Transcript: Tape 5

DATE: March 12, 1998
TAPE: Tape 5
INTERVIEWEE: Thomas Scully, M.D.
INTERVIEWER: Eileen Barker
PLACE: Dr. Scully's home, 1400 Ferris Lane in Reno
TRANSCRIPTIONIST: Teresa Garrison (Revised 2016, Haley Kovac)

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Thomas Scully: March the 12^th. So, I knew I was going to get assigned to either an Army or a Navy hospital, but as an Air Force officer; which was peculiar, because when I got there, there were about 10 of us who were in Air Force uniforms wandering around an Army hospital, which was all fine. We were in the Air Force and they had a little office there where they had a sergeant and somebody else who was our liaison. Be that as it may, when I opened it and it said El Paso; Celia and I laughed, we went home and literally we'd never been west, I'd been to California once with the Colgate Thirteen, I'd been to Alaska, we talked about that. But she, I don't think, had ever been west of Washington D.C. So, anyway we looked it up on the map and said 'Oh, it's way out west, Texas is pretty big, it's not near Dallas' we'd heard of Dallas and Houston. Her father used to go to Houston for consultations for Gulf oil occasionally.

Eileen Barker: You mean El Paso?

TS: Yeah. So El Paso, we looked it up and said 'Oh yeah, it's way out west someplace.' So, graduation in those days was around the end of May, first of June; so there was about a month.

EB: Was it a hooding exercise?

TS: Oh yes. Yeah, they hooded us.

EB: Who was your hooder?

TS: No. Oh no, not like us. No, no, no. The dean hooded everybody. You went across the stage and they put a hood on you and they handed you a diploma and the chancellor who shook your hands; but there none of this family or teachers or any of that doing like we do. No, our hooding ceremony which was, I think, designed originally by Ernie Mazzaferri and Burt Dudding and it was wonderful. No, it was very formal.

EB: So, much more personal, this one.

TS: You just walk across the stage, the dean stuck a hood on you or the vice president, somebody and they handed your diploma, and read out your name. So, in that sense it was fairly formal, which was fine. So, then we had about a month, but since I and several others like me from other medical schools had been getting a check from the Air Force every month for two years. But we didn't have a uniform on, probably didn't know how to put the uniform on. We were all sent to, that's what it was, Westover Air Force Base, I think in Massachusetts; where we had to spend two weeks, getting a physical and going through all sorts of stuff and learning how to put on a uniform and march and all that. So, in preparation for going to a hospital, so Celia went home with a baby, Peter. Peter, now is my oldest boy, he was born in October; so he was probably six months old, so it's June now of 1958. Celia spent a couple of weeks at home in New Rochelle with her mom and their first grandchild. I'm learning how to be a soldier and then we take off and head for El Paso. I went about two weeks early, found a house, bought a car, as I told you earlier, because we had two checks coming in that last two years; we actually had some money in the bank, so I bought a car. I rented a house from an Air Force officer; I bought a refrigerator, a washing machine, maybe even a dryer, a stove. The whole thing was unfurnished, bought all this stuff at Sear's; and so when Celia then came several weeks later with Peter in her arms, he's now seven or eight months old, she's pregnant with Chris due the next October and we move into this house all set up, had some beds in it. All of which I'd bought at Sear's, I remember a Sear's truck coming in with all this stuff; because we brought nothing essentially, a few things, but very little from our apartment in Albany. I guess we brought the piano, yes, we did that and we brought the dining room table that she bought and the sofa. So, she arrived in El Paso early July and I started my internship and that's where I interned for a year.

EB: Well, let's stop at that point to pick up a few things, because I'd like to pick up with your El Paso experience; this is post-medical school.

TS: Yeah, I'm an intern.

EB: And we'll start at that next time, but I want to ask you a few questions that were left over.

TS: Back to medical school.

EB: Medical school. You mentioned you worked in the blood bank.

TS: Yes.

EB: You didn't tell me much about that, how long did you do that? When was that, second year, did you say?

TS: I did that near the end of my second year, but also through most of my third year; 'cause I remember Celia and I were married and I'd get a phone call. It was on-call, the blood bank was not open 24 hours a day; it would close down around nine o'clock at night and occasionally I would get the late afternoon shift. I'd go in there at the end of school, maybe 4:30 or five, I'd work 'til nine, typing and cross-matching; usually typing and cross-matching bloods for the following morning's routine surgery.

EB: This blood bank…

TS: Was in the hospital and specifically for that hospital.

EB: Not a community blood bank for other hospitals.

TS: No, that was down the street.

EB: This was a private, I mean through the hospital.

TS: The pathology department ran it. My professor of pathology ran it; he was a hematologist and he hired me, he liked me and he gave me the job. He said 'I'm looking for a couple of medical students who I can trust to do night and weekend work' and we get paid for it. So, at one time I was even getting a third check.

EB: Were there that many transfusions?

TS: Well, no, it wasn't so much transfusion. Well, yeah there were some, but it was primarily to have blood on-call in case the surgery the next morning; which they were beginning to do heart surgery.

EB: Oh, I see. It was quite a hospital then.

TS: Well, it was a university hospital, oh sure. It was a big university hospital, well, it was called Albany Medical Center, but it was a university hospital and they had departments of surgery and neurosurgery and all the rest. So, the night person would often put up in the blood bank in the refrigerator, blood that had already been typed and cross-matched against Mrs. Smith who they're going to do a hysterectomy on tomorrow morning. Well, in those days, you always went into the hospital the day before surgery for the pre-ops; now of course, you go in for surgery and you're home in four hours. But in those days, you always went in the day before; afternoon, you were there that night and get operated on, whatever the surgery was. So, that's with the evening guy. Then, one of us would be on-call at home with a beeper, well we didn't have beepers, there was no such thing then; they call you on the telephone. And you'd be on-call so if there was an emergency, a train wreck or an automobile accident; you'd come in and do the typing and cross-matching for the emergency room. So, I did both the routine, evening stuff; that would also include Sunday. Frequently, you'd go in on Sunday afternoon and work for three or four hours typing and cross-matching blood for Monday morning scheduled surgeries. But, I can recall through my junior year and even part of my senior year, although I think I gave it up then; I would get a call at home and Celia and I would be in bed and they'd call and say 'There's been an auto accident, we need you here.' So, our apartment, that we had, was very close to the one I had lived in as a freshman and was right across this park. So, I could run, put on my clothes as fast as I could, I could run across to be in the hospital blood bank, five minutes most. If it was an unusual type of blood, I can recall, they'd have a big list; no computers in those days, they're all card files. You'd look through the card file and you'd call a donor who had O- or something and that donor would come in and then they had taught us how to draw the blood and type and cross-match it. But those would be for emergencies; mostly I guess stab wounds, gunshot wounds.

EB: Now, this was 195-

TS: 1957, '56; '56.

EB: The difference between the blood bank of 1956 and the blood bank of the 1990's has to be incredibly different.

TS: Oh, night and day. Oh, gosh it's got to be night and day.

EB: Not only the AIDS problem, but now you have people coming in off the street selling their blood.

TS: Yeah.

EB: Now you have people who will give their own, is that called autologous?

TS: Yeah, they'll take their own blood and save it.

EB: Oh, rather than take a chance and taking anything from a blood bank.

TS: Right.

EB: How much of that did you have then? Did you have people doing that, giving their own blood?

TS: No, no. I don't ever recall that. I mean, it may have happened, I wouldn't say it didn't.

EB: It was pretty uncommon then.

TS: Yeah, and of course we didn't know the risks of hepatitis in those days, there was no AIDS. We always did bilirubins and some other studies on them to make sure they didn't have hepatitis; but, frankly, these people had been chronic givers, they were known to the blood bank. They didn't, as far as I know, just accept anybody, but I think the use of blood wasn't as much as it became later. I don't know enough about blood banking now, but in those days by comparison it was pretty crude. What you tried to do was to avoid an obvious mismatch; then of course, the other thing we did a fair amount of…

EB: Who were these donors, they were just people?

TS: Oh, medical students, nurses, business men, all sorts of people.

EB: Did they get paid? They must have; especially medical students.

TS: Yes, I think they got paid after the fact; and, of course, you could count on them usually because their blood had been checked before and they had no known diseases. I assume that the director of the blood bank and the technicians who ran the place were satisfied to the degree possible, in those days, that these were safe donors. But I can recall calling in people and often calling the same person a month later. So, that was a job I had at the end of my second year and through most of my third year; and as I recall the Air Force permitted it 'cause they were just paying me to be a medical student. Because the deal was you signed a contract, I still have a copy of it that you would pay back to the military one year of each year of education they gave you, plus the two years of draft or Barry Plan that every other doctor was doing. So, I knew when I left medical school that I would owe them four years, but peculiarly if you did your internship in a military hospital, that was a wash; you did not have to pay that back, that year you were serving in the military hospital. So, when I finished my internship in El Paso, when I got out of medical school, I knew I owed them four years; when I finished my internship in El Paso which was an Army hospital, I owed them four years. I could have gone on active duty at that point; I chose to go into a residency, we can talk about that a little bit later. So, that was the job I had in the end of my second year; started that, I think, shortly after I got back from my honeymoon.

EB: Where did you get married?

TS: Got married in New Rochelle. We got married in Holy Family Church, the church that Celia and I had gone to all through grade school and high school and college; the place where I had always sung in the choir, where I had been an altar boy. The priest that married us was the priest that married Celia's mother and father.

EB: Oh my.

TS: He was no longer in that parish, I've forgotten where he was; he was someplace else in the diocese. But they had always been friends, so he came and he married us; and had married Celia's mother and father in 1929, I guess.

EB: One of the things I remembered from my parochial school days was that the sisters were not permitted to go to the weddings, in those days [inaudible].

TS: I don't remember.

EB: You obviously had a lot of friends; she must have had a lot of friends.

TS: Oh, yeah, it was a big wedding.

EB: No, I meant in the order.

TS: No, I doubt that any of them came. As a matter of fact…

EB: I think that's a trend that's changed too.

TS: But the Ursuline order is semi-cloistered.

EB: Oh, it is?

TS: Yeah. The Ursuline order would teach and they ran universities and colleges and girls' schools, academies; but you never saw them publicly outside of the school.

EB: Really?

TS: Yeah, they called themselves semi-cloistered. That was the same order my sister went into for a few years. So, you didn't see them at social events; whereas the Dominicans were not that way and they would come to church socials and other things.

EB: They had been earlier on, except that the Dominicans are a teaching order as well.

TS: Oh yeah, they have their home in Newburgh.

EB: Oh, really?

TS: The home of this order was in Newburgh, New York.

EB: Oh, really? 'Cause I remember my early days with Sister Seraphine and Sister Dominga, they wouldn't eat in front of layman.

TS: Frequently not.

EB: They didn't do anything like go to the movies or that kind of thing.

TS: No, no.

EB: And that was the reason why so many people objected to the being in the confinement of it.

TS: It was pretty confining.

EB: They made a lot of changes during that, whatever it was…

TS: Second Vatican Two. Vatican Two.

EB: You mentioned the Flexner Report.

TS: So, anyway, I don't know who was at the wedding, except that's where it was, Holy Family Church, and the exact same place where we had gone to mass for years.

EB: You told me already who was your best man.

TS: My brother Vini.

EB: Vini.

TS: Of course he died several years later.

EB: Let me ask you about the Flexner Report, how familiar were you with that when you went into medical school?

TS: Oh, never heard of it.

EB: That's not something students ever heard about, that was strictly for the teaching…

TS: Right, I had never, never heard of it. I think I went back and read it when I came out here and George Smith hired me; or actually I was hired at Washoe Medical Center and I got involved with the medical school and George kept mentioning it and so I looked it up and read it. But, when I went to medical school, I knew nothing about it and I suspect most medical students don't.

EB: What did you think of it after you did read it? It's value to…

TS: Oh, it revolutionized the medical education, there's no question about that; that's not my judgment, that's hundreds of people's judgment. It essentially brought medicine out of the preceptor era and the era of blood-letting and leaches and all of that, into a modern scientific era; and he picked up, of course, on what was going on at Johns Hopkins. 'Cause Johns Hopkins was the first really modern, scientific medical school developed at the turn of the century; and so he picked up on that and he had graded schools A, B, C, and D, there's no such thing any longer. And simply came to the conclusion and made a recommendation, I think through the Carnegie Foundation; although I'm not sure of that, that I can look up. 'Cause there was also a rejection of what was considered then to be quacks and cults, chiropractic, osteopathic, homeopathy, all of that, Thomasonian medicine, a variety of herbals, there were herbalists around. All sorts of people who called themselves…

EB: Midwifery.

TS: Doctors, and so there was a lot of [cough] excuse me, reaction to all of that. So, his report essentially said 'You got to make it university-based and you got to have science and research along with teaching and patient care.'

EB: So, he's pretty much held up over the years as being a genius that he was to take on such a dramatic change.

TS: Yeah, and I'd have to go back look it up, I will look it up for you next time; but I think he was a university professor, he was not a physician, don't know what he was. I'll have to look it up. Anyway, he did that report and it changed American medical education, which then of course changed American medicine as we know it.

EB: Now the other thing, what were your rotations?

TS: Yes, as a junior.

EB: You started rotations in your junior year.

TS: Correct, when I get back from our honeymoon, we started right out. I think my first rotation…

EB: You mentioned psychiatry.

TS: Surgery, internal medicine, obstetrics, pediatrics. So, that took up most of the junior year with the standard one; medicine, surgery, pediatrics, OB, psychiatry and I think there was maybe public health and community medicine, something like that.

EB: And what about surgery, what did you think of that? What was it like? Did you get to do anything or did you just observe?

TS: No. No, I didn't like surgery and so much of deciding what you're going to do in your life is the two-way street; you're attracted to one thing and repelled from something else. The minute I went into surgery I said 'This is not for me.' Now, I don't know if it was because junior medical students, to me, were not well utilized. We stood and we used to call it 'holding the idiot stick' and so you'd stand at the end of the table, pulling on a retractor and some surgeon yelling at you 'Pull harder'; and there'd be assistants in between you and if you were lucky you'd might be able to see the tops of people's heads, that's an exaggeration, but you didn't really experience very much. And you had to get up and go in there at an ungodly hour. I always used to joke I hated getting out of bed at 5 o'clock getting a shower and getting out of my pajamas and then going to the hospital and getting out of my clothes and back into pajamas in the OR, standing around for hours. I, personally, didn't get any satisfaction out of it, but of course I'm not a surgeon and those who went into surgery loved it and there were some of my classmates who just loved nothing better than to trail around behind some of the well-known surgeons and be at all their operations. So, I think it's a matter of interest, it was a good surgical department, we learned a lot of good academic surgery, I'm not criticizing that; but as a lifestyle I knew fairly soon as a junior that was not for me. And I was going to be involved in medicine, somewhere; well, pediatrics is medicine for children and youngsters.

EB: You had a wonderful relationship with Voorhees.

TS: Right.

EB: So that might have…

TS: That influenced me. But there were others in that department, besides Celia had our first child Peter at that time and so we had a nice relationship with the chairman of obstetrics who delivered her; and one of the faculty members took care of Peter and he was very good and I liked the way he handled my child. So, that was another thing besides at the time I'm finishing up medical school, I'm getting feedback that I did well in pediatrics, I'm seeing my own child grow and reading Spock; Celia and I read Spock almost every night side-by-side which also was an assigned textbook for us at the time. Spock was very popular, just come out with his first edition in the late '40s, early '50s. Anyway, we had to read the whole thing; this is part of your textbook.

EB: Didn't you find it interesting the thing that just came out in the newspaper with Dr. Spock.

TS: Yeah, yeah.

EB: We all raised our children with Dr. Spock and his books, but he could have been reduced to being destitute.

TS: Well, if you read the whole thing though; he's got a fairly decent income and he's got a couple of homes and a boat and some other things.

EB: Oh, I didn't hear about that.

TS: Yeah, it was in the New York Times. Destitute? No, but he's not living the same apparent lifestyle.

EB: Well, I guess I must have read something that was just shock journalism. That's what I remember reading.

TS: And many people said they're not going to give him a thing, but anyway.

EB: What did you think of OB/GYN?

TS: I thought about that at the time. As a matter of fact, I remember being there when Peter was born. Dr. Nesbit who was the chairman of surgery delivered Celia; it was on a Sunday afternoon and I was there. Nothing like today, I wasn't standing there telling her to push, but standing in the background; and they never let fathers in those days. But as a medical student, they made an exception. So, I was allowed to stand practically at the door which is ludicrous; well, those were the rules of the hospital in those days. But then I got into my internship, and remember in those days it's important to note that almost all of us, I think everyone, there may have been an exception, took rotating internships. You weren't signing up for residencies like they are today; junior and senior students aren't being asked to make a career decision in their junior or senior year and choose something. Almost everybody in my class and the vast majority, there were a few what was called 'straight internships' being developed in those days; but virtually all medical students took a rotating internship some place, which meant there was another repetition of your third and fourth year, but more concentrated on patient care. So I, like most others, when I got to El Paso I took a rotating internship so I went on medicine and surgery and pediatrics and OB all over again. So, it was in my internship year that I then finally came to the decision after a lot of questions and I'll talk about Dick Janeway in a minute, decided to go into pediatrics. So, very few people, now, there were some medical students, in my school and others who said 'Oh, I'm gonna be a surgeon' but no matter what they decided what they were going to be almost everybody took the rotating internship. Because we had such little clinical experience; now, I've seen my own sons do it, struggling in their third and fourth year to decide what sort of residency, 'cause the internship has been done away with per say. In that way, I thought it was an advantage to have a rotating internship gave me, because I was very immature and young, gave me and others an extra year to make a decision. So, I did not decide on pediatrics in medical school.

EB: But would also extend the period of time that you were studying.

TS: Well, not really because most residencies in those days were not four, five, and six years long; they were two and three years long.

EB: Oh, okay. I see.

TS: So, the total education was probably similar to what it is now.

EB: So, it was about the same.

TS: Sure. Four years of college, four years of medical school, a one year internship for most everybody with some exceptions, and then you'd go into a residency. But pediatrics was only two years and then now, it's three; medicine was only two years and then now, it's three. Surgery was only four years and now it's five; so that in fact the year internship in there did not make it any longer, as a matter of fact it's longer now for most specialties.

EB: What about the so-called family practitioner?

TS: No, that didn't start 'til the '60s.

EB: Or GP's rather. What about them, they graduated from medical school.

TS: Right, most of them would graduate from medical school, do a one year rotating internship and go into practice.

EB: Go directly into practice.

TS: Or join the military.

EB: But they would have to go into the…

TS: Many of them would do an internship and then many of them would go into be drafted for two years or join the Barry Plan; there was a variety of things going on because the Korean War was now over, but the military still needed doctors. But some of my friends, including one of my roommates finished a one year rotating internship and went into practice; and had been practicing in that small town in upstate New York for the last 40 years, with a one year internship. And there's people in this community, I won't use their names, but numbers who came to Reno after a one year internship maybe some military time and had been practicing in Reno for 30 years. So, that was very common and they were called General Practitioners then. Then in the late '60s the family practice movement started and the American Board of Family Medicine started, and I think became an officially recognized board in 1969. So, for the last 20 some odd years, no, 30 years now; family medicine has had three year residencies like all the other specialties and students enter that, but it was different in those days. I, personally, liked the fact that I had a rotating internship, but I think part of it was I began to blossom and realize I wanted to be a doctor and would be a good physician in my third and fourth year for all the reasons I mentioned earlier, but I still didn't know where. I had no role models; Mary Voorhees was one, a woman in pediatrics, there were a few others, but I really didn't know where I wanted to go. So, I ended up graduating, I got the pediatric prize, I went to El Paso, I started the same thing all over again, went through a rotating internship and one of my earliest rotations was pediatrics. I met two very good Army pediatricians who were very good to me, I liked their practice, one of them took care of Peter when he was sick and it was maybe halfway through my internship year. So, it's coming up on January of 1959. I decided and said to Celia, 'I've made my decision; I'm going to look for a pediatric residency.' Then I started looking for residency, but there was no matching program; you just went and applied, got on the telephone, called around, did the best you could to sell yourself and others would call or write letters and that's how I got into pediatrics. That decision was not made until I was an intern.

EB: What about Janeway now.

TS: Well, Dick Janeway graduates from Penn the same year I graduate from Albany, and as I said, we've been at each other's wedding. So, I called him on the phone, it was around Christmas time, 'Happy Christmas, how are you?' 'How's your internship?' 'Good. How's yours?' 'Fine.' We had talked, 'What are you going to do?' he said 'Well, I'm going to the Air Force' He had done the same thing I did. He had been in the Air Force in order to get money, like me, he was going to go in and pay back his time and then postpone any decision. Well, I said 'Well, I've made a decision to go into pediatrics.' 'Oh, you want to come to Penn.' I said 'Why do I want to go to Penn?' he said, 'Well, we just voted or are voting for the outstanding teacher at the University of Pennsylvania for our class is Lew Barness. He's a professor and head of the department at the University of Pennsylvania and one of my classmates Frank Oski is going to be a resident with him and Frank's a very outstanding student.' Well, turned out that Frank Oski became one of the premiere pediatricians in the country, written 15 textbooks and just died, but he had been chairman of the department of pediatrics at Johns Hopkins University. But anyway, Dick Janeway said to me 'Call Lew Barness, I know he's looking for residents. He's a wonderful teacher; and you'd be back east near your mom and your family.' So, I got on the phone, picked up the phone and called and introduced myself over the phone, said who I was and that Dick Janeway was my roommate in school, we're friends. He said I ought to call you, he said 'Well, yeah, I'm still looking for residents for this July, send me a letter.' There was no formal application. 'Send me a letter with a little brief abbreviation of who you are and where you went.' So, it turns out that at the time Dick recommended me, as I said earlier, Dick Janeway had been a very close friend; I'll finish in a minute. So, he again entered my life at another point, making a recommendation was turned out to be a marvelous recommendation, we can talk about it later, so I called Lew Barness, I sent him a letter. Lew happened to have been a classmate of my professor of pediatrics at Albany who had given me the prize as the outstanding student. So, Lew called Paul Patterson the chairman in Albany, and Lew and Paul talked about Tom Scully and Paul said 'Gee, I'd like having him come back to Albany' and Lew said 'Fine' so he said 'Sure, I'll take him.' But it was all done by telephone, I think I eventually got a letter from him; but it wasn't this running around the country interviewing and a matching program and all that, it was a different thing. Now, there's also a problem with that; it was a hustle and it was who could sell themselves, and who knew who. And, of course, it was not as fair as it is today; now it's, I guess, a much fairer system. But we can go into that later and the next time around. But that's how I got into pediatrics and the way I ended up at the University of Pennsylvania for the next couple of years after El Paso was really at the suggestion of Dick Janeway.

EB: Okay, well, shall we stop?

TS: Yep, stop.

[End]