Transcript: Tom F. Whayne, 1981

This is the Washington University School of Medicine Oral History Program.  Oral History number 51, May 7th, 1981.  I’m Paul Anderson and this is one of our series of interviews with alumni of Washington University School of Medicine.  I’m speaking today with Tom F. Whayne, M.D., class of 1931.

Dr. Whayne, I want to begin by reviewing your career, although you’ve held so many positions that this review will have to be somewhat abbreviated.  You were born in Columbus, Kentucky in 1905.

Correct.

Columbus is a little river town across the Missouri [ed. note: the Mississippi River] not far from New Madrid, Missouri.

No.  It’s north of New Madrid; it’s across from the former Missouri town of Belmont.  The only distinction it has is being just near the site of the Battle of Belmont of the Civil War.

Yes, I saw that on the map.  And then you attended public schools in the area?

Yes, there and in high school in Clinton, Kentucky, which is the county seat of our little county of Hickman County, Kentucky.

You began college at Bowling Green in what was then Western Kentucky State Normal School and transferred to the University of Kentucky where you graduated with an A.B. in 1927.

That is right.

Then you went to the Washington University School of Medicine and you took your internship at Missouri Baptist Hospital.

Here in St. Louis.

And followed this with residency at Missouri Pacific Hospital.

Yes, that was really not a residency in the true modern sense.  I was a house physician.

This is all between 1931 and 1934?

That is right.

In 1934 you entered the United States Army Medical Corps and your first assignment was to Fitzsimmons General Hospital in Denver.

Yes.  Well, I was still on the reserve status at that time, I guess that’s minutiae, and I came into the regular army after examinations taken while I was on the staff at Fitzsimmons General Hospital in Denver.

Through the Corps, you received additional training at the Medical Field Service School at Carlisle Barracks, Pennsylvania in 1935.

Yes.

Then if we look ahead to World War II you served in varying capacities, particularly concerned with preventive medicine in the European theater.  I’ll later ask you to trace your activities in this area.  For a year after the war, you remained with the American forces in Germany and then for about ten years, you were with the Preventive Medicine Division of the Surgeon General’s Office.

Yes.  Not all one period of ten years, but I served a total of approximately ten years in the Army Surgeon General’s Office – not all in one continuous period.

In 1955, you retired from the army, [and] became a Professor of Public Health and Preventive Medicine at the University of Pennsylvania.

Yes.

You also served as associate dean?

After about two years there, I became one of the associate deans of the College of Medicine of the University of Pennsylvania.

In 1963, you became Professor of Community Medicine at the University of Kentucky at Lexington and also served with the administration of the school and the medical center at Lexington.

I should say there that my primary responsibilities initially at the University of Kentucky – really totally at the University of Kentucky – were administrative, certainly for the first several years.  I went there as the Assistant Vice President of the Medical Center and Associate Dean of the College of Medicine.  Those were my primary responsibilities and I took little responsibility for actual teaching in the Department of Community Medicine.

I see, but this was the chair and the appointment that you—

I held the appointment, yes.

Any informal comment is quite all right for our program.  You were in this capacity until 1974 when you retired from the university, and you’ve been emeritus professor since then.

That’s right.  I retired from the administrative capacity a year, two years ahead of that, I guess, and went full time in the Department of Community Medicine.  It was in that capacity that I retired in 1974.  Is this too much detail?

No, but we will have to get back to some of these things and discuss them as we go along.  To return to your earliest years, can you recall any factors in your family background and childhood which influenced you to study medicine?

Yes, I think I can.  One of my paternal uncles was a physician in the small town of Columbus, as a matter of fact.  He conducted what in those days was a general practice, today’s family practice, along the old lines of house calls and going across the Mississippi River into the rural areas of Missouri, et cetera.  He was sort of a father figure in a sense to me and I admired him very much for what I observed him doing.  Another thing, simple as it may seem, is that in the winter of 1917-18, I had a serious illness which required a chest operation for empyema it was – for drainage of the chest – which was done in the little city of Cairo, Illinois.  The surgeon that did that in some way captured my imagination, so this was another fortifying factor for my becoming interested in medicine.  Then I should add to that, I guess, that in my family on both sides as far back as I can follow it up to the present time, there have been, I think, it’s eighteen physicians.  So it’s not an unknown family tradition in a way, my brother being a physician, my son being a physician, et cetera.

It is quite a tradition within your family.  In those days, medicine was considerably different in some major respects, was it not?  Can you recall any ways in which even general practice differed from the way medicine is now?

Well, yes.  Now I have to initially say that I did not engage in general practice outside of the army.  But in observing my uncle and the practitioners who practiced in our area, it was a foregone conclusion that every physician accepted house calls.  Those were the horse and buggy days, really, and they spent many hours either [on] horseback or in their carriages or buggies going out through the country.  This was the pre-Depression period and frequently they were not paid in cash or not paid at all, but frequently on a barter sort of thing: a sack of potatoes, a chicken or two or a dozen eggs or whatever – this sort of thing.  So this was practicing medicine in a hard way, but a very dedicated way.  This is one of things that I admired my uncle for.  I was amazed at his death to learn that he had, which in those days was a tremendous sum for a physician in a small town, over two hundred thousand dollars of uncollected fees on his books.  These people couldn’t pay and he didn’t push them.  This sort of thing isn’t today’s approach to medicine.

Were there any non-M.D.s practicing medicine – homeopaths for example?

I don’t recall a single such instance in the little section of Kentucky in which I grew up.  No, no.

Well, when it came for you to make your choice, how did you happen to choose to attend Washington University School of Medicine?

I wish I could be real sure about that point.  I had done my pre-medical work at the University of Kentucky and most of the pre-medical students in those days went to the University of Louisville in Louisville, Kentucky, and I did not feel that the University of Louisville was exactly what I wanted.  The other school that I considered seriously, and I’m not sure that I could have gone – I wasn’t accepted – was Vanderbilt.  In addition to that, my home, county, town – the town of Columbus in Hickman County – is at the very westernmost end of Kentucky and we were essentially halfway between St. Louis and Memphis.  We were more oriented to those cities than to anything to the east and I didn’t want to go to our own school in Louisville, as I said.  My uncle had also gone to the predecessor of Washington University – I’ve forgotten what it was called in those days.

Well, they had two of them, one was St. Louis Medical College and the other was Missouri Medical College.

I’m not sure which one it was, but it was the one that eventually became Washington University.

Can you tell me his name so maybe I can trace it.

Thomas Samuel Whayne, Thomas S. Whayne.  Now this is (spells) W-h-a-y-n-e, I’m sure you’ve noticed that.  So many people say “Well, that ‘H’ just shouldn’t be there,” but it is.

I’ll look him up in our records.

Yeah, he may be there.

We have fairly complete records for all the predecessor schools of Washington University.  Well, now having enrolled, what do you recall about the pre-clinical training here at the medical school?

Well, I think I found it exciting and I’m sure you have had others tell you the same thing.  It certainly was an experience far beyond my ken up to that point in terms of sophistication, having come from a small place with high school educational standards that are not comparable to a large city, for example, and [from] the pre-medical program at a then-small University of Kentucky.  This was a big step, as you can appreciate, to come into what was then considered, I think I’m correct in saying, certainly one of the outstanding medical institutions of the country.  We used to think we could say with assurance that it was among the ten great medical schools of the country and I think it probably was at that time.

What I’m saying is there was a certain amount of awe in coming into this environment and it took a while for me to adjust to it.  I also have to say quite frankly that I do not think I was adequately prepared to step right into such an accelerated biological sciences program as made up, even in those days, the first two years here.  So there was a certain amount of strain for me, too, under those circumstances and I had to work very hard.  I came as a very young person.  I was just twenty-one, you see, when I came here, and coming from the background that I had come from I’m sure I would have been better to have matured a year or two before I came.

Were there any pitfalls that came as a result of your immaturity?

Yes.  I want to be very frank about that, something that I used to find very painful to talk about.  It was in my year in physiology under Dr. [Joseph] Erlanger, and I had problems with physiology.  Dr. Erlanger did not feel he could progress me and asked that I repeat the course, which I did.  Dr. [Robert J.] Terry, who was chairman of the Department of Anatomy then, was very kind to me in picking me up during that interim.  I worked for that year in the Department of Anatomy, which gave me an opportunity to mature a great deal.  I came in close contact with Dr. George Williams who was on the faculty at that time.  Dr. Cecil Charles, who’s now dead, was on the anatomy faculty, [and] Dr. Mildred Trotter.  The association with this group of wonderful people gave me a lot of strength and encouragement and experience.

I did all of the photography for the scientific papers for the faculty in anatomy.  I had a lot to do with the work preparing bodies for dissection, et cetera – not a very glamorous sort of thing, but a year of maturing that I needed.  So as I look back on it, despite the fact that I was very hurt at that time, this was something that was good for me in the long run and I sailed right on through it after that and had no more problems.  When I got into the clinical years I think I did extremely well.

So your formal medical studies were held in abeyance for a year while you worked as a laboratory assistant?

Well, I think you could call it a laboratory assistant in the Department of Anatomy, yes.  So if I had graduated with the class that I entered with this would be my fifty-first anniversary instead of the fiftieth.  I don’t care who hears or reads this sort of thing anymore, but I used to be very sensitive about this.  I just want to say that again because we all mature slowly, or at least some of us more slowly than others.

And sometimes hurts or embarrassments last beyond their practical—

Right.  We need say no more about that, but I didn’t feel it would be honest not to make that point clear.

When you got back into studies, you said you progressed well.  Do you recall any other faculty contacts that were particularly important to you?

Yes.  I mentioned Dr. Terry and his group.  Dr. White, I’ve forgotten his first name, in physiology, biochemistry.  [ed. note: Whayne probably refers here to Harvey Lester White, M.D., associate professor of Physiology]  Dr. White – I just can’t say his first name offhand.  He was very kind to me and just very helpful.  I shall never forget taking an examination under him.  This was a practical examination and he gave me a fatty solution and asked me to separate the fats from the solvent.  I went through an elaborate process of saponification, which was good chemistry but not very good practical sense.  When I took it back, Dr. White said, “Well, yes, you’ve done a good job; you’ve accomplished what I asked you to.”  “But,” he said, “you could have accomplished the same thing by simply heating this and boiling your solvent away.”  I’ve never forgotten that.  You know, this was just a lesson in objectivity, a lesson in, “Use your head; think about that.”  You don’t have to display all of the intricacies of some elaborate process in order to accomplish an objective if you think it out.  That’s a minor, minor thing.

I think that in pathology, Dr. Leo Loeb, and his faculty had a tremendous impact on me, particularly Dr. Ralph [S.] Muckenfuss.  I don’t know whether you are familiar with him; he’s been away from Washington University for many years.  I don’t know whether he is still living or not.  He was in the field of bacteriology and eventually, virology, and was in Dr. Leo Loeb’s department.  Along with Dr. Joseph [E.] Smadel – whom I’m sure you do know of – who was in my class and we were very close friends.  Working with Joe Smadel and more or less under Muckenfuss, I was tremendously impressed with the activities of that department.  I think they gave me a feel for research [even though] I did not go into research like Joe Smadel did.  Joseph Smadel became one of the outstanding virologists, not in just in this country but in the world.  Anyway, that’s another group that impressed me.  I’m limiting this at the moment to basic sciences.

Well, let’s go on now.  When you began your clinical training, do you have any particular recollections?

Yes, I think one of the people who was most interesting and probably the best teacher was Dr. Harry Alexander in medicine, in the Department of Medicine.  He had a knack for making things dramatic and objective at the same time and presenting his material and his patients in a way that you remembered, that impressed one.  At least they did me.  Dr. [David P.] Barr also – while not the dramatic sort of teacher that Dr. Alexander was – nevertheless, was one of those sound clinicians that you just felt like that you had to learn when you worked under him and progressed under him.

I later, after – many years later – when I was in the army and Dr. Barr had accepted the chair, or at least a professorship, in medicine at Cornell in the medical school in New York.  I was there visiting – the president of the medical center was a person I had worked with; his name will come up later, Dr. Stanhope Bayne-Jones.  I’d been to see Dr. Bayne-Jones and while I was there, I thought I’d just call on Dr. Barr, which I did, thinking I’d take about five minutes to say, “I’m one of your former students, et cetera.”  Well, he said, “What are you doing, Whayne?”  I told him about preventive medicine, and he said, “I’ve never understood preventive medicine.  Please do sit down and tell me what this is all about.”  After about two hours I’m still not sure that I convinced him.  But nevertheless what I’m trying to say really is he was interested even in that stage in gaining more knowledge of different fields.  He was picking my brain and making me feel, like well, here’s a wonderful old teacher who’s giving me the opportunity to reciprocate in a little bit of a way.

I guess one of the other [memorable] persons would be Dr. Evarts Graham.  Dr. Graham was also a marvelous teacher and an impressive human being in every way as far as I can remember.  I shall never forget – I guess it was in my junior year – we were all in one of those surgical amphitheaters that are characteristic of all medical schools, tier upon tier looking down.  It probably doesn’t exist anymore.  In any event, the class was called together and we all met together for this session.  Dr. Graham walked in and was immediately followed by a big – a very large – black man on a stretcher, [which] was being rolled in behind him.  This had something to do with abdominal pathology, as he announced.  I’ve forgotten exactly how he announced it, but after he had made his little introductory remarks and referred to the patient, he looked up and he said, “Dr. Whayne” – [I was a] junior student, of course, no “Dr.” – “Dr. Whayne, will you come down and examine the patient?”  I, of course, had no alternative.

I went down to examine the patient and all I could find was a large, regular – not irregular – regular mass in the center lower part of the abdomen just above the _____(?).  I searched my brain for all the pathology that I could think of that might lead to such a thing and I couldn’t come up with anything.  I thought, “Well, I’ll probably be laughed out of here, but all I can say is that I think this man has a distended bladder.”  I admitted my thoughts to Dr. Graham and he sort of smiled from ear to ear.  He looked up at the class and he said, “Dr. Whayne thinks the patient has a distended bladder,” and he said, “the patient knows darn well he does.”

What he had done [was] have this man hold his urine for hours on end so that he had developed this assumed tumor to catch an unwary medical student.  Perhaps that’s the only reason I passed surgery. (Laughs)

It was a real set up for you and you didn’t get snowed.

No.

You know, I thought of Dr. Graham when you mentioned much earlier, of course, your brush with empyema.  Do you recall his research in this area?

Yes, I do.  I never discussed my history with him; there had been no occasion to.  I was a youngster of only about twelve years of age when this happened.  I had a simple rib resection.  This wouldn’t have been possible before World War I, but Dr. [Flint] Bondurant was the man who had done this in Cairo, Illinois and he had learned what to do about such matters because empyema was not an uncommon situation in soldiers in Europe in the American expeditionary forces of World War I, and so he knew about this.  So he resected three ribs and drained it.  I recovered rapidly and I’ve had no problems ever since.

Was this about the time that Dr. Graham was doing his early pneumonectomies?

I am not sure.  I don’t know when Dr. Graham started.  This was in 1918 when this episode occurred to me, and Dr. Graham must have started some time, you know, long before I came to medical school.

Flipping ahead to your clinical days.

So he probably was prompted to become interested in this field, if he didn’t indeed participate in it, because of what was learned in World War I in regard to rib resection for empyema.  Most of them died before that time.

Let’s change subjects slightly and talk about a more social matter, namely, where did you live when you were a medical student?

I’ve almost forgotten.  I did – which I consider a mistake now – join a medical fraternity, AKK it was.  I lived in the fraternity house for a couple of years, I guess.  Then one year I shared an apartment – a small apartment of rooms – with a young man from my little home town – a high school friend, who was not studying for medicine, but was studying for industrial arts.  For that year we sort of, as they said in that part of the world, we “batched” for a year.  We did our own cooking, et cetera.  Another year I lived in I guess what amounts to a boarding house.  I’ve even forgotten where it was located – not too far from the old site of St. John’s Hospital – somewhere over there.

Why was the medical fraternity a mistake for you?

Well, I think they’re disconcerting to start off with.  I don’t know whether this is characteristic of all medical fraternities, fraternities other than medical for that matter.  But I found that some of the social activities, some of the peer activities shall we say, were not really conducive to good scholarship.  I really didn’t know, I guess at that stage – I enjoyed some of these things to be sure, and participated in them.  But as I look back on it, I think this was not a good situation.  I guess based on that, and based on my observations of fraternities in general at two institutions – namely the University of Pennsylvania and the University of Kentucky – and in view of I think social changes that have come about in the last decade or so – two decades, let us say – I think I have come to feel that the fraternity movement in general is not a good and reliable and happy progressive social movement.  I think it’s anti-social, not in the sense of parties and this and that, but I mean anti-social in the sense of the good of society and the good of developing good members of the society.  So, you shouldn’t have pressed my button because what I’m telling you is of one of my prejudices, I suppose.

That’s what we’re here to hear and you’re certainly entitled to your views in view of your experience.  Did you encounter women medical students in your class?

Yes.  I guess the one I remember best was Elizabeth Moore, who became the wife of Joe Smadel, and an eminent pathologist in her own right.  There was no romantic attachment or anything of the kind.  Joe Smadel and I were just good, close friends, and he and Elizabeth were good friends at that time and we did see, under some circumstances, saw considerable of each other.  As far as students are concerned – oh yes, there was a young woman named [Louise] Powers, who I believe is attending this fiftieth anniversary who I came to know to some extent.

Yes.  I think her name is Ainsworth.

Ainsworth now, that is correct.  I didn’t know her nearly as well as Elizabeth Moore Smadel, but I did feel that she was a good example of women in medicine.

Do you recall whether women were treated any differently from men students when they were in the classroom or in the clinics?

I’m really not qualified to judge that, I think in a way, because I don’t remember that I was actually in a teaching group with a woman student.  There weren’t very many of them in those days.  I think there were four in my class and there was certainly no difference that I observed in the pre-clinical years.  As I say, in my groups in the clinical years I do not recall that there was a woman student as a fellow group member.  But I wasn’t conscious in any way of any special treatment or special attitude, pro or con, as far as women were concerned in this institution.  I think it did exist in other institutions.  I know it existed at the University of Louisville, for example; they wouldn’t even take women at that stage.

So this medical school was relatively more progressive?

I am convinced of that.  Yes, I think that’s true.

Can you think of any other ways in which it was more progressive?  I’ve fed you a leading question here.

Yes, you caught me a little bit by surprise but I think I can react to it in the sense that I think that one of the things that came through, certainly in the basic science years and in a different way in the clinical years, was the need for all physicians to acquire or contribute to new knowledge.  In other words, an emphasis on research.  This was a part of the environment even in those days and this carried on into the clinical years in the sense that as a junior – I think it was the junior year, it was one of the clinical years and I believe it was the junior year – we were required to prepare a short dissertation on some subject or another.  Every student – not just me, but every student.  This was an effort, I think, to encourage us to be concerned with contributing new knowledge and reporting the things that we had observed.  So I think [this] was one thing that came through to me as a major force.  I think this was one of them.

The other was, I think, emphasis on clinical excellence.  I’ve visited many medical schools in later years and so I think I have some way to judge, in a way, these attitudes.  In many places the emphasis may seem to be an overemphasis on research, but a less of a concern for the patient – they were something of a necessary evil that you have to learn about – or visa versa.  It may be that research – well, we’re not good; we don’t stress that – clinical care is our field.  I think it’s fair to say that even in those days I recognize that there was a melding of those attitudes, both of which are absolutely necessary to produce good physicians.

To return briefly to your research project that you alluded to just now – what did you do yours in?

Oh, I’ve almost forgotten.  I worked with Dr. George Williams in the anatomy department, and George Williams – I refer to him as George because we became close personal friends over the years – was interested in anthropology.  I had assisted George [during] this year I was in the department of anatomy, in the collection of much of his data in terms of measuring skull, and relation to race, and female versus male characteristics, et cetera, et cetera.  Because I had become involved in this, it was an easy step to give this slightly a clinical twist, but at the same time to prepare a short paper, which we did, and which I guess was published here.  I don’t even remember – I don’t think the reference to it is in the [catalog].  It was such a minor thing.

No.  I confess I didn’t come across it.  In talking about working with anthropometry – I don’t know if I have that pronounced correctly, but I recall that Dr. Terry had a pretty famous skeleton collection.

Yes, he did indeed.  He did indeed.

Did you see this and work with it at all?

Yes, I did [see it].  I did not work with that collection – no, but I saw the collection on a number of occasions.  I was involved.  I was one of the students – one of a group of about six students in anatomy – that were set aside in separate dissecting rooms to serve as demonstrators, really, for the remainder of the class.  Some of these things we did became actual specimens – not skeletal specimens – but specimens that were used for teaching and demonstration.  Part of the work in the anatomy department was not only the embalming of bodies and their preservation, et cetera, but also the skeletonization of them which I did not personally do, but which I was involved in to some extent.  There were some odd pathological things that – I don’t remember the details of it – that I’m not sure Dr. Terry integrated into his collection, but which he was certainly very interested in.

As you entered your clinical years and graduated, you can’t help but recall that America teetered on the brink of and then plunged into economic depression.  How did this affect your studies and career?

I’m not sure that it affected my studies so much because we were all poor in those days.  It affected me in the sense that my family were not well-off.  I grew up on a farm and in the Depression, money was just not available and I came to medical school on a shoestring.  I borrowed the money to start off with and had much help through the scholarship program here, and et cetera.  I would not have made it through medical school – couldn’t possibly financially have made it through medical school – without being paid by the department of anatomy, without some loan assistance under Mr. Parker who was the business administrator at that time, I believe.  I don’t recall his first name.  [ed. note:  Whayne refers to William B. Parker, Registrar and Business Manager at this time]  So the Depression had that sort of an impact, but then “genteel poverty,” if you want to think of it that way, was no stranger to us in west Kentucky.  The only problem was we just didn’t have sense enough to know that we were in poverty.

It was more then people who had grown up, I guess, in industrial environments.

I think, yes, [the people] that didn’t know how to cope with this sort of thing.  I’m not sure that I knew how to cope with it, but at least I was not unfamiliar with it.

We’ve alluded already to the medical research programs and the fact that you’ve had the opportunity to do some research.  Did you think at that time at all about a career in research?

No, I don’t think so.  I don’t know whether you would like me to say how—  There are accidents in career development, you know, and it funnels upon your previous question about economics.  Because when I came out of medical school owing the scholarship fund, owing banks in my own community, for those days substantial amounts, there was no way that I could have arranged to have bought the equipment to go out and start a practice of my own.  There were a number of other [graduates].  I can recall the names of two or three and I’m sure there were several others who found themselves in the same circumstances.  That, among other things, is what led me into a military career because here was the Army Medical Corps needing some people.  As low as their pay was at least it was substantial pay and the perquisites that go along with it.  And that’s basically why – If someone had told me when I started to medical school that I would become a medical officer in the army, I would have said they were crazy.  So I have no leaning, no family connection with the armed services in any way.  [It was] purely economic.

Did you have reserve officer training while you were in medical school?

I did.  I spent two or three summers at Fort Snelling in St. Paul – just outside of Minneapolis or St. Paul, I’ve forgotten which now.  Minneapolis.  I had had enough clinical experience at least for the last two [summers] – the examining of CMTC students, et cetera.  It was a very good experience.  So I had some military background; I had had this reserve commission since I had been eligible for it.

Was that something that was required of students at the time?

It was not required, here, again, [it was] economics.  When you went off to Fort Snelling or similar places, you were paid.  It was summer pay, it was experience, [and] it was a change.  There were several reasons for it being important.  So it was a job, in a way, that I got into for those reasons and I must admit that I enjoyed them.

Did you remain with the Reserve Officer Corps while you were an intern, too?

Yes.  Yes, I did.  I did no active duty during that period, neither the year at Missouri Baptist or the year at Missouri Pacific [Hospital].  I did no active duty.  I did something that I’m not sure came out in the curriculum vitae.  At the end of the year at the Missouri Pacific Hospital – again basically for economic reasons – I accepted active duty in what was then called the CCC, the Civilian Conservation Corps, and spent several months in northern Missouri, [in] a little town called Central City.  We had a camp of a couple hundred boys out [doing] things that the CCC thing did in those days.  Then we were ordered down to the Ozark region, sixty-five miles from Springfield, Missouri.

Thereby lies a slight tale of interest – in the sense that the former professor of military science and tactics here at Washington University was Dr. Robert Hardaway, Colonel Robert [Hardaway] – who later became Brigadier General Robert Hardaway.  Robert M. Hardaway.  He was really a wonderful person.  Being in the Reserve I came to know him reasonably well.  While I was on CCC duty near Springfield, I received a letter from then-Colonel Hardaway from Fitzsimmons General Hospital saying (or asking) would I like to come to Fitzsimmons.  Well, I did not wait to go through channels, being a little naive about such matters at that time.  I got in my little car and drove sixty-five miles to Springfield that evening and sent him a telegram that said, “Yes, I would be delighted to come to Springfield.”  He initiated the proper procedures through the surgeon general’s office and the next thing I knew, I was ordered to Fitzsimmons.  And that’s I happened to go to Fitzsimmons.

I don’t know whether you like to integrate these little asides or not, but after coming into the regular army, after all this was over and I’d had the course at Carlisle Barracks, I was ordered back to Fort Leavenworth, Kansas.  I walked in and saluted the surgeon of the post, Colonel Blanchard.  He didn’t even say, “Hello.”  He just looked over his glasses and he said, “Well, Whayne, you’ve come back to roost.”  What had happened was [as] I said, I went out of channel; I should have gone through him.  He felt a little miffed and quite appropriately so, that I had not consulted him.  But he got it off his chest at that session and I never heard any more about it. (Laughs)

He did recall the details; that’s interesting.

But the year at Fitzsimmons was equivalent to another year of what we would now call residencies-in-training, and it was a marvelous year in clinical medicine.  Tuberculosis was, of course, the major field in which the staff at Fitzsimmons was so expert both in the medical treatment and the then-budding surgical treatment of tuberculosis.  So it was a marvelous experience.

If we can backtrack for a moment to the CCC experience.  I’ve heard them described as a potential time bomb in terms of epidemic problems.  In bringing men suddenly from different walks of life, the army had to be really on its guard to make sure that proper public health standards and sanitation standards were maintained in those camps.  Was this an impression that you had, too?

Well, we never had that problem other than the minor little respiratory things that go around and I think maybe a little gastrointestinal thing or two that happened, you know.  You’re referring to some other sorts of communicable diseases.

I think it was that problem at Camp Dix that was described to me.

Right, including some of the virus diseases.  Poliomyelitis was one of the things they worried about and later on the Coxsackie diseases caused by the Coxsackie organism, et cetera.  Meningitis was another problem that came about in some of the camps, but I was not personally involved in any of this.  We had a good, sound vaccination program in light of the vaccines available in those days, and I think we maintained a very good sanitary environment.  I worked hard at that and my experience at Snelling was helpful in that regard.

I want to back track just a little bit further back to Missouri Baptist.  Can you describe that experience a little bit?

Yes.  I’d have to say I learned a lot at Missouri Baptist.  I don’t think I was ever totally happy there.

Where was it located then?

Over to the north.  I don’t remember the streets.  Goodness, over to the north and slightly east of here.  I just don’t remember the street address.  [The hospital was in] big, old brick buildings; I’m sure they’re long since torn down.  It was – I would have to say – a good community hospital, but it was not a good teaching hospital.  My feel for it – I don’t feel comfortable necessarily in saying these critical things now I guess, but after all you’re seeking the truth and my impressions were that there were too many cliques.  Dr. [Marion L.] Klinefelter and his orthopedic group [were] excellent, but they were a little, close-knit group and there was just no way—

They weren’t ready to accept the less-experienced outsider?

That’s right.  And you did it their way or you didn’t interfere.  I think a little of that is sour grapes in a way because here again, this economic thing [is important].  Missouri Baptist paid an intern stipend; Barnes [Hospital] did not at that time.  While I couldn’t say with a thousand percent surety that it could have been arranged, I was led to believe by two or three of the residents that I had become close friends with, that if I were to have really tried, I might have found myself on the non-paid – room, board and laundry sort of thing, no pocket money, nothing – at Barnes.  Well, I guess there’s a little sour grapes in this when I say that I felt a little bit – after I’d experienced the year [at Missouri Baptist], that I knew I had not had what I could have had if I had been able to, either by arrangement, or could have afforded to [have] gone to Barnes.  That’s, as I say, [a] sour grapes type of thing and that’s water over the dam, so there’s no point to discussing it except it gives you, I think, a little bit of an idea of why I didn’t feel completely happy with the situation at [Missouri Baptist].  [There was] Dr. [Willard] Bartlett in thyroid – his specialty was the surgery of the thyroid gland – and his two sons.  I remember them as being rather outstanding.  Dr. Klinefelter, no question, was outstanding in his field of orthopedic surgery.  There was a doctor [with a] Jewish name; I can’t recall it.  He was very kind to me and a very excellent medical clinician and teacher.  Those, I think, are about the only three men I remember over there, you know, certainly with any affection.

How about Missouri Pacific Hospital?  What was that like?

It was a good, practical training year.  It was, I think, equivalent to a year of residency training.  [It was] not comparable to Barnes Hospital residency or any other academically-associated hospital residency program, but in terms of community hospitals, hospitals in cities in general excluding the large city hospitals such as existed here in St. Louis, then I think it was a good experience.  Some of the faculty members of Washington University were on the staff there.  Dr. [Joseph Hoy] Sanford in urology I remember particularly.  [There was] a young man – I can’t say his name – he was young then but he was just out of his residency program here in clinical medicine.  I don’t recall his name offhand, but [he was] just an outstanding clinician.  Here we were seeing not what came in off the street like a big city hospital or even Missouri Baptist, but we were seeing a specialized clinical population – or patient population.

These were the railroad employees?

These were the railroad employees.

And their families?

And I believe their families, yes.  So these were real problems and they were real economic in the sense that these guys needed to get back to work, and the railroad wanted them back to work.  So there was an emphasis on good medicine and practical medicine and efficient medicine.  And so I look back upon that year as a good year.

In a way it reminds me of a health maintenance organization.

In a way, yes.  In a way, yes.  It certainly was because the hospital was well administered.  It was administered more or less the same as any other hospital, but functionally you’re right, it was not too different from the concept of health maintenance; although they were quite prepared to do and did major surgery and admitted clinical patients in all fields and kept them as long as was necessary.  But the emphasis was also on giving them good medicine and getting them out as soon as [possible] without neglecting them.  I don’t mean that they were pushed through and not taken care of.  The care was good.

We got earlier to the point where you were at Fitzsimmons in Colorado.  From there did you go to Carlisle Barracks?  Is that the progression?

Yes.  Well, we have to go back just a little bit because the same General Hardaway whom I mentioned earlier, as I said was at Fitzsimmons.  So I had a friend there and he was interested in having me come into the regular army.  The commander of the CCC camp of which I was the surgeon became very famous in World War II – a young man named Merrill.  He apparently liked having me as his medical officer and he urged me to come into the regular army.  While hating to lose me as his surgeon, [he] was pleased that I was getting this opportunity.

Do you recall his first name so we can track him down?

Yes, I’ll say it in a minute.  He became known as the commanding general of Merrill’s Marauders in Burma.  Frank – Frank Merrill.  There’s a book on Frank Merrill called Merrill’s Marauders.  If you wanted to—

Yes, I think I’ve seen it.

Oh, you’ve seen it.  Well, Frank was a close personal friend, and his wife, Lucy.  Even many years later after World War II was over, we saw them socially.  They lived in New Hampshire and we were in Boston at that time and so we visited back and forth some.  Anyway, to get back to your question.  And the commanding general at Fitzsimmons – I’ll think of [the name] in a moment, it slips me at the moment – also was interested in having two or three of us who were youngsters on the staff at that time, come into the regular army.  So we all took the physical examination [and] we took the mental examination, which was really a tough one.

I remember a young man named Malcolm Grow and I were failed, not in the professional examination but on the basis of our physical problems.  Malcolm – no, not Malcolm, yes Malcolm Grow, no John Grow (I’m sorry, I’m mixing up Grows) – John Grow was big, broad-chested, heavy fellow and he was overweight by army standards.  I had this scar from the chest surgery as a youngster.  I remember the commanding officer making a special trip to Washington to tell the surgeon general that here were two big, broad-chested guys that were in perfect physical health and he better darn well take them – he had some good men.  But we both had to rewrite the examination a second time because they had not let us in the first time, and that was a comprehensive examination in which the competition was tremendous.  Now this is something so different from what you are accustomed to [in] this day and time with the attitude towards the military services that’s developed, particularly since the Vietnam War and et cetera.

At that particular time, not only because of the financial situation of so many people and therefore a regular salary being important, the caliber of medical practice, especially in the army general hospitals, was at a very high level.  It certainly was at Fitzsimmons.  When I took these examinations I remember specifically that there were 450 applicants who took the examination and 44 of us were selected.  It gives you some idea of the interest and the competition for places in the medical service of the army at that time.

Well, after this kind of training and the experience you had, why was it necessary to go on to Carlisle Barracks?

Well, you have to know what Carlisle Barracks is about.  Coming out of the experience of World War II [ed. note: Whayne may mean World War I] when there was really no well-organized medical corps and they had to more or less pick up from scratch and develop a strong medical corps to cope with the medical problems of World War II, one of the undying lessons that came out of that experience was that the medical officer must be able to handle himself in the field.  He must know what line activities were about; he most know field sanitation; he must be able to do anything that the line officers could do in terms of accommodating himself to even combat conditions.  Because many of the medical installations were right up back of the fighting battalions, you know, and we weren’t prepared like that in World War I and many physicians failed in their roles, not because they weren’t good physicians, but because they didn’t know how to handle themselves within that environment.  So coming out of that was the concept that every regular medical officer must be prepared to know how to conduct himself under field conditions.

Now this is what Carlisle Barracks was all about.  There was no clinical training whatsoever.  We learned military organization, administration contacts, logistics, things like an army ______(?), not as professional physicians, because the class was made up, not of physicians alone, but veterinary officers, dental officers, some medical administrative people, et cetera.  We were all there to learn how to get along under field conditions.

That does make sense, but I didn’t realize that.

Well, so many don’t.

You’ve told me that you’ve known Dr. Crawford Sams for many years.  Did you meet him at Carlisle?

Carlisle Barracks, yes.  He was an instructor there.

Can you recall anything about him?

Well, I’ve known him over the years and I know him very well now.  An amusing little thing which Crawford would laugh at too, I’m sure now, if I reminded him of it, I’ve never forgotten, though, as an instructor.  He and I were medical students here together; he was two or three years ahead of me.  I guess we overlapped one year, anyway, I knew him here.  I had known him—  No, that’s right.  That is the only contact we’d had.  But anyway, at Carlisle Barracks – I don’t remember the details of it – but it was some little something that I had not done quite up to Crawford’s ideas of good military taste or accomplishment.  Crawford called this to my attention, which was appropriate, but he also got out his little book and said, “Now I’m making a note of this.” (Laughs) This came to me as a little bit of a shock – a former fellow student saying that sort of thing – but he was doing his job.

Crawford Sams was not only a good physician, but he was an outstanding military officer in the sense that I think he could have commanded a non-medical field unit because of his knowledge of logistics, administration, and tactics, strategy – outstanding.  We were later associated – I don’t remember all the details.  In Panama, for example, I was assigned [there] and Crawford Sams was there also and in Washington at one period.  So we knew each other over the years.  Then when he came back from that magnificent job he did as General [Douglas] MacArthur’s chief public health officer for Japan – I can’t remember the details of the association – I think he was in Washington again.  So I consider him one of my real good friends.  I’m a great admirer of his as you can obviously see.

Yes, I can.  A couple of weeks ago we interviewed another career military medical officer, but a man who is many years your senior.  I just want to know if you ever met him: Percy J. Carroll.  He saw service in World War I and then again in the Pacific in World War II.

Was he of the regular army?

Yes.  He entered the regular army at the time of World War I.

Yes.  I do not know him personally, but he was prominent and his name is quite familiar.  One will find him referred to in some of the military medical literature.  Yes, in helping to develop—  I just can’t say right off; it slips me for the moment what it was he wrote about in his book, but it was something to do with the military control of disease or sanitation, I’m not sure.  I don’t remember.  Anyway, he was outstanding.  I was thinking of another Carroll who was here in St. Louis; I think he was an internist.

Well, he also had a practice, this General Carroll did have a practice in St. Louis.  He had a long, fairly varied career.

Well, maybe that’s the same Carroll then, because when you said “Percy” that seemed to—

Well there was – perhaps his brother – another Dr. Carroll who practiced after the General’s retirement.

Yes.  The Carroll that I’m speaking of here in St. Louis was also very interested in the fraternity movement.  He was one of the people who came around for the AKK fraternity.  He sponsored the fraternity and was the advisor, consultant, or something of the kind that they had in those days.  I liked him.  But I don’t know whether these are the same Carrolls or not.

Well, where were you assigned after Carlisle?

I was assigned to the army post at Fort Leavenworth, Kansas.  Please don’t confuse that with the prison. (Laughs)

I understand.

It’s a large post concerned primarily in those days, and still is, [with] what was then called the Command and General Staff School.  This was in the mid-’30s.  I was ordered out there in 1935 – June of ’35 – and even at that stage the military people knew really in their hearts that we were heading for something similar to [a] World War II, if not indeed the details of it.  So the Command and General Staff School was the army’s effort to bring together the highly selected officers – line officers – to train them in what it takes to become the leaders in a combat army.

Was General [Dwight D.] Eisenhower at Leavenworth?

I think he was before I went there.  He was not there during my period.  Although I came to know —  I was in the outpatient department there, and therefore conducted what amounted to a general practice – a very, very busy one under these circumstances.  I remember my peak day of seeing seventy patients in my office and making thirty-three house calls to give you an idea of the pressure we were under.  I visited the homes of many of the students who later became the outstanding combat general leaders in World War II.  It was an amazing and fine experience.

What were you doing when World War II broke out?  Were you still at Leavenworth?

No.  In 1938, I was ordered to Panama and to the headquarters post for the Caribbean Defense Command, which was located at a little station called Quarry Heights.  I was the only physician there, but my charge was the high-ranking people that made up that headquarters.

Was this in the Canal Zone?

In the Canal Zone.  I spent the period 1938 to ’41 – two and a half years we were in Panama.  During that period, as I say, I was responsible for not only the health and sanitation and outpatient care of the soldiers assigned there, but also to General [David L.] Stone and his whole staff.  He was the commanding general of the Caribbean Defense Command and so I had them all under my care.  It was not a particularly difficult professional assignment, but it was a difficult diplomatic assignment.  You see what I mean.  And then of course Gorgas Hospital was just down the hill from us, and while I was not on the staff of Gorgas Hospital, many of my friends were, so it was not difficult for me to get medical help if I needed it.  It was a good experience and I learned a great deal about tropical medicine.

So is this where your interest in tropical medicine began?

My interest in tropical medicine began on that assignment.  That is true.

Can you elaborate more on the interest?  Malaria?

Certainly malaria, which had always been one of the big problems in Panama and even at that stage was still a considerable problem although the sanitation in the Canal Zone and on the army post was such that it was not a common thing.  Nevertheless, all of our houses were carefully screened and our movies were screened and we all knew better than to get out and walk around unnecessarily after dark because there were still the mosquitoes, potential malaria carriers, flying about.  So by all odds, malaria was one of the major interests.  Yellow fever had long since disappeared and was no problem.  The other things had primarily to do with worm burdens, that is, worm infestations, and with the gastrointestinal diseases which are so much easier to come by under the warm, humid tropical environment.

You mentioned diplomatic problems on an army post.  Was it the case that some distance removed from the United States military life was – I’ve heard stories about cliques that would form in military posts.  Was this the case?

No, I don’t recall that at all, and I probably shouldn’t have used the word “diplomatic” except in the sense that one was dealing with—  I was a captain at the time and I was the private physician for a major general [and] on down through the ranks, you know.  Most of the people living on this post were at least of the rank of lieutenant colonel.  The majority of them were between that and, as I say, General Stone, who was a major general.  And their wives and most of their families [were my patients].  Some of them had small children [but] not many of them.  So it was diplomatic only in the sense that one had to deal with people of these important stations in a way that they had a right to expect.

I see.  It was both professional and appropriate to their rank.

Both professional and personal and appropriate to the rank, yes.  So “diplomatic” isn’t a good word in the sense that you interpreted.  So it was a bad choice of word on my part.

You say you were in Panama when World War II broke out?

It had broken out in Europe; we had not entered.  I came back from Panama – of course my family was there with me.  In fact, our daughter was born there in the Canal Zone in Gorgas Hospital.  Anyway, we came back, I think it was in April 1941, which of course was several months prior to the Japanese attack on Pearl Harbor and our actual entry into World War I [ed. note: Whayne means “World War II”].  But I was ordered back to the surgeon general’s office.  That was my first experience in the surgeon general’s office.

Actually, another medical officer named Fred [Howenstine] Mowrey and I came up from Panama at the same time and actually reported to the surgeon general’s office at the same time.  Believe it or not, you’ll find this fantastic, but it’s a true story.  There were two physician [openings] for people of our rank – which at that time were captains – in the surgeon general’s office.  One of them had to do with hospitalization and the other one had to do with preventive medicine.  Fred Mowrey and I literally flipped a coin because we’d both been doing clinical medicine.  And I had no more idea of going into preventive medicine and I’m sure he had no idea of going into hospital administration or preventive medicine, so we flipped a coin to see which of us went to which job.  The coin fell for hospitalization for Fred and preventive medicine for me.

Then I reported in to the director of the preventive medicine division, Brigadier General James Stevens Simmons – James S. Simmons – and there I was confronted with yet another shock because General Simmons – he was a colonel at that time – Colonel Simmons said, “Well, Captain Whayne, I’m very glad to see you and I want to tell you, you’re going to be my medical intelligence officer.”  Well, I had never heard the words “medical intelligence” together before.  I didn’t know [anything] about what this was supposed to be, but I learned in a hurry.  The upshot was that at that time – this was in April of 1941 – nowhere in the United States – in libraries, the Library of Congress for that matter, foundations like the Rockefeller Foundation, military libraries or archives or any place else – nowhere was there reliable information on health and medical problems and developments on a global basis.  And we were planning a global war at that time; we knew it even though we had not entered.

So what this meant was [that] Colonel Simmons was saying, “Young man, we have this deficiency and I’m giving you the job of rectifying it.”  I set to work with a half-time secretary and within six months had a staff of twelve physicians and I don’t remember how many secretaries in that center.  This was our objective – [it] was to get together this kind of information on foreign countries.  We literally picked up information anywhere we could get it – not only in the library, but by interviewing people, both knowledgeable people, not only in our own country but [also] from other countries.  We actually sent some people out to some places we didn’t know about.  We picked the brains—  Some decided to call us “brain-pickers.”  We gathered this information from any source we could and wrote what we called medical and sanitary surveys on whatever the country was.  We tried to do this on the basis of the knowledge available to us at that time as to where we would most likely be involved militarily first.  In other words, there was the setting of priorities and that’s the background for these volumes.  As a matter of fact—

You’re referring to Global Epidemiology?

Right.

[A] Geography of Disease and Sanitation in three volumes.  The first volume looks like it came out in 1944, so it was in preparation for some time.

That’s right.  The material in all these volumes was based on the medical and sanitary surveys that we put together on these various areas which served as the guide for medical and logistic planning for combat activities in whatever theater or whatever area was involved.

I see.  I take it that the material in these three volumes was in a classified preliminary form for a long time?

Yes, it was at one time.  Yes, they were all in – as I say, medical and sanitary survey is what we called them and each [was classified] by country.  We stored those away, and then, in nineteen – I guess it was early ’44, maybe it was – I can’t remember exactly—

This first volume came out in 1944.

Yes, it came out in ’44, but it was [earlier than] that that we retained the services of a Dr. Ruth [Alida] Thomas, who you may have noticed is listed as editor.  Ruth Thomas, based on the surveys and with our help, put these volumes together for us – Dr. [James Stevens] Simmons, Dr. [Harold MacLaughlin] Horack, Dr. [Gaylord West] Anderson and myself.

I see that the last volume, the third volume of the series, came out many years later, in 1954.  Why did it take so long before the final volume came out?

Well, firstly, it was a tremendous job to go through all of this material.  Secondly, I guess, while the first volume – or the first two volumes perhaps it was – were financed by – this was not an army project.  It was financed by the John and Mary Markle Foundation, to start off with.  Then the John and Mary Markle Foundation felt that they had done their share, and they certainly had; it was magnificent of them to support it.  Then we had to find support for the last volume, which eventually the Public Health Service, under its grant program, picked up.

I see.  So you’re referring now to the publication of—

To the publication of these books.

But some of the data, even in the third volume which came out in 1954, was available to—

Long before that.

—accumulated during World War II when they needed it.

In preparation for World War II.  Of course, we continued this effort.  The medical intelligence division continued in existence long after I went overseas and should have, of course, quite appropriately.

During World War II, was nutritional concerns connected at all with public health?

It was indeed.  In fact, there was firstly, a section and I think later – oh, we went through so many organizational stages that it makes no difference whether you call it section or division or what.  But there was a section or division of nutrition in the Preventive Medicine Division and Medicine Service, as we called it at one time.  That was under the guidance of firstly Dr. John [Barlow] Youmans, whom you may know of as a famous professor of medicine at Vanderbilt University.  John Youmans headed up that program and had some really wonderful people who were not physicians but were nutritionists, in the literal sense, on his staff.

It was a big effort and a very important effort.  It had not only to do with the nutrition of American service personnel, because after all we were pretty well prepared to take care of that problem although we needed advice and help on it.  But it also involved the planning for Civil Affairs and Military Government.  [This] came about during the war, but principally after the war when we were responsible, as Crawford Sams was in Japan, for the welfare of the German people, [and] the French, others – wherever we were we had civil affairs and military government.  Nutrition was a major problem under these circumstances.  Not that I had anything to do with this because Civil Affairs and Military Government was a separate part of the army although it was under army auspices, but it had its own medical staff.  I worked with them in many ways, but I was not a part of it.  But a major part of their problem was dealing with the nutritional problems of these people, particularly soon after the combat phase before they were able to mobilize their own expert people.

A man whom you’ve already mentioned, I think, to my understanding was important at this time, Dr. Bayne-Jones.

Yes, indeed.

He was head of the typhus commission?

Right.  But he was much more than that.  Bayne-Jones had been head of the department of Bacteriology at Yale University.  [He] was professor and chairman of the department of Bacteriology – a very respected scientist in his own right.  He was brought into the Preventive Medicine Service as General Simmons’ principal assistant.  He was deputy chief of the Preventive Medicine Service Division – whatever it was called at whatever stage of organization we were in.  He was a man of great medical depth and research experience and administrative experience, highly respected by the medical community – I mean the national medical community.  So being director of the Typhus Commission was just one of the many contributions that Stanhope Bayne-Jones made.  [He was] an outstanding man.

I’ve heard this commission referred to as a model of organization in that it received the legal support to coordinate all the activities, get all the data that it needed, and that later on some government agencies, notably a nutrition survey agency called the Interdepartmental Committee on Nutrition for National Defense was modeled on this commission.

I was not familiar with that, but I do know a good deal about the Typhus Commission because I worked with Bayne-Jones and other members of the commission in Europe particularly, and also at some stages during my service in the surgeon general’s office.  There’s no question but what Bayne-Jones did set it up.  Of course, he had General Simmons, who was a superb organizer.

We passed over him and I want to return to him.  What can you tell me about General Simmons?

Well, General Simmons was a regular army officer who had chosen his special career or field in the army as laboratory medicine – epidemiology and laboratory medicine – and research.  He, being a very bright man, had been assigned to—  The army at that stage – this was prior to World War II – maintained at least two medical research units.  I’ve forgotten their precise name.  One [was] in Panama and the other was in the Philippines.  General Simmons had served on the staff of both of these research epidemiological units in both Panama and the Philippines.  Therefore, being not only very expert as a research person and as a specialist in laboratory medicine shall I say, but [also] very experienced in field research and epidemiology, particularly in relation to malaria.  He was one of the experts in malaria and tropical conditions.  Not only that, but he had the close association of several others that seemed to be something of a group and quite justly so.  I mean, this wasn’t something that anybody could do, these had to be specially trained and especially interested and especially gifted people to make up the research team.  Ray [Raymond A.] Kelser, a veterinarian, for example, made significant contributions and worked with Simmons, at least in the Philippines.  I don’t know whether he was in Panama or not.  Coming out of these field research units was much of the information and we based a good deal of the sanitary regulations and requirements of World War II [on this].

Not only that, Steve Simmons was very active on the national medical scene outside of the military in the sense that he presented his research findings at the Association of Bacteriology or the Association of Tropical Medicine and Hygiene, or wherever.  He was well-known and highly respected, not just as Steve Simmons, although everybody loved him, but because of the excellence of his research work.  He was recognized and that, of course, was why he was chosen as Chief of Preventive Medicine.  I mean, these qualifications and accomplishments were the reasons he was chosen as Chief of Preventive Medicine for the whole army for World War II – an outstanding man.  He retired from these activities in 1948 – yes, ’48 – and accepted a position as dean of the Harvard School of Public Health where he continued until his death in 1964, I think.  [He was an] outstanding man.

He and Bayne-Jones, of course, were very close friends and had great scientific respect as well as personal respect for each other on the basis of their scientific and professional association, as well as their administrative associations within the framework of the preventive medicine division.  It was on the basis of this mutual respect that Steve Simmons invited Bayne-Jones to become director of the Typhus Commission.  So Steve had a great input into—  In fact, I think that the concept of developing two things that had a great impact on good preventive medicine in World War II came out of Steve Simmons’ fertile mind, but at the same time was based on something that had been done in World War I.

There was established in World War I what was called – I’m not sure I remember the exact name – but the Commission on Influenza and Other Communicable Diseases.  I think that was the title of it.  And this brought together – you see, [in] World War II [ed. note: Whayne is referring to World War I] we experienced the pandemic of influenza in 1918 and therefore there was great fear that bringing all these young people together we might run into a similar situation in World War II.  So based on the experience of World War I and the idea or concept of such a commission, Steve Simmons and Bayne-Jones conceived the idea of re-establishing something similar to the World War I commission.  Which they first called the Army Epidemiological Board, which later became the Armed Forces Epidemiological Board, and integrated the needs of the army and air force as well.  Now this brought together—  I don’t know whether you’re interested [in this].

No, I am.

This brought together in a central board, the Army Epidemiological Board, later Armed Forces Epidemiological Board, the outstanding people – civilian people and academic leaders – people like your most outstanding bacteriologists or virologists or nutritionists or whatever you have on your faculty.  Well, from all over the country we had this pool of talent to draw from and so they were brought together to form the board.  Under the board, there was organized a series of commissions – Commission on Influenza, Commission on Environmental Sanitation, Commission on Viral Diseases – [no] Respiratory Diseases (I’m sorry) – Commission on Gastrointestinal Diseases.  I think there were eight commissions; I don’t remember them all.  But in each instance, each commission was headed up by someone perhaps not quite the status of Bayne-Jones, but still the up-and-coming bright young minds of research, [and] mostly, of course at that stage, in academic medicine at one place or another.  This brought together a nucleus of the best brains available.

And Steve Simmons and Bayne-Jones, because they were respected among these people and known, it made it possible for an outstanding liaison and mutual support sort of thing to develop answers as quickly as possible to very difficult epidemiological, bacteriological, virological, [and] similar problems that affected masses of troops.  This was part of the thing that was so precious to me in the sense that I was in the surgeon general’s office in those early days when all of this was going on and had the opportunity, because of my association with developing this information on a worldwide basis, to work with – not work with, but work under in a way, or certainly to be associated with these outstanding people.  It was an experience that just couldn’t be – you know, you couldn’t buy such a thing.  It was just one of those fortunate things that a young person may have or may never have.

It fell in my life to be associated and get to know so many of these people – outstanding men like Tommy Francis [Thomas Francis, Jr.] [who] is now dead, who was Professor of Epidemiology at the Michigan School of Public Health, [and] one of the outstanding virologists the world’s produced.  Albert Sabin, for example, the polio virus man who developed the final vaccine for polio.  His predecessor, Salk – Jonas Salk – was another one.  People like this, you know, made up the [group], and the organization carried on.  It’s been discontinued now, but it did carry on long after World War II and the volumes that have been written out of the collected papers – you must have them in your library here somewhere – the collected papers of the Army Epidemiological Board and the Armed Forces Epidemiological Board make a shelf this long of papers bound – that is, the reporting of the research and field investigation and epidemiological investigation that members of these various commissions made.  Because they were sent to the field; they were sent, you know, to Europe, to Asia to study specific problems.

That does seem like a very interesting episode in anyone’s life.  But in 1943, you were transferred out of that particular work and sent overseas.

Well, now you have to appreciate that I was of the regular army and two things were involved in that.  I wasn’t fired.  It was time for every regular army officer to go overseas.  After all, we were in the middle of a war then and it was time for me to go overseas, and I wanted to go overseas.  I had trained a very substantial, wonderful group of young physicians.  Dr. [Gaylord W.] Anderson, who was later dean of the School of Public Health at the University of Minnesota, was there to take over and he was not physically able to be sent overseas.  There was never a reason for me having gotten this thing going and—

This Dr. Anderson is the one who was later the collaborator of Global Epidemiology?

That is right.  And so I was ready to go; I’d done my job and here were new fields to be conquered.  I was sent overseas in an unusual capacity because I was the first assistant military attaché for medicine, and first person to ever serve in that capacity.  I was assigned to our embassy in London as the assistant military attaché for medicine.  And my job there for that period was – it was really a horse-trading job with the British and the governments-in-exile.  I worked much more with people of other countries than I did our own people, of course, although I knew so many of them – they were old friends – I’d known Paul Hawley’s staff, surgeon of the European theater.  So my job, as I say, was a horse-trading job.  I had special inroads to information in our surgeon general’s office, our medical organization and knowledge and structure.  I could also ask questions of the British or the representatives of the twenty-one governments-in-exile.

Twenty governments?

Twenty-one governments.

Twenty-one.

Yes, this was France, Belgium, Luxembourg, et cetera – all of those that were under Hitler’s control at that time.  They had an underground and a lot of people escaped to London, to Britain, and were headquartered.  So they established an embassy for the governments-in-exile as well as the American embassy, on [whose] staff I was, but I worked with the embassy for the governments-in-exile as well.  I remember once, for example, I had a request from the surgeon general’s office [asking if I] could get information on the nutritional status of the population of Poland.  I don’t know exactly why they wanted it, but they wanted it and they wanted it as quickly as they could get it.  Working through a friend I had developed from the Polish government and a member of the staff in exile – working through [him] – I asked him the questions.  He said, “yes,” he thought he could get [that information].  Working through his underground connections, within three weeks he had me a detailed report of the status of nutrition of the Polish people which I merely got back through the diplomatic bags to Washington.  This is an example of the sort of thing, the sort of horse-trading, that went on.  Sometimes they asked me questions and asked me to get information, too.

[Interruption in taping]

Well, when the tape broke, we were in London and you were dealing with the representatives of the governments-in-exile and the British government.  We hear that one of the most delicate governments to deal with was the French – the Free French – which I believe was led by [General Charles] DeGaulle right from their London embassy.  Did you have any contact with them?

No, I didn’t.  I had no occasion to.  Well, we had each month a luncheon at the Governor’s House hotel, I guess, for all the military attachés of all the [embassies] and so I’m sure I met the French representative, but I had no occasion to ask any special favors.  I probably met him, but I do not remember.

When did this period of service end?  With D-Day?

Before that, because here again, as I said earlier [in] reference to leaving Washington, it was time for me to go.  We were approaching the D-Day period and I certainly did not want to complete my military service in World War II in a job that was extremely interesting, but at the same time, you know, I felt I could make a greater contribution by becoming more personally involved.  So at the end of a year, this was in late April or early May, 1944, I asked to be transferred and was invited to become the Chief of Preventive Medicine of General Bradley’s headquarters which at first was known as the First Army Group and then later, as you know, the 12th Army Group.  The reasons for that were – the effort was to make the Germans think we had two army groups rather than one.  Of course we only had one, but anyway, [the commanding officer was] General Bradley – General Omar Bradley – who just died a few days ago – a couple of weeks ago.

Did you ever meet him personally?

Yes, I did under a very interesting circumstance.  Obviously, being down at the level I was staff-wise, there was no occasion for me to have any contact with General Omar Bradley at his level of things.  But during the time I was serving as military attaché in London, one evening I went to the senior officers’ mess (I’ve forgotten the address, it doesn’t matter), and had had a glass or two of wine.  I walked to the door of the dining room and I didn’t see but one seat, and sitting at the other side of that small table was a four-star general.  As a colonel, you can believe me, I was not going over and say, “Move over, General.  May I join you?” or some such thing.  But this gentleman looked up and saw my predicament.  I was about to turn around and go back and come in later, and this gentleman saw my predicament and he said, “Colonel, would you come and join me?”  And I said, “Sir, I would be delighted to.”  He didn’t say, “I’m General Bradley.”  He said, “I’m Omar Bradley.”  This was the kind of man he was, you know.  He was kind of known as the G.I. general.  Well, this is why he was known that way because I was an unknown colonel.  I’d never seen him before, and here he invites me to sit down and have dinner with him.  We had a delightful, at least to me, a delightful conversation.  He made me feel comfortable and conversation flowed.  I’m sure he took charge of it, but he made me feel like I was participating in it.  That’s the only time I actually personally met General Bradley, but it was one of those type of experiences that make you think, “Well, here’s a great man,” and indeed he was a great man.

You mentioned also you had some contact with General Eisenhower?

Not really.  I only met General Eisenhower once and that was after the war was over.  This was some function at Fort McNair and it was after I had returned to the surgeon general’s office.  There was some reason, some lecture; he came down and talked to the group or something of the kind.  I don’t remember the exact circumstances.  Then there was a luncheon and we all shook hands, there was no opportunity to really get acquainted with him.

I’m probably jumping the gun chronologically, but I know you’ve been involved with the writing of the history of preventive medicine in World War II.  How did that begin?

Well, I guess I’ve had an interest in the history of things, in a way, for a long time.  In the early days, while I was still in the surgeon general’s office, we had developed – had developed long before the war for that matter – a small section on the history of medicine.  The history of World War I was written under the auspices of a group in the surgeon general’s office.  So this was reactivated and plans made to develop the history of medicine of World War II.  As this progressed and developed after the war, one of my very close friends, General Joseph [Hamilton] McNinch, who you may have heard of in library circles because he directed what was then the Army Medical Library – it later became the National Medical Library.  Anyway, Joe McNinch was a great scholar and really interested in so many things.

You wrote an article with him later.

Yes, I did.  Yes, I did.  But anyway, I was anxious to be helpful to him and so I wrote several chapters in the early volumes of the History of Preventive Medicine in World War II; one on clothing, one on housing – I don’t remember, there were three or four of them.  They were simple things, but nevertheless they had to be done.  I also – from the very beginning because of my activities and association with the Preventive Medicine Service or Division – I was asked to serve on the board of advisors for the History of Preventive Medicine from its inception.  I guess this was soon after I came back in early 1946.  I still serve on that although the board is not active, really, anymore.  It was very active for a long period of time in planning each volume and working with the editors and the writers, and et cetera.  So I’ve been associated with the history almost from its beginning.

When did the project begin?

Are you speaking of the project I’m engaged in now?

Well, no, the earlier [one].

I don’t know exactly; I would say 1945.  I’m guessing, but I think [that] although the organization had been there and there had been some collection of data and information before that, the main impetus came about 1945, after the war was over.  [It] developed apace after that and many, many people who had contributed – members of these various commissions of the Armed Forces Epidemiological Board and others wrote chapters.  The people who really knew their field and had experienced it in the field wrote chapter after chapter in what turned out to be nine volumes of History of Preventive Medicine.  Now, my connection with that – [there] are two things perhaps I should make clear to start off with.  In addition to those three or four chapters – I wrote a chapter on environmental heat and cold injury.  At the same time, as you have gathered, I did my thesis at Harvard on the subject of cold injury in World War II.  So this, then, is the thesis that came out of that study in 1948.

In 1948?

In 1948-49.  Well, no, that’s not true.  I attended the regular School of Public Health in ’48 to get a little better preparation in statistics and other things.  Then I spent the academic year 1948-49 as a graduate student working towards my doctoral degree in public health, but the main objective was to develop this thesis on cold injury to study the World War II experience.  We’ll come back to that, but in terms of the history, it came time to talk about writing the history of cold injury in World War II, and I had done this.  There is a chapter in there on history of cold injury going back to the time of the Macedonians for that matter.

Dr. Michael DeBakey, who was then professor of Surgery at Tulane Medical School, was planning to write the history of cold injury on the basis of its pathology, its clinical picture, et cetera, et cetera.  Well, Mike DeBakey was a consultant to the surgeon general and I was in the surgeon general’s office and I of course knew him.  At lunch, or sometime, we just said, “Well, isn’t it silly for me to be writing a preventive medicine history of cold injury and you to be writing the clinical and pathological history of it?  Why don’t we combine efforts?”  Which is what we did.  [ed. note: their collaborative book, Cold injury, ground type in World War II, was published in 1958]  Now, you don’t have it out here, but I’m sure you have it.  But, anyway, the volume on cold injury, then, which is a part of the history series.

I would have had it could I have found it.

It really is a major effort and much more comprehensive.

I’m aware of it, it just wasn’t on the shelf.

Well, my feelings aren’t hurt about that.  What I mean is that that led to the development of a volume so thick which was produced by the history division, then under the surgeon general’s office, no longer so.  This is the only time that the whole problem of military losses from cold injury had ever been studied.  Mike and I were able to – particularly through the services of a medical editor named Elizabeth McFetridge, a marvelous little writer.  She dealt with two prima donnas like Mike and me, and kept us in line and helped us turn out what I think was a good volume.  I know it was, because we had literally hundreds of reviews from all over the world of that volume.  So it sounds like I’m tooting my own horn now, but I don’t mean it that way.  I wasn’t sent to Harvard just to get my graduate degree in public health.  I was sent there to do this because it was anticipated we might have a need for the control of cold injury and indeed we did.  You know, in Korea it was a major problem.  The reason this is presented in this form is that my thesis, of which there were only six copies made I think, was reproduced by the army in large numbers and distributed, not only to libraries but to the training echelons of the army getting ready for Korea.  So that the experiences that are recorded in here became the knowledge of not just medical officers, but line officers and training personnel, et cetera, et cetera.

And you’re referring to the government document edition of—

This one, the one you have in your hand, yes.  I don’t know that this is true, and it couldn’t be proved or disproved, but we had a very much better experience with cold injury in Korea than we did during World War II.  I’d like to think that the fact that – lots of people could have done this just as well or better than I – but the fact that the army had the foresight to send a medical officer to spend a year studying this, even though it led to an additional doctorate degree for him, was a very worthwhile effort in saving much injury and some death in American soldiers who participated in another war.

It sounds very like that.

Then, of course, to expand it into what Mike DeBakey and I expanded it into, I think it’s a unique volume.  There just isn’t anything else like it that’s been published.  Now there’s much more work been done since that experience.  The army established a research laboratory at Fort Knox to study that – a big tremendous cold chamber bigger than your end of the building – much bigger than that – to study many things including cold injury.  Joe [Joseph Reese] Blair did a lot of work there and they did a lot study in Korea and et cetera.  So a great deal has been accomplished and learned since the publication of Mike’s and my volume.  I’ll say only one thing more about it because I don’t want to take all morning on it, but cold injury – when you think of it in terms of the whole army – you say, “Well, that can’t be much of a problem.”  In World War II, we had a little over 90,000 cases of it.  In an army of on the average, six and a third million per year throughout the war period, it doesn’t sound like very much.  But there’s one very great extenuating circumstance, and that is: this is a malady of front-line rifleman, front-line combat people.  When you think about that and subtract from the total army all those people that are not fighting and say that there are 90,000 among this few hundred thousand, you begin to realize that the 90,000 amounted to losing fifteen divisions of fighting men.  You see what I mean?

You get upwards of ten percent of your people.

It was equivalent to losing one whole army of fighting men if you took the whole picture.  So it gives you an idea of how important this was and why it was important to do this, whoever did it.

Yes, that is very clear.  I think we did leapfrog your later experiences in World War II and right after that, you remained on Germany and must have seen very serious public health problems in a devastated Europe.

Yes, we did indeed.  I was, as I said, Chief of Preventive Medicine for [the] 12th Army Group.  This meant that it was my responsibility, working with the theater preventive medicine officer, who was Dr. John [Everett] Gordon – who in civilian life was professor of Epidemiology at the Harvard School of Public Health.  John Gordon was stationed in Paris – [and] the major bulk of our work came after we got across onto the continent.  Anyway, John Gordon and I literally rode thousands of miles together visiting military units, army headquarters, corps headquarters, et cetera, et cetera, checking up and studying what are the problems, et cetera, et cetera – he going back to Paris to his central office to do what was necessary, me trying to work through the administrative structure of the 12th Army Group to tighten things up.  I’d go back to his headquarters once every two or three weeks, you know.

It was a cooperative effort of trying to keep abreast of what our problems were.  Fortunately, primarily because we were feeding our troops through the K-ration, there was not a tremendous gastrointestinal problem – some, but not much.  Respiratory diseases – I’m speaking of Europe now primarily which is where I knew the picture most intimately – yes, some but not a tremendous problem.  In other words, we came out, because of many things that were done I think, with a remarkably good medical record.  To be able to play a small part in that; you could go on and talk about it for hours, the various things we did.  But that was the active period.

I stayed over after the end of the war for a specific reason.  I had decided by that time that I wanted to continue in the field of preventive medicine and you put your finger right on it, some major problems existed.  There was the problem of the returning refugee, the refugee problem, some of them bringing typhus back from the German/Russian areas.  Nutritional problems we mentioned earlier; diphtheria became a major problem.  It was a period of several months of intensive preventive medicine in which badly as I wanted to get back and be with my family, I felt professionally was something I couldn’t miss.  The venereal disease problem which became much greater after the combat hostilities were over, et cetera, et cetera.

People relaxed a little bit too much.

They relaxed too much, they did indeed.  They did indeed.  But that was the reason that I stayed over for a few months.  I came back in March of 1966, I think it was.

That would be ’46.

Forty-six, I mean.  I’m sorry.

And this meant your return to the surgeon general’s office?

Yes.  I was ordered to the surgeon general’s office as deputy chief of the Preventive Medicine Division, where I worked for about a year in that capacity and then I was made chief of the division.  I’ve forgotten the exact chronology, but anyway, in 1948 I went off to Harvard for those two years, came back to the Walter Reed Army Medical Center to the research institute there and served as Director of Training Doctrines, I guess they called it.  That’s where Joe McNinch and I collaborated on the “Fifty Years of Medicine” that you mentioned earlier.

It appeared in the New England Journal of Medicine in 1951.

That’s right.

“Medicine as a Social Instrument.”

Yes, right.  Unfortunately, the New England Journal of Medicine couldn’t carry on.  They were going to do this in every field: psychiatry, clinical medicine, et cetera, but for whatever reason they didn’t.  I wrote to them three or four years ago to ask how far they got and could they furnish me reprints, but they wanted so much for the reprints that I just didn’t feel I could afford to even bring the few that they had done together.  Well, that’s an aside.

Well, you mention Colonel McNinch as being connected with the Army Medical Library.  I’ve heard that the Army Medical Library during the war, and perhaps after, tried many innovations of its own.  They were interested in microfilm.

Yes, indeed they were.

They were also interested in current medical literature in compact form that could be disseminated?

Yes.  I don’t feel that I know enough about this to talk about it in detail, but I know [about] these things you’ve mentioned and Joe McNinch was responsible for a good part of this.  I think they eventually laid the groundwork for what eventually became the MEDLARS system in its very early form.  As you know, it was combined with other institutions and became the National Library of Medicine, which I’m sure you know a great deal about – a marvelous institution.

Yes.  Well back at Harvard, you were once again with your old superior—

Gordon, John Gordon.  Yes, he was my mentor.

Well, I was thinking about Colonel Simmons.

Oh yes, General Simmons.  He was dean, and John Gordon, whom I’ve mentioned working with so closely in Europe, were both there.  So I was among friends.

Well, it struck me originally that you shouldn’t have been there as a student, you should have been teaching.  But then you did allude to one particular area where you had things to learn, namely biostatistics.

Right.  And I needed to know some of the formal aspects of epidemiology too.  It made a lot of difference in the approach I took to this volume.  You think you know.  On the basis of experiences I had had I learned a lot of epidemiology, but not in a formal sense, so [being a student] was a good experience for that.  Later on, I was put on sort of a courtesy faculty appointment at the Harvard School of Public Health; [and went] back and forth from Washington to give lectures on now and again.

Would this be an appropriate time to sort of distinguish for lay listeners, like myself, preventive medicine from public health?  Did it begin to diverge or had it diverged already?

Well, you’re getting into a field that is certainly not clarified up to this point.  What do you call all of this activity that has to do with the things that in an organization or administrative way you do to protect the health of people?  Now is it preventive medicine?  Is it community medicine?  Is it public health?  What is it?  Anybody you would talk to in the field would probably give you a little different concept of this.  I can give you my own.  I feel very strongly that preventive medicine is really military preventive medicine in the sense of the sorts of things we did in the military.  In other words, the surgeon general and his people, like Steve Simmons and those of us who assisted him, were responsible for maintaining the health of an army of several millions of people.

Now what are all the things that you have to do to try to prevent and control?  It’s a matter of prevention, but it’s also a matter of control if something happens.  And so what are all of these things?  Well, things that come to mind immediately are immunization programs, environmental sanitation, nutrition.  Then as things began to mature and develop, we began to think in terms of “Well, there’s a medical care aspect of this, too.”  That led into the sort of the thing that Bob [Robert E.] Shank has done here and has happened in a good many other medical schools.  We attempted it in a smaller way than Bob has at the University of Pennsylvania, and that is to say, “Well, what are the things you can do in a clinical way to protect the health of people or to lessen the impact of disease?”  So this I relate to the term “preventive medicine.”

Public health – although the old public healthers would dispute this – I have come to think of more as the things in a purely administrative way, regulatory way, that you do to control water and sewage and develop one type of a control program or another.  But [it is] primarily the sorts of things you accomplish through administrative or governmental resources.

These are areas where schools like the University of Michigan School of Public Health specialize in, where non-M.D.’s train.

Oh, yes.  Sanitary engineers, for example, nutritionists who were not physicians, many, many different fields.  Entomologists [and] veterinarians worked in public health and many of them have been outstanding in it.  But anyway, it’s more the administrative side that I look upon as the public health aspect.  Community medicine – you can kind of say, “Well, after all if you want to take—”  We don’t need to get into this, but I’ll just quickly say that you think in terms of a community and what is the responsibility of both preventive medicine and public health to try to do the things that will maintain the highest level of health possible in that community.  This includes not only the vaccination programs and the environmental sanitation and all those things that are traditionally public health, but it also includes provision of timely medical care and the opportunity to seek medical care and expert advice when necessary.  In other words, preventive maintenance is what it amounts to.

Dr. Shank of our department, very recently did a survey of all the comparable programs at American medical schools and the name ‘family medicine’ has come up recently.  In fact, I think some people perhaps have exaggerated it as a wave of the future or a way in which medical students will not be funneled into research careers, but really will be trained to concentrate on what used to be considered ordinary general practice.

Yes.  It basically is the same sort of thing in a way that my old uncle did except on a much more sophisticated level and a much more efficient level, really.  Yes, it’s an important development, but it’s not a wave of the future that’s any different from the practice of good medicine in a community prior to this change of terms.  It changed from general practice to family medicine and what they’re going to call it next – I guess it’s static now that they’ve established their Board of Family Medicine, the American Board of Family Medicine – you know, one of the specialty boards.

Dr. Shank, as you know, has concentrated in his research on nutrition, but he’s added a great many other divisions to the department.

I was just going through the catalog that was sent me before I came up here and there were a good many things in there that I didn’t realize Bob had put into effect – [an] excellent program, one of the outstanding [ones].  This goes far beyond the traditional public health or the traditional military concept of preventive medicine.  It integrates a great deal of medical care into the picture, but still I think Bob Shank would be the first one to say to you, “I’m not doing this to compete with the clinicians, but I’m organizing it in a way that will be of assistance to them.  Not only that; it will bring medicine to people who need it at a time when they need it.”  In other words, sooner.

I’m not sure he has any regrets on the matter, but I get the impression also that his department has been an area in the administrative division where the school has placed divisions it didn’t know what else to do with like rehabilitation, lipid research, biostatistics.

Well, you see, this is part of this overall confusion of terms that I mentioned earlier.  This has happened not just at Washington University, but I could name a dozen places and I think many more if I knew about them, that the same thing could be said [of].  Whereas, preventive medicine is just not understood, and there’s been a lot of opposition to it on the part of the clinical departments for that matter, not understanding in the first place, [and] secondly, a feeling that it was a threat in a way and a waste of time in the minds of others.  So it’s taken various forms and shapes, and even in my own university they tried to demolish the department and indeed succeeded in it, although it’s being rehabilitated, reconstituted now.

This was after you left?

After I left.  Three years after I left.

Would you advocate a narrower definition so people would be clearer as to what preventive medicine means?

I wouldn’t use the term “narrow” because I think this is something that’s had to grow over the years, this concept of what it means to maintain health.  You mentioned health maintenance organizations, and this concept is sort of anathema to the dyed-in-the-wool practitioner of medicine, he didn’t like this idea.  We’re seeing a change in the attitude of medicine as I see it, throughout.  This is much more an acceptable idea – to maintain health – now than it was even five years ago.  They’re finding, too, that it is not the threat to their pocketbooks or their practices that they thought it would be because they still have more than they can do.  You see what I mean?  No, I wouldn’t narrow it, but I think it needs to be more precise, and preventive medicine has tried to do this.

In fact, the year I served as president of the Association of Teachers of Preventive Medicine, the thing I took as my project was the second conference on the teaching of preventive medicine which we developed and called the Saratoga Springs Conference, because it happened to be held at Saratoga Springs.  Bob Shank was on our board of planners, as a matter of fact, for that conference and took a very active part in it.  The whole concept there was to examine what we’re doing in preventive medicine, what it is, where we go from here, and how do we develop departments and teaching programs and research, and et cetera.  That was published as a little volume [and it] was very helpful.  Since then, there’s been one additional conference, this was after I became more or less inactive so I didn’t participate in the next one, but it’s a process of self-examination.  So the people in [the] community of preventive medicine, or however you want to call it, have not been remiss in examining their own failings and their own objectives.  But at the same time, it’s a very amorphous thing as I think has been apparent in our discussions.  So it is very difficult to tie it down and define it in a very precise way.  We’ve a long way to go and I hope that as we go along it can become more specific, but maybe part of its strength is because it isn’t totally specific either.

You alluded earlier to the fact that academic administration crowded out other things you might have done at Pennsylvania.  Did you enjoy being in the administration of a medical school?

Yes, I really did.  I also enjoyed my first two years there.  I was just handed the job of redeveloping the preventive medicine course for the second year class.  I initiated what I thought was a very new type of teaching program based on the Harvard Business School concept of case histories.  Well, if you can have business case histories, you can have preventive medicine case histories, and I spent a lot of time with a lot of people developing situations which we then presented to students in class.  [We] were having them work in groups to solve the problems that were brought up in these hypothetical situations.  Some of them weren’t hypothetical, and I had a lot of fun with this and learned a lot from it myself.

I think, based on student reaction, while it was not totally favorable – it never is in preventive medicine – it was well-accepted.  So I enjoyed that, but then at the same time it was not quite the full challenge I wanted.  John Mitchell, who was then dean, needed some help and I transferred in.  Not totally; I continued in preventive medicine throughout the period I was there, but I seemed to more and more be [involved in] the administrative field including heading the planning board for the magnificent Alfred Newton Richards building, which took an awful lot of time, but was a challenge of great scope.

Why did you leave Penn and go to Kentucky?

Well, both my wife and I are Kentuckians and as already has been said, [we] both grew up in a small town.  Philadelphia is a big, big city.  It’s a fascinating old city and we loved it, but just the same we didn’t want to spend the rest of our lives there.  Our daughter had completed her education at the University of Pennsylvania; our son had graduated from both the university and the College of Medicine.  So the education of our children was, in essence, complete except for our son’s post-graduate work, which he’d be doing off somewhere else.  Our daughter went for graduate work at the University of North Carolina so here we were, you know.  I wasn’t entirely happy with the way things had developed there and a new dean was being selected – whom I liked.  But I just felt that when the opportunity to come to Kentucky was presented by Dr. Willard, Bill [William R.] Willard, that, well, we can go home to our home state.  It was a challenge, it was a raise in pay.  So we decided to do it and we’ve never been sorry.  We’ve enjoyed Lexington, it’s a small city, the city/county is 235,000 or so.

Were your duties there similar?

Well, they were expanded because I went back as Willard’s principal assistant in his two capacities, one of which was vice president of the medical center as a whole which had five colleges within it.  Then he was also dean of the college and I was his immediate assistant in both of these capacities, which meant that my responsibilities were greater.

I take it the medical center means something different then from what it means here.  It’s not so much a collection of hospitals plus one medical school, but a collection of colleges.

Yes, they only have the one university hospital, but there are five colleges: dentistry, nursing, allied sciences, medicine, and (what’s the other one, well anyway, five colleges) pharmacy.  All of those then are under the administrative auspices of the Vice President of Medical Affairs.  So it was in that capacity – assistant in that capacity – that I served.  At that stage, the Vice President for Medical Affairs, Dr. Willard, was also Dean of the College of Medicine, and I was brought in as Associate Dean of the College of Medicine.  Then he had to be out a year because of illness and I served as acting dean of the College of Medicine for a year which was a great experience, too.  Then we decided—  Well, you’re not interested in all this detail at Kentucky.  When Willard came back it was decided to separate the medical center administration from the medical school administration, so we couldn’t continue the same structure.  I elected to stay with the College of Medicine as Associate Dean and that’s how I finished up my administrative career.

You saw many, many changes in students over that period of time.

Yes, and that was one of the really the great challenges.  [At] Penn, for example, one of the most interesting things was the student selection process, including interviews and visits to various colleges [such as] Harvard and Yale and some of the southern schools and et cetera.  [I had] a chance to sit down and talk with these fine young people.  You could only take 125 – that’s what our class was at Penn – and yet you could have had several hundred almost equally competent students.  How do you select?  It was a challenge and a responsibility.  I participated in a lot of the same thing at the University of Kentucky and was responsible, I guess, for developing a good many innovations there that were based on my experience at Pennsylvania.

Did you also find the experience vexing in that you saw decline of standards in certain areas: dress codes, personal behavior?  A lot of people cite these as vexing.

Well, I suppose I’d have to be perfectly honest to say that I didn’t agree with some of those changes.  I don’t know that I could describe them by the word “vexation,” because I found when I got underneath these exterior evidences of rebellion that they were the same good kids.  Now, they were handpicked, you know, of course they’re not comparable to the youth across the country totally.  But just the same it was a privilege to work with them and I’d have to say that I have the greatest admiration for our young.  I think they’re going to weather this – well, they are weathering.  I think there’s lots of evidence that they’re beginning to get over their drug binge, et cetera.  It’s still terrible, but there’s evidence that trends are changing, I think.  I don’t know whether you would agree with that or not.

What about affirmative action in choosing medical students?

That’s a very difficult thing because from the purely social point of view, it’s a very appropriate program and I agree with the concept.  But to put it into practice – how do you select from a group of minority applicants whose even high school [level] education is inferior?  I’m not saying inferior [intellectually].  I’m saying that their opportunity to learn has been inferior and whose college performance was similarly defective, many times because they went to inferior colleges and many times because they had no help to get through – and prejudice and all the rest of it.  So they were not prepared to undertake the responsibilities of getting a medical education with the same competence as white students who had had a much better opportunity.

Now, do you just lower standards and turn out inferior physicians and hope for the best, or do you gradually try to upgrade the underpinning of high school and undergraduate education?  I don’t know the best answer to this.  The solution has to be found to it.  The University of Kentucky appointed several years ago a young man named Victor Gaines, a black man who’s outstanding in many ways.  His job was to try to find minority students that could cut it.  We’ve had a good many graduates, even though we are supposedly a southern state or a border state.  We’ve turned out some good black physicians, but nobody’s found the right answer to this problem.

I think we have a similar officer at this medical school.

I’m sure you have.  I’m sure you have and I’m sure he’s grappling with the same sorts of problems.  The selection of students is just not there yet, and I think the major problem is that the black race – and white for that matter – are not thinking in terms of how long it’s going to take to effect all of these changes.  The blacks want to turn it on like a faucet and everybody’s all equal and equal opportunity and all that, but that’s not a substitute for the background that it takes to get to them.  This is true of certain other minorities; I’m not limiting this to the blacks.  In other words, as I have said so many times, it’s going to take 50 to 100 years for this to really be done.  They may as well accept it and we may as well accept it, and we may as well get our heads across the table and try to work these problems out rather than fighting about it and passing silly laws that some aspects of the affirmative action thing are.  It’s a matter of human cooperation in my view, and [we should agree] at the same time to push it along as rapidly as it can be pushed.  We have an ophthalmologist, for example, who’s a black man and he’s as good as anybody I know in his field, really outstanding.  We turned out an obstetrician, one of our graduates, really very good man.  So they can do it, they can do it, but they’ve got to be helped.  So you don’t, in my view, legislate these.  You legislate the opportunity, but you don’t legislate the—

The people.

Well, you shouldn’t have started me.

That is a necessary consideration for someone who’s been in academic administration as well as many other things.  Are there any major aspects of your career that we’ve glossed over that should be mentioned?

No, I really don’t think so.  What time are we getting at?

Well, it’s noon.

Noon, all right.  I’ll just say one other thing [that] gets back to the preventive medicine history.  I mentioned a long shelf of history: nine volumes that have been written now to cover the whole history of the preventive medicine activities in World War II.  My project at the present time is to bring these eight volumes down into one – a tenth volume.  Now, that’s not just a summary of what other people have said.  It is in a broad way, but this is an evaluation process of how well we did or did not do things in World War II in preventive medicine.  Each of these eight volumes is going to brought down into what amounts to a chapter in Volume 10.  Also, the administrative organizational structure – training structure, educational structure – of preventive medicine has not been covered anywhere up to this point and so I shall be getting into that.  I’m trying to summarize and evaluate the other volumes.  I’m working with – you probably have a copy of it here – the medical statistics volume of the History of Medicine series, a volume that thick of just millions of figures.  It’s organized very beautifully and it’s very easy to pull a lot of information out of that has not been put together.  There was not the opportunity to put [it] together at the time the former writers of the long series were writing, so I have that advantage.  I’m not just rephrasing what they said.  If I take anything from them I’ll give them credit for it, but I base it on my own investigations, reading that and many other things.  So I’m having a little fun with this now.

When will this volume be coming out?

Lord knows.  I hope within a couple of years.

Who will be publishing it?

It will be the same as the Whayne-DeBakey volume.

By the surgeon general’s office?

Well, no.  The Medical History Division is now under the Army Center of History.

Yes, I beg your pardon, I was aware of that.

It’s all one thing now and it will come out under their auspices, if I ever get it done.  I’m making progress with it.

Well, I appreciate greatly speaking with you and I thank you also for speaking longer than the hour we originally bargained for.

Well, I’m sorry I’ve talked so much.  I’m afraid that a lot of it’s fairly inconsequential.

Let me assure you that everything that we’ve talked about is germane to our program.  We’ve had discussions with other people on these very themes so that according to the computer index that I showed you, it will integrate nicely.  I think you’ve made a real contribution to our oral history program.

Well, thank you very much.  I appreciate that.