Transcript: Tape 7 Side A

DATE: March 31, 1998
TAPE: Tape 7
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: Okay, now we're on.

Eileen Barker: Okay, today is the 31st.

TS: Of March.

EB: Dr. Scully, we were talking yesterday about your trip to El Paso. You had graduated and you went to El Paso, which was Army, you said; but you were Air Force.

TS: Right, William Beaumont Army Hospital. I was in the Air Force medical student program. I think everybody did, match with the military, but since the Air Force had no hospital teaching programs at the time, they did a few years later, they sent those of us who were in the Air Force to Army hospitals. So anyway, I and a bunch of others got assigned to William Beaumont Army Hospital, someone to Walter Reed, someone to Fitzsimmons, someone to the Presidio. And we were in with about, I don't know, maybe five or six Air Force and maybe 15 or 20 Army interns; we were the interns of that year. All of the residents at the hospital, and they did have residencies in medicine and surgery and OB and some of those, almost all of them were Army officers who were doing their residencies and of course the staff, the full-time staff were all Army officers. So I arrived and got started shortly after I arrived. Celia stayed in New Rochelle with Peter I think for a couple of weeks and then she flew out subsequently and that's when we first realized, or I guess she did, maybe I had some recollection from my college experience, how big America was. Well, first we had to look up on a map where the hell El Paso was, we had no idea and we had no idea how long it'd take to get there. But in those days it was propeller planes, so you flew from La Guardia, I think down to Atlanta, Atlanta to Dallas and in those days, people would remember, you flew into Dallas, you took on passengers then you'd puddle-jump across to Fort Worth, because Dallas and Fort Worth were fighting over transportation. So it was the most ludicrous thing, you'd fly in on American Airlines to Dallas, stay there for I don't know how long, and then fly maybe five minutes up in the air and down to Fort Worth and of course now the Dallas-Fort Worth Airport was a political decision to put it halfway between the two cities to solve that problem.

EB: And it's huge.

TS: Yeah. Anyway, it took forever to get there and I remember picking her up at the airport, she must have left New York in the morning; she got there in the evening and was exhausted with a nine-month old baby and she was already pregnant with Chris, what, four, five months pregnant? And I had already started my internship. I had rented a house, I had bought a car, I'd gone to Sears and bought all the appliances; ‘cause there, an unfurnished house was literally unfurnished, except for the kitchen sink and the toilet.

EB: You didn't live on base?

TS: No, no, did not and we weren't required to. If you were single, you could get into one of the barracks; many of the physicians lived on the economy. So, I rented a house and had it all fixed up by the time Celia got there. We had shipped out the few things we'd had in Albany, bed, the dresser, a small little table, a few things that we had and that was it. Then the next twelve months was essentially rotating through all the standard rotations.

EB: Good medicine there?

TS: Very good medicine. The medical department was excellent, pediatrics was excellent. As a matter of fact, there were three or four excellent military pediatricians who ran the teaching program. The Army had good faculty and several of them were in for their two- or three- or four-year Barry Plan after their residency. So, they were fresh out of residencies, they were very bright. They weren't making the Army a career, they'd just been stationed there like I was to be later. One of them wanted me to go and do a residency in St. Louis where he had done his, another wanted me to go back to New York to Bellevue where he had done his. Actually, Dick Janeway gets into the act again; I think I may have told you this on a previous tape. But to be clear about it, what now medical students do in their senior year, trying to decide where they're going to go for a residency, we were doing as interns, ‘cause everybody was a rotating intern as we said. About the time of Chris' birth in October of that year, I had to start looking what I was going to do the following year. I would have had the choice, like any other medical student alumnus, to either go into the military as a General Medical Office, GMO, they used to call you in a clinic and pay back my time as Dick Janeway did, he was also in the Air Force program, and then get out and do my training after my obligatory payback. I decided that I wanted to get training first and then go and do my payback. So, I started looking around for residencies. I had pretty well decided because of my experience at Albany, as well as one of my first rotations actually in El Paso was on pediatrics. And I was on pediatrics when Peter got, what probably turned out to be roseola. He had 105° fever, he was in the hospital overnight, he was sicker than a pig at the age of nine months and frightened Celia and I; it was the first time he had ever been ill. But I was very impressed with how sensitive the two pediatricians, Claude Ballenger was one and Ted Capp was the other, who cared for Peter reassured us of course. So, I think that influenced me even further, I wanted to go into pediatrics. So, I remember talking to them about it, they both said they'd write me letters, which they did. I was a good intern and I was good in pediatrics particularly; I had done well in medical school, I really got along well with everybody and all the children. So, I remember talking to Dick on the phone and Dick was interning at Penn where he had graduated and he said ‘Well, if you're interested in pediatrics you couldn't go any better place than here at the University of Pennsylvania. Lew Barness is the chairman of the department. At our graduation in June we voted him the outstanding teacher, he's just fabulous.' I said ‘Fine.' I got on the phone, there was no applications in those days it wasn't like it is now, I just got on the phone. I called Dr. Patterson at Albany and said, ‘I've decided to go into pediatrics a roommate of mine from college who just graduated at Penn said that Penn would be a wonderful place to go.' What did he think? And he said, ‘Oh, I know Lew very well and I'll give him a call on the phone ‘cause Lew and I' this is Dr. Patterson speaking, the chairman at Albany ‘Lew and I had been residents together in Harvard. So I'll call him on the phone.' So, he called him on the phone, I called Dr. Barness on the phone and he said ‘Yeah, I've gotten some letters about you and I've talked to Dr. Patterson and we'd be happy to have you come to Penn and be one of our residents.' Well, the first time he said ‘I don't have any more slots. I've promised all of my four first-year pediatric slots, but since you'd be coming under an Air Force sponsored program and it wouldn't cost me' Dr. Barness, ‘any money. I'll just put a fifth person in and it'll help us make it a better residency out of it.' So, I then decided to just duplicate again what I had done in medical school; sign up for the Air Force residency program, go to Penn, get paid again for two years I was going to be there and get my training there. So, Dick Janeway was very helpful again in pointing me in that direction.

EB: Now what year were you to go to Penn?

TS: Well, I graduated medical school in '58. So, that would be in '59, the following year.

EB: Okay, so there was only one year in El Paso.

TS: Yes, the internship was a one-year internship.

EB: And how much did you owe the Air Force?

TS: When I got out of medical school I owed them four, but they said that if you did your internship in a military hospital that would be a wash, you wouldn't owe for that. If you did a residency in an Air Force or Army hospital you wouldn't owe for that, but if you did it in a civilian hospital then you would owe an additional year for a year. So, I was looking at four years for my medical school, nothing for internship, two more years for my residency. So, I knew that when I finished my residency at Penn, I'd have a six-year obligation. As it turned out, down the line, they let me out at the end of five years ‘cause they had more doctors than they needed then and they also said that the four years for two years of medical school was too much and so they cut one year off. So, actually I ended up getting five years of education and I paid them back five years. So it was a year for a year and I have absolutely no regrets and as I said yesterday, my kids and others have decided to borrow money, I borrowed time. But the internship was a very good year. And it was in El Paso that Celia and I decided that eventually, we didn't know exactly what our future would be, but eventually we'd end up on the West Coast or in the Southwest. We loved the desert and there was no particular reason to go back East, other than family, but family leave and die and all that sort of thing.

EB: So you had everything there at Beaumont.

TS: Yes, it was a very good hospital I thought.

EB: You said there were civilian employees and dependents?

TS: Yes, right. They had a fair number of retired people. Like many southwestern communities, military frequently will retire around an air base ‘cause they can use the commissary, they can go to the hospital and all that. So, a lot of the patients that I saw were either retired from the Second World War and/or dependents, a lot of children and a lot of wives. [Clears throat] Excuse me. There were very few active women military at the time, so most of the dependents were women rather than men. Now that's changed too. Good training, I saw some interesting diseases, it's the only place I ever saw a coccidioidomycosis, which is called Valley Fever, San Joaquin or desert fever, it's very prominent there. As a matter of fact, most people who go to the southwest after one good dust storm there, they're convert there, their skin test will convert ‘cause they inhaled the spores, but that doesn't mean they get sick with it.

EB: Was it one case?

TS: Oh, I saw lots of cases.

EB: You saw lots.

TS: Oh gosh yeah, had a whole ward filled with, particularly black soldiers and Filipino soldiers were particularly susceptible to systemic or pulmonary disease, less so of white soldiers.

EB: Was that something that's been born out?

TS: Oh yeah, sure. I think there's evidence for that, yeah. But I'm not an expert on it, but I saw that. I saw a kid with meningitis, I also saw the only rattlesnake bite I ever saw.

EB: Oh really?

TS: Sat up all night long with a young guy who had gotten bitten by a rattlesnake. I didn't know much about it, but the surgeons took care of him when I was on surgery. So, I saw a rattlesnake, I saw a couple of other very unusual diseases, acute intermittent porphyria was a very rare disease and saw a case of that when a woman came in from an outlying base clinic where she had apparently been upset for some reason or another and she had been given some, I guess, phenobarbital or some other sedatives. I've forgotten the exact [inaudible], but that sort of triggered this condition which is very complicated. I saw all sorts of garden variety things, I delivered babies of course, took care of a lot of sick kids with mostly ear infections that's when I learned how to look at an ear. Dr. Capp and Dr. Ballenger were very good teachers. So, anyway it was pretty much a year of…

EB: Of standard medicine.

TS: Celia taking care of one baby and having another.

EB: Anything unusual about the social conditions there?

TS: No, it was right on the border with Juarez. So it was sort of the first time that we had ever visited Mexico; we went over a couple of times and had dinner. Because Celia spoke Spanish, her mother was born in Morocco, raised in Spain, Celia was quite good with Spanish. So we were able to get a Spanish maid who would come in one day a week and clean the house and some of the other neighbors when they would have trouble communicating with the Mexican maid, Celia would go over and talk to them to see if they could figure out what was going on. One thing that was interesting was that, I don't know if it's a problem, but many Mexican women would go into labor in Juarez and walk across the bridge, walk around downtown in downtown El Paso go to the Hotel Dieu, which is named after the Hotel Dieu in Paris and the one in Montreal, I guess it is.

EB: D-E-U-X?

TS: D-I-E-U. Hotel Dieu.

EB: Oh, for God?

TS: Yeah, uh-huh. And there was one of those in El Paso and so a lot of these women would come over and wander around and go into labor and go into the hospital and deliver their baby and they then had an American citizen. Now, their child was an American citizen which, I guess under the law then I don't know what it is now, 18 years later they could come across. Many, many, many, many Mexicans from Juarez, men and women came across that bridge every day of the week working as laborers, working as cleaning people in hospitals and working as domestics.

EB: So, it was an open door policy.

TS: Oh it was, sure. Oh absolutely, and they'd go home every night.

EB: It must have been a nightmare for the doctors there to have to deliver a baby with no history, no pre-natal…

TS: Never happened to me, ‘cause they didn't come to the base.

EB: They didn't come to the base. Did you do anything in the civilian hospitals?

TS: No, not a thing. We had nothing to do with them.

EB: Any relationship?

TS: No.

EB: Staff meetings?

TS: No, not a staff meeting that I can recall. Now, there may have been some association at the upper echelon level between the attendings, but certainly nothing that I recall. But heck, when you're an intern you work and don't go to bed and hopefully you can talk to your wife or husband for an hour or two every third night. So, there wasn't much of that.

EB: So this was the 24-on, 24-off system still?

TS: Well, no, I think it was a little bit better than that. I think we were on every third night and of course, like every other house officer program, on some services you'd seldom get called. So you'd sleep the whole night in the hospital, but you'd sleep and others you might be up all night long if there was an auto accident on the base, you're up all night long on surgery. But in pediatrics you might have slept that night; there were always deliveries, you never slept in OB. But if you're on psychiatry for example, or maybe even internal medicine, there'd be times when there wasn't much going on. You'd make your rounds in the evening and nine or 10 o' clock with the resident, ‘cause there were always residents there too. You'd go to bed and you'd sleep through the night and say ‘Gosh, I was lucky. I wake up at six o' clock and shave and shower and go to work.'

EB: What's your philosophy on this situation that occurred in New York a couple of years ago, one of the patients died because the resident had been up.

TS: Allegedly that was what happened, that a mistake was made.

EB: Supposedly, yeah. But what came out to the lay people was ‘I did it when I was in medical school and they can do it.'

TS: But to me that's nonsense; that's like fraternity hazing. It's nonsense, it's crazy. As a matter of fact, New York passed a law, it's administered by the Board of Health or the Board of Medical Examiners…

EB: Recently?

TS: Oh yes, oh sure. There was a big article in the New York Times just recently and several hospitals have been audited and found that they weren't complying and were going to be fined. And the law is no more than 36 hours straight without having 24 hours off to sleep something to that effect, I don't know the exact terms of that. Now, yes, there are some older physicians who said ‘Well, I did it.' I don't buy that and the reason I don't buy that Eileen is the following: 40 years ago when I was an intern or a resident, and we talked about it earlier, there was very little that I really did that altered much of the outcome. Sure we gave IV's, and we gave blood transfusions, we gave antibiotics, but there was none of the sophistication that we have today. There weren't pace-makers, there was no intubation, there weren't people on ventilators, there were no ventilators at that point, they were being used in the OR. So as an intern I never intubated anybody, there was no ICU, I should say with the exception of anesthesia. What I'm trying to say is that all of the high-tech that takes up the interns and residents time hour by hour by hour. Blood gasses, we didn't do blood gasses, there was no such thing, there were nobody on ventilators, there was nobody on a pace-maker, there was nobody with the cardiac monitoring and there was no resuscitation, there was no defibrillation. All of that stuff was being developed experimentally, but it wasn't a part of the practical life of an intern or a resident. So, what I'm saying is that the intern and resident today who's working 24 to 36 hours straight is dealing with lots of sick people and decisions using a lot of high-technology that they need to be attuned to. All we would do when I was an intern, except in surgery as you pointed out, or a resident was very little intervention, you'd make your rounds, sure and you'd write orders and you might change the IV's; but we weren't hovering over or being called to ICU's and emergency rooms and sticking in chest tubes and all of that sort of stuff. So, I think for my generation to say ‘when I was an intern I did this, there's no reason they can't.' I think it's two entirely separate worlds of medicine and I think the younger people like my sons and son-in-law when they were house officers and the ones that are now house officers were under a much greater stress to perform are more accidents could occur and more mistakes could be made and I think it was different world and I don't think that being up 24-36 hours was fatiguing I'm not saying that, but I don't think we were put in the same position that kids are today, I think it's much more stressful. So, I don't buy the argument that ‘I did it.' I buy the argument that ‘Yes, there's a certain amount of things you must see.' One of the arguments is you got to see a lot in order to learn medicine, but I think there's also the counter-argument that if you're spending long hours and what you're hearing is going in one ear and out the other, it doesn't register and you're so tired you can't process this and in fact the patient is at risk from your mistakes or ignorance then we should control that. So, that's my argument, I think there needs to be reasonable limits and New York and some other states have already begun, but there have been a lot of controversy about it. And I, frankly, don't know what actually happened with the girl at Cornell; but certainly putting limits on sleep-deprivation and fatigue and over-work, I think, makes sense. And, frankly, I think the same for doctors in practice, I'm sure your patients always come first, but to practice medicine to the detriment to all the rest of your life, all aspects of your life, your family and friends and all the rest, I think, in the long run is detrimental.

EB: That's the way it's set up.

TS: Yeah.

EB: It's still set up this way.

TS: Yeah to a certain degree.

EB: For the beginning for medical students and residents and interns. So, in El Paso, was there a great deal of poverty? Of course, you were isolated.

TS: Yeah, I didn't take care of one civilian. So, my only remembrance of that was the large number of Hispanics coming across and you'd see them working in the fields and they'd be janitors in the hospital and you'd see going home in the afternoon or the morning you'd see a lot of maids getting off busses and walking into the suburbs to be housemaids or baby-sitters or whatever. But medically, no, everybody was employed, they were all military.

EB: You did take care of civilian employees of the base?

TS: That's a good question.

EB: They would have had a salary…

TS: I don't think so, I think if they were civilian they had to go and get their own medical care.

EB: Oh, they didn't get medical care at the base.

TS: I don't think they did. No, they didn't.

EB: So you were there a year.

TS: Full year, left the following June.

EB: And by then you had pretty much declared then in pediatrics.

TS: Well by January or February of that year I knew we were going to the University of Pennsylvania in Philadelphia because of several influences Dick Janeway and my professor at Albany saying it's a good place to go and also we were from New York, I had a brother living in Philadelphia and I had other brothers and sisters living in the New York area. So, in that sense it was sort of like going home although as a place to live we obviously preferred El Paso, but I wanted to get a good, as best I could, pediatric training and the University of Pennsylvania and the Children's Hospital in Philadelphia were certainly as good as any in the country.

EB: You were happy with your choice, but did you ever think that you should have done military residency?

TS: No, I guess I could have.

EB: At that point you could've cut your time down a little.

TS: Oh, I see what you're saying. No, I wasn't worried about the time.

EB: You weren't?

TS: Nah, didn't bother me at all. I mean we figured what the heck? You make a decent salary.

EB: You were making fairly adequate money?

TS: Yeah. I was making a lieutenant's salary, whatever that was. I was doing my income tax the other day, I went back and looked at the income that Celia and I paid in ‘57 or ‘58 whenever that was after we got married; it was only a couple thousand dollars a year whatever a lieutenant was making, I could look it up.

EB: You had the advantage of the commissary and the PX.

TS: Right, you could do that.

EB: And your entertainment was on the base too, wasn't it? Movies, things like that?

TS: It was at that time. In Philadelphia it wasn't, we had to go to the Naval Hospital, it was the closest, and the rule there was that you had to go to the closest military establishment for your medical care. I was a resident at the University of Pennsylvania, but Celia and I and my children, we're military, went to the Naval Hospital. As a matter of fact our third child, Geary, was born at the Philadelphia Naval Hospital in the summer of 1960, we were half way through my residency. So, I guess in a true emergency I could have taken Celia to the closest hospital and delivered her. But we were about equidistance from where we lived in a little town of Secane; which is a suburb west of Philadelphia out towards Swarthmore and that area. We were about equidistance to downtown Philadelphia and the Philadelphia Naval Yard which was down on the southern portion of the Delaware River, south portion of Philly. So, when Celia went into labor I took her there and that's where Geary was born. So we were still military, I didn't wear my uniform, but I got a check every month and Lew Barness didn't pay me a nickel, the University of Pennsylvania didn't give me anything.

EB: Now, the University of Pennsylvania was a teaching hospital?

TS: Oh, yes. It's called the Hospital of the University of Pennsylvania. It's a big teaching hospital, has been for years, major teaching hospital for the University. I think what I told you yesterday, Albany, we had about 60 in our class; I think Penn at that time was probably graduating, I'm guessing, about 100 medical students a year. And they had residencies in everything including all the subspecialties, there was nothing at the time that they didn't have.

EB: Did you subspecialize in pediatrics?

TS: No, I did my two years and finished and went into the service. Well, went on active duty, if you will, and I was on active duty but went in to pay back my time. But when I got to Penn, there were four second-year residents in pediatrics and then five of us in the first-year. And there, of course, a significant portion of the population there was black from central and western Philadelphia would come there for their care.

EB: Was that the inner city?

TS: Yeah, it's right on the edge. You're right on the Schuylkill River, large population at the time; but also a significant percentage of patients who had insurance and paying patients and a fair amount of referral. As a referral center there would be pediatricians in all of the suburbs, some who of course, used to help us, would send more difficult patients down to the University of Pennsylvania for the consultants there in the department. So the rarer diseases, the more complicated problems, that sort of thing. So, I think we're finished with El Paso, and, yeah, we headed out to Philly; reversed our steps and flew back.

EB: As regards to El Paso, how did the Army people treat the Air Force people?

TS: Oh, we were treated very nice.

EB: You didn't have any…

TS: Oh, absolutely none. They didn't care, I mean it made no difference; we all had a tan or brown khaki uniforms on with bars and you were all wearing white coats…

EB: No resentment.

TS: No, absolutely not.

EB: Because there were no Air Force…

TS: The first Air Force training program, as I recall, opened at Lackland in San Antonio, I think two years later. I think it was 1960 and I eventually went back to Lackland in ‘64 when I came back from Spain and I was a part of that teaching program, but at the time they had no Air Force teaching programs. They were building them or getting ready for them and the first one to open, as I recall, was Lackland in San Antonio in 1960, two years after I'd gone to El Paso.

EB: So, now you're at Penn State.

TS: Penn, not Penn State.

EB: Not Penn State?

TS: University of Pennsylvania.

EB: Oh, I see.

TS: Penn State's in Hershey, in the middle of the state. This is in Philadelphia, University of Pennsylvania. So, we're there, we're at a hospital. I find, actually through the help of my sister-in-law, who's in real estate, we find a little house in the town of Secane and one reason we did it. It was no more than a stone's throw from here to Plumb Lane from the railroad station, the little commuter train. So, I could get out of bed, dress as fast as I could, run down the street and the train stopped there and I'd get on the commuter train take it to the 30th Street Station and either walk five or six blocks across to the hospital or on a bad day catch a bus across town; so I could get back and forth pretty quickly. Lot of times when the weather was bad I just drove my car, but that would leave Celia isolated with two babies and pretty soon she was pregnant with a third child. So anyway, we got this little house, we settled in Secane, Celia now has two babies; Peter is a year and a half, Chris is six months, we're there and she's making some friends in the neighborhood, my brother and sister-in-law who were good to us and helped us get settled, they had a couple of older kids.

EB: What was your brother doing there?

TS: He lived there and worked, at the time I think he might have been working for Union Carbide or he might have been working for some other company that he had settled in Philadelphia. He was a travelling salesman like my father had been. So, that also was usually on every third night, every third weekend, pretty standard pediatric training. You'd spend so many months on the ward taking care of the in-patients, sick kids. You'd spend so many months in the clinic seeing the walk-ins and they would encourage us to schedule families that we got to know, so we would get some continuity of care and then there would be specialty clinics they'd send you to, so you'd go to the allergy clinic or you'd go to the dermatology clinic, or you'd spend some time in radiology or some time in pathology or in the lab or…

EB: You would do this as a pediatrician.

TS: As a pediatric resident. Yeah.

EB: Did you do T&A's?

TS: Nope, didn't do any surgery. No surgery.

EB: No surgery? They would be referred to the surgeons.

TS: Yeah, the ENT residents.

EB: I see.

TS: ‘Cause at that place they had ophthalmology residence for eyes and they had ENT residents. That was the era in the early ‘60s specialization had been in medicine for years at that point; but sub-specialization was coming in and so now the body [chuckles] was sort of getting divided up into every organ and every tissue, so yes you referred.

EB: Pretty high-tech hospital.

TS: Yes, it was. It was.

EB: More so than Albany?

TS: At that time I would say yes, it was and fewer attending physicians who came from the local community. Matter of fact, one of the problems in big cities in those days, even now, around the big university hospitals there were very few private practicing physicians. Most of them had moved to the suburbs and the only medicine that many of those communities could get was at the local university medical center. I remember in Philadelphia there was Penn, Temple, Hahnemann and Jefferson there were four major medical schools with big university hospitals in various parts of that city and so many of the inner-city, heavily black but also in Germantown Germen and other ethnic groups, would get their medical care in the clinics of those big hospitals. And the private practitioners, many of them were out in the suburbs, I don't remember many private pediatricians that came to Penn from Philadelphia proper. Yes, we had them out in Springfield and Swarthmore and various places, matter of fact I went to Bryn Mawr, the famous women's college. I went to Bryn Mawr in my senior year and spent a month at the Bryn Mawr hospital with a couple of pediatricians [inaudible]; as a matter of fact I can remember sitting and listening to John Kennedy's inaugural address of ‘ask not what you can do' while on call at the Bryn Mawr hospital for pediatrics. So, we did spend a few months out of those two years in private pediatricians' offices and community hospitals outside the city limits just to sort of see what pediatrics was like. But most of it was spent either at the University Hospital or downtown at the children's hospital, the old Philadelphia children's hospital which no longer exists. Now the new, modern, multimillion dollar children's hospital is right attached to the University of Pennsylvania. There was also, right next door, one of the largest county hospitals in the world, the Philadelphia General Hospital, I don't know how many thousands of beds where most of the indigents of Philadelphia would go and we would also go over there and take care of patients. That's where I saw some of the sickest patients I ever saw, simply because they would come in late in their disease.

EB: You mean infants?

TS: I was taking care of children and I can remember doing a spinal tap in a hallway and starting a child on antibiotics for meningitis because the place was filled with no beds and so we were taking care of patients in the hallway. That eventually was closed, I don't know the reason the Philadelphia General Hospital closed, but it was closed and eventually torn down, they also had a big VA hospital. It was an enormous complex of hospitals there. Actually, the university hospital was right across the street from Franklin Field, the famous big football stadium. So, it was a hospital university on a campus, but surrounded with a VA hospital and a county hospital which is now gone and some other. So, it was a very good training program, it was excellent. We got to see lots of interesting patients and excellent teaching; Lew Barness was an marvelous role model, still is. He's retired, I guess, still teaching part-time in Florida.

EB: Pediatric cancer patients?

TS: Yeah, sure. Everything you could think of. Now, obviously when there were surgical problems, you'd call in the surgeon and at the time actually Everett Koop was the chief of surgery at the Children's Hospital.

EB: Did you know him?

TS: No, I mean I didn't know him.

EB: I mean did you meet him?

TS: I met him of course and listened to his lectures and I think I went to a couple of surgeries where he operated. But he was then doing a lot of the early surgery of children with all sorts of disabilities, they were beginning to operate on little, tiny infants. I mean that was really forefront surgery in those days, 1960. He subsequently left of course and became the Surgeon General, but he was the chief of pediatric surgery there. There were some wonderful teachers, so I made a good decision to go to Penn and I can't think of anything unique that took place there other than some interesting medical problems and that Celia had our third child, Geary. He was born at the Naval Hospital, he was premature he was almost two months early, he was three pounds. Now he's 6'2'' and played football…

EB: Where did she deliver?

TS: Started to deliver in the parking lot and delivered in the hallway at the Philadelphia Naval Hospital and I delivered him.

EB: You did?

TS: Yeah, I delivered him. I got her out of the car because when we left home she was in labor, I had examined her at home and I said ‘Oh, you're going to have this baby.' Well, it's not due for six or eight more weeks. So, fortunately my sister Evangeline, who keeps coming back into my life, she was the one who gave me the kidney. She was visiting, she was on a home visit from one of her teaching assignments in Indonesia or wherever she had been, she had been overseas for years. So, she happened to be visiting us and so I said ‘Well, I'm taking her to the hospital, we'll have this baby in another hour; you take care of the other two.' So, we got to the parking lot, I yelled at somebody ‘bring a gurney' and we got my wife onto a gurney moved her into the hallway and she delivered.

EB: Normal delivery.

TS: Oh yeah, but he was only a three pounder.

EB: Any problems?

TS: Oh yeah, he had all sorts of problems. He spent a month there.

EB: Oh, he did?

TS: Sure and had several exchange transfusions, had severe respiratory distress syndrome and for a while there we weren't sure if he was going to live, but he did and spent a month there. But in those days, babies much under three pounds didn't survive, I think he was maybe three and a half pounds so he was on the cusp.

EB: That was a good military hospital.

TS: Yeah, that was the Philadelphia Naval Hospital and they had a pediatric residency and they also had very good physicians there.

EB: Did you like Philadelphia?

TS: Yeah, we did. But again without any help, we couldn't afford any help and Celia having three babies there wasn't much you could do. Occasionally we'd get a babysitter, occasionally we'd get to a movie, but I think we maybe only saw a couple of movies and I think we got out to dinner a couple of times. There was a nice restaurant in the next town over called The Lamb's Tavern and we'd go there. Celia was able to find a lady who would babysit occasionally, but three little kids and a resident and no money, we had a little wage. As a matter of fact the last week before my residency was over and we were due to go to Spain, I think we wandered all around ‘cause the kids were a little older then. Peter was now probably going on four, three and a half, Chris was going on two and a half, Geary was now one and a half. So, I think, we put them all in a car and we wandered around, saw the Liberty Bell and Independence Hall and did the tourist thing. There was very little that one could do as I recall except work.

EB: Well, now you were a resident so you had interns that you were responsible for. What were they like?

TS: And students. Oh they were very good, they were excellent and the students were very good at University of Pennsylvania. But there again a lot of their education fell to the faculty, but what we as residents would do was sort of provide them the practical experience as residents had done for us when we were students. Teach them how to start an IV, teach them how to do a spinal tap, teach them how to draw blood or teach them how to do a bone marrow exam or something you know. Whatever the procedures were, teach them how to examine a patient.

EB: These would have been pretty top students to get that assignment. That was a choice assignment, wasn't it?

TS: You mean to be admitted to the University of Pennsylvania?

EB: Yeah.

TS: Yeah, they were all very bright people.

EB: So, did you see anything lacking in any specific area that they came from.

TS: No, but I suspect…

EB: I'm thinking of your future medical education.

TS: No, not unlike what we said yesterday. There are students who like pediatrics and so you, as a resident, would respond to them and they'd be eager and they'd stand around and they wanted to learn more. And the others who were interested in surgery wanted to get out as fast as they could and go watch some surgery. So, it was like everything else. The ones who enjoyed it, were interested, would give you as a teacher or a resident a lot of feedback and they'd be very grateful and so you'd say ‘Sure, do some more.' And the ones who seemed not interested, had nothing to do with how bright they were or how talented, they just wanted to do something else. But American medical education was everybody goes through all of these hoops and unless you do, you don't really know what medicine has to offer as a profession and you don't know what patients have as problems. So, I still support every medical student ought to go through all aspects of it to see what's going on; but to expect an equal degree of enthusiasm or an equal degree of energy from each student in each rotation is silly. It just won't happen, never will happen.

EB: So, we're two years later now. [TS: Yeah] We're leaving Philadelphia.

TS: And one cute story I'll tell you, ‘cause it did have an impact later. After my first year there, now remember I'm there on a sponsored Air Force residency. So I'm getting my check every month from the Air Force. And Lew Barness, as my professor, had to send a report to the central office, which at that time was in Wright-Patterson Air Force Base in Ohio, that's where the residency program was administered from. So he sent back the evaluation that 'Dr. Scully was an average resident doing fine, satisfactory, we're pleased to have him.' And he gets back a letter a few weeks later saying that ‘If Dr. Scully is doing as poorly as your evaluation suggests, he may not be extended for his second year. We may have to terminate his residency.' So, Lew Barness got on the phone, he told me the story and wrote a letter, got on the phone and said ‘I don't know what you're talking about, I gave him an average.' ‘Yes, but in the Air Force, ‘average' was just not very good, he wasn't performing.' And I learned out later and how the military rates people and they have all of these scales. So, he said ‘Well, no. We want to keep him. Yes, he's as good as any other resident, is he outstanding? No.' And so whoever the captain or colonel or whoever it was on the end of the line said ‘Okay, we'll send you a new evaluation.'

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