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Ruth Silberberg – Oral History Transcription (Cont.)

BRODMAN: Please go on as much as you want. We’re delighted to have as much time as you will give us.

SILBERBERG: Well, immunopathology has come into being as an exceedingly important branch that increases in significance from day to day, really. So, at my age one really feels kind of outdated at times with the methods we were trained in.

BRODMAN: Still, you have been using them. You wrote an article in 1973 on using electron microscopy on osteoarthrosis and the aging process. I read it yesterday with great interest. Obviously, you have taken the new methods in with your regular work, so I think you’re just being modest.

SILBERBERG: No. I’ve taken in electron microscopy because this is really the one that is most closely related to the methods that were in vogue many years ago. Electron microscopy is morphology and I’m trained in morphology. But nowadays if you want to be an effective pathologist, I really think you have to have training in biochemistry and immunology as many of our young people have now.

BRODMAN: It’s very interesting to me as a historian of medicine to see a pattern like molecular medicine or molecular biology, which has so many tentacles. It is beginning to bring the world together on a new axis in medical science. I wonder if you would like to say a few words on how it affects pathology.

SILBERBERG: Well, it really moves the search for knowledge of diseases onto a different level. At the time of Virchow and the hundred years past him, we were concentrating on the cell. When electron microscopy came on we thought, “Well, we will find the essence of disease in the sub-cellular structures.” Now, we all have been a little bit disappointed in that because electron microscopy still is morphology and morphology has its limits. So has biochemistry, because if you match up your tissues you’re not able to localize disease processes. You may identify them but not localize them. I would imagine that the future really lies in those methods which combine the pharmacological and biochemical with the morphological aspects. So, the highly sophisticated technique tracing [particles] with the electron microscope would help a great deal. Cell centrifugation with separation of cellular constituents and then exposing these constituents to biochemical and immunological tests, as is being done now, will certainly lead us farther. Where the final solutions will be of course, nobody knows.

BRODMAN: I would think that we are at a place where no one method or no one explanation is the right one and unification is what we’re looking for. One has to look at the world from different points of view.

SILBERBERG: This is very true. As you say, unification, well, that should be a final goal. But on the other hand, the possibility that it will lead to greater diversification is also very great because you cannot possibly master all these methods that you would want for unification. So, the words “molecular biology” are a simplification of a great many things. How unification will ever be possible is really a very difficult thing today; it will take a great mind to put it all together.

BRODMAN: Perhaps we need a generalist who takes all the specialties together and makes one thing out of it. In this particular medical school, how has pathology changed? Obviously, it must have changed the way pathology generally changed, but how about more personal things in the changes here?

SILBERBERG: It has changed enormously. When we came here in the late 1930s, Leo Loeb was head of pathology. Of course, he was a great scientist, really one of the basic researchers especially in cancer, but also in endocrinology. His role as head of department can be questioned, but he was intelligent and unselfish enough to turn the administrative aspect and the teaching aspect over to his second man, who at the time was (Dr. Howard A.) McCordock, an excellent teacher and an excellent morphologic pathologist. Unfortunately, he died very shortly after we came [ed. note: Dr. McCordock died on November 13, 1938]. There was a brief interlude, then Dr. Robert Moore came and with him the whole attitude, the whole aspect of the department, changed completely. He has been quoted as saying, “I am a simple doc,” which really characterized the whole outlook. The work of the department was concentrated toward practical pathology, autopsy pathology in particular.

Surgical pathology at that time, was still in the hands of the surgeons – Dr. (Nathan A.) Womack. Only many years later Dr. (Lauren) Ackerman, a pathologist [and] a member of our department, took over the direction of surgical pathology. So far as our own research was concerned it certainly was difficult in the time of Robert Moore.

BRODMAN: Was that why you left and came back?

SILBERBERG: No, no. We had an opportunity for salaried positions. Our financial situation with Leo Loeb was impossible, to say the least. We enjoyed the scientific work with him and that’s why we stuck it out as long as possible. Then, in 1940 or 1941, he resigned even from his laboratory work. He retired completely and that was the signal for us to get away, and then we took these positions at New York University.

BRODMAN: And what brought you back here?

SILBERBERG: The City Hospital of St. Louis’ department of pathology was reorganized. It was in a pretty unorganized state, with part-time people. For some reason or other it was decided to reorganize the place. The head of the laboratory still was Dr. Sam Gray, who kept working as a part-time director, but the deputy director was John Saxton, a member of our department here, a very learned man and at the same time an excellent practical pathologist. Together with him, there was another senior position free at the City Hospital, which my husband took at that time. This was during the war (World War II). Sam Gray was in the navy. Sam Gray was [also] chief pathologist at Jewish Hospital; [when he left for the navy] they had no chief pathologist. So, I took over the pathologist’s job at Jewish Hospital. That gave us a very good base for a start here in St. Louis, and we were glad to come back, very glad. At the time it was agreed with Dr. Moore that we would be part-time members of the faculty.

BRODMAN: You said that Dr. Moore’s interests were not in research and yours were. Would that not have made it a little complicated and difficult to work here?

SILBERBERG: It was very difficult. I remember, to give you an example, we [got] a small grant from the American Medical Association for our research. We had a laboratory at the City Hospital. There were certain problems of administration with the city because they just didn’t have a setup for administering research grants in those days. So we asked Dr. Moore whether Washington University would take over the administration of the grant, and he refused.

BRODMAN: Did you lose the grant?

SILBERBERG: No, we got the grant with the help of the city administration. They set up this fund – it was a little bit unusual for them, it was a little unusual for us – but it worked out.

BRODMAN: What was Dr. Moore’s objection? Personal?

SILBERBERG: I do not know. I have no idea. Later on, things became a little easier. He agreed to furnish our laboratory in City Hospital. We needed some equipment and there was the Gerentological Research Foundation, associated with the school. They had quite a bit of money and he gave us some money for equipment. So, I think he relented a little bit.

BRODMAN: He has been said to be a politician more than a scientist. I suppose the fact that he was dean here and then went to be dean in several other places would bear that out. Was that your feeling about him, too?

SILBERBERG: Oh, yes. If I may quote something that I heard in New York, which amused us very much: In our department was a man who was a classmate of Dr. Moore’s at, I think it was Cornell University. He quoted Dr. Moore as saying during his first years in medical school, “I’m going to be a dean.”

BRODMAN: That seems to have been his thrust all along. How long did he stay? I guess (Dr.) Paul Lacy was the next one (head of pathology) or was there somebody in between?

SILBERBERG: Oh, no. There were a lot of people in between. You know, he took over the deanship and had both the deanship and the chairmanship of our department at the same time.

BRODMAN: As most of the deans do.

SILBERBERG: Apparently that proved to be unworkable and there were other heads of the department. I probably will have a little difficulty enumerating them in the right order. There was Gustav Dammin. He was a clinical pathologist and a member of our department. He is now in one of the Boston hospitals [ed. note: Dr. Dammin went to Peter Bent Brigham Hospital]. He was head of the department for some time; it may have been a year, it may have been a little less. Then, I think there was a short time that Dr. Moore came back as head of department. Then, of course, there was Dr. Stanley Hartroft, who came here [in 1955]. [With] this, the reversal of the changes instituted by Dr. Moore came about and the entire orientation of the department was back to research. Also, I would say autopsy pathology was not neglected, but the stress was on research. You know that Dr. Hartroft has really carried out a good deal of research, particularly on liver diseases. So, from then on things changed; they changed very much for the better for us, too.

At that time – Dr. Hartroft was here in the late 1950s – and in 1959 we received this pension from the German government and we decided that we would rather quit the routine work which had been our bread and butter at the City Hospital and go back for a time to research. In preparation for this we went to Switzerland for a year where we familiarized ourselves with electron microscopy. We came back in 1960 on a full-time basis.

BRODMAN: That’s very interesting. Since Dr. Hartroft’s time, the whole emphasis here has been on research, and yet it can’t be entirely on research because it must have the ordinary routine hospital pathology [also].

SILBERBERG: Certainly. We have a very elaborate program of autopsy pathology and surgical pathology. I think these aspects of pathology are taken care of in a meticulous and exemplary fashion. I think the training that our young men get, especially under the guidance of John Kissane, and the rest of the senior staff, is really excellent. It is not neglected by any means. At the present time, the time is divided about equally between training in routine pathology and training in research, and that is satisfactory all the way around.

BRODMAN: What made you enter pathology in the first place?

SILBERBERG: I was interested in biology. In those days, if you wanted to go into biology, you had two ways open. One was to become an academician and the other was to become a schoolteacher.

BRODMAN: Was this true of everybody or just women?

SILBERBERG: No, that was really true of everybody. So, I didn’t want to become a schoolteacher, and of course, there was no guarantee that as a woman you could make a living in academia. So the next closest [discipline] was medicine. I studied medicine and as soon as it was possible to look into the different disciplines of medicine, I got into pathology and I got stopped right there as a medical student.

BRODMAN: You got out of medical school just a year or so before Hitler came to power. Was that a very difficult time to be in Germany?

SILBERBERG: Yes. Of course, I was already an assistant in pathology. We saw it come gradually. The philosophy, if you can call it a philosophy, of Nazism took root first among the lower employees, who were, in part, former soldiers. They always had grudges against the ruling group, so I guess that’s where it started. The second group to be affected, I think, were the laboratory technicians, and then it slowly crept into the academic staff, too. Our head of department was an old conservative who always used to say, “Don’t worry, we’ll take care of Hitler.” Well, everybody knows how the conservatives did take care of Hitler. During the last year, I would say, from 1932 on, it became clearer and clearer to us that we would have to leave. Dr. Martin Silberberg having been here with Leo Loeb in the late 1920s, immediately began negotiating to find a job in this country.


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