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Virginia Minnich – Oral History Transcription (Cont.)

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.


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