In Her Words
Virginia Minnich – Oral History Transcription
Dr. Estelle Brodman, librarian and professor of Medical History at the Washington University School of Medicine, interviewed Virginia Minnich as part of the School’s Oral History Program. The interview was recorded on March 25, 1981.
Introduction by Estelle Brodman: This is a biographical sketch of Ms. Virginia Minnich of the Department of Medicine at Washington University School of Medicine in St. Louis. It is dated March 25, 1981. Ms. Minnich was born in Zanesville, Ohio on January 24, 1910. She received her Bachelor of Science in Home Economics degree from Ohio State University in 1937 and her Master of Science in Nutrition degree at Iowa State College in 1938. She came to Washington University School of Medicine immediately upon graduation from Iowa State and has remained here until her retirement and beyond. She retired in 1978 as Professor Emeritus of Medicine. Between 1938 and 1978 she was Research Assistant, Research Associate, Research Assistant Professor, Research Associate Professor and Professor of Medicine as well as Assistant Director of Hematology at Barnes Hospital. She has had much experience in foreign service having served with the University of Havana, the Faculty of Medical Sciences in Bangkok twice in her life and with the University of Ankara in Turkey – the latter under a Fulbright fellowship. She belongs to many societies connected with hematology. Her awards, besides the Fulbright award for research in pediatric hematology already mentioned, are an Honorary Doctor of Science from William Woods College in Fulton, Mo., an honorary service award from the Ohio State University Home Economics Alumni Association and Honorary Member of the Turkish Society of Hematology. In addition, she is a member of Sigma Xi, Iota Sigma Pi, and has two other honorary science citations. She has published many articles and sections of books and has talked frequently on the subject of hematology.
Estelle Brodman: We are particularly pleased to have you here. I am sure this will be of great importance to the knowledge of the history of this School and the history of hematology here, and we look forward to having this in the oral history interview collection which we have here. I wonder if you would just tell us a little bit about your work before you came to Washington University or background at home as to what got you interested in this field and what brought you to St. Louis?
Virginia Minnich: Well this goes back a long way. I wanted to be a nurse and at that time I wrote to Dr. Vilray Blair about being a nurse and he told me that field was crowded and I should do something else.
Brodman: Why did you write to Dr. Blair? How did you know him – was he connected with nursing?
Minnich: Dr. Blair was the plastic surgeon here that I had seen since the age of 13. He and his associates performed about 25 operations for me. So, I was a friend, at least friendly with Dr. Blair as well as he being my surgeon. So finally, I got out of high school and it was four years before I went to college – from 1928 to 1932.
Brodman: That was about the time of the Depression.
Minnich: That was the time of the Depression and I had no money. Finally, my sister took me to Ohio State and I intended to work on my room and board but she decided I had better not do that, so I lived in a university house where I could do my own cooking. It is amazing how much you could do on so little money. I worked on Saturdays and got $2.00 a day, and then when the National Youth Administration started I got $15.00 a month as a nurses’ aide. Well, I found out that you got $20.00 a month as a secretary, as a typist, so the next time I was a typist.
Brodman: What did your family do, and how many siblings did you have?
Minnich: There were six of us in the family; I was the third in line. My oldest sister had a degree in accounting and she was working as a waitress in Philadelphia. The sister just older than I am was a teacher, she was rich, she was making $350 a year. So, she was the one that helped me get started in school.
Brodman: What did your father do?
Minnich: My father was a farmer and we lived about a mile and a half out of Zanesville. I went to a grade school that was all in one room – eight grades in one room. My elementary education was not the best. Then, I went to Zanesville to high school. This was three miles and I usually walked.
Brodman: Every day, three miles? Winter, bad weather and all the rest?
Minnich: Every day. My sister who was just younger than I started the next year, so the first year I went, my oldest sister and I walked together. The second year my younger sister and I walked together. Many times we had rides because people got to know us and picked us up.
Brodman: It was a safer world in those days.
Minnich: A much safer world. So in 1932 I worked as a nurse’s aide. My second year I worked in the Dean of Women’s office as a typist. One year I worked in the archives at Ohio State University, in the stacks, typing the Ohio Tax Report of 1810.
Brodman: If you ever want to go back to it, we would be glad to have you come to work in our archives.
Minnich: I don’t know what they ever did with that typed copy I made. I had to read from script and it was really difficult. Then, my senior year I worked on NYA and got a job with the Home Economics department.
Brodman: Had you majored in Home Economics?
Minnich: I was majoring in Home Economics.
Brodman: Why did you pick that subject?
Minnich: Not being able to be a nurse, I decided to be a dietician, and this is why I went into home economics. In my senior year the home economics department wanted someone to determine the iron in fruits. Dr. Carl Moore was working with Dr. Doan in the hematology laboratory at Ohio State [and] was set up to do iron.
Brodman: He was at Ohio State?
Minnich: He was at Ohio State at that time. So I worked on iron in young women. He wanted to do serum irons in young women so he talked the home economics department into having 18 college girls submit to serum iron determinations every month. I did the serum iron determinations in his laboratory. Chemically. He had worked out the method and this was what he wanted to do. So, the home economics project, the iron in the food, went by the wayside. This is how I got started with Dr. Moore. I worked many, many years with iron. During my senior year I applied for graduate school in biochemistry at Ohio State and for nutrition at Iowa State College. Since I had decided to be a dietician I took the opportunity at Iowa State College.
Brodman: Did you get a fellowship or scholarship with it?
Minnich: I had a fellowship that paid $50.00 a month and my tuition. So I was able to pay my rent. Then, I weighed food for a food balance study on one of the students, and every Saturday I would digest the food and excretions with sulfuric acid and send it to Iowa City where it was analyzed for the different minerals. They were interested in iron and the different minerals. That is how I made my $50.00 a month. Through my whole education, including the master’s, the amount I had to pay was $1,450.00 for five years of schooling. Now this seems impossible. At Iowa State I realized I didn’t want to work with only women so I wrote Dr. Moore and asked him for a job. If he had one, I would like to have it. He wrote back and I just want to read part of this letter that he wrote on May 6, 1938.
Brodman: He was then still at Ohio State but he was planning to come to Washington University?
Minnich: He was planning to come back to Washington University School of Medicine. He said, “I have just returned from Atlantic City where I had the opportunity to talk at great length with Dr. Barr [David Barr, M.D., Head of the Department of Medicine, WUSM], about our plans for the next year. I am very happy, first of all, that he was able to get the money for you to join us beginning September 1 at $75.00 a month.”
Brodman: Well, that was an increase in salary . . .
Minnich: Yes . . . “We shall have to do all our own blood counts, shall have to take care of our animals ourselves, as far as special feeding is concerned at least, shall have to file our own data as we accumulate it and be in general handymen.” Then up on the next page was this one sentence, “The laboratory should be glowing at night as well as during the day. During the spring quarter of each year it will be our job to supervise the giving of a course in clinical laboratory diagnostic methods to the sophomore medical students. I hope that you and Ms. Bierbaum . . .” (who was Dr. Doan’s head technician, and was going to come with Dr. Moore).
Brodman: Dr. Doan was somebody at Ohio State . . .?
Minnich: Dr. Doan was head of hematology at Ohio State. “. . . would be able to assist in preparing material for the laboratory demonstrations. I don’t visualize the job at all as a stopgap and hope that I shall be able to get Dr. Barr to increase your salary to a reasonable level. As I said before, however, it is only fair to warn you that the highest paid technician at the University, to my knowledge, receives only $125.00 a month.”
Brodman: That is amazing when you consider today’s salaries, but I must say that in 1938 I was only making $100.00 a month also so I know that this is what very often occurred. So you came to Washington University knowing Dr. Moore. Are you going to give the letter to the Archives, Ms. Minnich?
Minnich: I intend to give Dr. Moore’s original letter to the Archives.
Brodman: This will be put in the files with Dr. Moore’s other material. Thank you very much for the letter. So you knew him before you came together?
Minnich: That is right. Actually, he went to Europe in the summer of 1938 and when he came back, we started September 1, 1938.
Brodman: Ms. Bierbaum was somebody you knew from Ohio State, also?
Minnich: I knew her at Ohio State.
Brodman: Had you worked with her or you just happened to know her because she was around?
Minnich: I was a shy, little undergraduate and I knew who she was but of course I never talked to anybody but we became very good friends when we got here. Actually, I learned all of my morphology from her. She was an excellent morphologist.
Brodman: She was a technician in hematology?
Minnich: She was the chief technician at Ohio State.
Brodman: How long did she stay here?
Minnich: She was married in 1945 to Dr. Donald Bottom, who was in Radiology.
Brodman: Still?
Minnich: He was doing radiology and left here to go to Alton, Illinois. He died three years ago.
Brodman: When she married she left the field?
Minnich: She left the field. She didn’t do any more after she left.
Brodman: When you came here, what were the topics you were working on?
Minnich: I worked on iron. We worked on iron absorption and iron utilization. Those were the two main problems I remember.
Brodman: Had Dr. Moore been working on this at Ohio State? I noticed that the first article you wrote with him seems to have been number three in a series of studies in iron transportation and metabolism. Had he done number one and two somewhere else?
Minnich: Yes, he had done one and two at Ohio State. That was before I started. He was the one who really worked out the method for serum iron and the first one who said that serum iron was a transport iron.
Brodman: What is a transport iron?
Minnich: A transport iron means that it is going from one place to another . . .
Brodman: It takes with it something?
Minnich: It takes the iron, the iron is in the serum and so it goes . . .
Brodman: It is transported?
Minnich: It is transported. It is transported from the intestinal tract into the blood stream and then finally it is deposited in the bone marrow to make blood cells.
Brodman: I noticed in a number of your first articles you worked on the difference between the absorption of ferrous iron and ferric iron. What is that all about?
Minnich: Well, ferric iron is not absorbed well and Dr. Moore was actually the first who said ferrous sulfate was better absorbed than the ferric chloride. We then tried iron with Vitamin C and that was absorbed much better. You could take Vitamin C and ferric chloride and absorb as much as you did with ferrous sulfate.
Brodman: The importance of this is in the anemia?
Minnich: The importance of this is that all the drug companies now make a ferrous compound in their iron tablets rather than a ferric. When we were first working on this we found [that] dogs absorbed ferric as well as they did ferrous iron, but not humans.
Brodman: I noticed in one of your 1944 papers you said humans absorb ferrous iron better than ferric iron, but animals are different. Dogs absorb both equally?
Minnich: That is correct. We also worked on fortification of bread with iron.
Brodman: Yes, I noticed that. I want to know if that was the only nutrition study in your whole bibliography?
Minnich: Iron absorption is actually nutrition. So it really was not such a bad jump from home economics to hematology because, after all, nutrition is reflected in the blood counts.
Brodman: Yes, except whenever we think of dieticians we think of the food rather than the blood.
Minnich: When I went to Ohio State I was told really that I should not be a dietician because I would have to meet too many people.
Brodman: Why is that bad?
Minnich: Well, because my face was scarred from the burn I had at age four. You can’t disassociate my career from the burn at four. This is why I came to St. Louis to see Dr. Vilray Blair.
Brodman: Do you think they would have thought that today or was that just a condition of the 1920s?
Minnich: I think it was a condition of the 1920s. I don’t think it would mean so much today.
Brodman: Has it bothered you since, or have you gotten over it?
Minnich: I hardly think about it now. Of course when I was young, I did. Also, they told me I should not be a dietician. This is really why I went into research. But goodness, I met as many people in hematology.
Brodman: I am amazed at the number of people with whom you wrote articles.
Minnich: No patient ever questioned me. So I don’t think it would have made any difference; even if I had been a nurse, I think it would have been all right.
Brodman: It probably would have helped you in understanding the traumas that other people have with illness.
Minnich: Yes, but at that time it was better than being hidden at home.
Brodman: I should say. This is one of the reasons they often think people ought to go into libraries – because they are not good with people.
Minnich: I have always been pretty good with people. It really has made a difference. I think it made me more ambitious.
Brodman: It took more courage after everybody said it couldn’t be done, to do it. You certainly have been very successful, so looking back on it you can take great pride in how you overcame what other people thought was going to happen.
Minnich: I think my family were very good about this. They never treated me differently from the other children in the family. There are six children and I was always just treated as one of them.
Brodman: Were all your siblings sisters, or did you have any brothers?
Minnich: There were five girls and one boy.
Brodman: The boy was the youngest?
Minnich: No, he was next to youngest. He is an airplane engineer and worked with Curtiss-Wright and then he moved to Indiana and worked with Allison [and] General Motors.
Brodman: Well you have certainly overcome whatever difficulties you had. In looking over your publications I get the feeling that anemia was the next thing you went to from the iron metabolism – to anemia and various kinds of anemia. Could you tell us a little bit about that?
Minnich: Well I really began this study in 1945 when Ms. Bierbaum got married. I decided I wanted her job and Dr. Moore told me if I took her job I would never get back into research, but I took it because she always told me it was better than my job.
Brodman: What was her job?
Minnich: Chief Technician. She did all the blood counts and the differentials.
Brodman: There would be no research attached to that?
Minnich: Well, no, there wasn’t really. I still thought the grass was greener on the other side of the fence.
Brodman: In fact, it paid $10.00 a month more.
Minnich: So I took over her job. I stayed in it until 1949 and I saw it was a dead end. I really got very restless and then Dr. Harrington came. He was the one who really started immuno-hematology research here, by giving serum. Actually he gave himself one unit of blood from a patient with idiopathic thrombocytopenia. His platelets went to zero. He didn’t die from it, but it is really a wonder that he didn’t. At that time we could do things on each other which we can’t do now. He thought it was an immunological reaction and this is why we did it, so from 1949 to 1951 I worked on platelets. Dr. Moore told me I could go back into research and help Dr. Harrington on this platelet project. I worked with platelets for about two years. Then, Dr. Harrington went to the U.S. Public Health Service.
Brodman: Before we forget Dr. Harrington, that paper which you published with him in the Annals of Internal Medicine on immunologic mechanisms in idiopathic and neonatal thrombocytopenic purpura (Annals of Internal Medicine 38:433-469 [1953]), is one of the most-used articles in this library. When I went to read it, I found that it had been underlined, comments had been scribbled in the edges of the pages, and some pages had to be photocopied to be bound in. Is this an extremely important article or classic article that sets forth something new?
Minnich: This is a classic article. The work has stood up under everything.
Brodman: Would you tell us a little bit about that?
Minnich: As I said, Dr. Harrington took a unit of blood from a patient with idiopathic thrombocytopenic purpura and his platelets went to zero and he had petechia after he had taken it. He took it at midnight one night, he and the other hematology fellow. I was in South America, but I got a return to St. Louis and he was in the hospital.
Brodman: He had done what, he had injected himself?
Minnich: He had injected himself with one unit of blood from the patient with thrombocytopenic purpura.
Brodman: He thought it was agglutination?
Minnich: He thought it was an agglutination reaction.
Brodman: In the article he concluded that there was more than one cause for idiopathic thrombocytopenic purpura. Is that right?
Minnich: That is right.
Brodman: He listed at least three possibilities: the deficiency of the factor for platelet formation, the suppression of formation of platelets already there by the spleen or metabolic dysfunctions, and excessively rapid platelet destruction. These were his suggestions. Did he ever follow up on these?
Minnich: Well, these are really platelet destruction, really the agglutination of the platelets. Platelets agglutinate, form thrombi, and then are destroyed. They are taken up by macrophages. Now platelet production, can be decreased, as in aplastic anemia and the platelet production is just cut down, or they can be destroyed once they are made. These are pretty well documented. These are the reasons for thrombocytopenia.
Brodman: What ever happened to Dr. Harrington? When he left him he was in the hospital about to die?
Minnich: Dr. Harrington recovered in about five days. His platelets started to go up at about five days and after five days they really recovered. But those five days he sat up in bed so he wouldn’t bleed into his head if he was going to. It was rather a traumatic time. Actually two fellows did this at night. Dr. Hollinsworth, who was a fellow on hematology, the same as Dr. Harrington. The next morning Dr. Harrington went into the lab and saw he had no platelets and said on rounds to Dr. Moore what he had done. Well, they immediately put him in the hospital and he did recover.
Brodman: Without the platelets he would have died of bleeding?
Minnich: Yes. So after that, we all took blood or plasma from people with idiopathic thrombocytopenic purpura but we didn’t take a whole unit. That way we would work together to get our platelets down just half, to be significant.
Brodman: When you say you take?
Minnich: Injected ourselves.
Brodman: When you got them halfway down to zero, what would you do?
Minnich: Then we would watch it come back up.
Brodman: Why were you doing this?
Minnich: To be sure this was an immunologic reaction. It was quite an exciting time. Then, Dr. Harrington and I worked out the in vitro agglutination test so we could see if a serum was going to agglutinate platelets. It was different if they didn’t agglutinate platelets; [if] you had low platelets from lack of production for instance, they didn’t have platelet agglutination.
Brodman: In other words to identify the cause of the reaction. How long did you work on this in this field?
Minnich: I worked on this field from 1949 to 1951 and then went off to Thailand.
Brodman: Yes. Before we go off to Thailand, let’s finish off on this. Was that test named after you?
Minnich: No, I never had any tests named after me.
Brodman: Well now, Dr. Trotter was sure you did.
Minnich: No, the only thing I had named after me was the laboratory in Turkey. It is still named the Virginia Minnich Laboratory – but no tests.
Brodman: You are also the honorary member of their society, the Turkish Society of Hematology?
Minnich: Yes.
Brodman: Excuse me, you were just about to leave the country when I interrupted.
Minnich: At that time we had the Korean War and Dr. Harrington was drafted into the U.S. Public Health Service and was in Washington, D.C. I was in Thailand, so the work practically stopped until I returned.
Brodman: What got you to Thailand?
Minnich: What got me to Thailand? Well, Dr. Harrington had left and I was sort of at loose ends. Dr. Ben Eiseman, who was here in Surgery, had been to Thailand and had set up an exchange program with medical institutions there. He was recruiting people to go to Thailand and I applied. I went to Thailand.
Brodman: You were there twice.
Minnich: Yes, I was there in 1951 and 1952. When I was there, I set up three hematology laboratories.
Brodman: Only in Siriraj Hospital?
Minnich: No, I did it in Medicine and in Pediatrics at Siriraj and then in Medicine at Chulalongkorn University.
Brodman: I was there ten years later than you were so I know the University.
Minnich: When I was there we were paid by the U.S. Public Health Service, which gave the money to Washington University, so actually we weren’t on leave of absence. We were just getting paid the same, only in Bangkok.
Brodman: Besides setting up a routine laboratory, you did other things there because you published some things on genetics – thalassemia and Cooley’s anemia.
Minnich: When I was there we had all these patients with thalassemia so we worked these patients up both in pediatrics and medicine at Siriraj Hospital. We had a great big chart on the bulletin board and we wrote down all the results so that they could see the research that we were doing. Everybody, I mean I didn’t want anything under the table.
Brodman: Were you the only one from Washington University?
Minnich: No, there was a biochemist, [and] there were three nurses . . .
Brodman: All from the United States?
Minnich: All from the United States, and then there was Dr. Belioyost in Pathology. Dr. Belioyost graduated from here. He and his wife and then there was a bacteriologist from Kentucky or West Virginia, so there must have been three, four, seven of us I believe. The nurses, weren’t too busy so I took one of them and she helped me set up the filing system for the Departments of Medicine and Pediatrics at Siriraj. I had requested some equipment from the U.S. Public Health Service and it didn’t come and it didn’t come. Really, our methods were pretty primitive. However, they were very cooperative and we remodeled the lab. Before that, you had to sit at a high table with a high chair to look into a microscope. We put the tables down so we could put our feet on the floor. These were beautiful tables, all teak, and then we set it up so that anybody who wanted to come in and look at a slide could do so. We did have then lots of doctors and the house staff coming in to look at slides on their patients.
Brodman: You had gone there specifically to set up the laboratories or you went there with research projects in mind?
Minnich: I went there. Really, I had nothing in mind of what I was going to do.
Brodman: Did the whole team really have nothing in mind?
Minnich: We worked at whatever field we were in. I got much more out of it than anybody else, but I also put more into it.
Brodman: Why did you get so much more than they did? I would think they would have all gotten a lot.
Minnich: They went for a good time. I went to work and we did a lot. I was ready to come back in six months because the equipment had not come. It was so hard to get anything done at all. You had to work five times as hard there as you do here to get that much done.
Brodman: Yes, I know, India is even worse. Did you stay there longer than six months? One time you were there for six months.
Minnich: At six months, things just started to roll. I stayed then the whole year. Things really started to come together; we got good results and everything.
Brodman: What do you think in general about giving sophisticated equipment to countries where they don’t have this? Is that likely to be self-defeating and they are not going to get any more, or . . .?
Minnich: I think it is self-defeating to give too-sophisticated equipment to people who don’t know how to use it. When I was there the Pasteur Institute had put in an electron microscope and nobody knew how to use it. It was very easy to buy beautiful examining tables but if you wanted a test tube you couldn’t buy one. It was very difficult.
Brodman: The Food and Agriculture Administration of the United Nations puts out a little booklet, Computers in Third World Countries, and the first sentence says if you don’t have any electricity in your country it is no use buying a computer. I wonder if sometimes we aren’t doing just about the same thing with some of the equipment that we send to these developing nations.
Minnich: Exactly. Now when I went there we had used a Sahli apparatus for determining hemoglobin. They had no water suction pumps to clean the pipettes. We did all that by hand. I had ordered a colorimeter; it never came. Finally I found out it was in the Pathology Department and they just hadn’t turned it over because of jealousy between departments. I got it and we did hemoglobins the good way, then, but it really was very difficult.
Brodman: Well, you said you worked so hard in addition to actual physical work in getting things done. What subjects were you working on?
Minnich: We were working on the anemia that was so prevalent in Thailand. When I wrote up the paper, the very first paper of these 32 patients with thalassemia, one of the reviewers suggested that an abnormal hemoglobin might be connected with this. I had them send over samples of hemoglobin when we got our first electrophoretic power supply and electrophoresis on paper. We found hemoglobin E in the samples sent from Bangkok. In 1952 there were no jet airplanes and so this all had to come over by slower air transportation.
Brodman: They sent them here to Washington University?
Minnich: They sent them here from Bangkok to Washington University and they came in pretty bad shape, but we knew we had an abnormal hemoglobin. There was a doctor in Philadelphia that I [I knew] might have hemoglobin E, or this abnormal hemoglobin. He sent us some blood and it was a real good sample. Then we recognized it as hemoglobin E.
Brodman: “E” standing for?
Minnich: Well at that time, the hemoglobins were being alphabetized; every new one was a new letter of the alphabet. When they found we were running out of alphabet then they began to name them according to the hospital or the country or the patient. So I worked with hemoglobins for 15 years.
Brodman: What did you conclude from all your work on the Mediterranean Anemia?
Minnich: In Thailand, I calculated or estimated that about one out of every four Thais has some abnormality with hemoglobin or with thalassemia. In one section of Thailand 35% of the people have hemoglobin E.
Brodman: This results from what?
Minnich: No one knows why there is so much E. It is not the same as with Hemoglobin S, sickle cell hemoglobin. We think that patients who have Hemoglobin S have less malaria. This is not true in Thailand – the E have just as much malaria. So I don’t think it has to do with malaria although that is what they thought. I don’t think so.
Brodman: When they have this hemoglobin E, what is the result?
Minnich: If it is just a E heterozygous, you would never know it. If it is E-homozygous, it is much like hemoglobin C-homozygous, there is not much connected with it, not much anemia. But if you combine it with thalassemia, then it is a disease and not just a genetic marker. They not only have lots of beta thalassemia but they have lots of alpha thalassemia, meaning that the alpha chain is not being synthesized.
Brodman: When that happens, what is the effect?
Minnich: Then the genes just do not work, so you’re not making that globin chain and you have anemia.
Brodman: I noticed that when you did the hemoglobin E carriers in the entire population you used electrophoresis and found that 13.6% of the Thais (you examined over 1,000 Thais) had the hemoglobin E. But in 213 Chinese you didn’t find any at all.
Minnich: The ones that have E, are the ones in Southeast Asia, the Cambodians, the Vietnamese, the Malayans.
Brodman: Are they all one race?
Minnich: I am not sure they are all one race, but they are in some way intermixed.
Brodman: They have lived in the same area for so long it would be hard not to have intermarriage. In 10 members of a family in Thailand that you examined you couldn’t differentiate thalassemia homozygous hemoglobin E from the heterozygous hemoglobin E disease. How did you explain this?
Minnich: This has been pretty well worked out since I started working on it. If you have thalassemia with E, it just means that your chains are not like your alpha chain. Beta chain is not working, just not structurally there, they are just not being made. So if you put E with alphathalassemia, for instance, with a homozygote then you probably have only one gene that is making anything and this one gene is making E.
Brodman: Is there anything that can be done for these people?
Minnich: Nothing except for genetic counseling and that is it. That is a hard thing to do, especially if you are not from that culture.
Brodman: You also examined the hemoglobin in newborns, you studied the instances of abnormal hemoglobin in cord blood.
Minnich: They sent me the cord blood and it had Bart’s hemoglobin. Now Bart’s was first described by Lehman in England at Bart’s Hospital, so that is why it is named Bart’s. It is seen only in cord blood in alpha chain abnormalities.
Brodman: And you thought it might be due to the slow synthesis of the alpha chain?
Minnich: Actually, now it is pretty well settled that it is due to a gene that just is not there. It is not even synthesizing any hemoglobin.
Brodman: Mostly it is in the Negroes, or blacks, as they call themselves.
Minnich: Yes, it is more in the blacks than in the white population.
Brodman: Is there any relationship to their sickle-cell anemia?
Minnich: No, I figure there are just more genetic abnormalities in the blacks than the Caucasians in the United States.
Brodman: You continued to work overseas in Turkey. You worked on pica. What did you find?
Minnich: We found that the women were eating clay. The clay in Turkey is used for washing clothes and every household buys it at the grocery store and the women just take a pocketful of clay and eat it. [It is] just a habit much like smoking cigarettes, and when they feel like it, they eat some. The clay itself in Turkey combines with iron. I think, though, the pica comes first. They are eating clay because they’re iron deficient and it just makes it worse. That is really what I think. They don’t get the iron deficiency from eating the clay; they eat the clay as a result of the iron deficiency.
Brodman: Is that true here in the United States?
Minnich: That is true here in the United States, too. People who have pica here in the United States are iron deficient to start with.
Brodman: Can they be helped to stop eating the clay?
Minnich: As soon as they get enough iron, they stop.
Brodman: They stop on their own?
Minnich: They stop on their own. Children will do it too. As soon as the child’s hemoglobin starts coming up he stops eating it.
Brodman: If they don’t, what happens to them if they continue to eat the clay?
Minnich: They continue to be anemic.
Brodman: Is the clay the same in the United States as in Turkey?
Minnich: No, I have tested a good many clays and they are not the same. Our clay is much less alkaline than the clay in Turkey. The clays I tried here did not decrease the absorption. There, it is much like celation. The iron is exchanged for the calcium in the clay.
Brodman: I suspect these women who are iron deficient also may be calcium deficient, too.
Minnich: Well, they get plenty of calcium from the clay. They might be, but I don’t think so.
Brodman: Usually you think of women with many pregnancies as being calcium deficient.
Minnich: Well, in some of them there is a big calcium deficiency I am sure. I was only working on iron.
Brodman: You did most of your work on anemia and iron, sickle cell anemia and sickle cell traits, thalassemia and hypochromic anemia?
Minnich: That is iron deficiency.
Brodman: What do you think were your major findings over the years?
Minnich: I think probably the best thing I did was to set up laboratories – get laboratories going. I did that in Havana and I did it in Thailand and I did it in Turkey. I think that is one thing that I can do is to set up a lab and get it started and working. I think the other was the hemoglobinopathies. I did a big study in newborns, here, and followed them until they were over a year old.
Brodman: What did you find?
Minnich: At that time, the theory was that you were born with all the alpha chains that you were going to make. They were there when you were born. The work I did confirmed this with laboratory tests and showed this was really what happened. All alpha chains are there when you are born, or just about all of them. So the alpha chains – if you had a child with an alpha chain deficiency as in G Philadelphia – were the same at birth as when it was a year or two old. That is one thing I found. Also, we noted that the alpha chains could go with the gamma chains of hemoglobin F so that you had a new hemoglobin. They called that hemoglobin F St. Louis. I never called it that because all it was, was hemoglobin G Philadelphia with gamma chains which are the chains that make fetal hemoglobin – alpha and gamma.
Brodman: You followed these children until they were about a year old? Later on they did not change either?
Minnich: No change. Well, I haven’t pestered any of them after five years, but usually in a hemoglobin G Philadelphia heterozygote the hemoglobin is not low. It has no effect on the amount of hemoglobin that you have and circulate. It was at that level. It was the same all through.
I think these things are really what I have done. My contribution is setting up laboratories, and getting others to work.
Brodman: Also knowing what is needed as well as all the things you have found out. I also noticed you did some work on mutagenesis.
Minnich: That was my last program. After I stopped on hemoglobin, I worked on audiovisual aids for two years. Then I worked on glutathione synthetase and worked out the method for glutathione synthetase with Dr. Majerus’ help. I did all the tests but it was he who suggested I do glutathione, so I did it.
Brodman: What did that test show?
Minnich: It shows that it takes enzymes to put the glutathione molecule together. We found the first synthetase to put the first two amino acids together and there is a second one that puts the third one on the end. It is three amino acids.
Brodman: It sounds like biochemistry.
Minnich: I have done some very sophisticated biochemistry in my lifetime.
Brodman: Yes, and I wonder how many people realize how good you are.
Minnich: Because I found one hemoglobin, did most of the work on it, separating it, doing the analysis of it, doing the fingerprinting for the amino acid analysis, and so . . .
Brodman: They also said you did away with electrophoretic methods in favor of a much simpler method of identifying hemoglobins. You have really done quite a lot. It is very unusual for somebody to spend 40 years in one institution. Did you ever think of going elsewhere?
Minnich: Well I think these trips elsewhere are the ones [when] I came back satisfied.
Brodman: Well that is a very good feeling indeed. How come you never stopped long enough to get your Ph.D.?
Minnich: I thought about getting a Ph.D., but Dr. Moore said, “Why do you want a Ph.D.? You don’t need one.” That is really why I don’t have one.
Brodman: You agreed that you didn’t need one?
Minnich: I don’t think I need a Ph.D., but I would have loved to have an M.D. He also didn’t see why I should be a M.D.
Brodman: Do you think it would have made any difference in the way people treated you if you had either one of them – a Ph.D., or an M.D.?
Minnich: No, but I think it might have made a difference in my salary.
Brodman: That is certainly true. He didn’t see that at all; he didn’t think it was important?
Minnich: I don’t think so.
Brodman: Is that because he thought women didn’t need to be upwardly mobile?
Minnich: I think he had some feelings in that direction.
Brodman: I have heard those stories about him. In general, did you feel that women were treated as well as men here?
Minnich: No, I don’t think they are.
Brodman: Ever? Not now?
Minnich: Not now, not ever.
Brodman: Besides your not being allowed to, or given the time to, or whatever to get your M.D. or Ph.D., what happened to you that makes you feel this way?
Minnich: Well I have really been very lucky, I have really been lucky to be a Professor in Medicine without an M.D., or a Ph.D. That was later on.
Brodman: After Dr. Moore’s death?
Minnich: Yes, that was after Dr. Moore’s death. Dr. Majerus was the one who supported me for a professorship and I got it.
Brodman: Why didn’t they give it to you previously?
Minnich: Well, I didn’t get the Honorary Doctor of Science until 1972.
Brodman: What do you think the Medical Center ought to do in order to treat its women equally with its men?
Minnich: Well I think one thing is that if you knew salaries, which are always confidential, it would help. But these are confidential so we will never get that information. Women will never know what the men are making and when they do they get so mad.
Brodman: Is it only salaries that show a tendency to treat men and women differently, or were there other subtle things?
Minnich: With me, it was primarily salary. When Dr. Harrington took over the Division of Hematology in 1954, he said it was silly that I was getting so low a salary, so he almost doubled in his first year. Then Dr. Elmer Brown got me the research associate professorship. That was the time I was going to leave, but didn’t.
Brodman: Where would you have gone at that time?
Minnich: I wrote to Virgil Clock [?] at the Rockefeller Institute and told him I wanted a job, a permanent job, and that I’d go any place in the world. I showed the letter to Dr. Brown and Dr. Moore. Elmer asked me, “Do you want to leave?” I said, “No, I didn’t want to leave, but I can’t put up with the way things are.” So he got me the research associate professorship. That was in 1967. That was the first time I ever complained in my life.
Brodman: Why did you wait so long?
Minnich: Because I was satisfied. But when someone else got a research associate professorship who had a Ph.D., I’d had enough. I asked, “Is this the reason I’ve not been advanced – that I haven’t a Ph.D.?” The answer was, “Yes.” I said, “I can’t take this, especially after Dr. Moore had said I didn’t need a Ph.D.”
Brodman: How long between the time Dr. Moore told you [that] you didn’t need a Ph.D., and 1967?
Minnich: He always told me that, from 1942 onward. You see, I wanted to stop work and go to medical school. I should never have listened to him. It’s my own fault. I had a friend at Vanderbilt and could have gotten in there. But during the Second World War we were so short of people. They really needed us, anyone who could work.
Brodman: You also did a lot of teaching while you were here. Were you the first one to make audiovisual teaching aids?
Minnich: I was working on them [at] the same time they were working on them in the dental school. But there weren’t very many teaching aids at that time. Actually, the way I got interested was through the 3M machine, Sound on Slides, an audiovisual device with little audio disks on the slides that could be used to provide explanation/description. Then, when the McDonnell Science Building was built we got money. So I ordered three machines; then I had to do something with them. And so I wrote the slide descriptions on the audiovisuals.
Brodman: How had you been teaching previously?
Minnich: Oh, just with talking and lectures.
Brodman: Do you find audiovisual methods good for teaching?
Minnich: I find them wonderful. I don’t know how good they are for the students but to me it’s good. They look at them and I don’t have to go over everything.
Brodman: Are you still teaching? You’re an Emerita Professor?
Minnich: I am now working on the audiovisual aids. This is called Blood and Bone Marrow Cell Recognition. I have turned it over to the American Society of Clinical Pathology and they are going to publish this. There are 10 units with 40 slides per unit. Ten of these slides are question slides for self-teaching and the other 30 slides are descriptive. I am on Unit 8, just about ready to send in Unit 8, and rewriting one, two and three – just a few descriptions that the publishers have sent back.
Brodman: Then you will be through pretty soon?
Minnich: Then I go back on staff July 1, part-time at Barnes. This is really as an Assistant Director of Hematology, but all the laboratory medicine staff there are on Washington University’s payroll. So I actually go back on the Washington University payroll and my title will be Emerita Professor and Lecturer.
Brodman: You’re pleased to continue your work here, you don’t want to retire?
Minnich: Not yet. Maybe someday I will.
Brodman: You have had so many honors, I am impressed with them. What do you do that brings you the most pleasure?
Minnich: What honors? Well the Honorary Doctor of Science degree was the one that really . . .
Brodman: You didn’t have anything to do with William Woods College before?
Minnich: There is a Professor of Biology at William Woods. She had some training with us in 1941 and she called me one day to ask if I would help her with a paper on sickle cell anemia. We worked and she went to Dr. Moore and told him she thought I should have an Honorary Doctor of Science degree. He agreed. She is the one who did it.
Brodman: I can’t think of a better person to honor.
Minnich: I really was surprised when I got that letter.
Brodman: That is a very nice surprise. Is there anything else which I didn’t cover?
Minnich: I don’t think there is much else.
Brodman: What about the changes here at the Medical Center?
Minnich: Oh, yes, the changes. I wrote down a few here, more buildings, many more people, everything now disposable. We used to have to be so saving of glass during the war it was just awful. Now money is more free. It used to be very tight.
Brodman: I wonder if that is going to continue now that the granting programs are being cut back.
Minnich: I think the ones that are doing good work will continue to get grants. I think they will cut out grants that are not so important. In our department we seem to have no problems at all. Maybe we will, I don’t know. We will have to see. You asked me who was here when I came. Dr. Evarts Graham was here, I think the Coris were here, too, I am not sure.
Brodman: Well at least Carl Cori was here when I came in 1961.
Minnich: I am not sure if they were here in 1938. There was Dr. Philip Shaffer, of course. He was the Dean. Dr. Robert Moore in Pathology; Dr. Mildred Trotter was here, and Dr. Margaret Smith, Dr. Cowdry, and Dr. Erlanger.
Brodman: In general what were they like? Were they all research-minded, all good teachers?
Minnich: Dr. Carl Moore was an excellent teacher. He was a good teacher, good researcher, good administrator. He was really a wonderful man. Honestly, some things I didn’t agree with but . . . really he was excellent. He was interested in patients and he wasn’t interested in getting a lot of money. He was really good with patients and he was a good clinician and a good hematologist. He could do his own blood counts and his own differentials.
Brodman: I didn’t realize he had been in Ohio? He came from St. Louis.
Minnich: He had an American College of Physicians scholarship.
Brodman: So he was in Ohio just a few years.
Minnich: He was in Ohio from, I think, about 1932 to 1938.
Brodman: Well, while he was here he got to be father confessor for most of the people in the Medical Center. I think that is why he was the first Vice-Chancellor for Medical Affairs. Was he involved in any way in the feud between Dempsey and Queeny?
Minnich: I don’t know. But he told me once that Mr. Queeny took ten years off his life.
Brodman: By doing what?
Minnich: By the contract with Barnes. You know, they worked on that contract for two or three years and finally got the contract together and he worked on that. Then, when he was getting ready to retire – you know he was going to retire to set up a cancer center, and he was not looking forward to doing that either.
Brodman: He was not looking forward to that?
Minnich: He was not looking forward to that. He felt that he had to do it. He thought it was his duty.
Brodman: His duty to leave the head of the Department for . . .?
Minnich: No, he had to retire as head of the Department. He was 65.
Brodman: But he could have continued in his research.
Minnich: He could have continued in his research, but I don’t think he wanted to do that.
Brodman: There was also that escape hatch that the Dean could have asked him to stay on until he was 68, I believe. But apparently . . .
Minnich: He would have stayed on, starting the Cancer Center.
Brodman: But if he wasn’t really very interested in it?
Minnich: He was interested in it. I think he thought it was going to be a terrific job.
Brodman: He didn’t want such a hard job at his age.
Minnich: I think that was really it.
Brodman: He died very suddenly of a heart attack, I assume.
Minnich: Yes, he did.
Brodman: Had he had any previous episodes?
Minnich: Not that we really knew of. I think he knew it himself – I think he knew. He told his nephew that he had something like an infarct about three weeks beforehand. I think he knew he had something but didn’t see anybody about it. He finished writing his last paper and this was a review on nutrition. He went down to the lake to take a swim and got out of the water. His wife went to their cottage and said that he asked for the morphine because he had such terrific pain. They got him to the hospital and he died that night. He monitored his own EKG, monitored everything they were doing for him. It really was a shock.
Brodman: In a way I think it is lucky for him to go that quickly.
Minnich: That is the way he wanted to go. He once told me that if he ever lost control of himself, I should come in and give him a shot of something. But you know I couldn’t ever do that, but he just dreaded so much being like Dr. Sam Grant. He said he never wanted that.
Brodman: I think most of us are fearful of that kind of thing.
Minnich: Now you ask if the medical students are the same as those in the 40s and the 50s. In the 40s and later, after the war, the average age went way up. Our second year class I think in 1947 was something like 28-1/2 years old.
Brodman: Because they were in the war?
Minnich: Yes. Then in the 50s I don’t remember them so much. In the 60s, that is when they started to lose respect. I remember Dr. Al Goldman, the chest man, was lecturing to the students in class. He was giving the lecture on sputum and the kids started to make noise. He said, “I will take any of you on that will come up here, I was an amateur boxer and if you are going to behave like that I can take you on.” They did quiet down. They used to boo; it was really a very bad period. Now, I think they are beginning to go back to looking and acting like doctors. I am awfully glad to see it.
I have taught since 1938. I started teaching in the laboratory medicine course, getting the student labs prepared. I did that for 40 years, which was enough.
Brodman: Do you like teaching?
Minnich: I love teaching, but I like informal teaching, like laboratory teaching. Then I taught at night a lot. My first class were four colonels who were sent here by the army. They worked in the clinics but they were getting bored. They asked if I would I teach them. Well, we had four nights, one hour each night.
Brodman: Was this informal?
Minnich: This was informal, at the microscope. This was an evening course. I know I didn’t know very much about it but that is how I got started, with evening courses. That was one of the reasons I went to Turkey, to get away from evening courses. Then, I taught some in the Continuing Education for Dr. Brown.
Brodman: I am still interested in the evening courses, were they official courses?
Minnich: No, I got paid by the students. I taught many pathologists and many physicians. I taught no medical students in these evening courses. There were a few technicians, but not very many. Most were pathologists and interns.
Brodman: Then you could have stopped at any time and said, “I don’t want to do this anymore?”
Minnich: I was getting requests all the time. Well, I just hate to say “No.”
Brodman: You loved your work.
Minnich: I do. I just wish I had kept a list of everyone I had taught. I taught practically every pathologist in St. Louis. I have Walter Bauer and Richard Payne down at Lutheran and Dr. John Bauer at DePaul and Dr. Gillespie at St. Luke’s, but these were all evening courses.
Brodman: I had not heard about those; this is all news to me. Do many people around here give such courses?
Minnich: No. This is why I was so popular.
Brodman: Others probably made more money so they didn’t feel they had to give evening courses and that was a little extra money for you.
Minnich: I know one time a pathologist asked me if I would teach him. I said it would be $20 and they didn’t come. If I had said $200 they would have come. But since I said $20 they probably thought it wasn’t worth it. I taught house staff for nothing. So I really have taught a lot.
Brodman: It sounds to me as if the Medical School owes you a great deal more than just money.
Minnich: You asked me if I wanted to comment on anything else. The only other thing I wanted to comment on was I have been the historian and the photographer for the Hematology Division.
Brodman: Oh, do they have a history?
Minnich: No, we don’t, but I have taken pictures of all the fellows and the people who have been here. Dorothy Moore has the first book of these – these were actually hematology fellows – and then I have the second book.
Brodman: What are you going to do with all your material?
Minnich: That is just it, what am I going to do with them, I don’t know.
Brodman: Why don’t you give them to the Archives or leave it in your will to the Archives.
Minnich: Well, I probably will do that if they are worth anything.
Brodman: Are you going to stay in St. Louis?
Minnich: Yes, I decided to stay in St. Louis, I don’t think I will be leaving.
Brodman: Then you don’t have the problem I have which is emptying my apartment now. But don’t wait too long to go through all this stuff, and turn over to us anything that you want.
Minnich: I shall do that. Is Mr. Anderson the one to see?
Brodman: He’s the archivist, yes. Thank you very much for this. It has been a very useful interview and I am sure the people who will listen to it in the future will be very pleased to get it. We do thank you for taking the time to do this. This is the end of the interview with Ms. Virginia Minnich on March 25, 1981.
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