Sady Sultan, M.D. Child & Adolescent Psychiatrist · New York City

Sady Sultan's father fled Spain during the Civil War after learning that there were plans to arrest and execute him for protesting Francisco Franco. He made it to Venezuela. He died there at thirty-four, of pulmonary edema, after rheumatic fever weakened his heart. Penicillin would have broken the chain. It wasn't available. His son was a month along, and would be born into a house full of stories about a man he'd never meet.

That is a childhood that teaches two things early. Medicine can be the difference between a life and a death, and a person can be labeled a criminal by a system that is simply wrong.

Dr. Sultan has built a fifty-year career on both.

“When they feel like you're treating them like any other patient — that you're treating them like they don't have a criminal record — that's when you really engage their humanity and their possibility.”

He trained as a physician at the Universidad Central de Venezuela, finishing in 1970, then came to the United States for an internship at Lincoln Hospital in the South Bronx. In that era that meant walking into one of the most overburdened hospitals in the country as a foreign medical graduate still working in his second language. He did his psychiatry residency and child psychiatry fellowship at Downstate Medical Center and Kings County Hospital in Brooklyn, and trained at the same time as a candidate at the Downstate Psychoanalytic Institute. Before he had finished, he was already the chief psychiatrist running the mental health unit at the Brooklyn House of Detention for Men.

Thirty-five years in Harlem

In 1976 he joined Columbia University's Division of Child and Adolescent Psychiatry at Harlem Hospital Center, and he stayed for thirty-five years. Academic child psychiatry offers plenty of exits. Private practice pays better. A university clinic is quieter. He kept choosing the emergency room where the children of Harlem actually arrived.

He was often the closest thing a patient had to a father in the room, and he has been direct about why that came naturally. “Many of the kids who didn't have a father figure, I related a lot to the issues that come out of that,” he has said. “It gave me an easy empathy.”

He became Training Director of the division in 1981 and held the role for three decades, which made him responsible for the didactic and clinical education of every child psychiatry fellow and rotating medical student who came through Harlem Hospital in that span. He was Deputy Chief from 1981 to 1995, then Chief of the Division of Child and Adolescent Psychiatry from 1995 to 2008. He was an Instructor in Clinical Psychiatry at Columbia from 1977 and Assistant Clinical Professor of Psychiatry from 1982.

Rikers Island

In 2010, at the point in a career when most physicians are narrowing their exposure, he moved into correctional psychiatry, and he has treated patients on Rikers Island ever since — first through the St. Barnabas Hospital affiliation he had worked with since 1998, now with NYC Health + Hospitals/Correctional Health Services. About a quarter of his patients prefer to be seen in Spanish, and he sees them in Spanish.

His method there is not complicated and it is not sentimental. He lets people be heard, and he refuses to let the charge in the file become the patient in the chair. “I try to get them to see themselves in their own future in a positive and optimistic way,” he says.

Asked about his father, he keeps it short: “I try to live up to his expectations.”

Other work

He has served as psychiatric consultant to the Tribunal of the Diocese of Brooklyn since 1976, acting as the medical expert in annulment proceedings, and maintained a part-time private practice in Great Neck, New York, from 1976 to 1997. In 1980 he was a co-author on a study in the Journal of Nervous and Mental Disease assessing psychopathology in abusing, neglecting, and comparison mothers, work that came directly out of the child abuse population a public hospital sees first. He was elected a Fellow of the American Academy of Child and Adolescent Psychiatry in 1984.

Family

Two of his sons followed him into medicine: Ryan S. Sultan, M.D., a child and adolescent psychiatrist who, like his father, teaches on the Columbia University psychiatry faculty, and his brother, a pediatrician. He also has a daughter.

The line about the father he never met turned out to run in both directions. He was, for a great many children in Harlem, the father figure in the room. He raised two more doctors at home.

What does a child and adolescent psychiatrist do?

A child and adolescent psychiatrist is a medical doctor who diagnoses and treats mental health conditions in children and teenagers. Because they hold an M.D., they can evaluate the whole picture — development, family, school, medical illness, and medication — rather than any single piece of it. Dr. Sultan has done this work in New York City since 1976, largely with children arriving at a public hospital emergency room in Harlem.

What is the difference between a child psychiatrist and a child psychologist?

A child psychiatrist attends medical school, completes a psychiatry residency, then a two-year fellowship in child and adolescent psychiatry, and can prescribe medication. A child psychologist holds a doctorate in psychology and provides testing and psychotherapy but, in New York, does not prescribe. The two frequently work together, and a good psychiatrist will tell you when therapy alone is the right answer.

How long does it take to become a child psychiatrist?

Roughly fourteen years after secondary school: four years of college, four of medical school, a year of internship, three years of general psychiatry residency, then two more of child and adolescent fellowship, followed by separate board certification in each specialty. Dr. Sultan ran exactly this training program at Harlem Hospital Center for three decades as its Training Director.

Are there child psychiatrists in New York City who see patients in Spanish?

Yes, though far fewer than the need. Dr. Sultan trained as a physician in Caracas and practices in both English and Spanish; about a quarter of his current patients prefer to be seen in Spanish. Language is not a detail in psychiatry — the assessment is the conversation, and a patient describing their inner life in a second language is giving you a thinner account.

What is correctional psychiatry?

Psychiatric care delivered to people who are incarcerated. In a jail like Rikers Island, that means treating serious mental illness, withdrawal, trauma and suicidality in an environment built for custody rather than care. Adolescents in detention are among the most psychiatrically burdened young people in the city and among the least likely to have been treated before. Dr. Sultan has worked in that setting since 1998.

Is Dr. Sultan accepting new patients?

He practices with NYC Health + Hospitals/Correctional Health Services and is not taking private referrals. Families looking for a child and adolescent psychiatrist in New York City can contact Integrative Psych, where his son Ryan S. Sultan, M.D. practices child and adolescent psychiatry.