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Mildred Trotter – Oral History Transcription (Cont.)

Brodman: And whom did Dr. Dempsey bring in place of these people?

Trotter: He brought Drs. Sam L. Clark, Jr., Sarah Luse, Roy Peterson, Duncan Chiquoine, Allen Enders and others.

Brodman: The work which they did was very often in the field of neurology. Sarah Luse’s, at least, was in the field of neurology. What general, overall changes did you see in the Anatomy Department from the twenties to the present?

Trotter: [I would name two, above all:] reduction in the number of teaching hours and a great increase in the amount of money available for research.

Brodman: Was this money available to other medical schools, or was Washington University simply more successful in acquiring it? Or, perhaps, did we have so little to start with and, therefore, any new funding represented a great increase?

Trotter: I think that most medical schools [attempted to find new sources of funding. As for earlier years, I wouldn’t say that] we had so little money. I think we were well off. [The medical school was] certainly well off compared to the rest of Washington University.

Brodman: Then why earlier, did they not give much money to research?

Trotter: [Research] just wasn’t done to the extent that it is today.

Brodman: You mean generally people didn’t do research in anatomy?

Trotter: I didn’t mean just in anatomy. I meant throughout the whole medical school.

Brodman: But wasn’t research one of the things that was emphasized as a result of the Flexner Report?

Trotter: Yes, and also a full-time rather than a part-time staff. A proportion of each departmental budget was assigned to research.

Brodman: But a small proportion?

Trotter: This I don’t know.

Brodman: I’m just trying to flush out your answer that there was a little money for research and now there is a great deal more. Is most of the money now from the United States Public Health Service, which means it goes through study sections and councils?

Trotter: This I can’t answer either. My own research is funded by the National Institutes of Health, but I don’t know whether this is true of most of the research budget of the anatomy department or of the medical school as a whole.

Brodman: The reason I ask is because grant funding provides a kind of indication about how high a department or scientist is regarded professionally.

Trotter: Oh, I think this department has had a high rating among anatomy departments here and abroad. But I’m sure it had a high rating when Dr. Terry was head, too. After all, [we spoke of the fact that] it was recommended to [Raymond] Dart in England that he come here to work with Dr. Terry.

Brodman: With the coming of Drs. Sarah Luse and Paul E. Lacy (who, I understand, started out in anatomy), the whole complexion of the department must have changed.

Trotter: I think it is unlikely that Dr. Lacy had ever thought that he would be an anatomist. Paul was an M.D. who had been in the war and was all over Japan, among other places. He came back to [do research] at the Mayo Clinic. Sarah came here from Mayo’s and told Dr. Dempsey about him, and so Paul came for one year. I think he was in the department for only a year. [That was] to learn electron microscopy, because Dr. Dempsey was one of the leaders in this new technique. Sarah took it up and became one of the leaders, too.

Brodman: Interestingly enough, I met an anatomist in New Delhi who worked with Paul Lacy and Sarah Luse at the Mayo Clinic. He is married to an American woman he met at the clinic. They now have four children and he is head of the department in the All-India Institute of Medical Science. Electron microscopy is an interesting subject. It seems to me that whenever we have new instrumentation, whether light microscopes in the 1600’s or electron microscopes now, there is a tendency at the beginning to re-examine everything, just out of curiosity. Do you think that was true here? Is this beginning phase over now?

Trotter: I definitely think that [it was] true here and all over. In his presidential address to the American Association of Anatomists two or three years ago [Dr. Don W. Fawcett observed] that the hey-day of electron microscopy was over.

Brodman: In what field is electron microscopy still a primary research medium?

Trotter: It still goes on in anatomy, just as there is some very slight research going on in gross anatomy. Of course, as you know, electron microscopy is [employed in] any area that needs to be studied at the ultrastructural level. That includes pathology.

Brodman: You mentioned gross anatomy. That seems to be a field that is being de-emphasized in medical schools throughout the country.

Trotter: I think, perhaps, we take it for granted that a beginning student in anatomy already knows what the last generation knew. Perhaps this is necessary, since there is more to know and no more time in which to learn it. Maybe it isn’t important to know what bones are in the forearm.

Brodman: Do you think then that it is a good sign that most medical schools are giving fewer and fewer hours to gross anatomy?

Trotter: I have no idea.

Brodman: I remember that Dr. Sarah Luse was very unhappy when the number of hours of anatomy in the first year here was being lowered.

Trotter: That reaction was probably Sarah’s loyalty to the department.

Brodman: Well, it is hard sometimes when people have emotional reactions to separate what is emotional from breadth of vision. I was at the University of Illinois a few weeks ago, where first years of medical school are taught in Champaign-Urbana, as well as in Chicago. There the students do no dissection whatsoever. They learn it all by closed circuit television, computer assisted learning, film strips, and models. What do you think of these means of teaching anatomy?

Trotter: I think it is sad.

Brodman: What kind of surgeons do you think we will get if this continues?

Trotter: Maybe we won’t need surgeons, except to repair people after automobile accidents.

Brodman: How has Washington University School of Medicine changed as it has grown larger?

Trotter: It was more pleasant in the early days when the school was small, [that was] when all the pre-clinical faculty had lunch, along with all the medical students, in a little cafeteria in the middle of a connection between the North and South Buildings. Now the area is [taken up by] the first floor of the Cancer Research Building.

Brodman: We have some pictures of this cafeteria in our Archives.

Trotter: Yes, I recall that [even] most of the [clinical] faculty came to this dining room. I remember seeing Dr. [Evarts A.] Graham there regularly.

Brodman: How else has the school changed?

Trotter: It’s bigger and bustlier and seems to have grown up “like Topsy” – without any plan. It’s very easy to lose your way.

Brodman: Physically, but how has it changed in the way that it teaches, in the way that it considers medical care?

Trotter: I don’t know.

Brodman: I’m on what used to be called the Curriculum Committee, Committee on Medical Education, and it seems to me that the school is now several years behind schools elsewhere in its stance on medical education. Do you think this was generally true, or do you think that they were so far ahead to start with?

Trotter: I don’t know enough about what’s going on now to have an opinion. We [should] define what we mean by being ahead or behind. If being ahead [means] doing away with an anatomy department, or having no dissection and studying the structure of the body from film strips, I should hope we [are] not ahead.

Brodman: How about the proposal that is going around medical schools now and, indeed, has been taken up by a number of them, to reduce the required length of study from four years to three years?

Trotter: We are headed that way certainly, and I’m not sure how much difference it would make to medicine anyway.

Brodman: A lot of people probably agree with you. You think, then, that it should be cut down in the clinical years or in the pre-clinical years, or in both?

Trotter: I don’t know.

Brodman: Do you think that we have too many physicians and, therefore, should eliminate a few medical schools?

Trotter: I don’t know about that, either.

Brodman: What do you mean, then by stating that you don’t think that medicine is really as good as people think?

Trotter: It really seems to help very little. The art of it, I think, was, and perhaps still is, better than the science of it.

Brodman: And you think we’re losing the art?

Trotter: Yes, I do.

Brodman: Without gaining anything in science?

Trotter: I’m sure we’re gaining something in the science, but I’m not sure that what we’re gaining in science is good for the patient. Prolonging the life of a cancer patient, [for example].

Brodman: We have more students in the medical curriculum than ever before. Did we always have, in addition, graduate students who were not studying for an M.D.?

Trotter: The number of medical students has increased slowly but steadily from the time I came. I think there were seventy or less in the entering class in 1920, the laboratory was built for sixty, so [I would gather that] the number had [already] increased a little [since the reorganization]. Changes in the number of graduate students have been up and down, depending to a great extent on the point of view of the head of the department.

Brodman: Anatomy now has a fair number of them.

Trotter: Yes; it has, of course, also depended to some extent on how much money was available from grants for the support of graduate students.


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