As a college student, Karl Menninger was young, smart, and perplexed. The direction of his life lay ahead of him, a mystery waiting to unfold. His mother, Flo, a deeply spiritual woman, saw in him what so many mothers see in their sons — a potential for greatness. She had already discussed with Karl the possibilities of a literary life or one in banking or perhaps an evangelical calling by which the nation’s collective soul would fall into sure and righteous hands. His father, C.F., by then a respected medical doctor in Topeka, Kansas, was far less vocal about Karl’s future, except for a vociferous expectation — clearly stated — that he would excel in his academic studies, wherever they might lead him.

A glimpse of the young man’s future would emerge at an unlikely moment, as he was receiving relief from pain through medical treatment, an affirming metaphor for the rest of Karl Menninger’s life.

It was in a dentist’s chair suffering from a toothache that young Karl saw the light. Discussing what Karl might do with his life, the dentist, Dr. Fred Koester, said most young men would consider it a great opportunity and an honor to go into medical practice with Karl’s father. A moment’s thought transformed into a jarring revelation and Karl’s epiphany was complete. He loved the sciences, did well in them, and the very idea of working beside his father emerged in him like a lost ship finally sighting land.

Before leaving the office, Karl announced, “I am going to be a doctor.”

“Of course you are,” Dr. Koester agreed.

Hearing the news, Dr. C.F. hugged his son, his eyes tearfully welling up in joy. It was a harbinger of things to come. Now that the oldest of his three sons had committed to a life in medicine, Dr. C.F.’s wish that his boys would be doctors was beginning to coalesce.

Turning point
When Karl returned from his medical internship at Boston Psychopathic Hospital, Dr. C.F. recalled in an interview, “He told me that he had been greatly inspired and moved by what he had learned about mental illness and the need for a better understanding of the great number of forgotten, neglected, and suffering people outside the fold of general medicine.”

But Dr. Karl voiced doubts whether he could follow in the footsteps of his great teacher, E.E. Southard, chief of psychiatry at Harvard, and actually have an opportunity to practice such an unconventional medical discipline as psychiatry while remaining in his native Kansas.

His father — ever the optimist — encouraged him to stay in Kansas, where father and son could work together.

“I told him that, far from considering his new interest in psychiatry bizarre and foolhardy, I thought it the most interesting field he could enter.”

Though psychiatry was then something practiced quietly, the Menninger’s opened a clinic in the practice of neurology and psychiatry, and sought out other physicians to join them in a cooperative practice, a novel concept with a unique application. Patients would receive conventional medical examinations, but their psychological status would also be explored and recorded. Now, anxieties and sadness would be examined with the same scrutiny given tumors and infections.

Getting organized
The Menninger Diagnostic Clinic was formed in 1919 and suffered several false starts. Doctors didn’t readily flock to the Menninger idea of a medical cooperative. Dr. Karl’s enthusiasm for the little known field of psychiatry was meeting some resistance. Alarmed citizens went to court to stop him from operating a “maniac ward” at the local hospital, and thereafter he had to smuggle his patients surreptitiously, disguising them under erroneous diagnoses.

But gradually, physicians and patients were attracted to the clinic and by 1925 local investors helped found the Menninger Sanitarium on a 20-acre site.

“I am not looking at this just with the idea of seeing how many patients I can see or how many dollars I can drag in,” Dr. Karl wrote to his younger brother Will, who would join the sanitarium after graduating from medical school the same year. “... The joy you’re going to get out of your work is not directly related to the amount of money you make.”

A year later saw the formation of the Southard School for mentally retarded children, which eventually embraced treatment of all psychiatric conditions. The facility was named after Dr. Karl’s mentor, Dr. Southard, who told him, “... go back to Kansas, but don’t forget the children. ...”

New facilities continued to be constructed, although the operation did not necessarily turn a profit. In fact, Southard School, a ripe environment for research into children’s personality disorders, was expected to operate at a loss simply because families were apt not to pay as much for a child’s care as they might for an adult’s.

Milieu therapy replaced the popular “rest cure” of the times, and embraced the concept of combining activities like farm work or landscaping with treatment that fit an individual’s needs, the entire day scheduled.

With the specialists of the Menninger medical cooperative working together so well, it became apparent that specialized psychiatric training for nurses was necessary and a formal course of instruction was created. Soon, Menninger received approval to offer training to physicians in the specialty of psychiatry and in 1933 three residents began training, doubling the psychiatric staff treating 30 patients.

A burgeoning fame
Dr. Karl specialized in neurology and psychiatry, but his writing brought him fame. His first book, The Human Mind, attempted to educate the public in psychiatry. Writing the book was not an easy task for a busy psychiatrist, and Dr. Karl alluded to this in his preface: “One can’t stop living to write a book and I’ve had to put together this manuscript under difficulties.”

He says he wrote it “aboard trains, in depots, in cabooses, in hospital wards, and under the light of a farmer’s coal-lamp, all the while coping with the important and mundane interruptions that will come into a human life.”

Despite his hard work, the 37-year-old psychiatrist didn’t have much faith in the success of his self-imposed project, writing to a friend, “(the book) will probably not set the world by the ears.” He was very wrong.

The Human Mind was published in 1930 and immediately became a Literary Guild selection and sold 200,000 copies. It was one of the first books in which a psychiatrist explained the everyday workings that went on in his office, and showed the world as it is seen through the eyes of a psychiatrist.

Freud’s influence
It was once said of Dr. Karl that in using his skill for imagery and clear, vivid writing, he had translated Sigmund Freud, the world’s first psychoanalyst, into American literature. Many of Freud’s insights into the human mind, which seemed so revolutionary at the turn of the 20th century, are now widely accepted by schools of psychological thought. The Human Mind’s unraveling of Freud was the key to Dr. Karl’s initial fame and popularized his name with a public hungry to learn more about its inner self.

“Freud’s great courage,” Dr. Karl would say years later, “led him to look honestly at the evil in man’s nature. But he persisted in his researches to the bottom of the chest and he discerned that potentially love is stronger than hate, that for all its core of malignancy, the nature of men can be transformed with the nurture and dispersion of love.”

“This was the hope that Freud’s discoveries gave us. This was the spirit of the new psychiatry. It enabled us to replace therapeutic nihilism with constructive effort, to replace unsound expectations, first with hope, and then with sound expectations.”

Battling stigmas
Dr. Karl was a lifelong crusader against the stigma surrounding mental illness, and brought mental disorders out of the dark through teaching, letters, lectures, magazine articles, newspaper columns and more than a dozen books. It was a battle he and his brother, Dr. Will, waged throughout their lives. Dr. Karl also spoke out against social injustice and for nuclear disarmament. He supported the rights of neglected and abused children and Native Americans, and counseled understanding for inmates while raging against the system that imprisoned them.

“I sometimes feel as if I would like to scream out to the American public that they are squirting gasoline on the fire,” Dr. Karl told a congressional hearing in 1971. “The prison system is now manufacturing offenders, it is increasing the amount of transgression, it is multiplying crimes, it is compounding evil.”

The personal Karl
In his senior years, Karl Menninger could be contrary, swaying between moods both kind and brusque. Those who knew him say he was loving and mercurial, embracing a host of emotions at any given time as only a great man can.

This was the same charismatic man who told the world, “Love is a medicine for the sickness of the world; a prescription often given, too rarely taken.” And the man who insisted that “love is the touchstone of psychiatric treatment ... to our patient who cannot love, we must say by our actions that we do love him.”

At 82, Dr. Karl was to have said that he spent the first 50 years of his life in treating people, and he was going to spend the last 50 years in prevention.

And he kept his eye the horizon:

“Anybody as old as I am is thinking about dying — thinking about it quite often. You want to get as much done as you can before you die.” He did that and more.

At 96, he complained of rusty knees, bad hearing and forgetfulness, but he felt as though he were still plugging along: “I’ve tried to make life easier for people,” he said. “You hold a coat when you can and tie a man’s shoe when you can. You try to do what you can.”

Honors and awards
During his lifetime he toured Europe to assess the need for psychiatric care among returning military personnel, established the Menninger School of Psychiatry, the Topeka Institute for Psychoanalysis, then the only training facility west of the Mississippi, testified before Congress and elsewhere on mental health issues, was a vigorous participant in the formation of psychiatric organizations, and of course, ran Menninger wearing a variety of executive hats.

He received numerous honors and awards from his professional peers, from government, and from national groups. In 1981 he became the only psychiatrist ever to receive the Medal of Freedom — the highest civilian honor the country can bestow — from then-President Jimmy Carter, whose wife Rosalynn has been a Menninger Trustee since 1986.

After a career whose span embraced so many roles — teacher, orator, first-rate writer, administrator, activist, philosopher, psychiatrist, and more — Dr. Karl died four days short of his 97th birthday.

Spreading the light
Late in his life, Karl Menninger, cane in hand, posed before the Menninger Tower, the most recognizable symbol of Menninger itself. Reminiscent of Independence Hall in Philadelphia, the Tower was erected for the Security Benefit Association and taken over by Menninger in 1954. Erected in 1930, the same year The Human Mind was published, the Tower and the man share similarities.

The landmark can be seen from a far distance, its four-sided clock face illuminating the night like a lighthouse beacon, much as Karl Menninger towered over psychiatry for a lifetime, directing light into the shadows of the human condition.

Wit and wisdom from Dr. Karl
Karl Menninger, MD, co-founded The Menninger Clinic in 1925. During his long career in medicine, he was known as the “dean of American psychiatry.” A prolific writer and a dynamic speaker, Dr. Karl’s ability to capture a thought with a pithy comment or render an insight in a few brief words, reflected a sharp, and often witty, mind. Before he died in 1990, Dr. Karl had expressed opinions across a range of subjects. Some are presented here: