Friday, February 26, 2010

Centenarian's reflection on a life in medicine

I had the pleasure to speak on the phone this morning with David Gale Duncan, M.D., who celebrated his 100th birthday on February 1. Dr. Duncan was kind enough to answer some of my questions about his life and career.

Duncan was born in Litchville, N.D., in 1910. His father owned a grain elevator, one of five in the small town. His mother kept house and raised Duncan and his older brother. Diagnosed with breast cancer, Duncan's mother underwent surgery (performed by a young doctor from the Mayo Clinic) before dying at the age of 42 in 1918.

In 1928, Duncan graduated from high school in Lamberton, MN, and enrolled at the University of Minnesota in the pre-dental program. He was able to pay his way through college in the Depression years by waiting tables at a fraternity and serving as a driver for a wealthy woman in south Minneapolis. He switched out of the dental program, partly because of the high cost of the required tools, and joined the pre-med program. He transferred to Creighton University to finish out his program, largely because they had fewer students and fewer required classes, and then entered the medical school there.

Graduating from Creighton in 1936, Duncan came to Portland on the advice of his cousin. She knew the president of Emanuel Hospital and was able to facilitate Duncan's acceptance to the internship program there. Duncan was one of seven interns that year; at the end of the program in 1937, none of them were immediately able to find work as physicians in Portland. Duncan remembers that three of his fellow interns went out to the hospital in Pendleton. Duncan chose to join the Civilian Conservation Corps, moving around from Bonneville to Woahink Lake and back to Portland.

Duncan was then hired on by Union Pacific to serve as railroad physician in the busy hub of Huntington, OR. He remembers being told that he needed to treat a narcotics addict and a drunkard, and to get out there and set up an office. The only space available at first was a mobile home; after four or five months he was able to move his quarters and his practice into the town's hotel. His brother came out from Omaha, NE, to visit and, since he himself had entered medical school at Creighton, Duncan had him assist on some tonsillectomies. (Tragically, his brother was killed in a car accident in his senior year in medical school.)

In 1939, Duncan was recruited by Dr. Thurston to come out to Council, ID, to join a busy practice. Duncan got his friend, Dr. Gillespie, to take over the Huntington practice and moved off to Council with his new wife Miriam in tow. Their first son was born in Council in October of 1940, in the house that Dr. Thurston had built for the family ("He was very eager to get us!").

The partners maintained three offices in three area towns and maintained their own hospital. The practice was very busy, and Duncan learned a lot. But when the first call came out for military service in the run-up to World War II, Duncan--who had come out of Creighton with a commission as captain in the U.S. Army--was one of the first to go. He was assigned to the 41st Infantry Division out of Fort Lewis, and was there when the attack came on Pearl Harbor in December 1941. He was sent out to the coast to watch for Japanese planes and then was ordered overseas to serve in New Caledonia. There, he had responsibility for 100 soldiers, but "didn't do much medicine" beyond the daily sick call. He was then moved to Guadalcanal, where he served for 6-8 months as chief of a 50-bed ward. Another move took him to a hospital 60 miles north of Manila, where he assisted a neurosurgeon. Duncan doesn't remember that neurosurgeon's name, but thinks that he was the one who got Duncan sent home before the end of the war. Duncan had stopped eating anything but canned fruit, and had dropped to 120 lbs before his arrival back in the States at St. Charles, LA, in 1945.

After about a month, Duncan returned to Portland, where Miriam had purchased a house in the northeast part of the city. Looking for work, Duncan connected with Bernard Brown, M.D.; the two had gotten to know each other during Duncan's internship at Emanuel. Brown had recently suffered a heart attack, and was eager to turn his practice--and his home--over to Duncan. From 1946 to 1989, Duncan practiced general medicine in the Alberta neighborhood, seeing enough patients to do "real well"--despite the fact that he often accepted payments in kind or waived fees for his low-income patients. He delivered a lot of babies (especially in the postwar period) and had admitting privileges at Emanuel, Vanport City, Holladay Park, and Woodland Park hospitals.

He kept up in medicine by spending time with his Emanuel colleagues and participating in activities of the Oregon Medical Association (of which he has been a member since 1936). He never had much use for the medical school, but he never saw it as a competitor either--there always seemed to be plenty of people who needed a doctor.

Looking back over his career, he thinks the biggest change has been that most people used to have "their own doctor"--a general practitioner who would look after them throughout their lives. Now, fewer patients have that continuity, and Duncan sees this as a change for the worse. "Too many young people don't take care of themselves" these days, and without preventive medicine and regular checkups, obesity and other health problems have soared. He's very concerned about the present state of health care in America, but he doesn't have any answers. He's leaving it to a younger generation to work out a solution to this current crisis.

Thursday, February 25, 2010

Brooke Drug Co., Importers of Perfumes

Looking for a faculty photo in the Historical Image Collection, I flipped past this turn-of-the-century shot of University of Oregon Medical School graduate Francis Wesley Brooke, M.D., outside his pharmacy. Typed onto a card pasted to the back of the photo is this information:
Dr. F.W. Brooke standing in front of his combination drug store at 67 No. 3rd Street, Portland, Oreg. about 1902. Dr. F.W. Brooke, graduate of Oregon Medical School started practicing medicine in and around Portland 1896 until the early 20ies when he had a stroke. His medical office was in back of his drug store, which was operated by Mr. the right of the scale. In the start of his practice, Dr. Brooke was associated with A.W. Moore.
We don't know much else about F.W. Brooke, who graduated from UOMS in the class of 1896. There were several women in that year's group of twenty-two; the complete roster included:
Ainslie, George F.
Biersdorf, Herman R.
Brooke, Francis Wesley
Brown, Ella Pringle (Mrs.)
Clinch, J.H.M.
Davis, Jessie Fremont (Mrs. Martin Brooks)
Dedman, Henry A.
Dempsey, Lillian
Dittenhoefer, Tillie (Mrs.)
Faull, C.W.
Giesy, B.F.
Hartley, Olive Muir
Johnson, Mary P. (Mrs.)
Low, O.P.
Manley, J.M.
Marks, Thomas I.
Miracle, W.T.
Parker, William Lockwood
Reed, Elizabeth
Reid, Alexander
Rossiter, Albert J.
Witham, Albert Arthur
It's interesting to note that no 1896 graduates of the Willamette University Medical Department are identified in the 1951 alumni directory. Not quite a decade after the 1887 split, UOMS was definitely churning out more physicians than WUMD.

Side note: A web search brings up this Flickr image of a calendar issued by the Brooke Drug Company in 1905.

Wednesday, February 24, 2010

Upcoming History of Medicine Society Lecture, March 12

Mark your calendars for the next installment of the OHSU History of Medicine Society Lecture series, coming up on March 12. This event is free and open to the public. Full details:

Lecture: "Pericles and the Plague of Athens"

Guest speaker: Philip A. Mackowiak, MD, MBA, MACP, Chief, Medical Care Clinical Care Center, VA Maryland Health Care System, Professor and Vice Chairman, Department of Medicine, University of Maryland School of Medicine

Date: Friday March 12, 2010
Public lecture: 12:15 p.m.
Refreshments served at noon
Location: OHSU Old Library Auditorium

Dr. Philip Mackowiak is professor and vice chairman of the Department of Medicine of the University of Maryland School of Medicine and Chief of the Medical Care Clinical Center of the VA Maryland Health Care System. He is a graduate of Bucknell University (B.S. in Biology), the University of Maryland (M.D.) and the Johns Hopkins University (M.B.A.). He began his career as an Epidemic Intelligence Officer with the Centers for Disease Control in the early 1970s. In 1975, he joined the faculty of the University of Texas Southwestern Medical School in Dallas, where he rose to the rank of Professor of Medicine before joining the faculty of the University of Maryland School of Medicine in 1988. He has published over 150 peer-reviewed articles, editorials and book chapters on a variety of medical topics and is perhaps best known in the medical community for his work on the diagnosis, prognosis and treatment of fever. His book, Fever, Basic Mechanisms and Management, now in its second edition, is the first comprehensive monograph on the subject since one published by Wunderlich in 1868.

Medical history is Dr. Mackowiak's other passion and area of growing expertise. For almost a decade, he has hosted an internationally acclaimed series of Historical Clinicopathological Conferences in Baltimore. These have given rise to ten peer-reviewed articles and two books, one entitled Post Mortem: Solving History's Great Medical Mysteries (2007) and the other, Imperial Furies: Impact of the Julio-Claudians and Their Illnesses on Roman History, which is currently in search of a publisher.

The lecture is free and open to the public. If you have a disability and need an accommodation to attend or participate in this event please contact Sara Piasecki (503-418-2287) at least five business days prior to the event.

Tuesday, February 23, 2010

And the hits keeping on comin'

Dr. Charles M. Grossman, MD, today continued his near-weekly visits to the History of Medicine Room to deposit his papers--or, those he deems worthy of saving for posterity but not worthy of hanging on to for a future article or other personal project (and he has many lined up).

Among the delights delivered today is a draft version of his article "The American 'Invasion' of North Korea, Year 2000", which begins (in characteristic Grossman style):
Startling? Yes, of course. Newsworthy? Extremely so, some of us thought, but not the American press. Useful? Very definitely so, since the eleven vehicles and sixty Americans were not armed and had been invited by the Democratic People's Republic of Korea. Mission accomplished? Yes, but unfortunately without the necessary follow up. Please consult the Korean desk of the Department of State for more details...."
Grossman also brought in a folder of records pertaining to the National Federation of Settlements and Neighborhood Centers (later called United Neighborhood Centers of America), dating from his tenure on the national board in 1967-1970. As chair of the Linnton Community Center here in Portland, Grossman represented Pacific Northwest ideas on community outreach, but felt a bit small-time in comparison with institutions like Chicago's Hull House. The donated materials include meeting minutes, correspondence, newsletters, and a copy of the group's Social Policy Platform, marked up with Grossman's manuscript revisions from 1970.

We also received slides from a talk on cancer incidence among Hanford Downwinders, delivered by Grossman at a Beijing conference.

Since Dr. Grossman began donating items to HC&A in July 2008, we have compiled a 37-page inventory of the as-yet unprocessed collection. I think we all recognize this as the tip of a rather large iceberg....

Monday, February 22, 2010

Musings from a dental chair

Laying down for the first of three dental appointments in four weeks this morning, I was startled out of my happy place by the following snippet of conversation:
"Burnisher, please."
"Ball burnisher?"
Cantwell? Could this be a burnisher designed by the great Kenneth R. Cantwell, D.M.D, former faculty member of the OHSU School of Dentistry? If so, I figured I was in for a quick finish to my filling. After pioneering the use of the high-speed hand drill in dentistry, Cantwell went on to write the book (ok, it was just an article, with coauthors AW Aplin and DB Mahler) on "Cavity finish with high-speed handpieces" (Dental Progress 1(1) Oct. 1960), finding that "air-turbine handpieces can provide an acceptable finish to a cavity preparation when they are used in the stall-out zone."

As it turned out, the burnisher was wholly manual, but the thought of being in the ghostly hands of the famous clinician and educator was enough to cheer me through to the end.

Cantwell (1916-1990) was a 1943 graduate of North Pacific College (precursor to the OHSU School of Dentistry) who joined the dental school faculty in 1946. He served as chair of the Dept. of Operative Dentistry until his retirement in 1986. A devoted teacher, it was estimated at the time of his death that 90 percent of the dentists on the West Coast had trained under him during his tenure. The school's continuing education program is named in his honor, and numerous study clubs, such as the ones he established throughout his career, still meet regularly to discuss new techniques and materials. He lauded these groups in an OHSU newsletter in 1986, saying:
They are unique to the West Coast, especially the Northwest, and are a key to this region having what we consider the best dentistry in the world. I'm very proud of our Oregon dentists for their high participation--I think about half of practicing dentists--in continuing dental education.
Speaking as a patient, I too am proud--and grateful to Cantwell for leaving his mark.