We are talking today with Dr. W. R. Peterson, M.D., a member of the Washington University School of Medicine class of 1926. Dr. Peterson, could you tell us something about your family and your early childhood?
I grew up in a company lumber town [Port Blakely, Washington] up in the Northwest near Seattle, Washington, and started working in the lumber mills when I was fourteen years old. I went to high school in Seattle and then to the University of Washington in Seattle.
Did you work summers or after school?
In the summers.
What was your father’s occupation?
He came here as an immigrant from Sweden with the rest of my family and some of my brothers and sisters. He started out as a laborer and worked up to be a foreman in the lumber mill.
Some of your brothers and sisters were born in Sweden?
Yes.
How large was the family?
There were six of us: three boys and three girls.
Was there a local grade school?
[There was] a local grade school and being a typical lumber town, we had local native Indians and Japanese and Chinese students. There was quite a mixture in our grade school. We didn’t know what racism was in those days.
So there was no friction between different people?
None at all.
What made you decide to go on to high school? It wasn’t altogether common, was it in that day? Or did you accept this as the normal course of events?
A fair number, especially of Scandinavian descent, went on to high school. Everybody wanted to get ahead a bit.
When did you decide you wanted to become a doctor?
I don’t know; it was well into college. I liked the biological sciences very much and the more I got into chemistry the more I liked that. But I wasn’t any student; not until I was into college for a few years did I really ever do any studying.
Which college did you go to?
University of Washington. Incidentally, my records have been fouled up many times, having attended the University of Washington for my [undergraduate] college work and then coming to Washington University Medical School for my medical education.
Yes, I’m sure that’s happened. We get mail that’s been misdirected from time to time from them or to us. Did you take a pre-med course in college?
Yes.
How did you choose Washington University as a medical school?
I think it was primarily through my adviser in college, Dr. [John Locke] Worcester, who was professor of anatomy at the University of Washington. I’d been accepted at Northwestern University, also, and at Washington University. He had formerly been a teacher at the University of Michigan and he thought Washington University would be more desirable. He thought it was a more active and a younger and more progressive medical school.
I meant to ask you about some of your interests and activities outside of school in high school and college. Did you continue to work summers?
Work? I sure did. If I wanted to eat or get through school I had to work. [On] the income of my father in a lumber mill and with a large family, we [just] got along. We had a little ranch and had cows and chickens, but everyone was expected to work. If you wanted to continue education, you had to get out and dig for it.
Did you pay for your own medical school education?
What I didn’t borrow, yes.
And, of course, you paid for that [borrowed money] later.
Yes.
Could you tell us something about what medical education was like at Washington University when you were here? Perhaps you could mention some of the teachers you had and tell us if you remember any anecdotes about some of them. Were there any teachers at the medical school that impressed you?
I thought the faculty were very thorough and very fair and very stimulating, both in the basic [and clinical] sciences, especially Dr. [Philip] Shaffer and his staff in physiological chemistry.
Did you have much contact with Dr. Shaffer?
No, except for his lectures. Then [I remember] Dr. [Joseph] Erlanger in physiology. Later on, in the clinical side of it, of course, Dr. Evarts Graham was always stimulating and always made us question ourselves and question him. Dr. Ernie [Ernest] Sachs, professor of neurosurgery, was a great one. He really kept you on your toes mentally, without embarrassing anyone or hurting anybody. He was stimulating.
Did you have any fellow students that you were particular friends with at that time? Were you in a medical fraternity?
Yes, Phi Rho I think was the name of it. Ted [Edward] Helbing was a particular friend all through medical school. He was a local man. He’d grown up in St. Louis and his father was a physician here. He was quite an athlete; he’d gone to pre-med at Washington University here in St. Louis and was, I think, captain of the swimming team there. Bill [William M.] James, who had grown up and had his college work down in Springfield, Missouri, was a particular friend. We always enjoyed being around each other.
Were the medical fraternities exclusive societies as we sometimes think of fraternities being today?
No. The fraternities weren’t like in college. It was primarily finding a place to live as cheaply as possible – sort of cooperative living and companionship.
That was an important reason for joining a fraternity. They had residence halls at that time, didn’t they?
There was a dormitory on Forest Park Boulevard where I lived one or two years, but I didn’t have a feeling that fraternities were exclusive at all. I doubt if we knew which one anybody belonged to.
That’s an interesting point that one of the advantages of the fraternities was to provide board and room at a fairly reasonable cost. I hadn’t thought of that aspect of it before. How would you say that medical education was different then from the way it is now? Are there things that you notice have changed?
I haven’t [had] too much contact with medical schools now, although I was on the staff at the University of Pennsylvania hospital for twenty-five or thirty years in the clinical end of it. I’ve seen it develop – I think they’ve gotten away from the basic sciences more and more, which I think is a mistake. I think [that] if a physician doesn’t have the fundamentals in anatomy and physiology and pathology, he doesn’t have much to build on. But the field of medicine has become so extensive and so dependent on other fields [such] as physics and chemistry, and electricity, and whatnot that it’s pretty near impossible to decide which is more important anymore.
Did you find that there was a lot of competition and pressure to succeed in medical school? I believe they did have many more applicants than they admitted at that time.
I guess there was competition; I don’t know whether we recall it or not. [It was] mostly competition with ourselves to try to make the grade and make good. We were always wondering whether we’d passed or not and wondering what we were going to do when we flunked out of medical school. I guess it boiled down to competition with other students, but we didn’t feel that way about it. It was mostly competition for us against ourselves.
Did you continue to work in lumbering during the summers or did you have other jobs?
No. I went up to the Northwest, near Seattle and my home each summer for the first three summers. I could always get a job there since I played baseball and could always get on a company team. I could get much better wages up there than we could down in this area. As I look back, I think [it was] a wonderful thing from the health standpoint – getting outdoors. Physical labor, I think, is what [has] kept me going this long.
Where did you take your internship?
I [had] a year’s externship in pathology here at the medical school. The second year I was in surgery at Barnes Hospital.
Who did you work with in pathology?
Dr. [Leo] Loeb (spells L-o-e-b) was professor of pathology then and Dr. Junkins [ed. note: Dr. Peterson is referring to Frank A. McJunkin] was the associate professor at that time. They were very stimulating and I’ve never regretted that I had that year in pathology. They gave a basic idea of correlating all the different diseases affecting the body, and correlating all the different organs and how [each] one was dependent and affected by every other organ in the body.
In surgery, who did you work with?
Dr. Evarts Graham was the professor then and that was a real stimulation. Dr. [Nathan] Womack was the chief resident in surgery. He was really a pusher and really made us hustle, which I appreciate now.
What did you decide to do after your residency?
I first worked for about a year and a half or two years for the Frisco Railroad.
Where was that?
They had a local hospital.
That was here in St. Louis?
Worked there. We lived in the hospital and were able to have a private practice. I’d always been interested in orthopedics and was especially stimulated by Dr. Leroy Abbott, who was professor of orthopedics here. I used to come over and work in the orthopedic clinic in my spare time. After working for the railroad for a year and a half or two years and seeing so many accident cases and especially spine cases, I became more interested and that’s how I got into orthopedics. I got a residency at the New York Orthopedic [Hospital], which is part of the Columbia Presbyterian Medical Center in New York.
So you became interested in orthopedics and then left St. Louis and went to New York. How did you happen to go to that particular place?
Dr. Abbott and his associate, Dr. [John A.] Key, [with whom] I discussed where to go for an orthopedic residency, suggested the University of Michigan or New York Orthopedic. They said, “If you can get into the New York Orthopedic, by all means take that.” Working for a railroad, I had a railroad pass to travel around the country and, amongst other places, I went up to New York and was accepted there.
What type of work did you do during this residency?
It was all branches of orthopedics; this was entirely orthopedic. We were the housestaff and of course we had all the congenital deformities. There wasn’t much traumatic work at that time, mostly congenital, and a good deal of tuberculosis of [the] joints and a good deal of deformities as a residual of poliomyelitis, which we rarely see – either TB or polio, anymore – deformities resulting from that. Also, [we treated] a good deal of osteomyelitis. Since antibiotics came in, in the early ’40s, that’s a thing of the past, as well as TB in the joints.
Did you stay in New York for one year?
No, it was a two-year residency at that time.
It sounds as if you gained a lot of experience in orthopedics there. This was their specialty, then?
Oh, yes. New York Orthopedic, like everything in New York, had a tremendous patient load. I think their out-patient department ran thirty or forty thousand patients a year, just in the outpatients. We had to work in the clinic every day as well as in the operating room and on the floors with the inpatients.
What did you decide to do next?
The next thing was to get out and earn a living. I liked the East Coast. I was hoping to come back to St. Louis and when I left St. Louis to go up to New York for my residency, several of the orthopedic men whom I knew here said that when I finished my residency they hoped I’d come back to St. Louis. When I was finishing my residency I wrote to them but that was in the depths of the Depression and we never heard anything from these local orthopedic men. But I liked the East Coast and there was a request for an orthopedic man to assist an established orthopedic man in Trenton, New Jersey, which is only sixty miles south of New York City. So, I went down to Trenton and I was accepted there as an assistant and that’s how I started there. I felt it was an area I’d like to live in. Economically, I thought it was fairly good because being a state capital, regardless of the Depression, there were always a great many people employed there.
Have you continued [to practice] in Trenton up to the present time?
Yes. I do just office work now. I discontinued surgery about two years ago. After you hit your seventies surgery isn’t too easy. Now I just go to the office three days a week and do just consultation work.
You mentioned earlier that you were associated with the University of Pennsylvania.
Yes. When I went down to Trenton to practice, of course, there wasn’t much practice and I felt that I wanted to keep in touch with a teaching institution, so I wouldn’t forget what little I did know. Trenton is only thirty miles – a thirty or forty-minute drive – from Philadelphia. So, I went down to the University of Pennsylvania to see if I could work in the clinic there at the hospital. Dr. Bruce Gill, who was a professor of orthopedics at the University [of Pennsylvania] at that time, said, “Sure, come on in.” I guess he had looked up my background and training and he let me work there in the clinic with some of the other young fellows for a year or so and then he appointed me on the staff. I continued to work there for twenty-five or thirty years. I did some surgery but it was mostly outpatient work. That kept me in touch with a teaching institution and kept me busy.
You were on the clinical faculty?
Yes, on the staff – just as an instructor is all.
Have techniques in orthopedics changed a lot over the years from when you started out in Trenton?
The surgical techniques haven’t changed too much. It’s still a question of how to handle tissues and sterility. One thing that’s added, of course, in the operating rooms is to have the clean air. There are many different procedures now that we didn’t have then, especially in these joint replacements, such as a total hip [replacement] and putting in artificial joints – that’s the thing now. Even after I finished my residency, such a thing as the treating of the fractured hip just began in [19]30 and ’31 when nailing the hip was started by Smith Peterson in Boston. And that just developed in the early ’30s. Now, of course, with all these artificial joint replacements it’s much more extensive surgery, just as [in] other fields of surgery: vascular surgery, heart surgery, and so forth, even lung surgery. As I remember it, Evarts Graham, I think, was the first one to excise a lung or part of a lung. That has become much more common now and the survival rate is much better.
When you were practicing full-time, what was a typical day like in your practice?
It turned out to be mostly traumatic work, and that increased more and more. At first, it was some reconstructive work; automobiles had become more numerous and faster and younger age groups were driving [so] it was primarily traumatic surgery.
Did you usually operate in the morning and have office hours in the afternoon?
We had office hours – being [in] a small city like Trenton, we had office hours [in] the afternoons and a few evenings a week. Surgery was in the morning, usually, but with traumatic work there was always emergencies. Many times you were working at night.
So you were on call for emergencies?
Oh, yes.
Were you able to specialize in orthopedics from the very first in Trenton or did you also have a general practice at the beginning?
No. Orthopedics was just developing as a specialty in the early ’30s – more so as a specialty. Of course, it had been started many years before. Especially after the First World War it got an extra boost to be a specialty. I never did anything but orthopedic surgery. I passed my boards – I didn’t take them until, I think, the late ’30s – and got my certification in orthopedics.
What professional societies do you belong to?
To the local and state medical societies in New Jersey – that’s Mercer County. And then the state [medical] society and then the AMA and then the Academy of Orthopedic Surgery – that’s the organization for certified orthopedic men, the national organization – and then the New Jersey State Orthopedic Society.
Does the Orthopedic Society have an examination to certify orthopedists?
Yes. It’s like all specialties; after you’ve had your residency if you want to become certified you take examinations in your specialty (if you want to become certified). And then after you become certified, you can apply for membership in the American Academy of Orthopedic Surgery. Only if you’re a certified orthopedic surgeon can you apply for membership.
What state licenses did you hold? I suppose you started out with the Missouri license.
Yes. I wanted the local license here in Missouri. Having grown up out west, I applied [for] and got a state of Washington license. When I went to New Jersey, I got a New Jersey state medical license. Then, working at the University hospital in Philadelphia, I obtained a state of Pennsylvania medical license.
Have you had time to attend many national or international meetings in orthopedics?
Yes. For many years I used to go to our national orthopedic meeting of the American Academy of Orthopedics. [I attended] a few of the AMA meetings. [I went to] our state Orthopedic Society meetings, which met once or twice a year. I’ve only been to a few international meetings in orthopedics.
Did you have time to do much writing in the field?
I’ve never done any writing – which I expect I should have, but I’ve never articulated—
You had a large practice to handle. Another question that I usually ask is what your philosophy is as a physician, that is, your attitude toward medicine and the treatment of patients.
[As to] philosophy, I feel that everybody should be treated, regardless of their economic situation. If they can pay for it, fine; if they can’t, that’s all right, too. Unfortunately, the way things are now a tremendous amount of [the] work we did at that time, the government feels we did as charity work. The government feels they want to take care of it now through Medicaid and other things which I think is unnecessary. I feel doctors are still glad to do it. What did you have in mind?
That’s a good answer. That’s interesting.
When people came to an office or hospital there was never a question of whether they were paying or not.
So they were admitted whether or not they could pay?
Sure. They were always taken care of, regardless. Later, we went into the economic situation as to whether they were able to pay or not.
In orthopedics, did you have many long-term patients or was it specific [conditions]?
No. A fair number of them, of course, were long-term in comparison with general surgery. For instance, some fractures take a minimum of six months to heal, then there’s a follow-up, and later physiotherapy after that. Also, in the earlier days with tuberculosis in the joint, especially the spine and hip, that was a situation where they had to be watched and cared for many years. That was before the time of streptomycin and the other antibiotics that we use now.
To ask a little bit about your personal life – where did you meet your wife? Was that in St. Louis?
No, no. That was just in the last few years.
Do you have any other comments that you’d like to make about orthopedics, or about your career?
The only comment at present would be [that] the more research [that] is done the better, to extend the field or improve the treatment of patients or to solve some of our medical problems. The more research, the better or quicker we’ll be able to treat patients better and relieve patients better. That’s from the medical standpoint.
We hear a lot today about the high cost of malpractice insurance. Have you had this problem also? In another interview, the doctor said the high cost had prevented him from even practicing part-time. Does [your] consulting basis take care of this?
To some extent. In New Jersey, the malpractice insurance is a problem as [it is] everywhere else and especially in such fields as surgery and orthopedics. I stopped doing surgery maybe a year or two earlier than I would have because of the high malpractice charges. The malpractice [insurance] rate for just office practice and consultation work is not very much. I think I paid only about fifteen hundred [dollars] a year, which is peanuts today. I wouldn’t want to do any more surgery, anyway regardless, on account of my age. Physically, you just can’t do it and shouldn’t be allowed to after seventy.
Are there any other comments that you would like to make about the medical school or about your career in orthopedics?
I’ve always felt fortunate that I’d been accepted at Washington University Medical School and have never been ashamed of it, in New York or in any other part of the country. I was always very proud that I had graduated from this medical school, and also [proud of] my training since having graduated. Economically, unfortunately, now these boys finishing their training don’t know what it is to have to work for a living. They can go out from a residency and join a medical group or get a position at thirty or forty thousand [dollars] a year, which of course they aren’t worth because they’re inexperienced and have no judgment – which, of course, they don’t believe. But that’s part of the entire national picture – the economic situation – where [they] don’t know what it is to be hungry and to have to work for a living.
Thank you very much for agreeing to give this interview to us today.
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