Tullis: Yes, I think Honorato in Chile was very good, Rene Honorato. He had trained with Armand Quick, and then he came as a National Science Foundation Fellow and worked with me for three years here around the late 1950s. Then, I think, Dr. Jamra in Brazil would certainly qualify as a leader of Latin American hematology. He was more clinically oriented: he was a professor of medicine at one of the medical schools in San Paolo. And what a city, San Paolo! It's a city of three and a half million people. We don't realize that here in North America. We're so smug about ourselves. Then, Venezuela because of the early oil money, early being in the 1950s and early 1960s, was able to set up more basic research than any of the other South American countries, because they're on federal funding for it through their oil revenues. They established a National Institutes of Health, copied verbatim on our National Institutes of Health out in Bethesda. They have an institute of mathematics, and one of physics, and one of chemistry, and so on, and in all the medical sciences. And they produced some very good hematologists. I'm not very good on names but one of them was Tulio Ahrends, and one of them, whose name I can't think of at the moment, was working on red cells and did beautiful work. Then, in Mexico, there was Gonzalez Gutzmann, and who else? I can't remember the name of the other man that was doing most of the Mexican work.
Tullis: They related closer to Europe than they did to America, there's just no question about it, I think, probably, because of language differences. They simply cannot handle English very well, you know. Pavlovsky could, he was a very polished person who could handle about five different languages, as can Jamra, and some of the others, but most South Americans speak Spanish, and most Spanish-speaking people have trouble with the English language, the enunciation of English. Whereas with a Romance language, like French, or something else, they can get along; with Italian, they can get along very well. So that they tended to relate to where they could read the journals, and they related more to Europe than they did to America.
Q: Dr. Tullis, is there anything else you would like to add about Latin American connection to the development of Blood and hematology?
Tullis: The needs of the Latin American hematologists are really quite different from those of the American hematologists. And when we use the word "American” incorrectly, I obviously refer to the English-speaking countries of Canada and the United States. In South America, the development of the basic science of hematology is considerably behind the development of clinical hematology as a practice specialty, except for the few areas that I've mentioned where excellent work is going on, such as Pavlovsky's work, and Jamra's work, and so on. Four or five of the South American countries have major basic work, but with that exception, the vast bulk of the hematology is clinical practice of hematology. Persons in the clinical practice with weak backgrounds, as many of the South American hematologists had as far as the science of hematology, were totally unable to get their knowledge transcribed into American journals like the new journal, Blood, because the new journal, Blood, set very high standards of either basic research or standards of clinical types of study that require prospective double blinded studies which they could not get the people in South America to cooperate with. The great bulk of the articles from South America would be universally turned down for publication in Blood. This created a feeling of hostility and inferiority amongst people who really were good clinical practitioners in hematology, as I'll discuss later on when we get to the International Society and the role I tried to play there in South America. They became very paranoid about the United States, and, indeed, feel that way somewhat to this day, feeling that this manner in which we've handled them scientifically somewhat resembles the way we've politically handled things in Central America, which is sometimes heavy-handed and not with a true understanding of the local needs.
Q: Do you see any amelioration of that situation, or--
Tullis: Not immediately, no. I think it will wait until twenty years, or maybe two generations, forty years of education and raising of the standards throughout all of South America, so that their universities are doing scientific types of evaluations and studies before the hematologists there will be on a par as far as their ability to get their knowledge printed and disseminated.
Q: Was that seen as one of the roles of the journal Blood?
Tullis: I think it was very definitely seen by Dr. Dameshek. Yes, he understood the needs of South America, he had lectured there extensively because he had had a number of Fellows who had trained here in Boston at Tufts University with him in his department, and he had tried to help them out, but it was difficult for him to do. He was careful in the first copy of the first journal of Blood to include an article by Pavlovsky to represent South America, but from then on it was downhill as far as the numbers of Latin American publications that were actually turned out.
Q: Do Latin American hematologists publish in other journals?
Tullis: Yes, they publish more in European journals than they do here. Again, this is partly language, because they converse and write and read other Romance languages better than they do the Anglo-Saxon based English language, and it's easier for them to express themselves. So that they have published in Swiss journals; they have published in German journals, in French journals, in Italian journals. Mostly French, Spanish, and Italian, I would say.
Q: Perhaps we could return more to the Latin American hematologists when we discuss the International Society of Hematology.
Tullis: Yes.
Q: Okay. Could you, perhaps, give a quick overview of the development of the journal, Blood, in the sense of its content and the direction that it was slanted?
Tullis: It was started to be a journal which was of such high standards that it, itself, would elevate the standards of hematology. In other words, it wasn't being started merely to reflect the current modus operandi but rather as the carrot on the stick to which people would aspire, and it filled that role very well. I think Dr.
Dameshek as the original editor, and Stratton as the man who was financing it should be given great credit for that, because it had that role, and it made hematology, from the very beginning of its crystallization as a specialty, it made it strive to be of the very highest quality.
Q: Is there any way of discerning, or would you see any changes in the journal, Blood, in relation to the development of clinical studies, as opposed to basic research?
Tullis: No. The journal, Blood, was primarily concerned with the basic research, rather than the clinical studies, because, again, the clinical studies have meaning to a broader base of persons practicing medicine, and therefore should be published in the journals that are read by internists, rather than read by hematologists. Whereas the hematologic publications in Blood were those that the specialists working in the field, and often not practitioners at all, would need to read in order for them to stay informed of this specialty.
Q: Okay. Is there anything else you would like to add on the journal Blood?
Tullis: I don't think so.
Q: Okay. We may like to take up the topic of the International Society of Hematology, and if you would, perhaps, provide some background to its development, and then your particular role within it.
Tullis: I mentioned earlier in our discussion that in Europe hematology as a specialty and as an academic entity was established long before it was in this country. This in part probably relates all the way back to the original morphologists who were the pathologists that defined blood cells, and so on, and less to the physiology and the biochemistry of blood. But it was an accepted subspecialty throughout Europe. So that there were societies of hematology of many years duration in France, and Holland, and Denmark, Switzerland, Italy, Spain. Throughout most of Europe as we know it today, there were societies that were well established. After World War II ended, the persons who had been thrown together from America who were interested in hematology as a specialty had been influenced by the Europeans because of their presence for several years in Europe during wartime conditions. As a result of this, and the catalytic effect of a meeting on Blood Groups in Dallas and Mexico City in 1946, an organizing committee was convened in Buffalo, New York, in 1948, to consider founding an International Society of Hematology, which would represent North and South America, as well as it would represent Europe. In 1948, I was just a youngster who could barely make enough money to support his own eating habits, and I happened to be on vacation in Buffalo. Obviously, I was not invited to that meeting. But I was visiting a classmate of mine there and picked up the morning paper and read that this convocation was going to take place at the Statler Hotel. Being interested in blood, although I had no stature in blood--I was so new, and young--I went to the meetings. I was privileged to be present at that organizational meeting. I don't want to give numbers, but just by visual recollection I would say there were a hundred to a hundred and fifty people who had come. France was well represented, England was well represented, and Mexico was well represented, because of their interest in blood-groups and blood transfusions, which were just getting started in those days. As a result of this, the organizational meeting was held there, and it was a good meeting. And from that, which was the first meeting of the ISH, a biennial convocation was established which would meet in rotation, first in Europe, then in America, then in Europe, then in America, and on each fifth time someplace in the Pacific-Orient area. Then, it would go back to the cycle of Europe, America, Europe, America, then the Pacific.
Originally, the Society was set up with two divisions: the European division, and the American division, and there was no Pacific or Asian division because it was not felt there were enough hematologists, as such, to support the administration. Of course, that was just part of the ignorance of Americans, who always think nobody else knows anything. The American Division assumed responsibility for hematology in the Pacific area. The second meeting of the Society after that Buffalo meeting was in Cambridge, England.
Q: Before we go on, could you, perhaps, give some of the major names who were at this?
Tullis: Yes, of course, although names are not my forte--I constantly forget names. I would say at the original meeting--well, from this country, obviously, Dr. Dameshek was prominent, and Dr. Saul Haberman from Texas, and Dr. Joseph Hill from Texas; and Dr. Gonzalez Gutzman was there from Mexico, and Sir Lionel Whitby from England. The French hematologists were represented by Dr. J. Bernard-- a wonderful hematologist in Paris whose father was a physiologist at the turn of the century, and invented the concept of an "interior mileau." Marcel Bessis, who was an associate of Bernard at that time, later set up his own separate laboratories; and from South America, Pavlovsky; and that was essentially it at that time. Those are the leading names that come to my mind.
Now then they decided to have a meeting every other year, and--well, first of all, they set up offices for the two divisions. The American office, representing North and South America, was set up at the University of Baylor, under Saul Haberman, as the Executive Secretary, or Secretary-General, as they called him. The European division was set up in France under Bessis, Marcel Bessis, who was the Secretary-General, there. They were the two young men that had the time to do it and the organizational ability and so on to do it.
The third meeting, then, was held at Cambridge University with a very good British hematologist, Sir Lionel Whitby serving as President. From then on, the president was always the prominent person in the city where the meeting took place. After the meeting in Cambridge, on the rotation of America, Europe, America, it came back to America and went down to Argentina. That was a meeting that, I think, the world political situation kept on tenterhooks until the last minute, because two months before the meeting was to take place Peron took over the government of Argentine by seizure. No one knew whether any of us would be allowed to go, or whether a meeting would be allowed to take place, and so on. But Dr. Pavlovsky successfully manipulated and maneuvered and had a good meeting, down at Mar d'la Platte, about 150 miles south of Buenos Aires.
The fifth meeting then after the Argentinean meeting, two years later, in 1954, was held in Paris, under the presidency of Jean Bernard--no, I beg your pardon, it was not under his presidency. There was a more senior individual, Dr. Chevalier, a man in his eighties. Jean Bernard was the vice-president, in charge of the organization of the congress. That meeting at the Sorbonne went off very well and was attended by over a thousand people, which was unheard of in those early days for a scientific gathering of any type, in any specialty. Dr. Dameshek, at that meeting, on the last day of the meeting, was elected the president for the next time, which would be two years later, when it was to come back again to America, and it came to Boston. That was in 1956. Dr. Dameshek asked me at that time if I would be willing to become the vice-president for that congress, to set up the congress and organize it, because he was so busy he couldn't give it the time that it needed. He had to be traveling a lot. We did, and we had the sixth meeting here.
It was on that occasion, as I'll come back later, that a group of us, about ten of us, got together, one of the noons of the one week of the International Society meeting and said, "Well, this is wrong; America doesn't have a Society of Hematology, and maybe they should have a Society of Hematology." I spoke again at that luncheon meeting, which was just an informal discussion, iterating apprehension that since we had such a difficulty defining what hematology was that it might be inhibitory to start an American society because I wanted to be sure we didn't think of it as a practice-oriented society, which is what I was afraid it would become, and that it would discourage the anatomists and the chemists and the physiologists, and so on, who were just as much knowledgeable about blood, and the physical chemists, perhaps more knowledgeable about blood than the practitioners who were treating blood diseases as a specialty. But my fears were sufficiently overcome that when they asked me if I would be willing to be the repository for organizing a preliminary meeting of an American Society of Hematology two years later, I said I would be willing to do it.
We'll come back to that when we discuss the American Society later on. Now, then--yes?
Q: Would you see this first decade, then, of meeting of international hematologists as a period of defining what hematology is?
Tullis: In part it was that, and in part it was giving a forum to
the basic sciences that impinged on blood and had to know about all aspects of blood in order properly to do their work. For example, at that meeting in Paris, which was the first one I attended truly as a scientist--the others I was too young, I just went as an observer--but when it was time for that meeting, and the submission of papers from Dr. Cohn's laboratory in the summer of 1953, he asked us to get things together, and there were some eight or ten good scientific papers on totally different aspects of blood proteins, and so on, that had applicability and poignancy for people, whatever they were doing with blood. So he asked me not only to give my own paper on the work I had been doing on platelet antibodies, but to take all the other papers and read them for the person because transportation by boat in those days was a laborious, time consuming expense, and so on. One didn't just go off to Paris for the afternoon, like one does now! So that, I think, reflected that the new international society was fulfilling a role quite beyond defining the limits of hematology. It was exchanging basic knowledge which, up to then, had been inadequately exchanged.
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