In Memorium

In Memory of Paul T. Cash, MD.
by Richard E. Preston, MD

Paul T. Cash. M.D. was born and raised in the small south central, rural town of Lenox, Iowa on July 11, 1911. He died Apri112, 2003 in Des Moines Iowa where he had lived and practiced in the special- ties of psychiatry and neurology since 1948.

Paul's father was a family physician (M.D.), a "typical country doctor" of that era who lived and practiced in Lenox, Iowa well up into his eighties. Paul re- called that during his youth he would occasiona1ly accompany his father on "house calls" out into the countryside, sometimes on horseback. Other .members of his "nuclear" family achieved notable success in their careers with his brother John be- coming vice president of the Wyeth Pharmaceutical Company in Philadelphia, Pennsylvania, and his brother Keith a practicing attorney in southern Iowa.

Paul obtained his undergraduate and graduate education at the University of Iowa graduating from the College of Medicine in 1935. Growing up in the era of the "Great Depression" often necessitated his working two or three jobs simultaneously while obtaining much of his education. This in addition to family and developmental factors endowed him with an unusually strong work ethic and fundamental rural Iowa sense of individua1 responsibility and "core values" which characterized not only his practice of medicine, but his lifestyle in general. Those who knew Dr. Cash will recall seeing him walking rapidly throughout the hospital, always carrying his little black "doctor's bag" in which he carried the instruments to per- form all of his own physical and neurologic examinations.

Paul did his internship at St. Vincent's Hospital in Portland, Oregon (1935 to 1936) following which he did residencies in psychiatry at Clarkson Memorial Hospital in Omaha, Nebraska, internal medicine at the University of Iowa and neurology at the Neurologic Institute in New York City. He continued his psychiatry training as well as becoming a teaching staff member at the University of Nebraska in Omaha from 1940 to 1942. His career was then interrupted by World War II in which he served as a Major in the U.S. Army from 1942 to 1946, and was stationed at several different bases throughout the United States. Following

, discharge from the Army, he joined Dr- [ A.E. Bennett, a well-known psychiatrist 1- in the field of biologic psychiatry with -whom he practiced and did research for -two years in Berkley, California. He re- s turned to Iowa in 1948 where he established his own private practice.

h It is readily obvious that from his l- extensive training in several different specialties he was unusually well grounded in :h the field of general medicine as well as psychiatry. Perhaps his "first love" was neurology but the demands of the mentally ill soon occupied the bulk of his clinical practice. This led him to the development of a twenty-two bed inpatient psychiatric unit in the south wing of Iowa Methodist Medical Center as well as being largely responsible for establishing the current Mental Unit in Iowa Lutheran Hospital which opened in 1965. Paul also established and maintained the electroencephalography section at Iowa Methodist Hospital and donated his interpretation services to the hospital throughout his career. Paul was board certified both in neurology and in psychiatry. He was a founding member of the American EEG Society, a distinguished life- fellow of the American Psychiatric Association, the Iowa Psychiatric Society, the American Medical Association, the Iowa Medical Society, and Polk County Medical Society. In addition, he was a member of the Iowa Chapter of the Central Neuropsychiatric Society.

Locally he was a proud member of the Medical Library Club, which he at- tended regularly and took his turn in serving as its secretary and president. Paul acquired and maintained an exceptionally large private library of books and journals both old and current on the subjects of psychiatry and neurology including some classic editions.

In spite of his "'workaholic" tendencies he somehow managed to find time to share various non- medical interests with his wife Reva, stepson Peter Godwin, his wife Julie and their children. He maintained an active interest in football throughout his entire life and was a loyal Hawkeye fan rarely missing a home game up until later years when his health began to fail. One of Paul's very special interests was his ancestral family farm in Southern Iowa. This was a Century Farm, which was granted to his forefathers in a deed personally signed by President James Polk in 1845. He and Reva expended much time and energy on the beautiful restoration of the old home and buildings. Unfortunately, due to his failing physical health he was unable eventually to move on to the farm and en- joy the fruits of his labor.

Politically, socially and philosophically he was definitely conservative. In his personal life Paul was basically a very private individual but always pleasant and congenial. He had the capacity to maintain an even temperament and disposition that is very important in the field of psychiatry. He demonstrated an innate com- passion for all of his patients especially those who were suffering from major depression, which he felt, was "the worst suffering that a human being could experience." It is especially noteworthy that at the time he went into private practice Freudian theories and psychoanalysis had enamored the public and was achieving a strong foothold in psychiatry throughout the United States. Fortunately Paul maintained his allegiance to the "medical model" which succeeded in keeping psychiatry in the "House of Medicine" and currently dominates the field as "biologic psychiatry." The tremendous advances in neuroscience, genetics and behavioral neurology have reaffirmed and validated his belief that the major and serious mental illnesses are medical disorders of biologic etiology.

Professionally Dr. Cash has made a significant and lasting impact upon the specialty of psychiatry in the state of Iowa. In addition, he remained true to the "core values" of traditional medicine in the face of opposing forces. Personally, he was largely responsible for myself entering the field of medicine, and eventually he be- came my psychiatric mentor.