Sadly, membership in the UPA has been dropping, which has frankly mystified those of us who not only belong since – well, forever, but are active as well. Paige, our Executive Director decided to look at it from the opposite direction. Instead of asking why people don’t belong, she asked those of us on the Board why we dobelong. I believe this question deserves a thoughtful answer.

Why do people belong to anything. The most common answer, which in fact, is my answer, I will leave to the end of this essay. The second most common answer is FEAR, fear that our support is needed or something terrible will happen. Fear, sadly, motivates many people in society. In fact, demagogues rely on stoking fear in order to get support for their often nefarious schemes. We in Psychiatry know about how crippling fear is in our patients. Some of us call fear the dirtiest four-letter word in the English language. We work to help our patients with crippling anxiety, panic and PTSD to face their fears and live more bravely. Thus, while there are many things to be fearful of that impact Psychiatry like psychologist prescribing, DOPL potentially fining Psychiatrists over trivial records issues, onerous certification maintenance practices, parity issues, insurance issues, legislative issues, I for one, am not motivated by fear to belong to the UPA. (A disclaimer here – I’m not necessarily brave. As I draw closer to the age of retirement, all the practical concerns facing younger Psychiatrists become less relevant to me.) Maybe other Psychiatrists, for their own reasons, also do not find fear a potent motivator, and therefore don’t belong for that reason.

The third most common reason is collegiality – the longing to be with one’s fellows, to commune with kindred spirits. This also is not a motivator for me. I am an introvert, a loner, and while I have learned how to be socially graceful among others, I am not particularly drawn to be with anyone else. (OK, there are a few exceptions, but not many. I may be close to what Hugh Grant says in “About a Boy”: “Every man is an island. I stand by that. But clearly some men are island CHAINS. Underneath, they are connected...”) Maybe other Psychiatrists are like me in that respect, and so collegiality is just not a reason to belong.

Now I come back to the MOST common reason why people belong to anything, and that is LOVE! People who love stargazing belong to Astronomy clubs. People who love reading belong to book clubs. People who love the Mountains belong to the Sierra Club – and so on. And I LOVE Psychiatry! Yes, I’m excited about what other branches of medicine are doing, how oncologists are beating back cancer, how ophthalmologists have their lasik and cataract surgery. But NOTHING comes close to Psychiatry. As a Psychiatrist, I feel the same amazement considering our field that cosmologists and astrophysicists feel contemplating the universe. They have dark matter, dark energy, gravitational waves, singularities, quantum fluctuations, maybe strings and multiverses. But we have the brain, the mind, the heart, the interaction with the immune system. The human brain – just as complex as anything in the vast universe! Yes, I LOVE Psychiatry. And I love my patients. I see their suffering, and I LOVE the possibility and sometimes the actuality of helping them to better lives. And I want to see my profession advance, to have its knowledge and usefulness expand. I know that when it does, people’s lives, families, the whole country will be the better for it. And it just so happens, we have ONE club here in Utah (no slight intended to UACAP) that is for that advancement, that advocates for my patients, that seeks better lives for patients and families, for citizens. And that club is UPA – the Utah Psychiatric Association. So OF COURSE, I belong to it! How could I not?

And I ask my fellow members – do you belong for the same reason I belong? Or do you have different reasons? I would love to hear from you (there’s my island chain again.)

And I ask my fellow Psychiatrists who do NOT belong – WTF? No one forced you into Psychiatry. You chosePsychiatry, when you could have chosen any other medical specialty, any other career for that matter. Don’t you LOVE Psychiatry? Don’t you want Psychiatry to prosper? Don’t you want Psychiatry to advance. Don’t you want better lives for our patients? Don’t you want to ease the suffering of our patients? UPA is the one club (in addition to UACAP) that supports all of that, that has unpaid volunteers like me, working for YOU, and for YOUR patients.

Legend has it, that when Ralph Waldo Emerson was walking down the streets of Concord one day, he spied his close friend, Henry David Thoreau in jail behind bars. He walked up to the barred window and said, “Henry, what are you doing in jail?” Thoreau responded with, “Ralph, what are you doing out? Today, I ask my fellow Psychiatrists who are NOT members, the same question, “What are you doing out of the UPA?” I would sincerely love to hear your answer to that question. But if you don’t have one, then please – JOIN. We are your club. We are for you.