AUGUSTA -- More than any other staff member at Riverview Psychiatric Center, Dr. Jose Castellanos has witnessed transformation.

When the Mexico City native arrived in Augusta to work as a physician at the then-Augusta Mental Health Institute, he found an 1,800-patient facility where patients who checked in often spent their last days.

That was 50 years ago.

Today, Castellanos oversees medical care for half the patients at a four-year-old, 92-bed facility -- now called Riverview Psychiatric Center -- that has begun to focus on rehabilitation rather than isolation.

On July 30, Castellanos, 82, will mark 50 years of service at the psychiatric center. And retirement plans are nowhere in sight.

"Closing my eyes, the time flies," he said Friday in an interview in which he spoke in both English and Spanish. "I could retire tomorrow, but I still love my patients. They give me satisfaction more than any money can give."

Attending medical school at the National University of Mexico in Mexico City, Castellanos spent one year as an intern in Huasteca, a tropical region along Mexico's eastern Sierra Madre mountain range, where he performed some of his first surgeries.

He recalls one difficult operation during which he had to tie a "drunk fellow" to the operating table with ropes to restrain him. The equipment and treatments available to him were primitive, Castellanos said.

He finished medical school in 1950 and, after a brief stint at a Mexico City hospital, decided to relocate to the United States to continue his training. In 1953, he arrived in Massachusetts, where he worked at hospitals in Boston, Danvers and Lynn.

A simple economic decision led Castellanos to Augusta in 1958, when he chose a job at AMHI over an opportunity in Alaska.

"Because I didn't have a car to go to Alaska, I came to Maine," he said.

Castellanos relocated to an apartment, and later a house, on the AMHI campus with his wife, Doris, and two daughters, then 10 months and 2 years old.

Soon after moving in, Castellanos said he and his family discovered an anti-AMHI stigma in and around Augusta.

"In some ways, the people in the community were afraid of us," he said. "My kids, they were ostracized in school."

The facility where Castellanos began his work has changed fundamentally.

When he arrived in 1958, AMHI divided patients into male and female sections. Today, Riverview sends a patient to one of four wards, depending on the type of mental illness and legal status.

When Castellanos arrived at AMHI, the facility was entirely self-sufficient, save for the electricity it purchased from a utility. A barn housed cows, corn grew in open fields and a staff of painters, masons, carpenters and others tended to facility maintenance.

AMHI even employed staff members charged with sewing pillows and manufacturing mattresses, Castellanos said.

During strawberry season, he said, the sweet berries grew throughout the AMHI property to the delight of patients and staff members.

"All these places, they were full of strawberries," Castellanos said. "They ate strawberries until they came from the ears."

As an AMHI physician, Castellanos has had to deal with tuberculosis, hay fever and, most notably, diphtheria that spread through the institute.

In 1964, one patient in a crowded unit died after experiencing severe difficulty breathing, Castellanos said. Two weeks later, another patient reported the same difficulty and died soon after.

AMHI was on the verge of an outbreak of diphtheria, a bacterial infection that often causes the neck to swell and obstructs breathing, the staff discovered. Castellanos oversaw the isolation of the infected patients and the vaccination of AMHI employees.

"We used all the diphtheria antitoxin that was available to us in the United States," he said.

Castellanos became one of the first doctors in the United States to manage such an outbreak. He was poised to publish an account of the outbreak in The New England Journal of Medicine but, Castellanos said, his overseers prevented him from submitting the essay.

"If people find out there's diphtheria in Maine in the summer, it could affect the tourists in Maine," Castellanos said he was told.

He eventually published the essay in 1967 in The Journal of the Maine Medical Association.

Castellanos said his career has not been free of regrets.

He regrets, for example, the use of insulin and electroshock therapy and physical restraints on psychiatric patients.

"The only thing I feel bad about is the treatment," he said.

Castellanos said he fought with psychiatrists, urging them to stop using such restraints.

The doctor's life had another low point: the death of his daughter at age 21, during a dental operation. She died on his birthday, March 17.

"I remember that every birthday," he said. "That made me feel a little more humble."

It also motivated him to continue helping patients, he said.

Colleagues say Castellanos' career has been marked by his congenial relationships with patients.

"He's everyone's kind of fantasy of what a good doctor ought to be," said Riverview Medical Director Dr. William Nelson, who has known Castellanos for six years.

Dr. George Davis, who has worked with Castellanos 19 years, said the work at Riverview has kept the 82-year-old young at heart.

"It keeps your brain young since there's never a dull moment here," Davis said. "It keeps your brain sharp."

While he is modest, Castellanos is well aware of the affection some patients have for him.

As emergency room director of the former Augusta General Hospital, a job he took on in addition to his AMHI duties, Castellanos said he worked three nights each week. Patients would often visit the emergency room seeking treatment specifically from Castellanos.

"Sometimes," he said of the nights he was not working, "patients would say, 'I'll come back tomorrow.'"

Matthew Stone -- 623-3811, Ext. 435

mstone@centralmaine.com