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This oral history is one in a series of interviews conducted by the Columbia University Oral History Research Office in the late 1980s to early 1990s documenting the history of ASH and the development of the profession of hematology in the United States. Columbia University holds the copyright to this oral history, and anyone interested in quoting this transcript must first contact the University for permission.
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 three tape-recorded interviews with Dr. William Moloney, conducted by Madeline Marget in May, July, and September 1989 in Boston, MA. Dr. Moloney has reviewed the transcript and has made corrections and emendations. The reader should bear in mind that the following oral history is a verbatim transcript of spoken, rather than written, prose.
May 25, 1989
Q: Dr. Moloney, maybe you can begin by telling us of a little bit of your early life, and how you became interested in medicine and science.
Moloney: I became interested in medicine through my mother whose brother, Joseph Curry, was a graduate of Harvard Medical School in about 1899. He went directly from the English High School into Medical School and was one of the earlier bacteriologists, and my mother always told me many stories about him. Actually he was quite well known and worked in the department of pathology with the famous Dr. Councilman, who was one of the pioneers in the study of yellow fever.
My mother continually talked about Joseph, and he was, as I say, a very distinguished, young man. He died in his thirties, unfortunately. He went out to the Philippines to study yellow fever during and after the Spanish War. I held him up as the prototype, or the hero, in my life. She was always very supportive of my going into medicine, and from an early age she encouraged me to do so. We weren't poor, but we were not rich. My mother worked. She was the first supervisor of Mother's aid in the country. Under Governor David Walsh, she headed up what was later called Aid to Dependent Children. In those rather unsophisticated days we had other institutions entitled the Home for Destitute Catholic Children, also the Rose Hawthorne Home for the Cancerous Poor, and in Cambridge there was the Holy Ghost Hospital for Incurables. My mother was one of the pioneer social workers and eventually her department developed during FDR’s time into a very active social program. She was one of the architects of it. So I was always involved with a climate of social consciousness. My mother was a very tolerant person who actively engaged in communication with other people and also had a great sympathy for the poor and underprivileged, especially women whose husband's were in jail, or whose husbands were dead. She developed these ideas as a young woman and then went on from teaching into social work. So I think my social consciousness was developed through my mother. Certainly, she had driving ambitions for us and insisted on our going to the difficult Boston Latin School. You didn't have any ideas that you were going to go out and become anything else but a scholar of some sort, and I attribute a great deal of my career to my mother's influence. She was also a rigid, puritan-type, who would say, "I'd rather see you dead than drunk." As a result, I never smoked and I never drank until I got in the Army. And my brother, Frank, was abstinaneous; we both abstained from both smoking and drinking. My sister, who incidentally is a lawyer in New York, never smoked or drank. My mother would have been horrified at the very thought of it. On the other hand, she liked musical plays, and she was musical herself, so that we had a very warm and supportive family life. I was born in Charlestown, right near the Bunker Hill Monument on Chestnut Street. In fact, when my children were growing up they asked if I saw the Battle of Bunker Hill, which I assured them I hadn't. And then we moved from there to a variety of places. We went to West Roxbury, and finally landed in Roxbury in 1919. I spent most of my early years in Roxbury, and from there I went to Boston Latin School for four and a half years. My mother had a disagreement with the principle who insisted that her boys were not the Latin School type, because my second oldest brother was a real Peck's Bad Boy. He did everything anybody could conceive of, and a few other things that you wouldn't think of, such as nailing down all the desktops in a room, and then locking the doors in such a fashion that they had to get the fire department to get one of the teachers out of the room. After a few pranks like that, Mr. Campbell, who was the headmaster, fired him out of the school. My mother got in a row with him, so she took us all out, which was unfortunate. My younger brother, Frank, went with me to Jamaica Plain High School and graduated when he was fifteen. He got into Harvard when he was 15. I didn't do too badly in Medical School, so I think Mr. Campbell missed the mark about some of us. In any event, Roxbury was nothing like it is today. I lived on Townsend Street, over near Washington Street. We were surrounded by a variety of poor groups, mainly poor Jewish people. There weren't many Black people in the community at the time; they came in later. We had a close relationship with our neighbors who were mostly Irish Catholics.
I grew up in Roxbury, and actually it was a very interesting community. Down the street from us, not far away, Dr. [William] Dameshak, the famous hematologist's mother, lived there up until a few years ago. Theodore White also grew up in what was considered to be a very poor neighborhood, but produced some very intellectual people, many of them went to Boston Latin School and later to Harvard. In any event, that was the type of environment I grew up in. The other factor was my mother's insistence on our going to public schools. She had been a public school teacher herself, and graduated from the normal school. She just didn't have any faith in parochial education, although she was a very devout Catholic. She did not think the nuns at that time were very good teachers, in many instances and absolutely insisted on us going to non-parochial schools. Later, I went to Tufts, my sister went to Portia Law School, my brother Tom went to BU, and Frank went to Harvard. So our background was not the ordinary or usual type found in our part of Roxbury.
In any event, having grown up in that kind of a household, when I started to get interested in medicine, my interests developed rather rapidly. I had a bad injury playing high school football which landed me in the Boston City Hospital for some weeks. Subsequently, over a long period of time, I was going back and forth as an outpatient. Later I worked around the hospital summers as an orderly. After graduation from high school, I then went to pre-med at Tufts. In those days, you could get into medical school with two years pre-med. You didn't have to have a degree. But you had to cram into those two years all of the scientific subjects. That included physics, chemistry and all the other biologic sciences. So we got very little cultural reward, and I regretted that, and I think it's a mistake. But in those days, as I said we were not well-off, in fact, the Depression years were approaching and we were pretty poor. I might point out in those days, I think the fee was $150 a year for the pre-med, and for medical school it was $360 a year. We had a very large class in pre-med, and it was competitive in the sense that only one out of four of us would get into medical school. So we all worked our tails off, and from being a somewhat unsophisticated person, I had to develop rather rapidly a competitive spirit about survival, and I did get into medical school. I did fairly well considering the fact that I used to work nights at the Motor Mart Garage in the lobby at the cigar counter and tried to go to medical school at the same time, which is kind of a chore as you might imagine. Fortunately, in my third year in medicine, I was offered the chance to become what was called a house officer at the St. Margaret's Hospital and St. Mary's Infant Asylum in Dorchester. The latter was a home for unwed mothers and was associated with a very good obstetrical hospital, which was manned by some of the best obstetricians in Boston. But in any event, I spent about a year and a half at that institution which firmly convinced me that I would never become an obstetrician. Not that I minded getting up at night, but it just was not my interest. I was all thumbs. I could never tie a decent knot which obviously would be a detriment to a surgeon, and I was just not cut out for it.
Very early on I began to develop ideas about looking into things. I was inquisitive, so I began to do little projects, some of them rather silly in retrospect. But I would gather data together and try to analyze it, for example, infections in the nursery, and one thing or another. I graduated from Tufts Medical School in 1932 and I was fairly well up in the class, although I remember one course I was so tired that I used to fall asleep in the classes, because I was up very late at night working. I missed several lectures and flunked one course in neuropathology which kept me off the dean's list. That really, at that time, bothered me. At any rate, I went then to King's County Hospital in New York for my internship. In those days, and now we're talking about the midst of the Depression, in 1932-34, I arrived in Brooklyn at one of the largest hospitals in the country. It had everything in it from leprosy to typhoid fever. I don't think I ever saw smallpox, but we saw everything else. Although associated with the Long Island Medical School (now downstate), there was very little teaching by the staff. I took the King's County internship because the fashion in those days was to get a rotating internship so when you came out you would know all branches of medicine. I soon found out after I got there that surgery and obstetrics were not my fields, and I was very strongly inclined toward pediatrics, neurology, or medicine. So I selected those fields for my training which you could do in this rotating internship.
During my internship, we only got our uniforms and food; we didn't get one cent in salary. Although we worked 10 to 12 working hours a day, often six or seven days a week. We often admitted 15 to 20 patients a day. It was absolutely hectic. In addition you had to ride the ambulance around Brooklyn, and in those prohibition days we were having all sorts of problems with bootleggers and gangsters. We were in the center of all these Irish, Jewish, and Italian gangs. So we saw a lot of trauma; more than I ever wanted to see. I quickly conceived the idea that I wanted to do something in medicine. In fact, I again conducted a variety of small investigations, in spite of all the other activities. I then decided I'd stay on for a medical residency. However, the Depression got so bad, and financially things got so desperate at home, that I had to leave the King's County. I came back to Boston because I had gotten married in my second year of internship, and my wife was working. In those days, doctor's wives didn't work, at least if you were going into general practice, which I had to do. I had no choice. I went to Jamaica Plain and we hired a small flat and set up housekeeping, and I started to do general practice including some obstetrics, which I was unhappy about. I made my living mainly by the emergency calls from the telephone operators. There was an emergency system in those days where the operator would get a call and then she'd have a list of doctors. There were a lot of older doctors out there, and I was the first new doctor for years in that part of Jamaica Plain which is right near the monument at the junction of Center and South Street. The point was that there would be all kinds of emergencies during the night and they'd get you up at any hour. I had many interesting experiences, and I never regret having been a general practitioner for that period of time. I could tell stories which people won't believe. I mean this. On one occasion in the midst of the Depression, I got called down to a street in a poor section of Jamaica Plain. A young couple asked me to see their newborn baby, just a few weeks old. The baby was frozen to death in bed; cold, blue, stiff as a board. They had no heat. Another family in Roxbury that my wife and I befriended had 10 children. They were very poor, though the father had a job in a meat packing firm in Brighton. They were a good couple, but they just didn’t have any money. I remember going in and seeing this woman and her two infant twins. The house was cold, and they had practically nothing to eat in the house. Both twins had whooping cough. One baby was having convulsions and was cyanotic. Well I didn't know what to do, but I had read a letter in The Journal of American Medical Society, which said that sometimes in a convulsive state, you can control it with ether, which could be given in oil as a rectal instillation. So I got some olive oil from them, and I had some ether in the bag, and I made a suspension of oil and ether. Then I took a rectal tube, which I carried also, and a syringe, and I injected it. The convulsions ceased and the child fell asleep. We got this little one into the hospital, and she recovered. We talked to our friends about these people, and they bought them baskets of food, clothes, and one thing or another. Over the years we became very friendly. Later on this man who was a night watchman at the abattoir, supplied me with a lot of the tissues I needed to make different extracts which I used for clotting studies. I’d send some of the fellows from the hospital out there to get brains and other tissues from sheep and cows. The husband was very helpful in things like that, and also used to come and help around the house. So that was a nice story, but it reflects the close relationship you had with people. You'd go in and have a cup of tea in the kitchen and sit down and talk with them. Of course they never had any money. I never made much money, I think I made two or three thousand dollars the first year I was out. That's not a lot today, but it wasn't much even in those days. Well, what could you do? Many were on the WPA and came in and wanted a note saying they couldn't work. Some of them were fakes, you would just have to say “no way,” but others were legitimate, but they couldn't pay you. I suppose if they were out on a farm someplace, they would have brought me a bag of potatoes or something, but these people didn't even have that.
So during the Depression, I did general practice. I got on the staff of the Faulkner Hospital, which is an excellent hospital and had some wonderful physicians on the staff. Several helped me more than I can tell. At the same time, I wanted to teach. I liked teaching. I always enjoyed it, so I became a member of the staff of the Carney Hospital in South Boston. Now that's quite a trip from Jamaica Plain, but I went over through Franklin Park, and I joined the outpatient staff there and became an instructor of medicine at Tufts Medical School. When I was at the Kings County Hospital, I developed an interest in blood disorders through seeing cases of pernicious anemia. We had a whole ward full of patients with neurologic complications, many of them were paralyzed completely from spinal cord involvement. Today we rarely see combined system disease in patients with pernicious anemia. I became very interested in the disease and began to do my own blood studies and investigations in a very minor way. At this time, I became also interested in blood transfusions. In those days, there were no blood banks, of course. Blood banks were not developed until the late 1930's - about ‘38, ‘39. The first blood transfusions I saw as a medical student were given by direct transfusion. The donor would lie down on the couch, next to the recipient. An arm vein would be isolated in both subjects. Then 500 cc of blood would be removed from the donor in a paraffin tube and quickly taken to the recipient where a vein was opened and the glass nipple was inserted. The blood was then pumped rapidly into the patient's vein. Sometimes the blood clotted, and then you were left with a big expensive blood clot. It was a very expensive procedure and only a few doctors were doing it at the time. However, at the King's County, a citrate solution had come into use as an anticoagulant. It was just a simple citrate solution, and it did not preserve the blood very long and had to be used right away. Later, more effective citrate solutions were devised and permitted the storage of blood in the blood banks. When I got to the Carney Hospital, I joined the medical service, where I was made an instructor in medicine. That was my first faculty appointment in 1935. I used to teach physical diagnosis there, and we used to go down to Boston City Hospital with the students. While I was at the Carney, I began seeing patients with various blood disorders, especially anemias. There was no lab available for outpatient people. I used to carry around a cigar box in which I had a bottle of alcohol with a needle and a stopper, also little bottles for the red counts and the white counts, and slides to take smears with. As time went by, I got one of the nuns, who was a very cooperative person, to allow me to use a room with a table for my laboratory. I would take their blood and bring it back to my office in Jamaica Plain where I had a microscope. That was the one thing that I really indulged myself in, a good microscope, and I used to do all these counts and look at the smears. So I built up a little blood clinic out there. Mind you, at this point, there were none of the developments we have today. We had only the four blood groups, the Rh factor hadn't yet been discovered. The clotting factors were the classic ones that had been discovered at the turn of the century, and it wasn't until during WWII that the fifth clotting factor was discovered. Also in the west, a group of people working with cows and cattle had noticed a hemorrhage disease in cattle which occurred when they ate rotten hay. When these animals were dehorned, it caused them to bleed to death. This was investigated and found due to lack of a clotting factor known as prothrombin. Eventually, an agent was isolated from spoiled hay which was the anticoagulant dicumerol. This substance blocked vitamin K, which was essential for the production of prothrombin. A test was developed by Armand Quick and others to determine prothrombin levels in the blood. In this test you took some plasma, the liquid part of the blood, and placed it in a small tube. A small amount of brain tissue extract, called thromboplastin, was added, and with a stop watch you measured how fast the little fibrin plaque formed. You could see it form as a white film. The test was called the prothrombin time.
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