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Transcript: Herbert A. Anderson, 1976

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Interviewer: Darryl B. Podoll

Dr. Anderson, could you tell us something about your family and early childhood?

I was born in western Kentucky, outside of Paducah, home of [humorist] Irving Cobb and Vice President Alben Barkley.  I was the youngest of seven children.  I went to the county high school eight miles out of Paducah and went to the grade school, to a one-room schoolhouse, before going to high school.

Did you have to walk miles to get to school, as we sometimes hear?

When I was in grade school I walked a mile and a half to school, but in high school I either drove a horse and buggy or during the better season I rode a bicycle.

What was your father’s occupation?

He was a horticulturist.  I went to school on the product of apples, although the main product of that [area] was tobacco.  Apples happened to be my father’s occupation.

He grew apples but not tobacco.  You mentioned [that] the grade school was a one-room schoolhouse.  What was the high school like?

The high school was much better than a one-room school.  It was conducted by several teachers and it was quite different.

How many students were there in the one-room schoolhouse?

In the one-room school there were usually about 40 [students].

What were your interests and activities outside of school when you were young?

Farming, of course, and the usual play that goes with childhood in farm communities.

Did you help your father in his work?

Very much so.  I became so acquainted with the apple industry that I had no interest in pursuing it.  In fact, I intended to study medicine from my earliest recollection.

What attracted you to medical school, to becoming a doctor?

My mother’s brother was a doctor who came to St. Louis to study medicine at the old Missouri Medical College, which later became part of Washington University.  I liked this uncle very much and as far back as I can remember, that was [my] objective.

Did he live in the same area as you and your parents did?

Yes, he did.  He was the only doctor for that area of McCracken County.

How did you choose which college to attend?  Was it necessary to attend college before going to medical school then?

Oh, yes.  My family happened to belong to the Baptist Church and the Georgetown College up at Georgetown, Kentucky was the Baptist institution for that area.  In fact, it’s the oldest Baptist institution west of the Alleghenies.  So I went to Georgetown College.

And you went with the idea of becoming a doctor.  Did you take pre-med courses then?

That is right.  I went through for the degree.  I was there four years and had an A.B. degree upon entering Washington University.

What were your majors?

My major was English, strange to say.  The instructions were to get as much as you could; to fulfill the requirements for the medical school but to get the humanities.  So I majored in English.

Were there any teachers there that particularly impressed you?

Yes, the Dean of the school, named John L. Hill, and also the Professor of Greek, George Ragland.  Both had outstanding personalities.

What made you decide on Washington University as a medical school?

My uncle had gone to Missouri Medical College, as I alluded to a few moments ago.  I knew that Washington University was one of the two universities in St. Louis, and that was my choice.  It was the only place I applied for medical school.

There was competition to get into medical school then, too, wasn’t there?

It frightened me when I got up here and several months later I found out [that] over 600 had applied – and I had applied only one place.

Over 600 – and approximately how large was the class?

I believe [there were] about 68 in the class.  They had to limit it because they didn’t have enough cadavers for a larger class.

So of 68 in the entering class could you tell us approximately how many there were in the graduating class?

If I remember correctly, about 75.

How did this increase come about?

Transfers from two-year medical schools.

Did any of your teachers particularly impress you in medical school?

Yes.  There were two or three outstanding ones: Dr. Evarts Graham

Could you tell us something about Dr. Graham?  Did you have classes from him or contacts with him?

He was the head of the Department of Surgery and an outstanding personality.  He was not exactly a warm personality but he inspired people to work.  It was during that time that he and others did the work on the gall bladder dye and also on the removal of a lung for cancer – the lung kind.

Were you in classes that he taught or did you watch him perform surgery?

I was in classes that he taught.  I saw him operate, I think, twice.

Do you remember anything else about him; his manner of teaching?

He had a great admiration for medical history and we had a coordinating course about once a week during our junior and senior years, and he talked on the history of medicine.  He was quite adept at that because he was well-versed in it.  He was a good technician as a surgeon, I understand.  When I saw him I had not had enough [experience to judge] at that time, but he impressed me as a good technician.

What other teachers do you remember?

Well, no one could possibly forget Dr. Ernie Sachs.  He was the neurosurgeon, but he had a Thursday clinic in which we met in the amphitheater in Barnes Hospital.  He would bring in a patient and bring two students down from the class.  They would examine the patient and then he would quiz them on what they thought about the patient.  I remember one of them in particular – one morning they brought in this colored man who had an obvious Colles fracture.  Two boys examined him and [Dr. Sachs] turned to one of them and said, “What do you find?”  [The student] said, “He has a fracture.”  Dr. Sachs said, “Well, what would you do?”  He said, “I would take an x-ray.”  Then Dr. Sachs said “Why?”  And the boy furnished the pabulum for the rest of the lecture [when] he answered, “For your own protection.”  Well, that led Dr. Sachs to say that if anybody was in the medical profession for his own protection it was high time he was out, right now.  And he talked for the rest of the hour on that subject.

Do you remember someone else?

Yes, Dr. Barney Brooks who was the teacher of surgical pathology.  Everyone always followed him almost verbatim in their notes because he lectured rather slowly so that they could copy down what they wanted to.  We had no means of taping anything in those days; it was mouth to pencil and to the paper.  He was also a very good surgeon and a good teacher.  When he left here he went to Vanderbilt University.

Were there any other teachers you’d like to tell us about?

There was a pediatrician named Dr. Cook, who was an excellent teacher of pediatrics.  [He had] an excellent personality; a warm personality, as most pediatricians should be.  He was a very, very good teacher.

Could you tell us something about your contact with fellow students in medical school?  Did you have certain friends throughout the whole term?

Yes.  We had many fraternities in those days, but unlike college fraternities we crossed over the fraternal lines and fraternized with one another.  It was a very congenial class.  I happened to be a member of the Phi Rho Sigma Fraternity, but that made no difference; we liked one another.

How did medical education then differ from today?

In those days very, very few of the students were married and that’s quite a contrast to the present time, when I think the majority of the students are married.  Back in those days, the fraternities were quite popular with the students and most of the students belonged to one fraternity or another.  Now, the fraternities, that we thought would never die, no longer exist on the campus.  That’s one phase of it.  I think the teaching, perhaps, is no better today than it was then because we thought it was the very best of the best and we liked it.  In fact, during the summer one year I came back to do outpatient obstetrics down where the urban renewal is now – down around the railway tracks and the river.  Of course, that’s all cleared away and there are no patients down there now.  So where they do their outpatient obstetrics these days I do not know.

What other types of things did you do during your summers while in medical school?

I usually went back to Kentucky and did some work on the farm where my father was raising apples, but this one year I came back and did this outpatient work – between my junior and senior years.

You mentioned that there were some 60 students in the freshman class.  Does that mean that each class was this large or did they divide the freshman class into [sections]?

We took our Anatomy all together and we had our lectures all together.  The fact is, the class was supposed to be 75, but whether they couldn’t select that many students out of the 600 [applications]—

Did you find there was a lot of competition between the students then or much pressure to succeed and to compete?

The competition was great even in those days, no question about that.  But there was no hostility in so doing.  If one made better grades than another, congratulations to him.

Where did you take your internship?

I went to California.  My roommate in those days – his father was superintendent of the California Lutheran Hospital in Los Angeles.  So I went out there to take an internship with him.

Was it a general internship?

It was – comparable to any good internship in those days.  It was a hospital of about 400 beds, and it was a good rotating internship.

What did you do after you finished your internship?

I took a preceptorship with the chief surgeon of this [California Lutheran] hospital, who was also a very good teacher, and I spent five and a half years with him.  It was a superior type of residency.  After that, I went into private practice alone.

Was this in California?

Yes, in Los Angeles.

Was your practice limited to surgical patients?

In greater part.  At first there was some general practice, but very quickly it was limited to surgery.  I became a member of the American College of Surgeons seven years after graduation, which was the minimum amount [of time] you could spend before becoming a member of the American College, so [the practice] had to be limited.

What type of surgery did you do?

It gravitated toward abdominal surgery.  Of course, in California most of the people who do abdominal surgery do goiters and breasts [and] do pelvic surgery – maybe some varicose veins.  But beyond that, no bones, no urology, and no vascular surgery.

Did you continue to practice in Los Angeles.

That’s right.  I’ve been in the same place all these years.

From the time of your internship to the present time you have been in the same place?

That’s right.

Dr. Deutsch mentioned to me that you were a naval surgeon, also.  Could you tell us something about this?

When World War II came along, I had a notice from the Manpower Commission that I was available to enter military service.  I chose to join the navy and entered into the navy as a Lieutenant Commander and went the first year to San Diego Naval Hospital, which was a tremendous facility, where I was the chief surgeon for dependents of navy and marine personnel.  I had lots and lots of people.

In San Diego you dealt with families of naval personnel.  Did you deal with naval personnel themselves, also?

Not during the year I was there.  I went to sea for two years and during those two years I dealt with navy and marine personnel.

So you spent one year in San Diego and then you went to sea.  What types of ships did you serve on?

I served on only one ship: the U.S.S. Horton.  That was a hospital transport type of ship.  I was the senior medical officer aboard ship and we had seven operating rooms aboard the ship so that we could take care of the wounded during combat, as we did at Guam during the retaking of Guam.  Our ship and two other [hospital] ships took all of the wounded after the third day of the invasion until our ship was loaded with wounded, when we took them back to Pearl Harbor.

You must have handled a tremendous number of cases then, working on a hospital ship.

Yes, it was quite busy, particularly during that time.

So the hospital ship would follow the course of the battles and pick up the casualties?

Yes, back and forth.

[The ship] would then go to Pearl Harbor, leave there, and go back for more casualties?

That’s right.

And you were there two years, on the Horton?

That’s right.  We took out the marines and left them at various places and then we’d pick up the wounded and bring them back.

So on the way out, you served as a troop transport?

Exactly.

How many other doctors were there on this hospital ship?

Part of the time we had a skeleton crew, particularly going west with the marines, I would have only about four or five doctors with me.  But during the combat at Guam we had, if I remember correctly, twelve, [and] about 138 [medical] corpsmen during that time.

Did you perform only surgery that was absolutely necessary before they got back to Pearl Harbor, or did you perform all of the surgery?

We tried not to do definitive surgery aboard ship, if possible – that was the instruction from the Bureau.  But sometimes we had to do rather definitive things, particularly if [there were] abdominal wounds.

Did your hospital ship ever come under enemy attack?

Yes, but not close enough to have any hits from the enemy shelling.  At Guam we were under attack.

Was it painted as a hospital ship?

No, it was gray.

So the enemy couldn’t really know if you were functioning as a hospital ship or as a troop transport?

That’s right.

What other places in the Pacific did the ship go to besides Guam?

We were down at Nouméa (?), in the Western Carolines, [unintelligible], up at Okinawa, Eniwetok, the Marshall Islands, and in the Ellis Islands.  The fact is, during that time we made twelve crossings of the Pacific.  We were in the Philippines at Leyte and Samar during the period [of] fighting.

At the end of the war, did you ever get to Japan, or close to it?

As a private citizen, I went back aboard the S.S. Woodrow Wilson.  I resolved if I ever had the money and the chance I was going to cross this ocean one time under air conditioning, and that was the one opportunity.

What were physical conditions like aboard the ship?  You mentioned that there was no air conditioning.

Well, it was blacked out at night.  Being senior medical officer, I had a private room, with a starboard port[hole] and forward port[hole].  I was not a smoker so the captain, through his own generosity, let me have my two portholes open at night, which was worth a lifetime of not smoking, because when you cross the equator with all the portholes closed the heat is almost intolerable.  In fact, the heat is so intense as you cross the equator [that] you forget exactly how hot it is.  You could lie there with your fan blowing on you and still the perspiration rolls off you.  The rest of the ship was all blacked out because of [possible] enemy submarine attack.  We would have the early morning watch at daybreak, which was the great time for attack by submarines – we’d all be at quarters.

What was the food like aboard ship?

Most excellent.  Of course, the officers had their own mess, but being senior medical officer I had to inspect the crew’s food.  They had wonderful food – no problems.

Were you on this ship until the end of the war?

Yes, until after the war was over.  I happened to be at Pearl Harbor when the end of the war came in August, 1945.

What did you do when you got out of the service?

I came back to private practice.  I rested up for about two months and then went back into private practice in Los Angeles.

Specializing in surgery?

That’s right – abdominal surgery.

What type of professional organizations do you belong to in Los Angeles?

I belong to the Los Angeles County Medical Association, and by virtue of that I’m a member of the Surgical Society of that area.  Nationally, there’s the American College of Surgeons, the International College of Surgeons, [and] the American Society of Abdominal Surgeons.

Do you attend many of the national meetings?

I try to attend every year.

I suppose these meetings are held all over the United States.  Are they held abroad, too?

Yes.  Most of them are here in America.  The American College of Surgeons, in recent years, has had meetings abroad.  I went abroad twice with the American College; once to England and then we were invited by the Swedish Surgical Society another year, and we went to Stockholm to another meeting.  The American Society of Abdominal Surgeons has an international meeting annually, that meets in various parts of Europe.  I’ve been to several of those.

How many surgical cases did you do in a day after World War II when your practice was very busy?

Getting started again was a little slow, but [I did] one to three [cases].  I tried to bunch them together, if possible.  At the beginning I did not operate every day but in recent years I operated almost every day of the week, except Saturday and Sunday.

Have you retired completely from practice now?

No.  I’m just as active now as I was 25 years ago.

Last year, when I asked one doctor if he had retired he said, “Why ask me that?  Why don’t you assume that I’m still active?”  I guess I should have done that with you, too – assumed that you were still actively working.

Very much so.

Are you still in surgery?

Abdominal surgery.  Of course, goiters are not done as much now as they were years ago, but I still do goiters and do breasts.

So you’ve never really retired.  Do you plan to retire some day?

As long as I have my faculties and am mentally okay and agile, I plan to keep on.

Have you been active in any specific community activities in Los Angeles?  What are your interests in that field?

Largely musical things.  I’m not a golfer; I used to play tennis some.  I’m a member of the California Club, which is one of our better clubs in California.  The musical phase of it takes us to the symphony year by year as season ticket holders of the Los Angeles Philharmonic Orchestra.  We’re also guarantors of the light opera season.  My love for the light opera came when I was a student in St. Louis with the Municipal Light Opera here in Forest Park.  We find it very enjoyable.

The Municipal Opera in Forest Park doesn’t seem to do any light opera anymore.  It seems to do more popular musicals, and I was wondering how it got its name.  So in the past they have done light opera there, apparently.

When I was a student here in St. Louis, it was all light opera.  On occasion they did have grand opera there.  My first encounter with Aida was at the Municipal Opera.  In those days they had 10,000 seats and 7,500 were paid admissions and 2,500 seats were free to the community, whoever would like to come.  I don’t know whether that’s true today or not.

They still have some free seats but not that many, perhaps about 300.  I think it’s about the back eight rows.

Maybe the financial status of the community has advanced to the point where they don’t have 2,500 that might want to go free.

Well, the free seats always seem to be full no matter what is on.  Could you tell us something more about your medical practice?

It’s not insurance, it’s all private practice [with] referral by other doctors and by satisfied patients.  It seems that the practice of abdominal surgery, general surgery, is most satisfactory and more stable if one relies on satisfied patients.  The fact is, I have patients now who come back from great distances for surgery on themselves or members of their family, which I treasure as a compliment to the quality of surgery they had.

I’ve gone abroad every year for 21 consecutive years.  Most of those were for study.  I was particularly fond of going back to the University of Vienna and I’ve been back there some 12 years at the Allgemeine Krankenhaus, which is under the University of Vienna.  I was interested in finding out how they did surgery; I know how American people do surgery.  While over there I encountered the repair of the hiatal hernia by the Nissen method.  Dr. Nissen [ed. note: Rudolf Nissen] is a Swiss surgeon, so two different years I went up to the University of Basel in order to talk with Dr. Nissen about repair of the hiatal hernia.  In 1956, by chance, according to Dr. Nissen, he came upon this method.  His anesthetist told him one morning that when he was doing the classical type of sewing of the [unintelligible] that the patient was not doing bad.  He was an elderly gentleman.  So he very quickly attached the lesser [unintelligible] to the [unintelligible] expecting to go back later and repair it.  He found out he didn’t have to go back; he had discovered a new method.  That particular method has been largely abandoned now and the so-called Nissen fundoplication, which is all over the world.  I learned it over there and brought it back to Los Angeles to practice it there.

Back to Vienna – they teach the technique of doing abdominal surgery on a cadaver.  They have the privilege there of having fresh cadavers [in] almost unlimited number.  If one dies in a general hospital or dies out on the street, by decree of Maria Theresa many years ago they could take these bodies without permit from the family and use them for scientific purposes.  So the professor of surgery may be operating in the hospital in the morning and then over in the legal medicine part in the afternoon teaching students from various parts of the world.  When I say “students,” these are post-graduate doctors there to learn how to do their method.  It’s most exhilarating.  The fact is I learned how to do the Billroth I gastric resection while there.

Incidentally, in the professor of surgery’s office there’s a specimen which is the specimen from the very first successful gastric resection in the world.  That was done by Dr. Billroth [ed. noted: Viennese surgeon C. A. Theodor Billroth] back in 1881.  That specimen looks as though it had been preserved maybe less than a month ago.  It’s a treasure of the University of Vienna.  The sutures are all visible and this particular operation today is done very much like Dr. Billroth did it back in 1881.  Some do Billroth II.  Incidentally, practically all of the gastric surgery originated in the University of Vienna.  For instance, the popular vagotomy which, too, is losing some favor now, started with Professor Mandell (?) at the University of Vienna.  Dragstedt claims no originality for the vagotomy procedure; he learned it under Professor Mandell and brought it to America, popularized it, and it’s all over America now as the operation of choice for duodenal ulcer.  However, many of the old-timers like myself, I still stay with the gastric resection, like Dr. Evarts Graham did.  I find it very successful, doing either the Billroth I or the Billroth II type of procedure, learned at the University of Vienna.

The Allgemeine Krankenhaus in Vienna has around 5000 beds.  They ran a large series of vagotomies and they have now practically abandoned, except on rare occasions, doing any vagotomies whatsoever.  They’re back doing the Billroth I or Billroth II operations for duodenal ulcer.  That’s somewhat in contrast to some of the surgery that’s done in America.

Why have they switched?

They had too many complications, too many people with diarrhea with the vagotomies.  Some of them [were] completely debilitated with the diarrheas.  The fact is, I have a friend who had a vagotomy done and he was practically out of practice for four years because of the vagotomy.  Of course, a lot of them are perfectly successful, but the Billroth I or Billroth II resection in the hands of those who do them seem to fulfill the requirements for healing the ulcers in the duodenum.

You mentioned a man in New Orleans.  I didn’t quite get his connection to this.

Dr. Ochsner [ed. note: Edward W. A. Ochsner], who graduated from Washington University and was the protégé of Evarts Graham.  He went down to New Orleans to be professor of surgery at Tulane University.  He’s an outstanding authority in gastric surgery, as well as several other fields of surgery.  He is very much opposed to any type of vagotomy, [and] he’s opposed as well to anybody smoking because of the cancer possibility with one who smokes.  That also originated here at Washington University [with] the work of Dr. Evarts Graham.

Is there any other part of your professional work you’d like to say more about?

I think that takes in the greater part of it.

We certainly appreciate your coming here today and allowing us to interview you.

It’s been a pleasure.  Thank you, sir.

 

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