His finalist year: 1961
His finalist project: Figuring out ways to diagnose diseases using blood and urine samples
What led to the project: Bernard Rappaport grew up in a family of persuasive talkers. His earliest memories are of conversations and debates around his Staten Island, N.Y., kitchen table with his lawyer father and teacher mother back in the 1940s and 1950s. Some of his favorite dinner guests were his father's physician clients. He tagged along with them to the local public hospital, and knew from an early age that he wanted to go into medicine.
When Rappaport was a teenager, Thomas Greenslade, the chairman of the science department at the local New Dorp High School, encouraged him to do a project for the Westinghouse Science Talent Search. So Rappaport decided to use chromatography—separating mixtures in order to analyze them—to analyze blood and urine samples. He hoped to detect patterns of amino acids (the basic building blocks of proteins) that could show if a person had various diseases.
He did his experiments in his basement with samples a local hospital let him take home. He put the blood and urine in pickle jars and used blotting paper to wick up the liquid. The amino acids would separate out by different weights, and after 24 hours he would stain the papers and pass light through them to detect what was going on. He hoped that different diseases could be discerned clearly enough from the patterns revealed by the various types and quantities of amino acids, thereby allowing a diagnosis partly based on this kind of chromatographic analysis. It wasn't as sophisticated a project as those high school students do now. Still, it won him a 1961 finalist spot.
The effect on his career: Greenslade was proud of his young charge's accomplishments, but Rappaport remembers having a conversation with his mentor as he was preparing for the final round. "He let me down easy," Rappaport says. "He said, 'Don't get your hopes up too high, Bernie. You probably are never going to win a Nobel Prize in science.'" More immediately, he wasn't going to be a Westinghouse winner with his pickle jar project either. But even if the life of a great researcher wasn't in his future, he recalls Greenslade saying, his talents lay in his ability "to grasp complex science issues and communicate them to others."
"He pegged me just right," Rappaport says. Indeed, he didn't win. But he did enjoy talking to the judges and other students about his project. He decided that he wanted to go into a field of medicine that leaned heavily on communication skills and so, after going to Harvard for college and the University of Pennsylvania School of Medicine, he became a psychiatrist. He set up a practice in the Bay Area in California.
He specialized in patients who'd been through a traumatic accident or disease, and put his persuasive skills to use. Often, he says, people are reluctant to take medication for depression. What works in those cases are "metaphors, analogies and stories," he says—anything to make "the little lightbulb go on." After informing a patient about their thyroid condition, for example, he will add that the good news is there is a drug to help—and they'd be happy to take it. Taking drugs to conquer depression is no different.
Rappaport taught doctor–patient communication to medical students in California for many years. But he found his true sweet spot in 1984, when he was contacted by a lawyer for a patient of his who'd been in an auto accident. Rappaport ended up as an expert witness. He thought it was "a lot of fun" and asked the attorney how he could do more.
What he's doing now: These days, serving as an expert defense witness is a significant part of Rappaport's practice. He testifies in cases in which the plaintiffs are claiming some sort of psychiatric damage—airplane crash landings, auto accidents, malpractice cases. A current case, for example, involves a woman who was hit by a drunk driver four years ago.
Though not the issue at stake in that case, Rappaport's expert witness specialty is post-traumatic stress disorder (PTSD). Given that he thinks PTSD is "definitely overdiagnosed, especially in the litigation context," it's no surprise that he's more often retained by the defense in these cases. Whereas plaintiffs can have very sympathetic stories, he says, plaintiff lawyers often want psychiatrists to say that the victim is permanently damaged and may never get better, because that can produce a bigger award. But if Rappaport has learned anything through years of talking with patients, it's that "people can undergo horrific injuries and still feel really good afterwards." Not immediately, of course, but eventually they "can wind up being pretty well-adjusted and happy people," he says. "The human spirit is pretty resilient."
It's a point he seems to be making fairly well, according to his son Amon Rappaport, the director of communications at Business for Social Responsibility, a San Francisco–based organization that advises member companies on socially responsible business practices. Amon, who does a lot of media training, recently sat in on a trial to offer his father some professional criticism. "The unique challenge he has is how to convey his expertise in a way that doesn't sound too smart for his own good," he says. But overall, he said his father did a good job of giving "his expert opinion, not his personal opinion," and that he was "very relatable and accessible."