ASH Oral History: Samuel Rapaport (1/7)
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ASH provides the following oral history for historical purposes. The opinions expressed by the interviewees are not necessarily those of ASH, nor does ASH endorse or make claim as to the accuracy of any of the information included here. This oral history also is not intended as medical advice; you should always seek advice from a qualified health provider for your individual medical needs.
The following oral history memoir is the result of one tape-recorded interview with Dr. Samuel Rapaport, conducted by Keith Wailoo on November 9, 1990. Dr. Rapaport has reviewed the transcript and made corrections and emendations (both in 1990 and again in 2007). The reader should bear in mind that the following oral history is a verbatim transcript of spoken, rather than written, prose.
November 9, 1990
Q: I would like to ask you first about your childhood and early education experience, and how that might have influenced your choice of professions.
Rapaport: I was born in 1921 in Los Angeles. I have lived my entire life in Southern California except for: 21 months of military service (1946/1948) at the Aero-Medical Laboratory at Wright-Patterson Air Base in Dayton Ohio, two years in Norway in Oslo at Rikshospitalit (the primary hospital of the Oslo University School of Medicine) with Drs. Paul Owren and Peter Hjort-the first, in 1953/54, as a Fulbright Research Scholar in Medicine and the second, in 1964/65, on a sabbatical supported by an NIH grant, and 6 months in 1983 in Israel on a second sabbatical as a member of the Mortimer and Raymond Sackler Institute of Advanced Studies at Tel Aviv University in order to give a postgraduate course on Hemostasis and Thrombosis and to work with Dr. Uri Seligsohn.
I became a physician because my father was a physician. I respected and admired him. He was available for his patients 24 hours a day of every day for many years. I was also influenced by a book I had read as a teenager: Arrowsmith by Sinclair Lewis. Its protagonist was a doctor devoted to medical research. I decided that I wanted to be a doctor who cared for patients, like my father, but who also did medical research.
At age 15, I enrolled at the University of California at Los Angeles (UCLA) as a premedical student. I liked my time there; in the late 1930's, the campus was small and beautiful. After three years at UCLA, I applied to and was accepted at two California medical schools: the University of California's Medical School in the San Francisco Bay area and the University of Southern California's (USC's) Medical School in Los Angeles. I chose the latter because my father had experienced a myocardial infarction that had left him in congestive heart failure and I wanted to remain close to my family.
In my second year of medical school, the United States entered World War II. Many of the physicians from The Los Angeles County General Hospital, which was the medical school's teaching hospital, were in a medical unit that was sent to the India/Burma border theater of operations.
This stressed the medical school's small Department of Physiology. For one thing, the department chair, Dr. Douglas Drury, had changed how physiology would be taught in the next medical school year. He would no longer give lectures to the entire class. The class would be divided into three smaller groups. Each student would receive a syllabus that contained the essence of his lectures and a schedule of the reading assignments. The students were to have read the assigned reading before attending his/her small group to discuss what had the read as guided by a faculty member assigned to supervise the group. That faculty member would also supervise the members of the group in the course's laboratory experiments.
But a woman member of the Department who was also a physician had been sent full time to the Los Angles County Hospital to buttress its teaching and patient care activities. Dr. Drury's way to handle this was to expand his planned three student groups into four smaller student groups. This would reduce stress upon two "inexperienced instructors" who would replace her. He needed to find them and quickly. In order to hasten the supply of doctors for the armed forces, the medical school year had been shortened to nine months. The next "medical school year" would begin in July 1942--only a few months away.
There was a second perhaps more pressing problem. USC had accepted a contract from the Office of Science and Development of the National Research Council, Division of Medical Science for two war-related research projects in Aviation Medicine. The School of Medicine had created a new department, an Aviation Medicine department, in order to carry out these projects. The Dean of the Medical School agreed to provide funds to recruit two new teaching/research assistants who would be members of both the Physiology and Aviation Medicine departments.
I was asked to be one of the two new teaching/research assistants and I dropped out of school as a student at the end of the school year. The school administration obtained a draft deferment for me as an employee of the School of Medicine who would work on an aviation medicine project for the Army Air Corp and also serve as an instructor in an important medical school course.
I felt challenged to serve as an instructor in a course that I had just completed and to work in a field of research I knew nothing about.
Q: Can you tell me something about the aviation medicine projects?
Rapaport: One project involved the risk to the lungs of an "explosive decompression" of an airplane with a pressurized cabin. The other project was to determine the effect on the body of G (gravity) forces stemming from acute acceleration and deceleration. A "human centrifuge" was built on the campus for that project.
I worked on the first project as low man on the totem pole of a team of four more senior but less available persons. A rat with a thermocouple in its nose was put inside a small chamber at sea level pressure. The small chamber was then placed into a much larger chamber pressurized to an altitude of 40,000 feet. The thermocouple's temperature, which was continuously recorded during the experiment, served as an indicator of the phase of the rats' respiratory cycle. The temperature would fall when the rat inhaled air from the chamber and would rise as the rat exhaled air that had been warmed in its lungs. A person recording the thermocouple's temperature could open the door of the small chamber within and so "explosively decompress" the rat at any phase of its respiratory cycle.
The rat was then removed from the chamber, euthanized, and dissected. If the chamber had been opened at the end of expiration, then the rat's lungs appeared grossly normal. If the chamber had been opened at the peak of inspiration, then the rat's lungs were grossly hemorrhagic. A report of these findings was dispatched to the Office of Science and Development of the National Research Council.
After 18 months of teaching and research, I became a medical student again. I graduated in June of 1945 and began a general medical internship at the Los Angeles County General Hospital. The war ended in August of that year and the internship, which also had been shortened during the war to nine months, was lengthened to its former one year. I had planned to go east after my internship to enter an internal medicine residency but instead of heading east I was called up for military service.
Near the end of my internship Dr. Drury arranged for me to be interviewed by an Army Air Corp officer. Because of that, when I was called up for military service the end of my internship I was sent directly, as a first lieutenant in the Army Air Corps, to the Aero-Medical Laboratory at Wright Patterson Air Base in Dayton, Ohio.
At Wright Patterson I worked on a project to investigate if it would be possible, for fighter pilots flying in artic weather, to pilot the plane without wearing heavy gloves. It turned out, after many months in which I was both an active investigator and the research subject, that the answer was yes.
On my discharge from military service, I returned to Southern California and began an internal medicine residency at the Birmingham Veterans Administration Hospital, a new temporary VA Hospital located in the San Fernando Valley. It was named not for its location, as is usual with a VA hospital, but to honor an Army General. I chose that hospital for my residency instead of going back to the Los Angeles County General Hospital, where I had also been accepted for a residency, for a major reason.
Q: Did you think based upon your military experience that the VA Hospital would be a more interesting place to work?
Rapaport: That wasn't the reason. A classmate of mine from USC, Mortimer Morton, had used radioisotopes in medical research while obtaining a PhD before entering medical school. We became good friends. He was now in the process of setting up a nuclear medicine unit at the Birmingham Veterans Administration Hospital. He said that if I came to the VA for my residency, he would teach me radioisotope techniques that would be useful in medical research. And he did. I used external counting of radioactivity after injection of radioisotope-labeled albumin into calf muscle to measure the effect of different conditions---exposure to cold, smoking a cigarette, a sympathectomy ---upon nutritive blood flow in limb muscle. These experiments yielded enough data for two medical publications.
Going to the Birmingham V.A. Hospital proved a fateful decision for me for a more important reason. I met two doctors there who would greatly influence my professional life. One was Dr. Gurth Carpenter, a pioneer clinical hematologist in Southern California, who was a consultant to the hospital. The other was Dr. Thomas H. Brem, who was then on the hospital's Medical Service Staff.
In the late spring of 1950, the Veterans Administration acquired the beautiful multi-story Naval hospital in Long Beach, California. Patients and personnel in the wooden barracks of the temporary Birmingham VA hospital became the patients and personnel of the new permanent Long Beach Veterans Administration Hospital. Its medical service wards were divided had medical subspecialty wards: a Cardiology Ward, a Pulmonary Ward, a Gastroenterology Ward, an Endocrinology Ward (primarily for diabetic patients) and an Arthritis Ward.
There was also one other ward. There were not enough hospitalized patients with hematological disorders to fill a full ward and there were also patients who did not require hospitalization on a subspecialty ward. So there was a hybrid ward: the General Medicine and Hematology Ward. Dr. Thomas Brem had been the physician had been responsibile for the care of patients on the General Medicine and Hematology Ward. But just as I was finishing my residency, Dr. Brem was selected to be the new Chief of the Medical Service. He asked me if I would like to replace him as the medical staff physician responsible for the care of patients on the General Medicine and Hematology Ward. I jumped at the offer.
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