Transcript: Tape 10 Side B

DATE: May 15, 1998
TAPE: Tape 10
INTERVIEWEE: Thomas Scully, M.D.
INTERVIEWER: Eileen Barker
PLACE: Dr. Scully's home, 1400 Ferris Lane in Reno
TRANSCRIPTIONIST: Teresa Garrison; corrected by Dr. Sohn (Revised 2017, Haley Kovac)

---

EB: Got the [inaudible] on there. Okay, go ahead.

TS: So the regional medical program turned out, in the long run, to be very valuable because I made friends with people in medical education at the new school developing at Davis in Sacramento, I made friends with people in Salt Lake. But most importantly, in that first year at Washoe, with a lot of other doctors of course, I think I visited virtually every little town in Nevada and every hospital. Many of which had gotten some federal money to expand and the regional medical program was bringing doctors from the big city, Reno or from Salt Lake. Frequently from Salt Lake, they'd come in to Elko and Ely and put on all sorts of medical conferences and consulting clinics. I would see patients in Winnemucca and I'd see patients in Elko, children, and I would go to the Indian Reservation in Owyhee and various places. So I still continue to do a little pediatrics. But, basically, I was sort of coordinating all this.

EB: You were sort of campaigning for the medical school?

[cross-talk]

TS: Yes, I was, sure.

EB: [inaudible] attitude was in these little towns?

[cross-talk]

TS: They were very positive. Oh yeah, I think that they were very positive at the time. I was doing that, I was beginning to help George and Dick Licata look at the curriculum, and what was the educational program going to be like? Because the school was authorized in '69 by the legislature, but they had to open in '71. They had 24 months, they had two years to get the school started. Because the first class was going to enter in the fall of '71 and I think it had to in order to capture some of the federal money that was available for starting the school. If George and the university didn't get started by the fall of 1971, it might never have gotten off the ground, initially. At any rate, I then also, went to work every day at Washoe and developed some of their education programs. They had started some, to their credit, but I would then spend a fair amount of time putting on grand rounds; there was a tumor board. Ernie Mack had started neurology rounds and there were CPC's and I would bring in, with the help of the regional medical program, as well as some money Carroll put in my budget, bring in speakers from San Francisco and from Stanford. So we began to try and create, and of course, I have to say Dave Roberts, and Bob Myles, and Bob Barnett had done a lot of the ground work. But they were busy practitioners, they didn't have time to spend on this; so I then took on that role of Director of Medical Education. So I sort of had two or three part-time jobs, if you will, all under the umbrella of Washoe Medical Center. One of my agreements with Dr. Mack was that I could see children in the clinic one afternoon a week and Larry Russell who was running the County Clinic wanted a little help and I wanted to keep my hands in pediatrics, but I wasn't competing with anybody.

EB: ...ran the geriatric...

TS: He ran the whole clinic at that time. Larry Russell ran the whole clinic.

EB: For pediatrics as well?

TS: Oh, sure for anybody, anybody who walked in the door of the well-fare clinic, but I would see a lot of the kids; that was just part of my job. At that point, it was a county hospital run by the county commissioners, I'm not sure how the money worked out, but it didn't affect my income. And I wasn't competing with the other pediatricians in town, I was seeing all the free patients who were indigent. At any rate, I guess for the next year, year and a half, I spent most of my time developing education programs at Washoe, spending a lot of time with the doctors talking about the medical school and how it would function with Washoe. Also, lining up physicians who said 'Yeah, I'll help. I can give this amount of time.' And then lastly, taking programs to rural communities starting in Carson City and working our way out to Fallon, and Elko, and Lovelock, and Winnemucca, etc. I enjoyed it, Celia was happy here. We moved into this house, actually we rented this house from Bob Myles; he had lived here before.

EB: Oh, this is where he lived.

TS: Yeah. He lived here, so we rented it from him. He had moved around the corner and built a house right around the street where he still lives. And he rented it to us because he wasn't sure what he was going to do. And so, I think we took a two-year lease option and at the end of the two years, when the lease was up, he had already built his other house; I, by then, had saved up enough money to come up with a down payment. And so, we bought this house, just about two years after we moved in.

EB: That'd be 19?

TS: 1971. And we've lived here ever since.

EB: Let me ask you a question, when did the Howard Hughes funds kick in?

TS: Alright. Howard Hughes' money came into the legislature in the winter of 1969. The exact time, I don't know, but it's in that article, February or March. One of Howard Hughes' representative came into the legislature and said to the legislature that if the medical school started he would guarantee $6 million. That would be $300,000 a year for twenty years; it later got renegotiated down to $4 million that is $200,000 a year for twenty years. Why? I don't know all of the politics, but Paul Laxalt was the governor. He apparently had good communications with Howard Hughes' people and as soon as the legislature heard that, it swayed enough votes that the bill then passed. And the idea was that he would give to the Board of Regents and they would use it for starting up the medical school. Well, like everything else, we used to laugh and say George Smith put together the school with smoke and mirrors, because he would take some money and match it to other money. There was many, many grants and George was a master at. But the Howard Hughes' money was critical to getting started, but then, in came money from the Kellogg Foundation. Robert Wood Johnson wasn't founded yet, but the Kellogg Foundation, the Commonwealth Foundation and there was federal money. So many dollars per head, capitation if you took students they'd give you x number of dollars per student. All that's in that history that I gave you for [inaudible]. At any rate, that was where Hughes' money came in; and that, apparently, I wasn't here at the time I was still back in New Jersey, but that was critical to the legislature agreeing to do it.

EB: Did you ever meet him?

TS: No. George didn't, I don't think anybody did. I'm not sure Laxalt or anybody met him.

EB: It was mostly through his representatives.

TS: Apparently always through his representatives. The man's name escapes me at the minute, but it's in that article. Maheu. Mr. Maheu, I don't even remember his first name. He represented Howard Hughes. Well, at any rate...

EB: Tell me about Paul Laxalt.

TS: I didn't know him very well. I had met him when I was in Las Vegas three years earlier 'cause that was when he was elected governor. I met him at a party when he was running for governor. And also, after he was elected and I was working for Otto Ravenholt those few months in the spring of '67. I went up to Carson City several times with Otto and visited with him, at that time. Paul, the governor, Laxalt had asked Otto to get the State Health Department straightened out, which he did. And they eventually brought in a health officer and Otto came back the next year.

EB: So, he was very much for the medical school?

TS: Oh yes, he was very much in favor of it and very supportive; but it's like everything else in politics, if you don't have the votes in the legislature, it doesn't make much difference. No question, the Hughes' money was critical, the north was critical and the rural areas were critical, and they had more of the votes at that time. Vegas did not have the majority at that time in the legislature. There was a lot of north and south fighting about it; large numbers of physicians were opposed to the medical school.

EB: That was my next question.

TS: I don't have a good number. At the time, when the school started in 1969, by the legislature, there were only 5- or 600 doctors in the state. George used to say there's about a third of them that were in favor, most of them in Reno, there were about a third of them who were opposed and most of them were in Las Vegas. And their opposition was, it's going to break the state, the state isn't big enough, the university isn't sophisticated enough, they don't have the talent and by the way if they are going to start a medical school, it ought to be in Las Vegas anyway because we're the growing town.

EB: They'd already started that.

TS: Started that, sure, at least they were talking that way. Then there was another third of the physicians who couldn't care one way or the other what happened, it wasn't going to affect their life one iota. So, part of George and my job was to try and identify the roughly the third, 150-200 doctors, who were supportive and were very helpful. And this school would not have started without the volunteer help of a lot of doctors, statewide. Both in Vegas and in Reno. As a matter of fact, when we actually opened the school in '71, a lot of my friends who I knew in Las Vegas and had worked with and practiced with were very helpful. And we put students right away into doctor's offices down in Las Vegas that first year. But I'm getting ahead of myself. I think it's important to point out that shortly after I got here in '69, George hired Dick Licata. I think he was the first person he hired, who had also come from Chicago and had worked with George on animals and research on pace-makers, which are now common place; in those days it was still a research project. So, Dick Licata was hired and then George started looking for faculty. He found Emile Van Remoortere, the pharmacologist, who had been in a medical school in the Congo and was coming to this country and he also met and hired Matt Bach who, at that time, was at Tulane in New Orleans. So, he started by hiring three basic scientists, an anatomist, Dick Licata, a pharmacologist, Emile Van Remoortere, and a physiologist Matt Bach. So, now George, who has an office in the old Morrill Hall on the second floor, it's now been renovated, Morrill Hall the Alumni Hall. But in the old days, it was a rickety old place, he was on the second floor. Actually, I don't know if people know that George started the school really in a broom closet, just off of the lobby of the Orvis School of Nursing. The dean of nursing, Marj Elmore gave him a little office. And when I first met George, when I came out here in the spring of '69 to look at the job, I met George, he was in a little broom closet. And he had one secretary in there with him, it was not as big as this office we're sitting in now, maybe 10x10. And shortly thereafter, they gave him a little bigger office, when the school was approved by the legislature; they gave him a second-floor office on Morrill Hall and he hired Phil Gillette as his business manager and secretary and they sat up there for a while until they got some offices next door in the Mackay Science. They really started, literally, on a shoe-string in closets. At any rate...

EB: He was the perfect personality for that.

TS: Yeah.

EB: Because he had no ego.

TS: Oh no, he was wonderful. Anyway, he brings in these three people, all of who had enormous egos. Dick Licata, Van Remoortere and Matt Bach. Dick and Matt are dead, God rest their souls; Emile, I think is still alive, but quite old now. All had egos, they all had taught in medical schools, which George had not, although he had been a researcher. They all knew exactly how the medical school should start and all three of them had divergent views.

EB: They weren't in agreement.

TS: Divergent views.

EB: Of course, of course. [laughs] It had to be that way.

TS: Of course. In the meantime, George is meeting Bud Baldwin and John Altrocchi because he's got to get someone to do behavioral sciences, but they didn't come til later. At any rate, George, I remember, came over here one night and he had first tried to put Dick Licata in charge of putting together curriculum, then he tried to get Emile to do it, who didn't want to, then he tried to get Matt Bach to do it. They would call meetings together and George would sort of referee these meetings, this is the truth. And they couldn't get on a piece of paper what it was they were going to do and time is running out. Remember all the time that the legislature and others are giving permission; over George's shoulder is the Liaison Committee on Medical Education, the LCME that accredits medical schools. And they were sending out teams of visitors and constantly bombarding George with inquiries, with letters. We've got to come visit, we've got to be sure you're hiring faculty, we got to be sure you got a curriculum on paper, we've got to be sure you have a classroom, you got a cadaver, you've got a lab, all these things. So George is juggling all these balls. He came over here one night and he said, 'I know you work for Washoe and you're helping us, and I've talked to Dr. Mack and I've talked to Carroll Ogren and I'd like you to chair the curriculum committee and to try to get these people to work together because we have to get something on paper before' I've forgotten the deadline but for the sake of argument 'within four months we got to get something paper.' In order to show the visitors that we weren't still sitting around talking about it, but we were moving and we had names of people who were going to teach. And I said 'okay' and Carroll released me at this point, I think, for the first time. The university put a small amount of money in my salary, 80% with Washoe and 20% with the medical school; six months later I think I went 60/40 and of course within two years I left Washoe and was full-time with the medical school by the time the school opened in 1971. What I then did was at George's request became chairman of the curriculum committee and we just sat down and afternoon after afternoon. At that time George had met John Altrocchi who was at the faculty at Duke and was professor there of psychology and John got a sabbatical and came to work with us on a one-year sabbatical. Well, he never left, but he came thinking he'd go back to Duke but he liked it here. So anyway, he sort of began to provide the psychology and then part of the argument for the medical school is we would use people from the university which would save on salary. So the biochemists of the university, Chuck Heisler and then Chuck Rose from the Department of Chemistry and Ron Pardini and some of them; they all came in and started participating in the biochemistry. And then to make a long story short, finally George met Russ Brown, the microbiologist, who had just retired from Tuskegee Institute. Russ Brown had a reputation, national reputation for helping on the development of polio virus vaccines at Yale back in the '40s right after the war. Anyway, he would retire from Tuskegee and wasn't going to quit and so he brought Russ Brown out. Russ was the first black faculty member we had at the medical school and one of the first black faculty at the university as far as I know. He also had a pretty big ego, but was very fun to work with and he was very, very supportive and he had new ideas. So, we now have an anatomist, a microbiologist, a pharmacologist, a physiologist, a couple of biochemists. None of whom have ever worked together before, all from different parts of the country, all converging on a school which is only on paper and in little offices scattered around the university and no home.

EB: [inaudible] classrooms?

TS: No classrooms, no home. And poor Dick Licata's trying to find where's he's going to get cadavers to start dissections. George says 'Well, Tom's in charge. You've got three months to get this done.' So, I just called meetings afternoon after afternoon after afternoon many nights and we just sat there. I can see it now on the second floor of the old Mackay Science building was a big, big room and it had blackboards around it and I think it's now a part of the Department of Geography or something. I guess at one time it had been chemistry or physics, anyway they gave George a couple of offices there in that big room and an auditorium. And so, we sat around this table and we just filled the blackboards and everybody expressed their ideas on what are we going to do with 32 students that are going to show up in September of 1971?

EB: This was the [inaudible]?

TS: Yeah, 32 at the time. In the meantime, Dean Fletcher who was professor of biochemistry, George appointed the chairman of the admissions committee and put together a group of people from around town and people from the campus and they were starting taking applications. They had announced we're going to open the school in September of 1971. So I slowly began to leave Washoe, I worked there, but I mean less and less time there. I was there every day, but my focus then was on the medical school I still was running the educational programs, but I was trying to get the physician involved. So anyway, we're now into the summer and fall of 1970, we've got about nine months to go. These various people I've mentioned have all shown up, they bought houses or rented houses; there's about nine or 10 of them. That's all the money George had to hire people, but we got a lot of voluntary help out of people like Jerry Dales and Mal Edmiston, Dave Roberts and Bob Myles, Jim Atcheson, David Johnson all of them were very important, Tom Hall. I think the first chairman of pathology was Tom Hall from St. Mary's. And he came up...

EB: What about Wesley Hall?

TS: No, oh Wes didn't do much. And Jack Callister, so George depended upon them to teach the pathology so that filled, with George, in the last basic sciences. So, we now had all the basic sciences covered as well as psychology or behavioral sciences with John Altrocchi; subsequently Bud Baldwin and his wife showed up. So by the time the school actually opened the doors and we took in our first students, I think in the last week of August or the first week of September in 1971, there were, I could count them, but there might have been 12 or 13 paid faculty, all basic sciences and myself. By then, I think I was half-time and then a lot of volunteers.

EB: And your title was what?

TS: At that time, my title was Director of the Division of Clinical Sciences. So, I was responsible for all the involvement of physicians and then there was a Director of Biomedical Sciences which was Matt Bach, the physiologist and he was responsible of all the basic sciences teaching. And then there was a Director of the Division of Behavioral Sciences who ultimately became Bud Baldwin, he showed up and his job was to do all of the behavioral sciences interviewing psychology all of that. And the three of us would meet, there were no departments at that time; we were a two-year school focusing on an integrated, interdisciplinary kind of curriculum and they all took on their roles. And my job, at that point then, after the curriculum was on paper and we had signed up people was essentially to take the students one afternoon a week, there were only 32 of them that first year. Take them one afternoon a week to the VA and to Washoe or to the offices of various doctors in town and teach them how to do histories and physical examinations and how to listen to the heart and all that. And what we essentially did was try to get the physical examination class, I think it was every Wednesday or every other Wednesday sort of coordinated whatever it was they were learning in the lecture hall. If they were dissecting the heart, we would listen to the heart and their learning the physiology of the heart that sort of thing.

EB: How did you get these students? Did they take their MCAT's?

TS: Oh sure, well I could look that up. But many of them were right out of UNR, not many up to that point, as you know, had got into medical school; there were some from UNLV there were also Nevadans who went out-of-state, there was a small cadre of Mormon kids who had gone to BYU and there were a couple who had gone to schools in Oregon and in California. But, they all were basically Nevada residents at that time, I think that first class were all Nevada residents there might have been one or two from Idaho or Montana, I've forgotten exactly. And once the call went out and it was made public that there was going to be a medical school they took MCAT's like anybody else.

EB: But they would take them somewhere else.

TS: Oh yeah, oh sure. They were at some other university or they might have actually even been at UNR or UNLV at the time. And they would take their MCAT's and they'd apply just like any other medical school and we used the central admissions process.

EB: Do you remember, were there a lot of applicants? You only needed 32.

TS: You know, I was not on that committee. Dean Fletcher ran that and then subsequently after he left and Tom Kozel showed up George appointed Tom and he was the second microbiologist to come on board, Russ Brown had recruited him from Iowa. When Tom came, Tom was made the Director of Admissions for several years and then George met Owen Peck and he came after the school actually opened, but he came really in the beginning of the second year and his job was to get them all transferred 'cause remember at that point this was a two-year school. All 32 of them had to be transferred to some other place for their third and fourth year and that in itself was a problem and it was not assured there was no contracts. We didn't have any contract with any school saying 'We shall take x number of your kids.' it was all on a case-by-case basis. So Owen spent a lot of time wandering around the country essentially finding places here and there, one here, one there, two there, one there for this first 32.

EB: Did these students, when they finished the second year here did they take their National Boards?

TS: Sure.

EB: The way they do now?

TS: Exactly, exactly. And as a matter of fact almost...

EB: On the basis of that they might be accepted into these [inaudible]

TS: No, most of them were accepted contingent on their passing. So they all were accepted, Owen had worked out a place for every one of them.

EB: He did?

TS: Oh yeah, and some of them got places on their own and everybody helped out. All of them had a place come spring of their second year, but every one of the schools said it's contingent on you passing the National Board. I think there was one who dropped out, did not go on and there was one who dropped out after having transferred. So of the first 32, 31 actually began their third year elsewhere and 30 of them eventually became physicians.

EB: How did they do on their National Boards? Do you recall? Well everybody would be watching for that.

TS: Yes and that record is in that history. It was acceptable, they passed with one exception, but frankly I don't know how well they did. My guess is they did probably a little less than average, but who cares it wasn't important; turned out that many of them turned out to be excellent physicians. And I've forgotten how many of them, about a 1/3 are now back in Nevada practicing. As a matter of fact, the president of the Alumni Association was in that first class, my cardiologist was in that first class.

EB: Who are they?

TS: Malin Prupas and Larry Noble. Wonderful, wonderful students and good doctors. But remember, getting into medical school then and even today had always been in the west at least. If you didn't have money to go to a private school and your only choice was to go to a state school then you had to be a resident of a state that had a school. And that's why kids from Nevada and Idaho and Montana and Wyoming for years got into medical school in very small numbers. And I went back and studied that as a part of putting together the conversion proposal years later and I've got this data for about twenty-some odd years going back to the time of Fred Anderson and Ernie Mack. There were never more than four or five Nevadans going to medical school out-of-state in any one year and most years it was one, two or three. Sure, Fred Anderson went to Harvard and Ernie Mack went to McGill, of course, but everybody can remember those handful. But there weren't 25 and 30 or 40 every year. So once the medical school started all of a sudden 30 and then ultimately 48, and now 52, Nevadans most of them, are going to medical school. And we had a 25-year history that came from the Department of Chemistry and Biology, we went into the records of the Registrar's office; we got all the records we could find and by name could find them. And there were a handful, I think there was one year that maybe six Nevadans went to medical school; and I can show you those figures later when we go back to edit this. But, most of the time it was three or four a year. So, there were a lot of good Nevada kids who weren't getting into medical school, not because of their grades or their ability or their motivation, but they just lived in the wrong state. Now, there were a few who had money or could afford it would go to Georgetown or back east to Creighton or other private schools. So that is sort of my entrée back into Nevada, the first two years at Washoe, splitting my time as I've said, but focusing more and more and more with the support of Carrol Ogren. So finally, the school was about ready to open, it's in the Spring of '71 and I met Ernie Mack coming down those rickety stairs in that old building and 'How are you Tom?', 'Fine.' I don't know if he called me Tom or Dr. Scully, I always called him Dr. Mack and I still do to this day. He said, 'I think probably, with the school opening you should consider Fred Anderson and George Smith's proposal to go to the school full-time.' In those days, you didn't have to do national searches and I said, 'Well, I really enjoy it here, but I think my interest is in medical education and with students.' And he said, 'Well, I think your career is in medical education, you've demonstrated that and I think you should take that job. And we'll get somebody else to do this job.' Well, I don't think they ever actually filled that job again. Because they then had some secretaries and committees that ran those education committees. I then, I think in July when they usually made contracts and he had already talked to Fred and I talked to Fred in the hallway. So, that's when I then went full-time to the medical school, so when the medical school had opened; well, that's not true, it was probably in the next year, I'd have to look that up. But somewhere after the school opened I essentially then went to....