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Transcript: Virginia Minnich, 1981

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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 interview in the our collection of oral history interviews 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 here?

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 the field was crowded and I should do something else.

Why did you write to Dr. Blair?  How did you know him – was he connected with nursing?

Dr. Blair was the plastic surgeon here that I had seen since the age of thirteen.  He and his associates performed about twenty-five operations for me.  So, I was a friend, at least friendly with Dr. Blair as well as he being my surgeon.  So, I was out of high school for five years before I went to college – this was from 1927 to 1932.  I guess it was four years – 1928-1932.

That was about the time of the Depression.

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.

We’re practically co-evils.  I know all the problems of that time when nobody had any money.

It is amazing how much you could do on so little money.  I worked on Saturdays and got $2 a day, and then when the National Youth Administration started, then I got $15 a month as a nurse’s aide.  Well, I found out that you got $20 a month as a secretary, as a typist, so the next time I was a typist.

What did your family do, and how many siblings did you have?

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.

What did your father do?

My father was a farmer and we lived only 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 wasn’t the best.  Then, I went to Zanesville to high school, which was three miles and [I] usually walked.

Every day, three miles?  Winter, bad weather and all the rest?

Every day.  My sister, who was just younger than I am, she 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.

It was a safer world in those days.

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 – back in the stacks, typing the [Ohio] Tax Report of 1810.

If you ever want to go back to it, we would be glad to have you come to work in our archives.

I don’t know what they ever did with that typed copy that 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 Ec. department.

Had you majored in Home Economics?

I was majoring in Home Economics.

Why did you pick out that subject?

Not being able to be a nurse, I decided to be a dietician, and this is why I went to the School of Home Economics.  In that senior year the home economics department wanted someone to determine the iron in fruits.  Dr. Carl Moore – his laboratory at Ohio State was set up to do iron.

He was at Ohio State?

He was at Ohio State at that time.  So I worked on iron in young women.  He wanted to do the serum irons in young women, so he talked the home economics department into having eighteen college girls to submit to serum iron determinations every month.  I did the serum iron determinations in his laboratory.

Chemically?

Chemically.  He had worked out this method, and this was what he wanted to do.  So, the home economics [project], the iron in the foods, went by the wayside.  This is how I got started with Dr. Moore.

And with iron.  He did a great deal with iron.

I worked many, many years with iron.  During my senior year I applied for graduate [school] in biochemistry at Ohio State and for one in nutrition at Iowa State College.  Since I had decided to be a dietician, I took the one at Iowa State College.

Did you get a fellowship or scholarship with it?

I had a fellowship that paid me $50 a month and my tuition.  So I was able to pay my rent.  Then for my food, I weighed food for a food balance study on one of the students, and then every Saturday I would digest the food and excretions with sulfuric acid and send it off to Iowa City where it was analyzed for the different minerals.

They were interested in mineral metabolism.

They were interested in iron and the different minerals.  That is how I made my $50 a month.  Through my whole education, including my master’s, the [total amount] I had to pay was $1,450 for five years of schooling.  Now this seems impossible now.  At Iowa State I realized I didn’t want to work with all 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 wanted to read part of this letter that he wrote on May 6, 1938.

He was then still at Ohio State but he was planning to come to Washington University?

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 about our plans for the next year.”

Excuse me, Dr. [David] Barr was the head of the Department of Medicine at Washington University [School of Medicine].

“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 a month.”

Well, that was an increase in salary for you.

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)

Dr. Doan was somebody at Ohio State?

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 a month.”

That is amazing when you consider today’s salaries, but I must say that in 1938 I was only making $100 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?

I intend to give Dr. Moore’s original letter to the Archives.

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 and you came together?

That is right.  Actually, he went to Europe in the summer of ’38 and when he came back, we started September 1, 1938.

Ms. [Olga] Bierbaum was somebody you knew from Ohio State, also?

I knew her at Ohio State.

Had you worked with her or you just happened to know her because she was around?

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.

She was a technician also in hematology?

She was the chief technician at Ohio State.

I don’t know the name from our files.  I guess I never came across her.  How long did she stay here?

She was married in 1945 to Dr. Donald Bottom, who was in Radiology.

Still?

He was doing radiology and left here and went to Alton, Illinois, and died three years ago.

When she married she left the field?

She left the field.  She didn't do any more after she left the field.

When you came here, what were the topics that you were working on?

I worked on iron.  We were working on iron absorption and on iron utilization.  That was the two main problems.

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?

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.

What is a transport iron?

A transport ion means that it is going from one place to another.

It takes with it something?

It takes the – the iron is in the serum and so it goes—

It is transported?

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.

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?

Well, ferric iron is not absorbed well and Dr. Moore actually was the first one who said ferrous sulfate was better absorbed than the ferric chloride.  Then we 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.

The importance of this is in the anemias?

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 first were working on this we found [that] dogs absorbed ferric as well as they did ferrous [iron], but not humans.

I noticed in one of your papers that you said that.  I must admit that some of these were beyond me, but I did notice in you said that in 1944 – humans absorb ferrous iron better than ferric iron, but animals are different.  Dogs absorb both equally.

That’s right.  And then we also worked on fortification of bread with iron.

Yes, I noticed that.  I want to know if that was the only nutrition study in your whole bibliography?

I considered iron absorption – that’s nutrition actually.  So it really was not such a bad jump from home economics into hematology because, after all, nutrition is reflected in the blood counts.

Yes, except whenever we think of dieticians we think of the food rather than the blood.

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.

Why is that bad?

Well, because my face was scarred from the burn I had at age four.  You can’t hardly disassociate my career from the burn at four.  This is why I came to St. Louis to see Dr. Vilray Blair.

Do you think they would have thought that today or was that just a condition of the 1920s?

I think it was a condition of the 1920s.  I don’t think it would mean so much today.

Has it bothered you since, or have you gotten over it?

I hardly think about it now.  But of course when I was young, I did.  And so, they told me I shouldn’t be a dietician.  This is really why I went into research.  But goodness, I met as many people in hematology.

I am amazed at the number of people with whom you wrote articles.

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.

It probably would have helped you in understanding the traumas that other people have with illness.

Yes, but at that time it was better though than being hidden at home.

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.

I have always been pretty good with people.  It really has made a difference.  I think it made me more ambitious.

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.

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.

Were all your siblings sisters, or did you have any brothers?

There were five girls and one boy.

The boy was the youngest?

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.

Well you have certainly overcome whatever difficulties you had.  In looking over your publications I get the feeling that anemias was the next thing you went to from the iron metabolism – to the anemias and various kinds of anemias.  Could you tell us a little bit about that?

Well, in ’45, 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.

What was her job?

Chief Technician.  She did all the blood counts and the differentials and all that.

There would be no research attached to that?

Well, no, there wasn’t really.  I still thought the grass was greener on the other side of the fence.

It probably paid $10 a month more.

So I took over her job.  I stayed in it until ’49 and I saw it was a dead end.  I really got very restless and then Dr. [William J.] 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’s 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 immunologic reaction and this is why we did it.  So from ’49 to ’51 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 off to the U. S. Public Health Service.

Before we forget Dr. Harrington, that paper which you published with Dr. Harrington 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?

This is a classic article.  The work has stood up under everything.

Would you tell us a little bit about that?

As I said, Dr. Harrington took this unit of blood from a patient with the idiopathic thrombocytopenic purpura and his platelets went to zero and he had petechia.  At the time he took it – he did it at midnight one night, he and the other hematology fellow.  And I was in South America, but I got a return to St. Louis and he was in the hospital.

He had done what, he had injected himself?

He had injected himself with one unit of blood from the patient with thrombocytopenic purpura.

He thought it was agglutination?

He thought it was an agglutination reaction.

In this article he concluded that there was more than one cause for idiopathic thrombocytopenic purpura.  Is that right?

That’s right.

He listed at least three [possibilities]: the deficiency of the factor for platelet formation, the suppression of platelet formations already there by the spleen or metabolic dysfunction, and excessively rapid platelet destruction.  These were his suggestions.  Did he ever follow up on these?

Well, these are really the platelet destruction, the agglutination [of the platelets].  The platelets agglutinate, form thrombi., and then are destroyed.  They are taken up by macrophages.  We worked mostly—  Now platelet production can be decreased, like 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.

What ever happened to Dr. Harrington?  When he left him he was in the hospital about to die?

Dr. Harrington recovered in about five days.  His platelets started to go up at about five days and after five days then 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.

Without the platelets he would have died of bleeding?

Yes.  So after that, we all took blood or plasma from people with idiopathic thrombocytopenic purpura but we didn’t take a whole unit.  So that we would work together to get our platelets down just half, to be significant.

When you say you take?

Injected into ourselves.

When you got them halfway down to zero, what would you do?

Then we watched it come back up.

Why were you doing this?

To be sure that this was an immunologic reaction.  It was quite an exciting time.  Then, Dr. Harrington and I worked out the agglutination test in vitro so that we could see if a serum was going to agglutinate platelets.  It was different then if they didn’t agglutinate platelets; [if] you had low platelets from lack of production for instance, they didn’t have platelet agglutination.

In other words to identify the cause of the reaction.  How long did you work on this in this field?

I worked on this field from ’49 to ’51 and then went off to Thailand.

Before we go off to Thailand, let’s finish off on this.  Was that test named after you?

No, I never had any tests named after me.

Well now, Dr. [Mildred] Trotter was sure you did.

No, the only thing I ever had named after me was the laboratory in Turkey.  It is still named the Virginia Minnich Laboratory – but no tests.

You are also the honorary member of their society, the Turkish Society of Hematology?

Yes.  That’s right.

Excuse me, you were just about to leave the country when I interrupted.

Dr. Harrington was—  At that time we had the draft so he was drafted into the [U. S.] Public Health Service and was in Washington, [D.C.]  And I was in Thailand, so the work practically stopped until I returned.

What got you to Thailand?

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] Thailand.  He was recruiting people to go to Thailand and so I applied and went to Thailand.

You were there twice.

Yes, I was there [in] ’51-’52.  When I was there, I set up three laboratories – hematology laboratories.

Only in Siriraj Hospital?

No, I did it in Medicine at Siriraj and in Pediatrics, and then in Medicine at Chulalongkorn University.

I was there ten years later than you, so I know the University.

When I was there we were paid by the U. S. Public Health Service, who gave the money to Washington University, so actually we weren’t on leave of absence.  We were just getting paid [the same] – just assigned to Bangkok.

Besides setting up a routine laboratory, you did other things there because you published some things on genetics – thalassemia and Cooley’s anemia.

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 actually had a great big chart on the bulletin board so 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.

Were you the only one from Washington University?

No, there was a biochemist, [and] there were three nurses—

All from the United States?

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 over 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 Public Health Service and it didn’t come and it didn’t come.  Really, our methods were pretty primitive.  Except that 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 – teak, all out of teak, and then we set it up so that anybody who wanted to come in and look at a slide could.  We did have then lots of doctors come in looking at slides on their own patients – the house staff.

You had gone there specifically to set up the laboratories or you went there with research projects in mind?

I went there just really – I had nothing in mind of what I was going to do.

Did the whole team really have nothing in mind?

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.

Why did you get so much more than they did?  I would think they would have all gotten a lot.

They went for a good time.  I went to work and we got a lot done.  I was ready to come back in six months, because the equipment hadn’t come.  It was so hard to get anything done at all.  You had to work five times as much as you do here to get that much done.

Yes, I know – India is even worse.  Did you stay there longer than six months?  One time you were there for six months.

At six months, things just started to roll.  So I stayed then the whole year.  But they really started to solidify and get good results and everything.

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 in that they are not going to get any more, or—?

I think it is self-defeating to give 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 a beautiful examining table but if you wanted a test tube, you couldn’t buy one.  It was very difficult.

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.

Exactly.  Now when I went there we had used a Sahli [apparatus] for determining hemoglobin.  They had no water suction pumps to clean the equipment, 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 Pathology and they just hadn’t turned it over because [of] jealousy between departments.  I finally got it and we did hemoglobins the good way, then, but it really was very difficult.

Well, you said you worked so hard in addition to actual physical work in getting things done.  What subjects were you working on?

We were working on the anemia that was so prevalent in Thailand.  When I wrote up the paper, the very first paper of these thirty-two patients with thalassemia (thirty-four, something like that), one of the reviewers suggested that there might be an abnormal hemoglobin might be connected with it.  I had them send me over samples of hemoglobin, when we got our first electrophoretic power supply and electrophoresis on paper.  So then we found hemoglobin E – this was from samples that they sent from Bangkok.  In ’52 there were no jets and so this all had to come over by [slower air transportation].

They sent them here to Washington University?

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 thought might have hemoglobin E, or this abnormal hemoglobin.  So he sent us some blood and it was a real good sample.  So we then recognized it as hemoglobin E.

"E" standing for?

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 then for fifteen years.

What did you conclude from all your work on the Mediterranean Anemia?

Well, we found out in Thailand, I calculated or estimated that about one out of every four Thai has some abnormality with hemoglobin or with thalassemia.  In one section of Thailand, there’s 45 percent of the people that have hemoglobin E.

What results from this?

No one knows why there is so much E.  Now like with [hemoglobin] S, we think that malaria—

Like sickle cell—

Like sickle cell hemoglobin.  That the ones who have it [Hemoglobin S], have less malaria.  But this is not true in Thailand – they have malaria just the same, the E.  So I don’t think it has to do with malaria although that is what they thought.  I don’t think so.  I don’t really know why so much E.

When they have this hemoglobin E, what is the result?

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.  And alpha-thalassemia is meaning that the alpha chain is not being synthesized.

When that happens, what is [the effect]?

Then the gene just does not work, so you’re not making that [globin] chain and you have anemia.

I noticed that when you did the hemoglobin E carriers in the entire population you used electrophoresis and found that 13.6 percent of the Thais (you examined over 1,000 Thais) had the hemoglobin E.  But in 213 Chinese you didn’t find any at all.

The ones that have E, are the ones in Southeast Asia – the Cambodians, the Vietnamese, and the Malayans.

Are they all one race?

I am not sure they are all one race, but they are in some way intermixed.

They have lived in the same area for so long it would be hard not to have intermarriage.  In ten 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?

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 alpha-thalassemia, for instance, with a homozygote, then you probably have only one gene that is making anything and this one gene is making E.

Is there anything that can be done for these people?

Nothing except for genetic counseling and that is it.

That is a hard thing to do, especially if you are not from that culture.  You also examined the hemoglobin in newborns.  You studied the instances of abnormal hemoglobin in cord blood.

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.

And you thought it might be due to the slow synthesis of the alpha chain?

Actually, now it is pretty well settled that it is due to a gene that is not there.  It is not even synthesizing any hemoglobin.

Mostly it is in the Negroes, or blacks, as they call themselves.

Yes, it is more in the blacks than in the white population.

Is there any relationship to their sickle-cell anemia?

No, I figure there are just more genetic abnormalities in the blacks than the Caucasians in the United States.

You continued to work overseas in Turkey.  You worked on pica.  What did you find there?

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 they take it [by] habit – much like smoking cigarettes.  And then they eat some whenever they feel like it.  The clay itself in Turkey combines with iron.  I think, though, the pica comes first.  They are eating clay first 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 the eating of the clay; they eat the clay as a result of the iron deficiency.

Is that true here in the United States?

That is true here in the United States, too.  The people who have pica here in the United States are iron deficient to start with.

Can they be helped by stopping eating the clay?

As soon as they get enough iron, they stop.

They stop on their own?

They stop on their own.  Children will do it too.  As soon as the child’s hemoglobin starts coming up he stops eating it.

If they don’t, what happens to them if they continue to eat the clay?

They continue to be anemic.

Is the clay the same in the United States as in Turkey?

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 cut down on absorption.  It’s much like _____(?).  The iron is exchanged for the calcium in the clay.

I suspect these women who are iron deficient also may be calcium deficient, too.

Well, they get plenty of calcium though, from the clay.  They might be, but I don’t think so.

Usually you think of women with many pregnancies as being calcium deficient.

Well, in some of them I’m sure are zinc deficient, too.  I suspect some of them are calcium deficient.  But I was only working on iron.  (Laughs)

You did most of your work on anemia and iron, sickle cell anemia and sickle cell traits, and thalassemia and hypochromic anemia?

That is iron deficiency.

What do you think were your major findings over the years?

I think probably the best things I could do was to set up laboratories – get laboratories going.  I did that in Havana and I did that in Thailand and that’s what I did it in Turkey was to set up the labs.  I think that is one thing that I can do is to set up a lab and get it started 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.

What did you find?

At that time, the theory was [that] the alpha chains were born, all of them that you were going to make were there when you were born.  The work I did showed this – the laboratory tests really showed this was what happened.  All your 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  like G Philadelphia – at birth, that G alpha chains were about the same as when you were a year or two old.  That is one thing I found.  And that these 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.

You followed these children until they were about a year old?  Later on they did not change either?

No change.  Well, I haven’t tested any of them at that, 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.  And so it was at the level.  It was the same all through.

I think that has been what I have done.  My contribution is setting up laboratories, and getting other people to work.  (Laughs)

Also knowing what is needed as well as all the things you have found out.  I also noticed you did some work on mutagenesis.

That was my last program.  After I stopped on hemoglobin, then I worked on audiovisual aids – for two years I worked on audiovisual aids.  Then I worked on glutathione synthetase and worked out the method for glutathione synthetase with Dr. [Philip W.] Majerus’ help.  I did all the tests, but he was the one who suggested I do glutathione, so I did glutathione.

What did that test show?

It showed 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.

It sounds like biochemistry.

I have done really some very sophisticated biochemistry in my lifetime.

Yes, and I wonder how many people realize how good you are at that.

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—

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 forty years in one institution.  Did you never think of going elsewhere?

Well I think these trips elsewhere are the ones that I came back satisfied.

Well that is a very good feeling indeed.  How come you never stopped long enough to get your Ph.D.?

I thought about getting a Ph.D., and Dr. Moore said, “Why do you want a Ph.D.?  You don’t need one.”  That is really why I don’t have one.

You agreed that you didn’t need one?

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.

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.?

No, but I think it might have made a difference in my salary.

That is certainly true.  (Laughter)  He didn’t see that at all; he didn’t think it was important?

I don’t think so.

Is that because he thought women didn’t need to be upwardly mobile?

I think he had some feelings towards that direction.  (Laughs)

I have heard those stories about him.  In general, did you feel that women were treated as well as men here at the medical center?

No, I don’t think they are.

Ever?  Not now?

Not now, not ever.  I don’t think so.

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?

Well I really have been very lucky – I have really been lucky to be a Professor in Medicine without an M.D., or a Ph.D.

But that was just later on.

That was later on.

A little bit after Dr. Moore’s death?

Yes, that was after Dr. Moore’s death.  Dr. Majerus was the one that suggested me for a professorship and I got it.

Why didn’t they give it to you previously?

Well, I didn’t get the Honorary Doctor of Science until ’72.

What do you think the Medical Center ought to do in order to treat its women equally with its men?

Well I think one thing is that if you knew salaries, which are always confidential, it would help.  But they 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.  (Laughs)

Is it only salaries that show a tendency to treat men and women differently, or were there other subtle things that came along?

With me, it was primarily salary.  When Dr. Harrington took over from Dr. Moore – he took over the Division of Hematology in ’54 – he said it was silly that I was getting such a low salary, so he doubled it almost the first year he was there.  Then Dr. Elmer Brown got me the research associate professorship.  That was the time I was going to leave, but I didn’t.

Where would you have gone at that time?

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 to Dr. Moore.  Elmer asked me did I want to leave.  I said, “No” – I didn’t want to leave, but I couldn’t put up with the way things were.  So he got me the research associate professorship.

That was in ’67.

That was in ’67.  That was the first time I ever complained in my life.

Why did you wait so long?

Because I was satisfied.  But when someone else was made research associate professorship who had a Ph.D., I brought it up.  And I said, “Is this the reason I’ve not been advanced because I don’t have a Ph.D. or an M.D.?”  The answer was, “Yes.”  I said, “Well, I can’t take this.”

Especially after Dr. Moore had told you you didn’t need one [a Ph.D.].  How long between the time Dr. Moore told you [that] you didn’t need one [a Ph.D.], and 1967?

He always told that to me, from 1942 on.  You see, I wanted to stop and go to medical school in ’42.  I really should have stopped and just gone and never have listened to anybody.  It’s my own fault.

Well, I think this was true of a great many women.  It would have been difficult to get into medical school.

I had a friend at Vanderbilt and could have gotten into Vanderbilt.  But during the [Second World] War we were so short of people.  They really needed us, anybody who could work.

You also did a lot of teaching while you were here.  Were you the first one to make audiovisual teaching aids?

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 3M machines, the Sound on Slide [an auto-instructional audiovisual device], which was the little disks on the slides.  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 then I wrote – I started on the audio things [audiovisual teaching aids].

How had you been teaching previously?  Talking and lectures?

Yes.

Do you find audiovisual methods good for teaching?

I find that they’re wonderful.  I don’t know how good it is for students but to me it’s good.  They look at them and then I don’t have to go over everything.

They can go back—

They can go back

Are you still teaching?  You’re an emerita [Professor]?

I am now working on the audiovisual aids.  This course is called Blood and Bone Marrow Cell Recognition.  I have turned it over to the American Society of Clinical Path [Pathology] and they are going to publish this.  There are actually ten units with forty slides per unit.  Ten of these slides are question slides for self-learning and the other thirty slides are descriptions.  I am on Unit 8 – just about ready to send in Unit 8 – and I’m rewriting some, of [Unit] 1, 2 and 3 – just a few descriptions that the publishers have sent back for slide replacement, and so forth.

Then you will be through pretty soon?

Then I go back on staff July 1st, 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 U. payroll and my title will be Emeritus Professor and Lecturer.

You’re pleased to continue your work here, you don’t want to retire?

Not yet.  Maybe someday I will.

You have had so many honors, I am impressed with them.  Which gives you most pleasure?

What honors?  Well the Honorary Doctor of Science degree was the one that really—

You didn’t have anything to do with William Woods College before?

There is a Professor of Biology at William Woods.  She had some training with us in about 1941 and she called me one day to ask me if I would help her with a paper on sickle cell anemia.  So she brought it in and we worked and then 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.

I can’t think of a better person to honor.

I really was surprised when I got that letter.

That is a very nice surprise.  Is there anything else which I didn’t [cover]?

I don’t think there is much else.

What about the changes here at the Medical Center?

Oh, yes, the changes.  I wrote down here: there are more buildings.

I’m sure of that.  And more people.

Many more people.  Everything now disposable.  We used to have to be so saving of glassware, covered _____(?) during the war it was just awful.  Now money is more free.  It used to be very tight.

I wonder if that is going to continue now that the granting programs are being cut back.

I think the ones who are doing good work will continue to get grants.  I think they will cut down 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’ll have to see what the future will bring.

We will have to see.  You asked me who was here when I came.  Dr. Evarts Graham was here; I think the Coris [Carl and Gerty Cori] were here, too, at that time – I am not sure.

Well at least the male Cori [Carl Cori] was here when I came in ’61.

I am not sure if they were here in ’38.  There was Dr. Philip Shaffer, of course.  He was the dean.  Dr. Robert Moore in Pathology – I’m not sure he was here at that time, though.  Dr. [Mildred] Trotter was here, and Dr. Margaret Smith, Dr. [E. V.] Cowdry, and Dr. [Joseph] Erlanger.

In general what were they like?  Were they all research-minded, were they all good teachers?

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 an excellent man.  He was interested in patients and he wasn’t interested in getting all that money.  He was really good with patients and he was a good clinician and he was a good morphologist, a good hematologist.  He could do his own blood counts and his own differentials.

I didn’t realize he had been in Ohio?  He came from St. Louis.

He’d had an American College of Physicians scholarship.

So he was in Ohio just a few years.

He was in Ohio from, I think, about ’32 to ’38.  Maybe ’33 or ’34 up until ’38.

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 [Edward] Dempsey and [Edgar M.] Queeny?

I don't know.  But he told me once that Mr. Queeny took ten years off of his life.

By doing what?

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 and set up a cancer center, and he was not looking forward to doing that either.

He was not looking forward to that?

He was not looking forward to that.

Why did he agree to do it?

I don’t know.  I think because he thought he had to.  He thought it was his duty.

His duty to leave the head of the department for younger people or something?

No, he had to retire as head of the Department.  He was sixty-five.

But he could have continued in his research.

He could have continued in his research, but I don’t think he wanted to do that.

There was also that escape hatch that the Dean could have asked him to stay on until he was sixty-eight, I think it was.  But apparently—

He would have stayed on, starting the Cancer Center.  He would have stayed on.

But if he wasn’t really very interested in it?

He was interested in it.  I think he thought it was going to be a terrific job.

He didn’t want such a hard job at his age.

I think that was really it.

He died very suddenly of a heart attack, I assume.

Yes, he did.

Had he had any previous episodes?

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 on a review in nutrition.  [He] went down to the lake to take a swim and got out of the water.  His wife went in [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.

I think in a way it is lucky for him to go that quickly.

That is the way he wanted to go.  He once told me that if he ever got so he couldn’t have control of himself, I had to come in and give him a shot of something.  I said, “You know I couldn’t do that.”  But he just dreaded so much being like Dr. Sam Grant.  He just never wanted that.

I think most of us are fearful of that kind of thing.

I think so too.  Now you ask here are the medical students are the same as those in the ’40s and the ’50s.  The ’40s and after the war, the average age went way up.  Our second year class, I think, in ’47 was something like 28-1/2 years old.

Because they were in the war?

Yes, and then [went] into medicine.  And 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 our class on the chest – sputum.  He was giving the lecture on sputum and the kids started to make a 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 a very bad period.

I sat in on some of those lectures.

But now, I think they are beginning to go back to looking like doctors and acting like doctors.  I am awfully glad to see it.

They’re becoming much more conservative in the last few years.

I have taught since 1938.  I started teaching in the laboratory medicine course, getting the [student] labs prepared.  I did that for forty years, which was enough.

Do you like teaching?

I love teaching, but I like informal teaching, like laboratory teaching.  Then I taught at night a lot – morphology.  My first class were four Army colonels that the Army had sent here and they worked in the clinics.  They were getting bored so they asked me [if I] would I teach them.  Well, we had four nights a week, one hour a night.

Was this informal?

This was informal, at the microscope.

Not a medical school course?  This was just one you made up.

This was an evening course.  I know I didn’t know very much, but anyway that is how I got started on evening courses.  And I taught evening courses.  In fact, I went to Turkey, to get away from evening courses.  That was one of the reasons.  (Laughs)  Then I taught some in the Continuing Education for Dr. Brown.

I am still interested in the evening courses, were they official courses?

No, these were—

Did you get paid extra?  By the students?

I got paid by the ones [students] who had taken it.  I taught many pathologists and I taught many physicians.  I taught no medical students in these evening courses.  There were a few technicians, but not very many technicians.  Most of them were pathologists and interns.

Then you could have stopped at any time and said, “I don’t want to do this anymore?”

I was getting requests all the time.  Well, I just hate to say “No.”

You loved your work.

I do.  I just wish I had kept a list of everyone I had taught.  I taught practically every pathologist in St. Louis.  I’ve had Walter Bauer and Richard Payne down at Lutheran [Hospital] and Dr. John Bauer out at DePaul [Hospital] and Dr. Gillespie at St. Luke’s [Hospital], but these were all evening courses.

I had not heard about those; this is all news to me.  Do many people around here give such courses?

No.  (Laughs)  This is why I was so popular, because they couldn’t get it anyplace else.

Others probably made a lot more money so they didn’t feel they had to give evening courses and that was a little extra money for you.

I know one time a good pathologist asked me [if I] would teach him.  I said it would be $20 and they didn’t come.  I’m sure, if I had said $200 they would have come.  But since I said $20 they probably thought it wasn’t worth it.  House staff I taught for nothing.  So I really have taught a lot.

It sounds to me as if the Medical School owes you a great deal more than just money.

(Laughs)  You asked me did I want to comment on anything else.  The only other thing I wanted to comment on was that I have been the historian and the photographer for the Hematology Division.

Oh, do they have a history of the [division]?

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 – these were actually hematology fellows – and then I have the second book.

What are you going to do with all your material?

That’s it, what am I going to do with them?  I don’t know.

Why don’t you give it to the Archives or leave it in your will to the Archives.

Well, I probably will do that, if it’s worth anything.

Are you going to stay in St. Louis?

Yes, I decided to stay in St. Louis.  I don’t think I will be leaving.

Then you don’t have the problem I have which is emptying my apartment now, as I leave the city.  But don’t wait too long to go through all this stuff, and then turn over to us anything that you want.

I shall do that.  Is Mr. [Paul] Anderson the one I’d see?

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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