Previously uncited archival material, principally letters between Adolf Meyer and Sandor Rado, is used to document the importance of a relationship between two influential figures in American psychiatry and psychoanalysis at a fateful moment in the evolution of both. Although Meyer and Rado have each fallen into relative neglect, their interaction not only was a crucial part of the schisms in American analysis in the 1930s and 1940s, but represented an important juncture in the history of the relationship between medicine, academic psychiatry and psychoanalysis in North America. Meyer's powerful influence was thus an essential component of Rado's attempts to rewrite psychoanalytic theory and terminology wholesale. Moreover, Rado specifically integrated the results of a radically integrationist agenda he had consolidated in his contact with Meyer into the organisation and educational programme of the psychoanalytic institute he founded at Columbia University in the early 1940s.