sinai School of Medicine and an adjunct assistant professor of psychiatry, Weill-Cornell Medical School of New York Hospital. Dr. Mosovich is a skilled diagnostician, a published author (American Journal of Psychiatry and Neuro-Pyscho Pharmacology, among other peer-reviewed journals, an aspiring meditator (he’s working up to 25 minutes a day), and a devoted coffee drinker. I was served delicious Intelligentsia coffee perfectly prepared in an Arrow Press. “I’m a very big coffee consumer,” Dr. Mosovich told me. As am I, so that set the tone for a highly engaging conversation about our mutual interests and passions. Curious? Read on!
I don’t know that much about what you do, aside from the fact that you are a doctor.
I am a psychiatrist.
That’s not necessarily a fast-paced specialty.
What is fast-paced? I’m a psycho-therapist, and I see sick people.
So you’re prescribing?
I prescribe, and I try to resolve problems. The people I see are quite sick. Many of them are developmentally disabled.
And do you do talk therapy with them as well?
Well, most don’t talk. Developmentally disabled. Autism.
That must be difficult.
It’s very nice, actually. They are well taken care of. Mind you, I see other kinds of patients. I see all types of people. But I like seeing people with developmental disability.
Why is that?
It’s this affinity I have with them. I understand their plight. The issues are fairly straightforward. Mostly self-aggression. Then you have to determine what might be wrong.
I imagine that’s fairly difficult when you’re dealing with a patient that doesn’t speak.
Right. But then you have somebody who comes with the patient who tells you about the patient, so you can put things together. Mostly you use medication that has to do with impulse control.
You mentioned you often treat patients with autism. I don’t know that much about autism, but I had a friend who has a son who was born autistic. But they worked with him so closely in the early years of his life that he’s fine now.
It’s a tremendous amount of effort. You have to have a lot of money, or you have to know how to use services. It’s very intense, 35 or 40 hours a week.
It’s like a full-time job.
One thing my friends don’t and didn’t do, however, is adjust their son’s diet, which is something you hear about a lot now. Some people advocate a gluten-free diet. What do you think of that idea?
I don’t think very much of it. I don’t have much background information about it, but with autism, you’re not going to modify things that have to do with connectivity inside the brain with gluten modification. It’s not possible.
So you don’t think that nutrition can have much of an impact?
Well, I think nutritional intervention might help you and me, but for seriously ill people, I don’t think so.
Where is that idea coming from?
I don’t know. To be serious about how these things develop, one has to go back to desperation. People are willing to try anything. The other day I saw a patient who is a lady past her 70s. She has been diagnosed with Parkinson’s, and she’s totally bent out of shape. She’s a photographer. She told me a story about how she had a runny nose for 30 years, and then she discovered she had an allergy to something that was in leafy vegetables. And now she’s doing fine.
Speaking of photography, I’m going to deduce from the contents of your apartment that you’re an art collector.
I’m not an art collector. I like art.
What do you think makes a good photograph?
That is a very difficult question. I’m trying to understand photography. I read Susan Sontag, and I think she’s extraordinary. She’s one of the most intelligent critics that existed. Razor sharp. As a matter of fact, I just threw away, just now, the last page of The New Republic, where there was a photograph of that guy in South Africa, Oscar Pistorius. The article that accompanied it mentioned her. I have some photographs here that I think are extraordinary, but in general it is very difficult to understand photography, to decide what is good, what is not good. I do take good pictures of skies, and I would love to learn how to do portrait photography, but in general I can’t say what’s good. Magnum photography is extraordinary. I have known people who were in Magnum and the work was extraordinary.
So like Robert Capa?
Well, Capa, yes, but I’m talking about people I know right now. Taking photographs is very difficult. Diane Arbus was very good at it, but to be a copycat of Diane Arbus–there’s really only one person who captures these things. There was recently a documentary about a woman called Vivian Maier that I did not see, but that sounded very interesting.
I saw the show, when it was here, at a gallery on 57th Street. The basic facts of her life were very interesting—she was a nanny.
I think she was weird herself, perhaps developmentally disabled.
You would know better than I.
From what I read and saw, it seemed that way. I’ve seen pictures of her.
What about the pictures made you think that she was developmentally disabled?
From what I understood, she was totally disconnected, she had trouble with distance, getting close to people. She was always alone, she was always taking pictures in a particular way. In other words, it was very circumscribed. And she looked very odd.
Do you consider the work that you do an intellectual problem that must be solved, or something else?
Most people, no. Some people, yes. Developmentally disabled people, especially the ones that are in the spectrum, are the ones that I’m interested in. They are called shadow syndromes.
What does that mean?
They’re in the shadow of other things. The shadow of bipolarity, the shadow of ADD, the shadow of Asperger’s, the shadow of personality disorders. They never get better because nobody knows what they have.
Because they have too many things?
Exactly. Because they have a lot of smatterings of things. It takes guts to say, “This is not what it is. This is something else.”
It also takes the willingness to say, “There may not be only one diagnosis here,” which people don’t like, because they want a problem to be wrapped up neatly.
Well, people want that because they want a sense of direction. And this kind of thing only happens in psychiatry. You don’t go to a cardiologist and have him say, “Well, it might be this.” That doesn’t go over well. It’s totally immeasurable. That’s the problem with psychiatry. There are no measures.
That’s also why people tend to believe there isn’t anything wrong—you can’t see the problem physically.
So when I came in, you mentioned that you were starting to meditate. What prompted that?
I’m familiar with bad sleep. Do you meditate before bedtime?
I try to meditate any time I can, in the morning when I wake up, or at night before I go to sleep. Without much success. I think I’m counting back to ten all the time. Someone is teaching me, but it’s very, very difficult. I have a thousand things in my head all the time.