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Q: Okay. I was wondering if you could comment on the purpose behind the publication of Blood in 1945. Were there differences of opinion about what its function should be? At this time, there was no society of hematologists in the United States. As you mentioned, the first major textbook in hematology had just been published in 1942 by Max Wintrobe. Was this seen as a push towards organizing it as a discipline?
Ross: At far as I'm aware, I don't think it was recognized that it was pushing toward an organization at that particular time. I think it was felt by the people we've just been discussing that it was a very appropriate thing to have a common site of publication of articles that dealt with the hematopoietic system. It certainly provided that. As a consequence of this interest, I think there was organized what was called the Blood Club, which met in Atlantic City in conjunction with the meeting of the Society of Clinical Investigation and the Association of American Physicians.
Q: Dr. Ross, I'd like to now talk about the International Society of Hematology. Its first organizing meeting was held in Dallas, Texas, and Mexico City in 1946. Could you perhaps talk about its early start and its purpose?
Ross: I believe that the spark plug in back of the creation of the International Society of Hematology was a hematologist in Dallas whose name was Joe Hill. He worked with another man name Haberman. They had interests in trying to establish an international organization. It's of interest that this antedated the American Society of Hematology by quite a few years. He was able to interest the Mexicans, as well as the Americans in doing this. It was agreed, after an initial sort of rump session, that there would be a planning meeting. I participated in the draft of the constitution and bylaws for the International Society of Hematology [ISH]. Subsequently, there was a meeting of the ISH. I think it was the first meeting, in Buffalo, New York. Is that correct?
Q: Yes. In 1948.
Ross: In 1948 under absolutely intolerable climatic conditions. I think the temperature was one hundred and ten, the humidity was two hundred and fifty, and it made everybody pretty limp. Anyway, in spite of that, the organization got under way and it became really a very successful organization. It led to meetings that were held in different parts of the world at different times.
I remember there was another early ISH meeting that was held in Mexico City in which some of the American participants got deathly ill. One of them was my friend Clement Finch. He got gastroenteritis so severely that he had to be taken to the hospital and given intravenous fluids to replenish what he had lost by rectum. Some people thought he wasn't going to make it. I remember we had a great big picnic in a park at which they served barbecued goat along with certain other delicacies. I was somewhat familiar with some of the problems that confront Americans when they eat too much Mexican food. I was very circumspect in what I ate at that picnic and I didn't get sick. There were an awful lot of the other ladies and gentlemen who were there, who did get very, very ill!
That was a fascinating conference. We met in one of the Mexican public buildings which was exquisitely wired for sound, for projection of slides, and time devices to limit the speaker. They had a very novel device and at the time that a speaker's time was up, not only did the warning light on the podium go on but the electric current was cut off from the loud speakers and from the microphone so the speaker had to stop talking because nobody could hear him. I've always thought that was a good thing to do!
Anyway, the ISH prospered and it still meets. It has representatives from all over the world. It, fortunately, is not a very expensive organization to belong to, and I think it serves a very useful purpose. It served a useful purpose in the United States in promoting the establishment of the American Society of Hematology.
Q: Can you recall any of the international hematologists who participated in some of the early meetings?
Ross: I confess my memory isn't quite up to doing that, Mr. Hoffman. I wish I could. I remember a few. There was Jan Waldenstrom from Sweden who had described an interesting syndrome known as Waldenstrom's disease, and had done studies of familial relationships in porphuria. He was an active participant in the ISH. Doctor Tanhauser, who had come from Germany, was an active participant, and there were others, I think, from Italy. I can't remember whether Dr. Guglielmo was at that time involved, but I believe that he was. There were other individuals from Italy who I cannot remember. There were active people from Japan and that's about as far as I can take it at this point.
Q: Okay. During the--as you pointed out yourself--during these meetings, Americans who were practicing in hematology would come together and yet they had no society of their own. It was by 1954, I believe, that an informal blood club was formed.
Ross: It was recognized that there was no really very convenient way for people interested particularly in hematology to get together and talk about things, so there was a group of us that decided that we might as well form what was called a Blood Club, which was highly informal. There were no dues, no by laws, no minutes, no elections. There was nothing except the annual meetings. The chairman for the next year's activities was, in essence, appointed by the chairman of the past year's activities. The chairman was responsible for putting together a program. In the interests of trying to diminish travel costs it was decided to hold this in conjunction with meetings of the Society of Clinical Investigation, and the Association of American Physicians, and the American Federation of Clinical Research, all of which met at the same time in Atlantic City. So, we decided to try to have a meeting there on one of the evenings which didn't have any other formal activity going on. This was extremely successful. There were hundreds of people who turned out to participate in this. The programs were usually very excellent! Each year the program was arranged by the chairman who invited people that he knew were dealing with current items of interest who were good speakers, and good communicators. They were very successful activities!! This perpetuated itself. I believe that it is still going, although I haven't gone to these meetings for the last several years. However, it still is informal. The only charge that is levied now is that they charge a dollar to fill out a postal card which will be mailed out the next year to the individual who fills it out to inform him about the Blood Club and what the program will be. That's a wonderful way to run a meeting. That has continued, and that, again, served to increase the interest in the field of hematology and sort of meld people together who wished to come together in a more formal organization than had existed previous to that time. It also was an anlage to the establishment of the Society of Hematology.
Q: Should the Blood Club be seen as a compromise between those American hematologists who would have liked to have formed a professional society as opposed to those who were not wanting to see such a society exist?
Ross: Yes. I well remember an initial discussion held in Atlantic City in--I believe in Carl Mooer's room--in which some of the representatives from the Thorndike, including Bill Castle, were present. They thought it was quite inappropriate to try to make a formal organization in the field of hematology. They thought hematology was a part of internal medicine and they felt that to establish a separate society of hematology would fragment the field of internal medicine. They had certain, very cogent arguments to support this. Indeed, what happened when the Society of Hematology and other specialty societies did get formed was precisely that. It led to the segmentation of the specialty of internal medicine in to many subspecialties.
That has gone on. There are specialty organizations not only in hematology but in cardiology, nephrology, endocrinology, all kinds of things, and it has led to a fractionation of the general specialty of internal medicine, but that's the way that human intellectual endeavor and human cultural endeavor develops. When something gets big enough and important enough, you make a new organization which is an offshoot of the preceding one which will be concerned specifically with the separate field. After all, this is the way that biochemistry sprung up out of physiology and physiology sprung up out of anatomy. Radiology, interestingly, developed out of surgery. There's nothing wrong with this to my way of thinking. Nobody can know everything about everything. Knowledge and competence is acquired as a consequence of these specialty organizations and concentration in certain more limited fields.
But what you say is quite true. There was considerable opposition to establishing a formal society and, possibly as a compromise to that, it was determined that we would try to have a Blood Club, which was to meet informally, as I said, in conjunction with other organizations.
Q: Who were some of the driving forces behind the Blood Club at that time?
Ross: I think you would say Dameshek, Carl Moore, Joe Ross, Charlie Doan. I think Hale Ham was supporting that and I confess that my recall is not much greater. I'm sure there were others but I can't really recall them.
Q: They seem to be some of the same people who were grouped around the journal Blood, it's editorial board.
Ross: That's correct.
Q: The members of the Blood Club also participated in the International Society of Hematology. It was at a meeting of this society in Boston that the suggestion came up, once again, to form an American Society of Hematology. Can you, perhaps, recount what went on there?
Ross: It was decided to hold a meeting of the International Society of Hematology in Boston. Invitations went out around the world and lo and behold, I think something like two thousand people showed up at that meeting, which was far greater than had been expected. Of those two thousand people, it's my recollection that twelve hundred or fifteen hundred of them were Americans. It was an excellent program and the enthusiasm and the scientific excellence of the presentations was really quite striking.
In the course of this meeting, there was a sort of an ad hoc group that got together for a dinner at the Harvard Club, which was immediately adjacent to where the ISH meetings were being held. I think this dinner was paid for by Shields Warren. Shields Warren was there, Charlie Doan, Bill Dameshek, Carl Moore, I was there, and there were other people there, too. I think Bill Castle didn't see fit to attend since he didn't think there should be a separate organization at that particular time. After a very good dinner, there was a concrete discussion about forming a Hematology Society, and it was decided that if 1200 Americans wanted to come to a meeting like this ISH meeting, there ought to be an opportunity for them to have their own organization and to schedule their own meetings.
That was the beginning of the American Society of Hematology. An ad hoc group was appointed to develop a constitution and bylaws which was accomplished. There was some confusion about that--as to how much expertise was going to be required for anybody to join the society. It ultimately was decided that it should be inclusive and not exclusive, and that we should welcome people to this organization who might be chemists, physicists, bacteriologists, as well as clinical hematologists, and it became an inclusive organization that welcomed anybody who had interest in the field.
[end of side one of tape four; beginning of side two]
Q: Dr. Ross, I was wondering if you could provide some background information on some of the people who participated in the ISH meeting in 1956 which finally called for the formation of the American Society of Hematology. Could you first begin with Dr. Berman?
Ross: Lawrence Berman came from Detroit. He was a professor of medicine in hematology and a very effective organizer. He had been designated as chairman of the bylaws committee. I remember he made a trip to Los Angeles to see me to try to obtain my views as to whether this should be an exclusive or inclusive organization. I urged that he right the bylaws to make it inclusive and I think he got a good deal of advice to that effect and it was done, which, as I commented, was a very wise and a very successful endeavor. The society, now, has all kinds of different specialists in it, although the preponderant membership is clinical hematologists.
Q: Doctor Tocantins, was it?
Ross: Doctor Tocantins. I believe he was of Brazilian national derivation. He was employed in Philadelphia, Pennsylvania and he was, I think, a pathologist fundamentally. He was interested in the dynamics of certain aspects of hematopoiesis. He brought an international flavor to the group. He strongly supported its establishment, too.
Q: Dr. Jacobson?
Ross: Dr. Leon Jacobson was the head of hematology at the University of Chicago--a very colorful gentleman. He ultimately became dean and he sold the medical school to the Pritzker family, so it's now the Pritzker Medical School at the University of Chicago. In the process of doing this, he raised some five million dollars for the school so I guess it was all right. But Jake was very interested in the hematopoietic effect of the kidney and hematopoietin. He exploited this very successfully. He, too, was a very astute gentleman and a very good clinical hematologist. He contributed a great deal to the concept of establishing the Society of Hematology. Jake is retired now. So far as know he's in good health but I don't know whether he does anything in relationship to hematology now or not. It might be worthwhile to contact him and find out.
Q: Dr. Crosby?
Ross: Bill Crosby worked with Bill Dameshek. He was a colonel in the Army--and an excellent hematologist and a very good organizer! He contributed a great deal of wisdom. He ultimately had very severe visual difficulties with cataracts, which were removed, so he was burdened with very thick lenses in his glasses, but this didn't dilute his interest and effectiveness in hematology. He was a good writer and he wrote a great many articles which contributed to our understanding of such diseases as paroxqsmal nocturnal hemaglobinuria and others. For a while, he was in San Diego. I confess I don't
know where he is now.
Q: Dr. Philip Levine?
Ross: Philip Levine--I think he pronounced it Levine--if I'm not incorrect, was a blood grouper. It was he who recognized the importance of the so-called lesser factors in blood grouping and compatibility, and discovered the Rh factor. He was a very interesting and a very dynamic person. I think he ultimately went to work for industry. He also was a very strong supporter of establishing an American Society of Hematology and contributed good ideas about it!
Q: Doctor Joe Hill we mentioned before. Doctor Jones?
Ross: Oliver P. Jones was an anatomist who came from Buffalo. He was a professor of anatomy in that school. His primary interest was the cytology of blood cells and the morphology of blood forming organs. A very stimulating gentleman! Because of his initials, he was usually referred to as Opie. I think he’s still going strong. He's a charming gentleman with a very considerable interest in the history of medicine.
Q: Did Henry Stratton continue to play a central role in bringing together hematologists at this stage?
Ross: Yes, he did. He provided the funding to establish a Dameshek Memorial Award after the death of Bill Dameshek. He attended all of the meetings and he made appropriate comments at the time that they should be made. He was a very good advocate of the journal Blood, and wanted it to become the official journal of the society. Ultimately, he was awarded an honorary doctor of medicine degree. I'm not sure which institution it came from. He was made a member of the American Society of Hematology. I think if you had asked him, he would have considered himself as a parent of the American Society of Hematology. He was a very effective promoter and a very effective publisher. He just died fairly recently. In his memory, the Society of Hematology Stratton Award and lectureship were established. I believe that the funding for the Dameshek Award was provided by Henry Stratton--and I'm not sure, but I wouldn't be surprised but that he also provided the funding for the Stratton Award and lectureship.
Q: You've mentioned that numbers of people who participated in this meeting of the International Society of Hematology and gave the call for an American organization came from different disciplines. Were they generally connected to hospital services? Or was there any input also from academic departments?
Ross: I think the primary stimulus came from people who were academics. On the other hand, there were many, many people involved in this who were hospital pathologists and who worked in hospitals. I'm not sure that there were any of them that were solo practitioners and did nothing except practice hematology. I think most of them derived from institutions which salaried them and perhaps sponsored and fostered their interest in hematology. I can't give you a percentage breakdown, but I think roughly that's about the way it developed. But there were pathologists, anatomists, physiologists, biochemists, clinicians. There was a whole mix of all of these people together, which I think led to the development of this field, which is an eclectic field and also an inclusive field. I think is splendid!!
Q: Did programs develop at this time in other universities in terms of teaching at the postgraduate level or within the medical schools concerning hematology?
Ross: Yes, I think the stimulus of the creation of the American Society of Hematology, the publication of the journal Blood led to an increased interest in hematology in many institutions. All medical schools very shortly had divisions of hematology, most of them dedicated to research endeavor as well as to patient care. This, of course, was complemented with the establishment of the subspecialty of hematology as a certifiable subspecialty of the American Board of Internal Medicine, because this then made it possible to establish formally organized and recognized residencies in hematology in medical schools and hospitals with the opportunity for the graduates of these residencies to become Board certified hematologists. This developed very rapidly. There was a certain contention between the Society of Hematology and the American Board of Internal Medicine as to who was going to have the responsibility for this specialty certification, but there was a very strong gentleman named Jack Myers, who at that time was chairman of the American Board of Internal Medicine. I remember he made a visit to the Society of Hematology meeting and members of the Society were protesting what they considered to be the preemption of the field by the Board of Internal Medicine. Jack Myers had a short fuse. He got up and he said, "I don't care what your going to do, the Board of Internal Medicine is establishing this and if you have any sense you'll join in and support it to make it good because you're not in a position to offer accreditation of training programs or to really issue any special certificate in the special field of hematology!!" He said, "You'd better join up with us and we'll do it together and make it much better," and that occurred to the great advantage of hematology, the Society of Hematology, the American Board of Internal Medicine, and most importantly the citizens of the United States.
Q: In April of 1957, hematologists came together to carry out the first meeting of the American Society of Hematology. Could you recount some of the events during that?
Ross: I believe, although I'm not sure, that that meeting was held in St. Louis. Is that where it was held? I think so. At the time, Carl Moore was the President. I can't be too sure of that either. At the first meeting, it was planned that we should go ahead and make as good an organization of this specialty as possible and that we should rotate the meetings in different parts of the country to make it possible for people who couldn't afford transportation costs to attend some of the meetings. That has been done since. The meeting, I think a year or two later, was in Los Angeles, then it was in Columbus, Ohio. At one time it was in Canada. Usually, the meetings rotated to be held in the location of the city in which the president resided. I was president-elect when we met in Los Angeles and president when we met in Columbus, Ohio. This was really determined at the first meeting of the society and, again, it was an attempt to be all inclusive and make possible the participation of as many people as possible. That's continued and now the society meetings are very large and there are multiple sessions that provide an opportunity for anybody who has got anything worthwhile saying to say it. Initially, there was only one session for the whole duration of the meeting. When I was president at the time we met in Columbus, Ohio, for the first time I started dual sessions that were simultaneous. This provided an opportunity for twice as many people to present papers, but it also meant that there were conflicts in attending sessions. People who had an interest in a subject which would be presented here in Session A and also interest in a subject presented at the same time in Session B couldn't attend both presentations at the same time. It made it impossible for a person to hear all presentations, and this led to criticism. However, dual or multiple simultaneous sessions have continued. Now there may be many sessions held simultaneously.
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