Q: What would account for that, do you think?

Tullis: Well, I think it comes back to one of the questions you asked earlier about the interaction between hematology and other sciences, that the hematologists had a tendency to have a strong scientific orientation and interest, which was attractive to committees that were appointing professors of medicine. It's as simple as that. They had lots to work on and no inhibitions, and they didn't, I don't think, as a rule, go out and deliberately write papers as a career thing to try to make themselves look better, but there was so much to write about there was plenty of opportunity to collect a large bibliography.

Q: Which fields outside of hematology would have most influenced the thinking that was within the field at the time?

Tullis: Well, it was before the era of infectious disease as a sub-specialty interest. Pulmonary disease was on the down swing because people were starting to stop smoking, and tuberculosis had partly been wiped out. Infectious disease didn't have a great deal of appeal at that time---I think rheumatology had a lot of interest, because of its interaction with immunology. Rheumatology and immunology were very closely allied from the work on cortisone and so on. Endocrinology produced a number of professors of medicine, but hematology was unquestionably way out front.

[Tape interruption]

Q: I would like to ask several questions dealing with the development of hematology as a discipline from an institutional point of view. Perhaps we can start by a discussion of the formation of the journal Blood, and some of the people who were instrumental in developing the journal, people such as Henry Stratton, and others.

Tullis: I think one would begin a discussion of the journal Blood by referring first to Henry Stratton, whom you probably already have information on. He was a young Viennese who came to this country in, I think, the middle 1930s, or late 1930s, and decided to publish scientific journals and medical journals. I think, secretly, he had always wanted to be a physician, but for reasons that were personal, he never achieved this, except as an honorary degree late in life. But he was a very knowledgeable, very suave, very sophisticated individual who could get along with people, and he started a couple of journals, and formed his own publishing firm of Gruen & Stratton. One of the journals he wanted to start was Hematology, which later was called Blood.

Q: Who is Gruen?

Tullis: I don't know.

Q: Okay.

Tullis: I don't know. I never met Gruen; I knew Henry well. Never met Gruen, can't tell you anything about him.

Q: Okay. So this is 1945 now that we're speaking about?

Tullis: Yes. So in the late 1940s, Henry began to come to a club that we had organized in Atlantic City called The Blood Club. The Blood Club was a totally structure less, unformed meeting of the kind I just loved, and my training with Edwin Cohn had made this such a natural thing that I was one of the sponsors of this--which was just to sit down and talk! People working in the same discipline. And we decided to have it always at the time of the Young Turks' Meeting, which was the Society for Clinical Investigation, and the young people working in full-time departments of medicine throughout America. It was always held at the Chalfone-Haddon Hall Hotel--I guess those are gambling places now--in Atlantic City.

I have to pause to say that my grandfather was a very austere Quaker who not only didn't believe in gambling, he didn't even believe in music. He had a friend, Mr. Leeds, who had formed Haddon Hall, and so my grandfather spent the summers always at Chalfonte Hotel in Atlantic City. I used to go as a little boy to visit him and they wouldn't even allow string music in the dining room because it was a thing of the Devil! And when I think of the gambling palaces that are there now, I'm sure my grandfather's bones are turning over in his grave.

Anyway, the Young Turks used to meet there, in March, or April, I don't remember which--April--every year. So we began having, on one of the Sunday evenings of that meeting, an informal meeting where we'd just sit around and drink beer and talk medicine, and somebody'd get up and talk about what he was currently working on, and so on. Then we began to formalize it a little bit, and have dinner with it, and it moved up to the top floor of the Haddon Hall, where a room seated about a hundred people. And we would discuss single themes. We would take one theme; one year, it was platelets. So I discussed what I was doing with platelets, and so on. Somebody else would discuss what he wanted to do with platelets, and so on. Henry would very much be a part of sitting in to sort of assay what was going on and determine whether it was of value, and he started the journal Blood in part because of this. And he closely related to that, and he began, then--I don't want to anticipate your questions, but you'll be coming to ASH, I'm sure; the American Society of Hematology--and he began saying at our meetings of The Blood Club, "This is so good, it's got to be published. It's got to be formalized. You've got to have a real Society of Hematology." And one person that immediately supported this concept was William Dameshek. Now, William Dameshek, who was in a different medical school here in Boston, was down at Tufts, and he very much got interested in this. Then, in 1954, at our meeting of the International Society of Hematology in Paris, Bill was elected President of the International society, and there were about five or six of us at that meeting from Boston. That was the fourth international meeting of hematologists. There were five or six of us from Boston, and he got us together right after the Paris election, and he said, "Now, you people have to, to really help this.” When we got back here to Boston, he asked me to come over to his house one evening, he said, please, would I do the administrative part, because he said he was so busy, he couldn’t? And I was young enough, so I didn't have any pressing obligations. So Bill's interests in hematology were so world-wide that he very quickly picked up the concepts of wanting also to have a formal American Society of Hematology.

Q: Could you, just as an aside, comment a bit on William Dameshek?

Tullis: Yes. William Dameshek was a very sound man; not brilliant, but excellent in his fundamental ability to transfer knowledge to young people. He was the son of Russian émigrés who had come to America when he was, I think, three, or four, he told me. He didn't even remember it, he was so young, but his mother was the figure that had raised him and gotten him through medical school, and really had just done an excellent job of making him a fine man. He was head of hematology down at Tufts and did not represent the, if you will, vested interests of the old-line group, if you know what I mean, and yet he was able to stand up to them on every level, you know, and prove himself over the years. So they accepted them, which I think is great, and he just did a fine job of this. And he developed Tufts; really, he was one of the main movers of Tufts. He began to get referral patients coming here because of his skills and knowledge. It wasn't that he did any unusual research, or that he was brilliant in science, or anything, it was just that he was a good teacher, every inch a good teacher, and he had vision that when somebody told him something, he could see the potential of it. Of course, his editorship of Blood, which Stratton conned him into taking, again, was a great thing in advancing his career, because everybody then knew William Dameshek.

Q: The funding of Blood, in its initial years, was provided--

Tullis: It was all private, always during the Stratton era. It didn't come under control of the Society until years and years and years later.

Q: I was wondering if we could possibly discuss some of the original associate editors. Dameshek was the first Editor-in-Chief. But possibly if I went through names of some of the first associate editors, just to have an idea of who it was that helped to define this field of hematology at that time--?

Tullis: Well, you didn't feel much influence, except from, I would say, the two people who were pushing the concept of trying to establish hematology as a recognized specialty, and those two people were Dameshek and Stratton, because they were in a position to do it. You see, one of them controlled a journal, and the other one had a heavy influence academically on teaching hematology. There were other persons around the country that felt this shouldn't go too fast. Believe me, there was a strong negative feeling about this. For example, Doan, who was a superb hematologist--

Q: He was one of the first associate editors--

Tullis: That's right--

Q: --also Moore?

Tullis: Yes, I know. But he didn't much believe in pushing hematology too fast. Dr. Moore was absolutely paranoid against any formal organization in hematology. He fought against formation of an ASH until he saw how successful it was, then he realized he had made a mistake.

Q: On what grounds was the resistance to hematology?

Tullis: Well, I don't know. Everybody was busy in his own shop. There was just limitless work to do. They were all well-funded and they didn't want to get too involved in national or international things. They felt they were doing their own thing--do you follow this? It was almost like there was a political movement at the same time in the United States, away from world involvement, you remember, and this was part of the same thing. It was the parochial re-establishment of schools as independent entities, anti-nationalistic, if you will.

Q: How were the original members of the editorial board selected, then?

Tullis: I don't know.

Q: There was Doan, there was Dr. Ham—

Tullis: Ham, yes.

Q: I have Dr. Roy Kracke?

Tullis: Roy Kracke.

Q: And Nathan Rosenthal and Maxwell Wintrobe.

Tullis: Max Wintrobe, yes.

Q: Okay. Were all of them in resistance to--

Tullis: No, they weren't all in resistance, but there was a strong feeling I'm just trying to get across to you--

Q: Okay.

Tullis: --of, "Well, is this the right way to go?”

Q: Okay. But they were all recognized as part of a new field of hematology?

Tullis: Oh, yes. That's right.

Q: Was there anything that they held in common, as far as their research interests, style?

Tullis: No, they were specifically selected because of different interests in hematology, and they were all participants in our Blood Club, and doing research, quality research, that had been published in some areas of hematology.

Q: And this pretty much, would you say, influenced the actual discipline itself of hematology?

Tullis: No, no, I don't think it influenced the discipline of hematology. I think it--well, that's a good question. No, I think hematology, in those days, was growing and determined to grow, no matter what happened, because there were so many people now beginning to work in the field and to publish, and so on. It's a way that brought it together, so that it was cohesive, but that's all. I don't think the journal influenced it in the sense of making it more, or anything else; it just made it easier to read what somebody else was doing.

Q: Outside of publishing in Blood, where would participants in hematology publish?

Tullis: There were some European journals. There were some published in English that were very good that were in the blood field. But there were--well, look at my own reprints. In addition to publishing in Blood, I published in the New England Journal of Medicine; I published in the American Journal of Physiology. I published in all kinds of journals, depending on what the particular report was. If it was a report that was in biochemistry, I'd do it in a biochemical journal, that sort of thing. But there was no place that you centralized things for hematology, but you didn't have to. It just depended on what it was you were publishing. You could publish in medicine; you could publish in lots of sub-specialties.

Q: You referred to Europe just a minute ago. Were they organized into hematological--

Tullis: Oh, much more organized than we were in America. Their organization of blood began as a medical subspecialty. They even had professors of hematology in the 1940s and 1930s in different countries in Europe. We not only didn't have a professor of hematology, we didn't even recognize it! And I remember one of the arguments I used against the establishment of the American Society of Hematology--because I was one of the doubters in the early conceptual phase--I said, “Tell me, what is a hematologist, and I'll tell you, whether we should have a society.” Nobody could, because you had people now getting into nucleonics, that were into isotope work, and so on, who also considered themselves hematologists. You had basic biochemists who were doing hematology work. You had clinical people doing hematology work. You had physical chemistry; you had all these different people. It was such a heterogeneous group that I felt it would be disastrous if we overly structured or defined what hematology was. It would keep us from growing.

Q: Which would have been the continued nature of the Blood Club itself.

Tullis: That's right; that's right. I liked the informality of the Blood Club, but I was the first one, finally, to admit it: "Yes, you know, we're never going to get anywhere--we need something more formal than this."

Q: Okay. It appears fairly early on that there was a desire to have connections with, for example, Latin American hematologists.

Tullis: Yes, that was Bill Dameshek.

Q: Okay. That was his interest.

Tullis: Yes, because he had, I think, more Latin American Fellows than anybody else.

Q: At Tufts itself.

Tullis: At Tufts; yes.

Q: Okay.

Tullis: Latin American Fellows were very uncommon in most of the places. They aren't now, but they were at that time, except Dameshek had a lot of them.

Q: Are there any names that stand out that you think should be commented on? I have a list of the original contributing editorial board; I don't know if it would do to go through them.

Tullis: Well, I can tell you some of the ones from Latin America that I think stood out. First, beyond any question, is A. Pavlovsky, and Pavlovsky, who was of Russian heritage--well, three generations earlier; he's an Argentinean--was a superb individual. Some of the South American cities, like Buenos Aires, and San Paolo, and Santiago, in Chile, and Lima, to a lesser extent--some of these superb cities and countries have excellent schools and highly cultural academic scientists. You don't hear about them because their countries are not rich enough to support basic research.

Q: Could you say a little bit about Pavlovsky's work, possibly?

I remember one time--I guess the first time was about 1960--that I was asked to go down and work there. They took me and my whole family, brought us down to Buenos Aires, and here was a building devoted to nothing but hemophilia! There wasn't anything like it in the United States! On his staff, he had biochemists working on new ways of fractionating plasma to get the Factor VIII out. He had priests advising the hemophilic women, the carriers, what their odds were for having affected children, and whether it was appropriate to have children, even before one talked about such things as birth control in a Catholic country, if you can imagine such a thing! He had clinicians who were taking care of these hemophilics; he had physiotherapists showing them how to get the joint free. He had everything right there! The research, and treatment, all together. I remember he had four hundred active hemophilics under care the two months I was first there. And that's a lot of hemophilics in one institute.

When freezers first became available, which would be, I guess, about the time of World War II--of course, they weren't involved in World War 11, so their work was able to go on--he had some of the first freezers installed there, and had one of his young women, Dr. Simonetti, an Italian coagulationist, mix the plasma from all these hemophilic patients. This is in the first journal of Blood--first copy, first journal--Pavlovsky was smart enough to postulate that if hemophilia is a deficiency disease where one of the proteins needed for clotting is missing, one should not be able to correct the defect of hemophilia with another hemophiliac’s plasma. So he started taking out of the freezer these scores of plasmas, frozen, and mixing them, and by golly, along about, I don't remember, ten, twenty, thirty mixings, there was one plasma that corrected another, and he found, when he had done his whole study, that about ten percent of hemophilics would correct the hemophilia deficiency of other hemophilics. So, obviously, there was more than one kind of hemophilia. This was published right at the time that the Christmas boy first got sick in Oxford, and the Christmas boy was the son of a woman who was a singer on the stage. She had her boy in England, and he bled, and he had been diagnosed as hemophilic, and Rosemary Biggs, working in Oxford, found that when she did the standard test that she had just devised for hemophilia, that he was different from all the other hemophilics, and it was a serum, rather than a plasma factor which was missing. So all of this came out right at that time when Blood was first published, and Pavlovsky really was the first one to prove that there was more than one kind, and then Rosemary Biggs substantiated what it was. Later on, there were three kinds of so-called hemophilia.

Anyway, Pavlovsky was a good scientist and had a good coagulation laboratory with a high level of quality research, and so on, and similarly in the lymphoma era. Now, currently, two of his sons, two twins, have carried on. One is a coagulationist, and the other is a leukemia specialist. The leukemia person is currently in Bethesda, and is head of Latin American studies supported by the NIH oncology. The other one is running the coagulation laboratories in Argentina.

Back to Dr. Tullis's Profile