Dr. Milton Mazer, the Vineyard's first psychiatrist whose pioneering work in the field of rural mental health led to the establishment of Martha's Vineyard Community Services more than four decades ago, died Jan. 7 at the Long Hill assisted living home in Edgartown, where he had been a resident for the past six years. The cause of death was renal failure; he was 95.

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Dr. Mazer is still widely known for his book People and Predicaments, a clinical study of the Vineyard population and the psychological stresses that are unique to Island life. Published in 1976 and now out of print, People and Predicaments remains a timeless textbook with its deftly wrought profile of mental health problems among Islanders - including depression, alcoholism and suicide ­ - problems that persist at extraordinarily high levels today despite profound changes in the Vineyard way of life.

"This is a suspense story," wrote Gazette columnist William Caldwell in his review of the book when it first came out more than 30 years ago. "In spite of its scholarly apparatus - 35 appendices, 11 pages of bibliography, charts and graphs and explications of sampling techniques - this study of people in the predicament which is life on Martha's Vineyard is a suspense story . . . . But it is also a love letter, and no professional confidences will be violated by a reminder that the gist and purpose of this art form is reassurance."

Dr. Mazer, who began his professional career as an internist and later turned to psychiatry, moved to the Vineyard full-time in 1961 to become the first resident psychiatrist. He founded the Mental Health Center, which would become the charter agency of Martha's Vineyard Community Services, the umbrella social services organization that today includes an array of social service agencies from early childhood to visiting nurses to mental health.

Quiet in manner, slight in stature, with a steady gaze and a twinkle in the eye, Dr. Mazer treated his patients the old-fashioned way before the age of advanced psychoactive drugs: with deep listening, compassion and concern. He found the close-knit community on the Vineyard acted as a natural antidote to the isolation and stranded loneliness that is a stubborn plague in the lives of Islanders.

"The stresses that arise from the community's small size cannot be prevented but are compensated for to some degree by its inhabitants' awareness of a common destiny, by their long tradition of mutual helpfulness, and by the nurturing bonds of its intricate social network," he wrote in People and Predicaments.

In an early chapter in the book, Dr. Mazer offered the following glimpse into the psyche of the average Islander:

"The Islander refuses to be hobbled by the values of the Protestant work ethic: thrift, piety, work for work's sake. He is willing to earn less as the price of freedom. He shows little interest in the unionization that would increase his wages, because he fears it would limit the range of his occupation and curtail his free time. When the deer season comes, he expects to be able to take the week off because he is often paid only when he works. If he cannot afford to, he expects to be able to have his gun at hand if the job is out of doors and near a wood. If he has inherited land, he values it more than the things its sale might permit him to have, for the possession of land gives him prestige and deference from his neighbors, and its sale is felt as a betrayal of his past. Many Islanders who are rich in land live quite poorly, selling bits of land in crises when illness strikes or when a child wants to go to college . . . . When Samuel Covell, electrician, was asked to have a drink with a summer visitor while at work in his home, he accepted readily, though it was mid-afternoon and he had a long list of promised calls in his pocket. When the summer visitor, knowing that Samuel had once tried working in Providence, asked why he had come back to the Island, Samuel raised his glass, grinned, and asked, ‘Where else would I be doing this in the middle of the day?' "

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Milton Mazer was born March 5, 1911, in New York city, the son of Michael and Rose Orman Mazer. He was a second-generation American whose father had come to this country from the Ukraine. He grew up in South Philadelphia, Pa., where his father worked as a tailor. He was educated in public schools and later attended the University of Pennsylvania on a scholarship. He received his medical degree from the University of Pennsylvania Medical School in 1933, with a specialty in internal medicine. His early years were spent working in Veterans Administration hospitals in Philadelphia.

In 1943, he enlisted in the Army Air Corps and was stationed in England, where he attained the rank of captain. His commanding officer was Dr. Francis Chinard; the two men went on to become lifelong friends and Music street neighbors in West Tisbury.

After the war, Dr. Mazer temporarily quit the field of medicine and tried a brief career in writing. He had a short story published in The New Yorker and another one published in Esquire magazine. He then became interested in psychology and enrolled in the Academy of Psychoanalysis in New York. He obtained his degree in 1950 and practiced psychoanalysis in New York until his move to the Vineyard 11 years later.

In 1936, when he was working for the Veterans Administration, he did a stint in Biloxi, Miss., where he rented a room from Virginia O'Leary and her husband. She was later widowed, and in 1948 she married Dr. Mazer. They had two children: Ruth and Mark. They lived in Larchmont, N.Y., and began summering on the Vineyard in 1954. That first year they rented Tom Maley's barn in West Tisbury in the heart of the village. In 1957, they bought a property on Music street from Percy Burt and built a summer house, which Dr. Mazer designed himself. The house was winterized in 1961 when the Mazers moved to the Vineyard full time.

The move came about after Dr. Mazer was recruited by a committee of two Island clergymen and four family doctors, including the late Dr. Robert Nevin.

In a 1983 interview in the Gazette with Polly Woolcott Murphy, Dr. Mazer recalled coming to the Island to meet the recruiting committee. "It was during a boat strike and we had to come over on a fishing boat, which was scary," he said.

Dr. Mazer agreed to stay for a year and give it a try. He opened the Mental Health Clinic in what is today the Dr. Daniel Fisher house in Edgartown. Fees were set on a sliding scale.

"Originally the lowest fee was 50 cents, but people didn't really like that, so we raised it to a dollar," Dr. Mazer recalled. "We had a weekly fee of three or four dollars so people could come as often as they needed without worrying about additional money for extra visits."

He also said: "My patients became my friends. They showed me their children and brought me gifts of fish and scallops. It's been very different from the anonymity of city practice. You do become a part of the community and that in itself is rewarding."

Using grants from the National Institute of Mental Health, Dr. Mazer took his research deep into the community, studying court records and consulting other health professionals and teachers. He wrote 12 research papers. The work culminated with People and Predicaments.

"He was like a father to a lot of people, and he was certainly fatherly with me," said Dr. Charles Silberstein, the Island psychiatrist who opened a practice here after Dr. Mazer retired. "He did ground-breaking research on Island life that had implications beyond the shores of Martha's Vineyard - he studied the Vineyard in depth in a way that no one ever had before. People and Predicaments is still incredibly relevant; He really understood this community and continues to help this community," he added.

Dr. Mazer's life on the Island was not confined to his work. He took up pond sailing in the summer with his friends Dr. Chinard and Dr. Russell Hoxsie, and on winter Saturday afternoons he played pool with the Maleys. He served as town moderator, where his skills as a psychiatrist sometimes proved useful.

"At some of those early meetings where I was moderator, there were always a couple of people who would have had too much to drink and would try to disrupt the meetings," he told Mrs. Murphy in the Gazette interview. "By law I could have had them removed, but I would go and speak to them instead and they always settled down. The only creature I ever had ejected from town meeting was my own dog, Fred, who came in without permission and began to make deep rolling noises - groaning in basset hound fashion. He had to go."

He was predeceased by his daughter Ruth Mazer, who died in 1978 at the age of 29, and his wife, who died in 2000 at the age of 87. He is survived by his son Mark Mazer of West Tisbury and two grandchildren, Laurie and Rafe Mazer.

A memorial service is planned for February. Details will appear in a future edition of the Gazette, along with an obituary prepared by the family.

Contributions in his memory may be sent to Martha's Vineyard Community Services, 111 Edgartown Road, Vineyard Haven, MA 02568.