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Q: Shortly after he won the Nobel Prize.
Ross: That seems so terrible, doesn't it?
Q: Yes.
Ross: Why did he commit suicide?
Q: He became almost reclusive, I understand, from comments by David Rittenberg and others. Nobody knows. There's no clear motive.
Ross: I've had several friends commit suicide. It's always terribly distressing! I always wonder why bright people who could have made so much more of a contribution and lived such a wonderful life could be so dumb! I knew a physician named Saul Hertz, in Boston, who used radioiodine on the East Coast. He was a nice man and very effective investigator. He [committed] suicide. His co-equal radioiodine investigator Mayo Soley on the West Coast [committed] suicide. So, suicide was not unique. It occurred in San Francisco, Iowa City, Boston, in Rochester, and New York.
Also Carl Moore, in St. Louis, began to use radioiron as a tracer. It was rapidly being recognized that radioactive tracers were an effective way to studying the physiology and the dynamics of biological processes.
Q: Do you know if the Rockefeller Foundation was behind the promotion of use of radio isotopes?
Ross: So far as I know, only in as much that they made isotopes available through the funding of the cyclotron in Berkeley initially, and they supported George Whipple's activities in Rochester, but I do not know that they specifically went out to enhance the use of these tracer materials. That's as far as I know.
Q: Could you comment some more about the research that you did in your period under Whipple in Rochester?
Ross: Yes, we were interested, as I say, in the rates of formation of hemoglobin and these studies were done on dogs that were made anemic by repeated phlebotomy and then we studied the rate at which they could regenerate blood under different circumstances and with different dietary supplements. For example, if a the dog was profoundly depleted of protein, he couldn't regenerate hemoglobin even if he had an adequate amount of iron and if he had plenty of protein but no iron he couldn't regenerate blood either. Studies were also made of the effect of certain types of amino acids in stimulating blood formation. All these studies were made on animals. In Dr. Whipple's laboratory no work was done on human beings, and when I came to Boston I began using radioactive iron in studies in humans of rates of hemoglobin synthesis, blood formation, and also in the preservation of red blood cells. I've already mentioned that labeled my own blood with radioactive iron. We'd bleed this out and store it with different preservatives for varying periods of time and transfuse these, my radioiron labeled erythrocytes into people and find out how long the cells lived. I developed a hemorrhagic anemia myself as a consequence of this work. The major product of my hemorrhagic anemia was that it made me unduly susceptible to the effects of alcoholic beverages. On one or two occasions a couple of drinks put me under, which is regrettable but I never really got hurt as a consequence. What was the question you asked?
Q: I was asking more about the research that you undertook at Rochester.
Ross: Oh. I told you about the work done with Leon Miller in terms of the protective effect of the protein and methionine in toxic hepatic disease. Subsequently, this was found to also have some beneficial effect in human beings who had various types of infectious, as well as toxic, hepatitis. For example, we saw some patients who were alcoholics who had knocked off the wall a carbon tetrachloride fire prevention suppresser device and developed toxic poisoned with carbon tetrachloride poisoning and hepatitis who when given methionine were greatly benefited and survived. It's not really as effective in patients who have infectious types of liver disease, although it does benefit them. So my work there was primarily tracer studies with Paul Hahn in terms of the kinetics of hemoglobin formation and the studies with Leon Miller of the protective effects of protein and methionine on toxic hepatitis. I also performed one hundred autopsies, and did surgical pathology in Rochester. Right now that's about all I can remember.
[recorder turned off and on]
Q: Doctor Ross, could you please comment about some of your activities in the clinical services dealing with hematology?
Ross: As I have stated, during the time I was working in Rochester I also had active involvement in the autopsy work of the institution. While I was there, there was a series of six patients who died of mismatched transfusions, which produces a hemolytic process with release of hemoglobin into the blood stream. This hemoglobinemia then blocks kidney function. This stimulated a great concern in regard to this subject. I did a great deal of work on this and recognized that the hemolytic processes that occurred as a consequence of mismatched blood transfusions eventuated in kidney failure. Also while I was there, I began to realize that people who were subjected to transurethral prostatectomy also developed hemogloginemia and hemoglobinuria the usual irrigating fluid that was used to fill up the bladder was water. Interestingly, there was a reflux of water from the bladder into the venous system with the production of acute hemoglobin release into the blood stream and renal failure. This bore a relationship to the field of hematology since hemolysis was caused by the introduction of water into the bloodstream. I think these observations were facilitated at Rochester because the clinical and laboratory services were in one building. The medical school, the pathology laboratories and autopsy room were only a few steps from the clinical areas where the patients were experiencing their problems. This was really more effective than the situation at Harvard where the great hospitals were physically separated from the basic fundamental laboratories. It wasn't quite so easy at Harvard fundamental research with the clinical activities that were going on in the hospitals. Although each of these great hospitals have their pathology laboratories, I think that the correlation of the clinical and the pathological observations was probably greater in Rochester when I was there than at Harvard, or as I subsequently experienced it at Boston University.
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Q: Dr. Ross, in 1940, you moved back to Boston, and assumed a position at Boston University as Assistant Professor of Medicine and Head of the Division of Hematology. I was wondering if you could comment on this move.
Ross: Yes. When I was in Dr. Whipple's department at Rochester, I considered going into pathology; he offered me a job, but I decided I'd rather work with living rather than dead patients. At that time, Dr. Chester Kieffer, who had been at the BCH Thorndike Memorial Laboratory and professor of medicine at Harvard University, moved to Boston University medical school, which was across the street from the BCF and Thorndike, and became the Chairman of the Department of Medicine at Boston University. He recruited a number of young physicians. He was in the process, really, of revising not only the Department of Medicine but the whole school, which had been a homeopathic institution. Dr. Reginald Fitz anteceded Dr. Keefer at B.U. and started the change--from a homeopathic to an allopathic medical school--but Chester Keefer vigorously made it even more effective. He subsequently was effective in recruiting new professors of surgery, and of other departments and a new dean, Dr. James Faulkner. He brought a group of physicians at University medical school and salaried them with funds provided by the Robert Dawson Evans Memorial Fund which must have had a very sizable endowment. And all of financial support was paid from this endowment, of which Dr. Keefer was the director. I think he had some questions as to how he was to use these monies. We were housed in a quite old building, and it was very crowded, but we were very productive and had a very good time! He provided all of us with a laboratory, an office, a secretary, and technicians. I went there and began to use radioactive materials to investigate red cell kinetics, to treat leukemia, polycythemia with P32 and thyroid disease with 1131. At that time, there was no central supply of radioactive materials, so I made an arrangement with Harvard University, Dr. Kenneth Bainbridge, professor of physics to obtain radioactive materials from the Harvard cyclotron. I was provided with the cyclotron targets which were iron phosphide soldered on a copper block. It was my job to take these targets, dissolve them in aqua reglo, and ultimately to separate the iron, phosphorus and copper and other materials from the solution. As we received these from the Harvard cyclotron they were quite intensely radioactive, and the major part of the radioactivity was in the copper target to which the iron phosphide had been soldered. We really didn't have adequate facilities for processing this highly radioactive material. The technicians wouldn't come near it, so I was responsible for performing the chemical procedures for separating the various constituents. I wanted to use the radioiron. Dr. Shields Warren at the New England Deaconess wanted to use the radiophosphorus, which, by that time, was in the form of sodium phosphate, for treatment of various diseases. I also used some of the sodium phosphate for treatment of leukemia polycythemia rubro vero and other diseases. I used the radioiron for research work. It's of interest that the Harvard cyclotron didn't have very good safety regulations. When the individuals who ran the cyclotron would take out the targets and the parts of the cyclotron which were called, "dees," they would get a sunburn of their faces, from the intense radiation to which they were exposed. And I did some blood studies on a couple of these fellows and they had marked aberrations of their leukocytes, and I've never known what finally happened to those poor fellows; I sure wish I could track them down, sometime, maybe, I can. But they didn't have adequate protection, and the people in my laboratory including me didn't have adequate protection. Dr. Franz Ingelfinger who shared my lab had a technician who was a lady not in her greatest youth, who had a period of amenorrhea. She knew there was radioactivity there, and she got very disturbed, and went to Dr. Keefer complaining about the fact that this radioactive material was giving her amenorrhea. But then, in due course, it appeared that she was pregnant, and her amenorrhea was not occasioned by the ionizing radiation. This was sort of a catastrophe to this poor lady: she was not married, and she was not terribly young, and she resigned from her position. I never knew, really, what finally happened to her, but the ionizing radiation didn't cause her amenorrhea. The--
Q: When did--excuse me--when did discussion come up about the safety hazards due to radioactive isotopes?
Ross: There wasn't very much discussion of this. It had been recognized that X-ray caused health troubles, and there were attempts to control the use of X-ray, particularly fluoroscopy, because, when I was there, people were getting terribly burned from fluoroscopic procedures, particularly orthopedists. A young orthopedist who was setting bones under a fluoroscope got so badly burned that he had to have his hand cut off! Very tragic!! But the concern about the radioactive isotopes, radium, and radon was really not very great, which was unfortunate. The exposure which I received as a medical student calibrating radon and radium was supplemented by the exposure I got processing the cyclotron targets, and using radioactive materials. The radioactive material was hard to come by, although it was not terribly expensive, since Harvard gave it to me for free, as a gesture of good will. But we tried to recover the material by chemical processing of the stools that patients passed to recover the iron and use it again. And this, I think, produced a significant exposure. How much I don't know. We didn't have any personnel monitors to determine how much ionizing radiation exposure we had received, maybe that was just as well.
Anyway, this was very exciting for me, and lots of other people, and the use of these materials made it possible to label many substances and to study what happened to them in the body. In addition to studying hemoglobin formation, I also studied absorption of radioactive iron in order to determine from the gastrointestinal tract and also for direct measurement of the red cell mass. At that time, the red cell mass was determined indirectly by calonaling red cell mass from the plasma volume, which was measured using dyes. It became apparent that, under pathological conditions, the dye known as Evans Blue, was bound to plasma protein which did not really stay entirely in the vascular system, but leaked out into other places in the body. This gave an erroneously high indication of the plasma volume. Since the determination of the red cell mass was calculated from the measured plasma volume and the hematocrit, it was also too high, and a hematocrit measurement from blood, taken from the peripheral vessels, was an erroneous indicator of the total body hematocrit. We did studies trying to determine the relationship between the hematocrit [that is, the percentage of red cells] in the circulating blood as determined on a sample of venous blood and the total body hematocrit, in order more accurately to try to calculate the total red cell mass from the determined plasma volume. But then, we also realized that this was not really the best way to measure the total red cell mass. Therefore, working from information that had been provided by Dr. Von Hevesy, we developed techniques for labeling red blood cells and using them to determine the actual red cell mass. Initially, this was done using radioactive phosphorus as a label for red cells. However, it was not really very satisfactory, since the radioactive phosphorus leaked off the red cells and again caused inaccuracy. We were able to use erythrocytes tagged with radioiron that had been incorporated into the red cell hemoglobin. When the cells were made in the bone marrow this was a very accurate way to determine red cell mass but it necessitated administering radioiron to the donor of the labeled red cells. Subsequently, with others, we developed a technique for labeling red cells with radioactive sodium chromate. The radiochromate that entered the red cell left the red cell at a quite stable and a relatively slow rate. This made it possible to determine quite accurately the red cell mass. This is a technique which is still used clinically in quantitating the red cell mass in individuals who may have polycythemia, in determining whether the polycythemia is "spurious polycythemia" or polycythemia rubra Vera. There was a medical resident who worked with me, named Milan Chapin, who came from Maine. He was a wonderful gentleman, and a very industrious fellow. We worked very hard at this research. Neither of us was married, and we could dedicate nights, days and weekends to this work, which we did. This research eventuated in a series of publications, which, I think, would stand up even to this day; nobody's refuted the data that we presented. And then the war began. I was working on-
Q: Before we go on to talking about the war period, I was wondering if you could give some more information about the early use of these radio isotopes. At Harvard, you had connections with the Physics Department, is that who administered the cyclotron?
Ross: The Physics Department of Harvard College operated the cyclotron. My friend, Dr. Shields Warren, a Professor of Pathology at the Harvard Medical School, assisted me in my contacts with Professor Bainbridge of the Harvard Physics Department. When I began research with radioactive iodine, I developed contacts with scientists both at Massachusetts Institute of Technology [M.I.T.] and also at the Harvard Medical School's Massachusetts General Hospital. The use of radio iodine to study thyroid physiology developed almost simultaneously on the East and the West Coasts. There was a M.I.T. professor of chemistry named Roberts, who was very helpful to me in terms of the localization and the characterization of radio iodine in the thyroid. This was, again, an example of the free intercooperation of individuals from disparate disciplines, and from different institutions who really worked together very well. There was never any very great consideration of the financial aspects of this; there was money available for most of these endeavors without having to do an accurate cost-accounting. From the standpoint of a young physician and a scientist, this was wonderful, but I suppose from the standpoint of economics, as we would do it today, it was really very loose.
Q: Were there any other monies besides this Robert Dawson Evans Foundation?
Ross: Not that supported me. Shields Warren, I don't know where he got his money. He was salaried, I think, by the New England Deaconess Hospital, where he was the hospital pathologist. Whether he had other funds or not, I don't know. The gentlemen at M.I.T., were salaried from their professorial positions at M.I.T. As far as I know, there was no other subsidy provided. And, this was a very pleasant and a very good cooperation. I also was involved in studies of blood preservation with Dr. Robert Evans, Professor of Physics at M.I.T.
In those days there was no commercial source of equipment to accurately quantitate radioactivity or to do the measurements that we had to do. A very fine gentleman named Ivan Getting, who subsequently went into the space industry was very helpful! He arranged for a technician who was working at Radcliffe College to build for me a counter and scaling circuit, instruments to quantitate radioactivity. This young man was salaried by Radcliffe College. Ivan Getting was salaried as a Professor either of Physics or Engineering, and I think probably both, at Harvard. But he very kindly provided the diagrams of circuits, supervision, et cetera, et cetera, to make the scaling counter. However, the instrument that did the actual detection of radiation was made by my friend Dr. Bill Bale, of the University of Rochester, with whom I had worked when I was there: he very kindly prepared the Geiger Counters which I used. This was, in essence, a cooperative effort of five different universities!
Q: How do you spell Bale's name?
Ross: B-a-l-e. William Bale. B-a-l-e. He was a physicist at Rochester who had cooperated with Paul Hahn and George Whipple, when I was there as a resident. This very kind gentleman was able to provide assistance. When we got this equipment set up, we worked it around the clock, and learned about the problems that occur from fluctuating voltage in the electrical system. We learned this the hard way, and had to get voltage stabilizers because every time the elevator would go on in the building in which we did these studies, the voltage would drop so much that it would interfere with an accurate quantitation of the radioactivity. But we had lots of support from Dr. Keefer and lots of support from everybody and we were able to proceed.
We gave radioactive iron to individuals. We started out with patients who had iron deficiency anemia and pernicious anemia, and were able to show a markedly different rate of absorption of iron, and of uptake and disposition of iron in the erythrocytes of these individuals. I remember there was a little boy eight or nine years old, who had one of the most profound cases of iron deficiency anemia that I have ever seen, primarily because of bad diet. And, perhaps cruelly, I used to phlebotomise him after I had given him radioiron, in small amounts. Ultimately, I gave him a couple of transfusions and iron medication and cured his problem. I recollect that I became very attached to him; I took him to the circus and to ballgames, more or less as a walking cooperator in my research endeavors. Then, the war came along, and I was working in my laboratory on the fourth floor of the Evans Memorial Building on the afternoon of December the seventh, when news of the bombardment of Pearl Harbor came over the radio. This was very disturbing, not only to me, but to the rest of our group at the Evans. This interfered with our research for a while. The young man, Milan Chapin, who was working with me, immediately volunteered to go into the Army, and at that point, Dr. Keefer became concerned that the rest of his staff also was going to depart. He had connections in Washington, and he urged all of us to stay where we were, and he obtained deferment from military service to continue the teaching and research work that we were doing. At that point it became apparent that there was going to be need for blood transfusions on the battlefront.
Q: Just before we go on to that as a separate section of discussion, I was wondering if we could talk about some of the research investigators under Keefer who were present when you first arrived at Boston. We started to talk about Franz Ingelfinger before.
Ross: Franz Ingelfinger was in my class at Harvard Medical School. His father was a south German, a very jovial, large, wonderful gentleman who married an American lady who had gone to Germany to teach English. After they were married, they came back to the United States, and they had Franz Ingelfinger, who was a wonderful fellow, my best friend. We shared an apartment before we married our wives. He was interested in gastroenterology. After completion of internship at the Boston City Hospital, he went to Philadelphia to work with Osler Abbott who was studying the physiological aspects of gastroenterological function. I think he was there for two or three years. He was brought back to Boston by Chester Keefer to introduce these studies and to head the gastroenterological division at the Evans Memorial at Boston University. He had a very distinguished career; he made very excellent contributions in the field of gastrointestinal motility, particularly of the esophagus. Then, later on, he became the Editor of the New England Journal of Medicine. He filled this position with very great distinction for a number of years, and then, sadly, he developed carcinoma of the esophagus, one of the fields in which he had done a great deal of work. He had a resection of the esophagus, and replacement with a section of intestine, but this never was really very satisfactory. He continued to have great pain, and ultimately, the carcinoma killed him. Interestingly, a UCLA professor, Morton Grossman on the West Coast, who also was working in gastrointestinal physiology, also developed carcinoma of the esophagus and died within a few years of Franz Ingelfinger. That seems to be a peculiar coincidence to have two people on opposite coasts who worked on the same organ system to die of the same rather uncommon disease. It is sort of similar to the two people who had worked on thyroid disease in Boston and San Francisco, both of whom died of suicide. But Franz Ingelfinger and the gentleman out here did not suicide; they died of carcinoma.
Q: You mentioned also Robert Wilkins?
Ross: Robert Wilkins was a Harvard graduate who came from the South, and I think he had been working at the Thorndike, and Dr. Keefer brought him to Boston University to be the head of the cardiovascular division. Bob was very actively concerned with investigation of the function of the heart. He was one of the first people in Boston, at any rate, to use heart catheterization to study blood flow through the coronary vessels flow through the chambers of the heart. He was a very effective investigator, he also had great concern for the problem of pulmonary embolism; pulmonary embolism killed a huge number of patients following satisfactory completion of surgery. Bob and the Head of the Department of Surgery, Dr. Reginald Smithwick, conceived the idea that if they would compress the diameter of the veins in the leg with elastic stockings, it would accelerate blood flow and diminish the rate at which thrombosis might occur, and thus decrease the incidence of pulmonary embolism. This concept was developed by Wilkins and his associates, and it worked extremely well. It is used today in post-operative patients and in other people who are inactive and lying in bed. This appreciably has decreased the incidence of pulmonary embolism. And Bob Wilkins was married to the heiress of the Fisher Body Works, which at that time made all the bodies for General Motors autos. So he had a lovely wife, a wonderful person, and she was exceedingly well-to-do, and Bob didn't really have to work, so at a relatively early age, he retired, and went up to Newburyport, where he still lives. He has no contact with medicine, which seems sort of sad, because he was an innovative, brilliant investigator, and a very fine clinician, and took excellent care of patients. But he just went up there and, I heard some people talking about him last week: he's active in the town affairs in Newburyport, but he doesn't have any contact with medicine, which is kind of unusual. But he was a very good stimulus to the rest of us; he was older than we by a few years, and he sort of assumed a relatively significant role in representing the group to Dr. Keefer.
Another excellent colleague was Francis Cabot Lowell, who was a graduate of Harvard in my class, and he was interested in immunology, and allergy. He worked intensively on studies relating to antibodies that develop against insulin, in diabetic patients who were treated with insulin injections. He was busily involved in making insulin out of chicken pancreases. He determined the per unit value of insulin from the chicken pancreas, compared with that from pigs, porcine insulin. He developed antibodies against that insulin quite successfully. The work that he did, in terms of antibody formation to insulin has borne fruit and it's an extremely active area of concern, even at this time. He subsequently went to the Massachusetts General Hospital at Harvard, where he was head of clinical immunology activities. Unfortunately, he had a heart attack and died in his bathroom in the middle of the night five or six years ago. Very sad! He inherited his name, Cabot Lowell, from the Cabots and the Lowells. He occupied the Lowell mansion in Concord, which was a wonderful place. And he and Frank Ingelfinger married sisters, named Shurcliff. Both had wonderful children, and all of us and our children used to visit Frank Lowell's establishment in Concord, and had a wonderful time! It's tragic that he expired at a relatively early age!
Another very interesting gentleman who was at the Evans was Louis Weinstein, who came to Boston University with a Ph.D. in bacteriology from Yale. He arrived on the scene a little later than the rest of us, although I think he was about the same age. He considered himself Yale's gift to Boston, and Yale University's gift to Boston University. He was a very vigorous, very aggressive, very intelligent and very competent young gentleman! He worked under the jurisdiction of an infectious disease man named Charles Rammelkamp. Rammelkamp, Lowell, Ross, Ingelfinger and Wilkins served as an abrasive force to rub off some of his rough edges and to educate him in the ways of Boston medicine! He took it very well!! He has done very well. He was a wonderful fellow! He became Professor of Medicine at Tufts University, and when they retired him there, he went to the Peter Bent Brigham, at Harvard, and is continuing to pursue an active and a very productive career. He played the cello, and Ingelfinger played the piano. They used to play duets in a most excellent fashion. Another very pleasant activity at the Evans!!
Charles Rammelkamp was another of the people that were brought to the Evans by Dr. Keefer, and Charles was a very good comrade. He married Chester Keefer's secretary, which didn't please Chester Keefer very much, and when the lady got pregnant, and became obviously pregnant, he sacked her, which I always thought was a big mistake! There's nothing wrong with being pregnant, but her appearance embarrassed Chester Keefer. The Rammelkamps had several children. They went to Western Reserve, where he was a professor. He was in charge of infectious disease investigations for the Army at one point, and did extensive, crucial studies of the incidence of streptococcal infection in military personnel stationed in various parts of the world, particularly up on the Colorado plateau, where they had a terribly high incidence of streptococcal infection, with complicating nephritis. And now he's dead. I think he also died of a heart attack several years ago. Another individual who was there was Stanley Bradley, who was studying the kidney. Stanley and his wife worked together in the same laboratory. Stanley is still living, and his research has been very productive. He became the Bard Professor of Medicine at Columbia University, and on his retirement, he has carried on investigative activities in Switzerland. He also had an arrangement in the summer time in which he would go to Bar Harbor and study the kidney function of seals and sea lions: if you put a seal's nose under water, he immediately clamps down on the circulation through the kidney in order to circuit the blood from there to the heart and other places that were more vital to his under water activities. The Bradley’s had a wonderful experience at Bar Harbor, and, in addition, did very good research work. He had a daughter, Jane, while he was at the Evans. Jane is a lovely lady! She worked here at U.C.L.A. as a resident in medicine, and subsequently went back to a faculty position in hematology at the University of Pennsylvania. She married a very nice Iranian gentleman, Abass Alavi who's director of nuclear medicine at Pennsylvania.
Additionally, at the Evans there was Arnold Relman, who was interested in endocrinology, he went to be chairman of the Department of Medicine at the University of Pennsylvania, and, after Ingelfinger's death, became Editor of the New England Journal of Medicine, which he now is doing. Do you want any more about these people? I don't know how much all of this is relevant, but--
Q: Sure. Well, the point of interest is that Keefer is coming into Boston U. to do over the University and, on the one hand, he apparently has a source of funding; on the other hand, he brings in a number of new investigators. So, the next question is, is there anything else, did he bring a particular philosophy of how a medical school should be established.
Ross: Chester Keefer was a top flight magnificent clinician. He had an encyclopedic memory. He read very extensively. He knew everything about everything, it seemed to us at the time, but his emphasis primarily was clinical medicine. He developed extremely excellent clinical services, both inpatient and ambulatory, and he was able to attract extremely good interns and residents who got a great deal of his philosophy in their training. But he also recognized the value of more basic, fundamental and laboratory research, which he supported very vigorously, and most of the people that he employed, in addition to being good clinicians, were interested in these various basic science approaches to medicine, Chester was very anxious to fund, and this work he did fund these researches extremely well! And he transformed this old homeopathic Boston University medical school into a top flight research and teaching institution!! When we arrived there, there was a homeopathic pharmacy that had a room filled with medications with titrations out to the five-power dilution. These were supposed to be effective in the homeopathic system of medicine in treating disease. Chester didn't cater for that very much. On the other hand, there were funds which had been given for homeopathic medicine, and he ran into trouble with this, and the physicians who were persuaded of the possible benefits of homeopathy, took all this money, and established a new hospital out in Washington Heights: a very elegant, small hospital with beautiful stainless-steel everything, et cetera, et cetera! That was a loss to the Boston University School of Medicine, but I guess there was no other way to solve the problem, since the money was given to the university with the stipulation that it was for homeopathic studies. They were unable to modify the bequest. Dr. Keefer made B.U. a really first-class medical school! It, as does Tufts University School of Medicine, suffers in the shade of Harvard Medical School, which is such a tremendous organization. Neither B.U. or Tufts medical schools achieve the recognition that they might if they were in another city. On the other hand, B.U., Tufts and Harvard get along, really, very well, and all three of them have thrived. Harvard Medical School has such success in raising money that it sort of out distances the other two institutions. But Chester Keefer really made a tremendous and vast change in the medical school! Unfortunately, he had a tragic and bad death. Just as I was leaving Boston, he had prostatectomy and the path report benign prostatic hyperpasia. Well, it's of considerable interest that twenty years later, he noticed a lump in his neck, which he thought was lymphoma; a biopsy showed it was carcinoma of the prostate. Review of the material that had been removed in 1954 revealed there was cancer in the prostatic tissue. In thinking about this, it maybe was a good thing that it had not been diagnosed originally, because, had it been recognized in 1954, they would have castrated him, they would have radiated him, and they would have given him chemotherapy. There's considerable question as to whether that really would have eradicated his disease or prolonged his life. He had twenty good years of good life, so, I think, maybe it was a good thing they hadn't recognized it. Chester had terrible pain at the end, which was excruciating and very difficult to control. It was considered desirable to give him radioactive phosphorus to see if this would control his pain. It didn't help his pain very much at all. He was a very great gentleman and a very great man physician!! He made great contributions to the field of medicine, medical education and to mankind!!!
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