We have the privilege today to talk with Park Jerauld White, M.D. Dr. White was born in Green Ridge, Staten Island, New York, on December 31st, 1891. He received his A.B. cum laude from Harvard in 1913, his M.D. from Columbia University College of Physicians and Surgeons in 1917. He was an intern at New York Hospital, 1917 through 1919, a first lieutenant in the medical corps of the United States Army from 1918 to 1920. He was involved in the private practice of pediatrics in St. Louis from 1920 to 1955, externing in clinics and wards and laboratories. He was at St. Louis Children’s Hospital, serving on the staff, beginning in 1920 and becoming emeritus in 1968. He was lecturer in Medical Ethics at the Washington University School of Medicine from 1923 to 1950. He was assistant instructor, assistant professor of Clinical Pediatrics, Washington University School of Medicine, now emeritus; director, Department of Pediatrics, Homer G. Phillips Hospital from 1945 to 1966. He is a past member of the mayor’s Milk Investigating Committee. Dr. White was past president of the St. Louis Pediatric Society and state chairman of the American Academy of Pediatrics. He was a former board member of the Leukemia Guild, Civil Liberties Union of St. Louis, St. Louis Committee for Nuclear Information, which has changed its name to the Environmental Information and has now merged with the Scientists Institute for Public Information. Dr. White has been a board member and is now advisor of the Washington University YM/YWCA. He is post-doctorate associate, Washington University Center for the Biology of Natural Systems, chairman of its Task Force on Infant Mortality, and is author of articles in medical and other journals.
Dr. White, can you tell us why you wanted to become a medical doctor?
I could answer that best by quoting the greatest doctor of our century. I think many will agree that his name is Sir William Osler. When Osler addressed the freshman class at McGill he said, “If you have come here to study medicine because you think you will find it lucrative and interesting, please go home. If, on the other hand, you’ve come here because you feel that you best can use your talents in the interest of your fellow men, then we welcome you.” I’ve always felt that the best way to look at any enterprise is to see whether you can leave it better than you found it, which applies to the world in general, period.
Dr. White, why did you decide to come to St. Louis and to Washington University to practice as a doctor?
My wife, Maria Bain White – we just celebrated our sixtieth wedding anniversary – has been throughout a St. Louisan. She, however, said she would adjust to just about anything that we might do. In visiting her I met up with Dr. [Williams] McKim Marriott of the St. Louis Children’s Hospital and realized that he had made a tremendous contribution to pediatrics, which may be summed up in, I think, four words: “Give the baby enough to eat.” Well, Dr. Marriott was a great teacher, a great biochemist, researcher and so forth. When I consulted Dr. Franklin McLean, then of Chicago – he headed up the Peking Union Medical School where my first boss, Dr. [Luther] Emmett Holt went to teach for a time and where he died later on – I became interested in that. It’s a subject that has always interested me; however, it was obvious that for many, many reasons I should stay in this country. Dr. McLean said to me, “We want for the Peking Union pediatric department one of Marriott’s men. At which I brightened visibly and said, “Aha.” So out to St. Louis I came to be in his department. I met him in the corridor of the hospital and asked him where I could find Dr. Marriott and he opined as how he knew. We went on beautifully from there and I met up with his remarkable department, consisting of Philip [C.] Jeans, Jean [V.] Cooke, Sam [W.] Clausen and latterly, Alexis [F.] Hartmann, [Sr.]. We couldn’t have had a better group to instruct me, among many others, in pediatrics. No wonder then I felt, and still feel, entirely bound to St. Louis pediatrics.
After Dr. Hartmann’s untimely death, we were most fortunate in having as acting director and professor, Dr. David Goldring, a very special person here at Children’s Hospital and very special with me. [In] the number of years elapsing since the arrival of Dr. Philip R. Dodge as head of the department we have all flourished, as might have been expected. It was Dr. Dodge who appointed me as professor emeritus, for which I am very grateful to him.
Dr. White, I notice on your curriculum vitae you list that you were lecturer of Medical Ethics at the Washington University School of Medicine from 1923 to 1950. How did you become interested in teaching medical ethics?
My interest certainly does not and did not stem from any idea that St. Louis medical students are any less ethical than any others. But it did occur to me in 1923, with every encouragement of course from Dr. Marriott, that a course in professional conduct would be in order in any medical school. Medical ethics, of course, dates back to and before even, Hippocrates. And that is sometime ago. When I started this course in ’23, I used these two paragraphs which will answer Mr. Podoll’s perfectly proper question:
“Is the medical student any more responsive than the rest of us to the admonition, ‘Be ye, therefore, perfect’? Probably not. When he has completed a course which sets before him a high standard of professional ethics and conduct has he learned anything not already a part of that ‘good, moral character’ (quote) which he is unofficially and officially supposed to possess?
“It depends, of course, on the course and on the student. As he nears the end of his four years of strenuous acquisition of facts, the student is tempted to relax and say with Woodrow Wilson, ‘The war thus comes to an end.’ But, on second thought, he knows that it is just beginning. What shall he do with all his hard-won knowledge? Those more or less lofty ideals which made him a disciple of Aesculapius, have they been drowned in the Pierian spring? Or have they survived, only to be smothered by Mammon?”
Thereby, you see, hang many admonitions, much instruction and much thought. To try to enumerate all of these things – the old reliable, ethical maxims and practices and so forth, would take at least a month.
Dr. White, what kind of responses did you receive from the students?
From my point of view, and I hope from theirs, very satisfactory responses. There was lively discussion, a good deal of interest of course, and back and forth repartee and whatnot, so that that worked out very well and to the satisfaction of Dr. Marriott, at least, and [the] Dean and so forth.
What were the major changes you made in your lectures during the twenty-seven years?
There weren’t so many changes that had to be made while I was giving the course, but since then, i.e., since 1950 – as you can imagine – the changes have been many and rather radical, so that we’ll have to take that up a bit later. Meantime, I think we ought to give a quick summary of the course itself. We started off considering the following: the importance of a good internship, the importance of selecting companions who will stimulate and improve one. That means, of course, education by contemporaries, which is one of the most important parts of any medical or other education. Then, a consideration of the young practitioner – where to start practice, advertising and salesmanship and the reasons why these have to be frowned upon, mostly. Consideration of group practice, specialization, and then the layman and the young practitioner, [and] the status of women M.D.s – something which as anyone knows has very radically changed. Then comes medical finance, and that has been greatly changed by exactly one thing – namely, insurance. And that is good; it doesn’t keep some doctors from exercising their sense of avarice but just the same the whole thing has been quite revolutionary, as anyone listening to this would know.
All right, medical finance – pay clinics and middle class patients, free clinics and poor patients, industrial medicine – you see, all of this has changed a great deal. How much should a doctor charge? How remarkable when a doctor can say truthfully – or feel truthfully – that he has actually saved a life.
Is that in keeping with what happened, by the way, to Sir Walter Scott? Here’s an example: Sir Walter Scott was standing on the dock on a lake in Scotland. A very rich man was beside him. The man stumbled and fell [into the lake] and had a great time trying to stay alive. A young fellow jumped in very quickly and saved this rich man and when the rich man came out of the lake he gave the man a shilling. A friend turned to this brave young fellow who saved so important a person and said, “That’s all it’s worth.”
Well, I’ll leave it to you to decide how much you should charge for operations, for long and detailed treatment courses and so forth. There is a subject that we simply haven’t time to deal with right now. All right? Next, consultations, and then medical ethics. Couldn’t that be summed up in the Pauline admonition, “Be ye kind one to another”? And that other admonition – namely, the Golden Rule – “Do unto others as you would have others do unto you”? All right, but there are many manifestations and varieties of response to both of those admonitions. Finally, organized medicine – the reasons why organized medicine has ever been so conservative. Physician and druggist, physician and nurse, and then, birth control, abortions, euthanasia – these have to be dealt with very carefully and in some detail later.
Here’s a lecture on quackery, fads and cults in which one pays one’s respect to Christian Science and other cults, always with dignity you understand. That is about it for now. I just wanted to put before you a quick summary of what the course has been. As to what the course is, that’s something else again.
Dr. White, could you tell us something about the status of women M.D.s?
That is one more subject which has shown the greatest change over the last two or three decades – a change, of course for, I don’t mean necessarily of course, but a change for the better. I can distinctly recall when a very fine pediatric practitioner back in the thirties, with whom I practiced pediatrics, did not receive such a fair shake, especially from motherhood here in this town. This person, and I don’t see why I shouldn’t mention her name, which was Dr. Katherine Bain [ed. note: M.D. 1925, Washington University School of Medicine], who, through Dr. Marriott and Dr. Elliott, went in 1940 to the Children’s Bureau where she has remained and done a very great job. When I’d go out of town or not be available in the early days, women would call up and ask Mrs. White or my secretary for someone to see the baby and whom should she call. [When they were given] the name of Dr. Bain – and the name “Katherine” was emphasized, a lady doctor – a number of women said, “Oh, a woman doctor? Oh, no.” So then relations sort of cooled and those who did come around and call this lady or others found out to their great satisfaction that they had called in some very good help. That’s just one example.
It reminds me of the discussion I used to have with the class on medicine in Russia. The mere mention of that now does not mean that I was or am soft on Communism, please. Anyway, for the decades, anyhow, in 1920 and ’30, the percentage of women practicing medicine [and] surgery in Russia was 75 percent. That’s a pretty high percentage, meaning, as you might gather, [that] the men wanted to exert their efforts in other directions. You can think that one over. Since then, it is well known that in academic, research, laboratory medicine, [and] surgery, too, women have come very much to the fore, and it’s about time.
One thing I should have mentioned. The same is true in the practice of both medicine and pediatrics, practice which is rather reluctantly taken over [by women] in the country but is doing much better in the city. So that that particular topic, “Women in Medicine,” is well on the way toward being well-cared for.
Dr. White, I notice one of the topics in your course was about fee-splitting. Could you tell us something about what you told your students about that practice?
[I’m] very glad to. That’s one thing that really hasn’t changed very much. If you don’t mind, I’ll read from this outline. The heading is “About high fees, surgical and otherwise.” One, it’s not always a case of Mammon – Greed, M.D. Two, in view of the enormous amount of training involved, the development of specialties within specialties – metabolic diseases, thoracic surgery, brain surgery, for instance – all of that certainly warrant rather higher fees.
Referring patients must not be done on a financial basis. Some doctors, of course, must raise their prices in self defense and also, let’s admit there are extremes that we cannot approve; never mind about that. Surgeons must expect patients to shop to get the most reasonable rates available under the present circumstances, anyway. Then, deliberately underbidding a fellow practitioner is reprehensible. All that shopping puts the whole thing on a financial basis rather than on a basis of competence. That’s one reason it is, and should be so, universally condemned. [Fee splitting is] a secret financial arrangement between doctors about which the patient has every right to know and to demand such knowledge if he has suspicions, which of course he shouldn’t have, because doctors shouldn’t be worthy of such suspicions. The patient is referred to the surgeon or other specialist who will divide the spoils, rather than to the one with the best personal qualifications. That is reprehensible. It was, is now, and ever shall be, world without end. Amen.
Dr. White, could you tell us what you think about the high cost of malpractice insurance?
Mr. Podoll, thereby hangs a very unpleasant tale – especially in California, where this subject met with not excitement but fury. The rates of malpractice insurance [were high]. In one instance the doctor’s insurance bill – the premium – exceeded his own income. That, of course, is extreme. But any, let me give you an example that might help to clarify the situation. I’m not an orthopedist, but every fracture is a potential lawsuit. If the patient is not satisfied with the result of treatment of a fracture, if function is interfered with, if an avarice-minded attorney can convince the patient that the result is very bad, then comes the lawsuit. That got to be so much of an abuse that in all branches of medicine and surgery – but again, especially orthopedics – in all branches, the insurance rates were so high that something had to be done and something was done. The doctors took the matter to the legislature, they discussed it with the better variety of lawyers and the law groups and they discussed it among themselves. [As a] result, naturally, the whole business is by way of clearing up to quite an extent, but there’s much yet to be done, period.
Dr. White, I understand that there was a problem in the Academy of Pediatrics about the admission of black doctors in 1944. Is that correct? Do I have the date right?
The date is approximately correct, as far as I remember. The whole thing was well-managed by a bunch of other pediatricians in the Academy. The story is that, to start with, here were two very eligible black pediatricians, highly-trained, one of them a professor at Howard, and the other an excellent practitioner, who were eligible for membership in the Academy. There was local opposition to the same, but after much discussion – mostly friendly – the group, and I could name them who were very friendly and cooperative, we got together. After a bit of agitation these men were elected to fellowship in the Academy and nobody was any the worse for it. It was clear to all that everybody was very much the better for the same.
The same goes for other medical groups – locally for instance. [It’s] exactly the same story; certain kindred-minded folk got together and a very difficult situation was amended. The result is peace and progress. And so we are duly grateful.
Dr. White, I notice that two of the topics you talked about to your classes at the medical school were – in your classes on medical ethics – were abortion and planned parenthood. I was wondering if your views on these subjects have changed over the years and what you told your students about these subjects.
Oddly enough for this subject, [my] ideas have not changed very radically. It was so clear throughout – ever since I began work here – so clear, that from the pediatric point of view the unwanted baby is not so likely to thrive. The mother is likely to be not well-enough nourished, the economic difficulties are very considerable although illegitimacy is by no means confined to the poor and economically disadvantaged. Therefore, it’s still true as it was in my beginning anyway, that planned parenthood – child spacing, otherwise known as birth control – is not practiced where it is most needed. Many, many efforts have been expended by very many people – and we need more – to get planned parenthood more to the fore and more [widely] practiced than ever.
This reminds me of a certain situation in Moscow, Russia, with which I’m not familiar – I’ve never been there. However, I’ve read a good deal about this sort of thing as it works out in many cities and countries. In Moscow [there] was a certain institution known as an abortarium. People there who performed ninety-one thousand abortions in one year, none of them after the third month of gestation. During the third month of gestation any fetus cannot be regarded as viable. So that the controlling factor there – and we are now approaching a thing about which great noise and heat are being generated, as you all know.
This abortarium put up a big sign, “Let this abortion be your last.” In other words, the Russian higher-ups, who do have more power over their not-so-free folk, they could put this thing over perhaps more rapidly and more thoroughly than can we in the so-called free countries. Well, we do our best anyhow. Let this abortion be your last; get busy, learn about planned parenthood, how to prevent conception and then the abortion problem will vanish away, period.
Dr. White, one of the other topics I’ve noticed from reading your article that lists the topics [that] you discussed with your medical ethics class is on euthanasia. What did you tell your class about euthanasia and have your views on the subject changed over the years?
Strictly speaking and etymologically speaking, euthanasia – eu thanatos – means “pleasant death.” This now becomes a matter of semantics and it was [discussed] in the beginning in my talks with the students. Do we ever have any right to permit a patient with an inoperable carcinoma or an inoperable or really vainly treated condition – do we have any right, with of course, the patient’s permission, to allow – if the patient is able to grant such permission – to allow that patient not to live? We put it that way. In other words, we can put it this way: it means a willingness on the part of the doctor to cooperate in the termination of agony and unnecessary suffering. After all, we doctors are in – shall we say, “in business” – to prolong and [to] save life. Nowhere is that more important than in pediatrics because, you see, the newly-born child or the viable child has every right, and then some, to life. Therefore, we should be even more reluctant to (quote) “give up” on such a patient, namely a young patient, than on some person in the 80s and 90s – an octogenarian like myself, for instance. This has also been in the press lately, on television.
The famous patient who was in a coma for so very long – how much longer should we keep that person alive when from anything that we know about such a patient the end result can be only one thing and that is death. We’ve been trying for years to do the right thing here. The right thing is when any adult, any person who can make up his own mind and express his own desires, puts it in writing with the collaboration and consent of that person’s doctor. That person would have every right to say, “If a condition does supervene which would prevent any recovery and in which any treatment would be futile—” – I think that any such patient has a perfect right to put down on paper his will to absolve the doctor from his duty to prolong life, when such prolongation can mean only suffering and have no favorable outcome. Obviously, this has to be an individualized and highly individualized [decision]. To make any blanket statements and pronouncements would be highly out of the question. So let’s do this very, very, individually, period.
Dr. White, I noticed in several of your published articles, you talked about your experience in treating children who had lead poisoning. Could you tell us about your experience?
Here we come very definitely to economic matters. This is especially common, naturally, among very poor people of whatever race. The disadvantaged folk have to deal with old housing where even the inside paint is old and cracking off, peeling off, and is made available to kids who like to play with and eat anything that happens to be around. I went to one household where the only furniture in the bedroom was a big rocking chair and a bed. The older child had a good time rocking the chair up against the wall and knocking the paint – the old, chipped paint – off the wall onto the floor, where the two-year old picked it up and ate the same. Well naturally, he got lead poisoning with all the signs and symptoms thereof, and had to be treated for a long time. Even worse is the most toxic form of lead poisoning, namely that obtained from inhaling lead-filled fumes.
As you all know, automobile batteries are very-well equipped with lead-filled and tarry substances that coat the inner sides of the battery. So, they burn just beautifully. What with the tar and so forth, that makes a fine fuel. So, the poor folk pick these things up from the junkyards, bring the batteries home, put them in the stove, put the baby near the stove where he’ll be nice and too-warm and the fumes get into the air and are inhaled by grown-ups as well as children. We had nineteen children die of that form of lead poisoning in one year.
We didn’t just stand there; we did something. A group of us – Dr. Helen Nash, Dr. [Gene H.] Grabau, myself, and others – went down to see Mayor [Aloys P.] Kaufman. He said, “What we’ll have to do is make sure that these discarded batteries are not thrown into junkyards and made available to the very poor folk.” He called in the commissioner of streets who said, “Well, Mr. Mayor, we just don’t have the funds to do that.” The usual response. So, he [Mayor Kaufman] said, “We most certainly will see to that.” And he did. After that, the number of deaths from that source dropped to zero.
Latterly, we have many tests, much screening of patients, to see whether from pica – that is, eating paint chips and so forth – the blood of patients who do manifest certain symptoms and signs of lead poisoning, whether ordinary patients picked up on that account can be found to have too much lead in the blood. That has been a very helpful though, of course, somewhat expensive thing to do. Therefore, in any situation where it is necessary to economize. Economizing in this direction would be plain to anyone how dangerous such economy is to be. So much for lead poisoning.
There is another thing that the very poor are open to, subject to – namely, rat bite. Oddly enough, the commonest age at which children who are bitten by rats are found is about six or seven. That’s where the kids play in the alleys, and in certain parts of town rats run around with the children and the children chase the rats and get bitten accordingly. The thing that started things up, especially at Homer Phillips [Hospital], was finding in the wards several infants – three, four months old – whose faces and even tongues had been bitten by rats. That’s the sort of thing that wakes people up to how terrible the surroundings can get to be. The rat controller, so called, was a very conscientious fellow, but he didn’t have— His name was John Sadowski, for whom I had very much respect. He’s dead now. Anyway, he did the best he could with a very few inspectors. Latterly, funds were found so that the inspectors were increased in number, and that was another bit of preventive medicine. But, of course, all we have to do is relax a little bit and not find the money to do and take care of these things and there we go again with very, very bad results, period.
Dr. White, what are your views on prepaid medical care?
I imagine you mean, Mr. Podoll, that we’re to talk about prepaid, organized medical care in contradistinction to the fee-for-service system which has obtained for generations and with which, by the way, I’m more familiar than with the other type. Medicine – and I include surgery there of course – the whole practice [of medicine] has to do with the funding of such services and with keeping our excellent, excellent medical care system. [We need] to make it available where it is most needed and to stop the current system of not having it available where people can’t afford it and can’t reach it. The point is that group medicine is pretty much the answer to this. The use of it has to come because one doctor can’t cover everything. Solo medicine – the kind that I used to practice – solo medicine is getting to be less and less possible as diagnostic procedures and therapeutic procedures get more complicated and, incidentally, more expensive. So there we go. If doctors – a few of them, I mean a few – the more avaricious ones, put in very high charges and wax very rich accordingly, no wonder the whole profession gets into trouble. So, this is a very complex thing and I’ll just have to generalize because at present there’s a great deal of work being done by a great many conscientious people, and the more power to them. Speaking of power, I think you have another question coming up.
Dr. White, what are your views about government sponsored medical care, or as some people call it, “socialized medicine.”
The point is that organizations like the American Medical Association have greatly opposed any such attempt at imposing medical care with rules and regulations as to fees and expense sharing. Doctors have been, perhaps, too afraid of that and yet doctors are entitled to go ahead with their present independence, if they don’t become excessive as far as charges and so forth are concerned. It’s very much better if we can attach ourselves to social medicine rather than (quote) “socialized medicine.” It’s not to be wondered at that socialized medicine such as has been practiced in Russia particularly, that that just couldn’t go in this country.
The British, with their panel system, have done quite well with it except that as expenses have increased the money available has not and the English are beset by many troubles in funding the medical care. The panel system is all right if doctors don’t take on more than, say, fifteen hundred [patients] to take care of at the same time. If they take too many they may get a little more income and give ever so much less service, and rapid-fire service – handing out prescriptions just very rapidly and without adequate diagnostic procedures and so forth. So, it is so complex that we’re working at it and we’ve just got to get somewhere before very long, period.
Dr. White, I noticed that in the American Journal of Nursing in July 1927, you wrote an article about teaching pediatrics to nurses. How many years did you teach pediatrics to nurses and did you find it a worthwhile investment of your time?
To that I can only say that I hope it was worthwhile. I must say [that] I enjoyed it; I don’t know how much the nurses did. I can only hope that they really got something out of it. This leads to a very important subject, that is, doctors whose training takes years of night and day work, training in the details of biochemistry, bacteriology, surgery, goodness knows what – all of which is very expensive and very time-consuming. Can we get help from paramedical sources – “para” meaning “alongside of” – paramedical sources such as nurse practitioners? Goodness knows they are on the up and up and very happily so. The paramedical folk – who can be trained more briefly but quite intensely, for that matter – they have got to be available to the doctors in providing the best possible and most available medical care. That has come up over the horizon and must be welcomed by the medical profession and by the laity. But, of course, that has to be paid for, too. Oh, be paid for, hmm-hmm.
Dr. White, could you tell us what it was like to be a pediatrician practicing for thirty-five years in the demanding practice and being solo, not part of a group?
Well, Mr. Podoll, I guess I should refer you to Mrs. White, but I guess we can’t do that right now. The point being that in trying to do solo practice – whether it’s pediatrics or any other part of medicine – the practitioner is not doing as well as he could do with a congenial and proper group [of] equally well-trained [practitioners], therefore so arranged that any patient calling in a member of the group would call in somebody competent to deal with any medical situation that comes up. Group practice really started with the Mayos [who] achieved a very high level of competence and desirability. Since the time of the Mayos, the whole movement toward group practice has just zoomed, and should [have]. So, the usual question is, “Well, Doctor, would you do it over again?” I’d have to say that I don’t think I could have managed anything like as well with any other form of work and also I’d do it over again, but with this proviso – that some of the time available for other things could be practically worked out. That means that I should very much like to have joined a congenial group in the practice of pediatrics. But, as the annoyances, the inconveniences and so forth came along, I wasn’t quite so cheerful about it at the time. Looking back, I can only wish that I had had sense enough to enjoy myself more as I went along, period.
Dr. White, you mentioned to me that you were the secretary of the Harvard Socialist Club. Could you tell us something about the club and what it did and your political views at that time?
I’ve always been glad to refer back and think over the liberal days in college. The group that I ran around with – or groups, there were several of them – were definitely what would now be called “liberal.” Well, what is a liberal? Some of the conservatives claim that they are very liberal and that’s a question. Anyway, back in 1910, ’11, ’12, ’13, this group that I was very friendly with – [and] still am, those that have survived. In those days we had come to the college certain folk like Lincoln Steffens, who was described by Teddy Roosevelt as a muckraker, and used by Teddy Roosevelt as a muckraker. There was a good deal of muck to rake, and he raked it all right.
In addition, we had sessions with Eugene V. Debs, who was one of the great Socialist folk and latterly, Norman Thomas. So, all in all, it was a very interesting time and led to various complications, and also led to this – young folk doing what’s known as (quote) “serious thinking.” Well, some serious thinkers can be pretty much pains in the neck. Anyhow, they did think, they did discuss, and they did not waste as much time as some others. So that some of us really got quite a bit of education from our “liberal” – underscore and quote – “liberal” friends. I don’t think that that sort of thing has done us any harm, but it may have caused considerable anguish on the part of our associates, period.
Dr. White, you seem to have been very consistent in your social concerns. I noticed that in 1925 in a magazine called The Nation’s Health you wrote about the health of colored babies in St. Louis. And pointed out that the colored baby in St. Louis had half the white baby’s chance for survival and from two to three times the white baby’s chance for contracting disease. In another magazine, The Journal of Housing, in February 1958, you were still pointing out that poor housing kills children and that death for children lurks in the walls of the old and run-down housing. In this article you talked about the lead in the old paint and plaster on the walls. [You] pointed out that “poverty continues to be Public [Health] Enemy Number 1. This is most poignantly true of the poor, at whom poverty strikes through malnutrition, crowding, and lack of good sanitation.”
Dr. White, did you make house calls when you were a practicing pediatrician?
The answer to that is, “And how!” I know of certain colleagues who made many times more house calls and office calls than I could and did it well, for that matter, did it very well. One can be critical of doctors for refusing to make house calls and yet, one must understand why. Let me tell about one patient who lived way out in St. Louis County. I made house calls out there as elsewhere, and this one house call, I recall, took two hours to make – that’s one call. The training that went into even me in those days was not such that it was well to use my time sitting in traffic jams. Also, we should remember that – and I’ve told the pediatric trainees just by way of making it picturesque – that a pediatrician who refused to make house calls should have an office with as many rooms in it as the Pentagon. That’s extreme – anyway, six or eight examining rooms – keeping and also trying very hard to do things by appointment and keeping children away from each other so they won’t hand each other diseases of various sorts. All the pediatricians do the best they can to cope with just that situation.
There again, that brings up this point – a doctor’s practice is about right in size for a half an hour. Prior to that half hour he is having too few patients; after that half hour he’s trying to cope with too many. That’s difficult; a doctor has to use great judgment and get what help he can from paramedical folk and from the appointment system, and any device that he can resort to to keep patients away from each other. That’s especially true in pediatrics, but in many of the forms of practice [also]. So the patient should be a bit reasonable when it comes to adjusting to having the doctor make less house calls than he used to make. Remember [however] that there are times when they should be made, when they must be made, period.
Dr. White, I’ve read your manuscript called Medical Leonardo of Boston: An Evaluation of Versatility. Oliver Wendell Holmes, M.D., 1809 to 1894. I know that you are a great admirer of Oliver Wendell Holmes. Did he inspire you to write poetry yourself?
No, I can’t say that he did to start with. I’ve always been trying to come up with verse, anyway, and preferably poetry. Holmes was very much blessed with a sense of humor and he was one of the greatest doctors. He was very, very great in the matter of preventive medicine. What he, like [Ignaz] Semmelweis in Austria did to prevent childbed fever was well worth anybody’s existence. However, as I came along, doing the best I could in that line, Holmes, naturally, became a very great inspiration. However, I am a mere, and I mean very mere, follower of Holmes, Sr.
A little story about him. His great son – who later was a justice of the United States Supreme Court, and one of the very greatest – once told his father, “Father, I’m going to go to the law school.” Holmes, Sr., M.D. said, “Wendell, what do you want to do that for? No lawyer can ever be a great man.” That’s word for word and it’s one the few very great mistakes that Holmes, Sr. ever made. So much for Holmes. This manuscript [Medical Leonardo . . .] is at present on the road and what’ll become of it I don’t know. I just hope for the best.
Dr. White, among your other accomplishments you are also a poet. While you were in medical school you wrote the “The Ballads of P and S,” written for the most part between 1913 and 1917. Your poetry has also been published in the New England Journal of Medicine. And in 1972 you wrote a book entitled Verse and Verse: Lilting on Paths Medical and Otherwise, the proceeds of which are used for programs of the Children’s Hospital. Would you read us some of your favorite poems?
Well, it would be safer to read just one. This is entitled “From the Children’s Clinic”:
Faith, hope and love, now abide these three.
Yes, Paul, but why do saints leave out mirth?
We lesser mortals must laugh, you see
Or else be hopelessly bound to earth.
How blest is he with a lilting heart
His yoke is easy, his burden light
He bears his own and another’s part
To him religion is pure delight.
What a wondrous thing is the way of God
The way of God with a little child
Who’ll dance along where his elders plod
Sure that on him the whole world has smiled.
This rhyming sermon with text complete
I owe to four little dark brown girls
Whose irresistibly dancy feet
Keep time with breezily bouncy curls.
A whirling circle of rhythmic grace
Age never planned such a lovely thing.
I think the clinic’s a dismal place
But not when four-year-olds dance and sing.
A song or dance in the midst of pain
Has faith within it which makes men whole
This dance in the clinic is not in vain
For through it glimmers a people’s soul.
[Recording ends abruptly.]
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