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Q: Did you find vast differences in approaches to nuclear medical education among the different countries that participated at this conference?
Ross: Yes. Most of them had no such education or training, no such concept, no such idea, and none of it was done. Anybody who used radioisotopes in many of these countries had learned to do so in England, or France, or the United States.
Again, in most of these countries their needs in medicine are at a basic level, far less sophisticated than nuclear medicine. They need to clean up their water supply, they need to improve their nutrition, and they need to do all kinds of things that don't require radioactive tracers and the elegant techniques that go along with it, but they all want to have those things. If they're not going to be provided by the West, they'll be provided by the East as a propaganda measure. So the West provides sophisticated equipment to these people, even though they aren't able to effectively employ them. But this was a stimulus to them. I have some correspondence with these people still from places like Iraq and Nigeria, who are very fine people. They recognize the limitations in their countries, and the fact that they have more important needs than nuclear medicine, but they would still like to have nuclear medicine available!
Q: I suppose we should also mention that a number of years earlier, in 1966, you were a participant in the World Health Organization and I.A.E.E.A. conference on the needs and availability of training in the medical uses of radioisotopes.
Ross: They conducted--the World Health Organization--a worldwide survey of facilities, opportunities, and education relative to the application of isotopes in nuclear medicine. My assignment was the new world, which was South America, North America, and Canada. Other people were assigned Africa. Somebody else had Asia. Somebody else had Europe. I made a whirlwind trip to the whole of South America, visiting all the countries and the people that I knew down there, discussing with them what they did about nuclear medicine education, which really wasn't very much, trying to provide opportunities for them to go elsewhere to learn what they needed to learn. We provided a report indicating, in essence, that there wasn't very much development or sophistication in these areas and suggesting that people who wanted to advance this discipline might go elsewhere to learn about it, and if they were provided with the proper equipment and tools when they returned home they could use them. I tried to emphasize that things should not be so sophisticated that they could not be applied in countries that didn't have the financial capacity to follow through.
That's a great problem in many of these countries. A doctor will come over to the USA, he will learn very sophisticated things, he then will go home, and because of his expertise, sophistication, and interest, he may be ostracized by his fellow physicians, who really will treat him as a pariah, and he doesn't have the opportunities to implement what he has learned which I think is most unfortunate.
Q: I'd like to now talk about your move from Boston University-- moving ourselves from the international plane--to UCLA in 1954.
Ross: This was really a terrible decision for me to make. I was offered an appointment at the new UCLA School of Medicine as a professor of medicine and an associate dean, also as professor of radiology in the field of radiation biology. I'm going to be very honest with you. We had five children. My salary as a professor at Boston University was not very great, nor was my revenue from practice very great. I had five children to educate. In Boston, this meant private schools from the time the children started high school until the time he finished college. I had come from California, which when I was a boy, had magnificent public educational facilities. It had the University of California system, which provided excellent education at very low cost. And my wife and I decided, in view of all these things, probably our children would be better off if we came here. So, we came out here and that was somewhat of a disillusionment. The land that I had remembered as a boy no longer existed. Los Angeles was a huge, sprawling metropolis. The school system wasn't up to what it used to be. The University of California was, in large measure, a huge, sprawled, rather inchoate mass of educational opportunity, and the barren cultural environment was sometimes disadvantageous to our children. Also this was the time of the beginning of the drug culture. That was very unfortunate.
However, we survived and my children have all done quite all right. I have five of them. I have eight grandchildren and they're doing splendidly! I believe implicitly in the statement of the Heidelberg confession of 1563, that "all things must fit God's plan for our salvation," and I'm sure that my salvation was coming out to Los Angeles.
Q: The medical school that you came to at UCLA was a newly formed medical school. Could you comment on something?
Ross: It was a newly formed medical school which had a very difficult birth. There was great contention as to whether the medical school should to on the UCLA campus, or be placed down by the big L.A. county hospital. The academics won their point and placed it on the UCLA campus, a decision which had been supported, in major degree, by the rest of the campus faculty until they found out that when they got the medical school here on the campus the capacity of the medical faculty to raise funds, to get research grant support, to appoint a large number of additional faculty, and the salaries that were going to be paid to these faculty members were a lot higher than the rest of the campus faculty were paid. At that point, all hell broke loose and there were invidious comparisons and designs made to limit the faculty of the school of medicine, and the salaries paid to them!
I came to UCLA as the associate dean and professor of medicine and radiology. Most of my endeavors were related to the deanship. We had terrible troubles trying to make medical faculty appointments because on every appointment committee there would be, maybe a professor of English, an astronomer, and a historian, and they didn't understand anything about medicine, but to get them convinced that somebody ought to be offered a professorship in a school of medicine at a salary higher than they were paid was almost impossible. It took a long time before we got that rectified, but it ultimately got rectified and then the appointments were made by medical school faculty committees and everything went all right.
I think it's a good idea to have the medical school on the campus. The interchange between the medical school faculty and the rest of the campus hasn't been as great as had been anticipated, but it is there and it's really very advantageous to have the hospital and the school right on the campus.
Q: Did you have any dealing with hematology at this point, when you first came to UCLA?
Ross: Yes. The chairman of the Department of Medicine was John Lawrence, who I had known in Rochester, where he was head of hematology. He was a friend of the founding dean, Stafford Warren, who brought John Lawrence out here. John brought with him Bill Valentine, and Bill Adams, who were hematologists. He brought the cardiologist, the nephrologist, and a lot of other people from Rochester. He protected these people and wanted them to thrive and prosper, which is all right. They weren't particularly enthusiastic to have me come out as a hematologist, and they didn't open any particular doors to doing hematology at UCLA.
But, my initial activities were those of an associate dean. That kept me very busy. It was the time that the hospital clinical services were being activated. I was chief of staff, as well as being the associate dean in charge of certain things, faculty relations, hospital development, and academic affairs. I worked very hard getting these things organized and I think the accomplishment of the school from the standpoints of a teaching hospital and good clinical services really have been very exemplary. Also, the school is very effective in developing research capability and I think it ranks among the best in this country from the standpoint of research, and clinical education, and patient care.
Q: Were you influenced in any way by Keefer's plans at reorganizing Boston University when you came here as Dean?
Ross: I had no say about that. That was in the hands of Stafford Warren and the chairmen of the departments that he had brought with him, primarily from Rochester. They were very jealous of their prerogatives. They didn't want anybody else interfering with them and Stafford Warren was one to hold to his guarantees that he'd made to these people when they came to UCLA. So I had nothing to do with the staffing of the school or the policies by which they made their selections of professors.
Q: Could you make any comparisons between the different developments that took place in the medical schools that you had been associated with at Harvard, Rochester, Boston, and Los Angeles?
Ross: Yes, one of the great virtues, benefits, and admirable aspects of the Harvard Medical School is the fact that they depended in large measure upon the great hospitals in the City of Boston. These were the Boston City Hospital, Peter Bent Brigham, the Beth Israel, the New England Deaconess, the Massachusetts General Hospital, the Faulkner Hospital, the Children's Hospital, the Good Samaritan, the Boston Lying In Hospital, and the VA Hospital. All of these combined to give a tremendous depth and a tremendous diversity of stimulus. In Rochester, there was none of that. The school was actively combated by the practitioners of the city who tried to keep the faculty off the staffs of many of the Rochester hospitals, so Rochester medical school was really sort of an ivory tower, an isolated activity. In Los Angeles, at UCLA, initially they attempted to have fairly close relationships with the big hospitals in Santa Monica, but the medical staff of these hospitals were very jealous of their prerogatives. One of the hospitals in Santa Monica kicked all the UCLA faculty off its visiting staff at one point. The Cedars of Lebanon and Mt. Sinai Hospital were more friendly to UCLA, since many of their staff had appointments on the UCLA clinical staff and that worked much better. But again, there was not the catholicity of approach to medical education, training, and clinical activity that existed at Harvard. This is being rectified now, and relations with the local hospitals are much better.
We had a chairman of the department of medicine named David Solomon, for ten years. He came from Harvard, and appreciated the value of the Harvard system. As a consequence, UCLA developed relationships with half a dozen hospitals, which have been very effective and very admirable. Each of these hospitals operates its medical service cooperating as a unit within the Department of Medicine. This provides some of the same stimulus that exists and existed at Harvard Medical School.
Q: Could you comment on the changes that took place within funding-- this is the post-World War II period now--with the development of the National Institute of Health, the National Science Foundation, and other funding agencies?
Ross: As I told you, when I started research work in 1940, all the funding usually came from private funds, which was very satisfactory and admirable. During World War II and subsequent to World War II, the United States government realized the tremendous importance of medical research and development, and the government began to support medical research very grandly and very elegantly! This contributed to the tremendous developments in scientific and clinical medicine in the United States! As you know, this government support for medical education and research now is being cut back. I think that that's unfortunate!! I believe that the United States government now is the major source of all medical research funds. It also is the primary source of the funds that subsidize graduate medical education by providing support for residents and interns from payments to hospitals for services to medicare and medicaid patients.
When I was an intern and resident, I never got paid except for my food, my room and four white uniforms a year. The sixth year of my residing in a hospital I got a hundred dollars for the whole year's work. Now, of course, residents after that length of time would probably be making thirty-five or forty thousand dollars at most of the hospitals in this country. Most of that money is derived from insurance payments for the provision of care of the patients, much of it from the Medicare and Medicaid. Now that's all going to be curtailed. It's already being cut back. Already we're seeing a diminution in the number of medical students, the number of residents, the number of opportunities for graduate medical education, and undoubtedly pretty soon, in the opportunities for these people to enter the field which is of most interest to them. Entry into these fields is going to be regulated by the federal government.
I think that's most unfortunate, but I don't know where else the funding is going to come from. The availability of private money to support medical research and education is any longer much of a research source in this country as a consequence of the tax structure. After four expensive years in medical school, most of these young men and young women don't have enough money to support themselves when they serve a residency and certainly not to pay any kind of a tuition charge. So I think it's going to shrink and shrivel. I hope it doesn't shrivel too far but it's certainly going to contract a great deal, which I think is very unfortunate!!!
Q: In 1958, you became chairman of the Department of Nuclear Medicine and Radiation Biology?
Ross: Yes, that was an interesting experience. This was done by Stafford Warren, the dean of the medical school. He said, "In essence, everything that you're doing running that A.E.C. supported research and educational activity is that of a department and I'm going to create a department." Well you should have heard the flack that arose as a consequence of that! My best friends would almost spit at me when they saw me in the corridor. They thought I was trying to steal their underpants and everything that went with them! This was a very troublesome and trying time. However, we were able to prevail to the point of building that building that you saw this morning and it was very adequately staffed. It was supported at that time with a budget of about--well, it was four million dollars in 1965 and 1966. In the 1958, when I became involved the budget was about one million dollars. In 1986 dollars that would be equivalent to three of four times that, and we had a very actively going facility.
However, this irritation on the part, primarily, of the Department of Radiology and, to a lesser extent, of the Departments of Internal Medicine and Pathology ultimately prevailed, and they fired me as the director of this AEC laboratory of nuclear medicine and radiation biology and chairman of the Department of Biophysics and Radiation Biology and markedly curtailed what was going on in that laboratory, which, as I told you, was completely funded both from a standpoint of construction and operation by the Atomic Energy Commission. So when they got rid of me, the day I walked out the AEC cut the budget by fifty percent. The budget and activities have continued to contract since. The place is now, unfortunately, very somnolent! Not a hell of a lot goes on there. The staff has dwindled, so there are not very many people around any more, which I think is most unfortunate. It's a great facility and the opportunities for research and education there are absolutely tremendous! However, all things but God's plan for our salvation; I'm sure it will come out all right in the end! The Department of Biophysics and Radiation Biology was abolished! I'm much better off doing what I do now than had I continued as director and chairman of that activity with the heartbreak that went along with trying to raise money and support people. I got along all right, and survived after some rough years!
Q: How long did you continue as chairman of the department?
Ross: Let's see. I spent four years as an associate dean. In 1954 when I came to UCLA they told me they'd make me dean in six months, but that never developed because Staff Warren fell into political trouble and they didn't promote him to vice chancellor of health affairs. He was supposed to become vice chancellor. So in 1958, I transferred from associate dean to be the director of the AEC laboratory and I continued in that activity, until 1965. At that point, although I had been successful in obtaining funding and getting the Atomic Energy Commission to agree to fund for their academic lifetimes eight full professorships in the for Labper-Bonnell in the Department of Biophysics and Radiation Biology this did not prevail and consequently everything fell apart. There's never been an opportunity subsequently to really attract top flight people into that laboratory in positions which would adequately recognize their expertise and their accomplishments. So this reality inhibited the appointment of people who could be leaders in the field of biophysics, nuclear medicine and radiation biology.
So in 1965, we had a showdown and they dismissed me from my position as director of the lab and dismissed me as chairman of the Department of Biophysics and Radiation Biology. I think this was one of the best things that ever happened to me. It was kind of hard in the way that it was done but I'm much better off having done what I have done since, than I would have been trying to sit there and promote the budget and the activities of the individuals on the staff! So I think it was probably a good idea that I got through that in 1965.
Then in 1969, after having sat in the outhouse for some three or four years, the chairman of the Department of Medicine, Bill Valentine, invited me to become chief of the Division of Hematology, which I did.
Q: Before going to that could we say something about what activities the Department of Nuclear Medicine was involved in?
Ross: The AEC laboratory had been established very soon after the so-called Manhattan District [which had developed the atom bomb] had been translated into the Atomic Energy Commission. The lab was awarded one of the first contracts that was let by the ARC. As a matter of fact, it was AEC contract number "Gen 12." So it had funding extending way back to the creation of the Atomic Energy Commission.
It was established, primarily, to study the effects of fallout, to study the effects of ionizing radiation on individual's organisms, organs and ecosystems. The lab carried on various activities. Probably the one that was most successful was concerned with environmental biology. Elegant studies were conducted of the characteristics of fallout following tests at the Nevada nuclear test site. There were fall out patterns traced all the way across the United States and the characteristics of the fall out material, which changes as time goes by and the material gets wafted around. These were really very important studies but they were classified at the time that they were made. Although they were reported in classified government documents, and they never really have been put out where people can see them and know what went on.
In addition to these environmental studies, we were interested in what radiation would do to certain organisms. We established a very large enclosure at the nuclear test site, which, as I recollect it, was around five acres in area. It was encircled with a fence with the metal going quite deep into the earth so that organisms couldn't get in and out, then a very large radiation source was elevated in the center of the area. It was designed to give a uniform radiation field over the five acres, and studies were conducted of the vegetation, of the rodents that lived in the area, of the insects, and of the lizards and the snakes that lived there. This was quite interesting. They showed a very definite progression as to what happened depending on their sensitivity to exposure to ionizing radiation. It almost wiped out some of the populations of lizards, but, interestingly, after a certain number of months and years they came back again in spite of the radiation. Some of the vegetation also initially got wiped out but some of it came back again. The same also applied to the rodents and the insects. It was very interesting to see how they were able to adapt to the presence of radiation and to survive in spite of these adverse conditions.
Then there was another program of considerable interest which related to biochemistry: the effects of radiation on lipids, and the effects on various other substances. We had an interesting project in which we were able to use radioactive carbon released--formed in the atmosphere as a consequence of the detonation of nuclear and thermonuclear weapons. By getting brain specimens back for a period of years prior to these detonations and subsequent to the detonations, we were able to show actual turnover of the proteins in the brain, over a period of time using this bomb produced environmentally occurring carbon, which so far as I know was the first time it was really shown that the protein material in the human brain was capable of metabolizing and turning over.
Then there were other studies, for example, the effect of ionizing radiation on the central nervous system, the use of radioactive materials in tracing the development of certain changes in the lung, certain changes in the heart, certain changes in the liver. These are the main things that come to my mind now. There were other studies, too, but these are probably the most important.
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