Q: And were there changes or influences upon the style of research, or the actual content of research that came from these?
Tullis: I think very much so. Let me just give you an example: one of the papers that I gave at that international meeting in 1954 was a description of a technique that we had tried to evolve for the diagnosis of autoimmune thrombocytopenic purpura, which was a disease that had been known for several decades, but no one had any way of diagnosing it or separating it from other platelet deficiency states. We had worked out a chemical way of absorbing the clotting proteins, and removing calcium, and doing it as an exchange type of column chromatography, ending up with a serum that only had the albumin and the gamma globulin in it, so it was non-reactive to platelets in the coagulation sense, but would react, if there were antiglobulins, specifically directed against absorbed globulins on the surface of the platelet. I had that paper, and there was a paper, also, from the laboratory in Holland under Dr. von Loghem. He was the principal hematologist in Holland. One of his students had a paper where he was trying to do the same thing, and lo and behold! there was another paper from somebody in another country trying to do the same thing. As a result of hearing each other's papers, we called a special convocation the last afternoon of the last day of the congress, and said, "Anybody interested in this field, please come, and we'll discuss result.”
Q: This was in 1954?
Tullis: 54! There must have been twenty people that came, including several from the United States that had already begun work in their laboratory but weren't far enough along to have anything formally to say in a meeting. But, then, under the informal atmosphere of just the exchange of scientists sitting around the room, we had about a two- or three-hour session that was of just great value to all of us, because we saw problems we had not ourselves unearthed, and they saw answers that they might not have thought of. We exchanged knowledge, and then got home and exchanged sera to do the same tests--you know, each man to do his own on the same serum, that sort of thing. So there was a quantum leap in that particular subspecialty. Well, the same sort of thing was going on in many different aspects of hematology. I just cite that as a single example. So that, already, there was this catch-up going on from the years when there had been poor communications because of the war, and so on, and when there had been poor exchange of knowledge. That, to me, was the greatest value.
Q: You had mentioned earlier that from the beginning of the meetings of this international community of hematologists, there was a strong influence coming from the European side to the American side. Could you, perhaps, comment on that?
Tullis: Well, hematology is high quality in Europe, and it has been traditionally right across the years. It's difficult to cite one country being better than another, because they were all doing good work, each in his own way or her own way. I don't want to try to favor one country over another, but in traveling around and meeting with these people and visiting in their laboratories, I was constantly impressed that, in their independent way, they had plowed ahead--
[end of side two of tape two; beginning of side one of tape three.]
I keep saying this, but I'll say it again: we have a very parochial attitude in this country that we've got all the answers and that the rest of the world is behind us. Truly, it isn't, in some aspects. It may be economically or it may be politically, or something--I don't want to get into that!--but in this, just the hands-on, bench-top, basic knowledge, they are good.
Q: When did the Pacific and the Orient division of the International Society occur?
Tullis: Well, let's see. After the meeting in Boston, we went back to Europe for the Seventh Congress because that was before this rotation to the Orient had been put in--
Q: This is 1956.
Tullis: No, in 1956, it was Boston.
Q: Boston, right.
Tullis: Then we went back to Europe, to Italy in 1958. Let's see, what was the name of that man, there's a disease named after him, a malignant disease--sort of a strange one, DiGuglielmo. Dr. DiGuglielmo was the president at that time. And the Japanese came to that meeting and, indeed, they had come to the Boston meeting. The reason they had come to the Boston meeting was that Dr. Katsunuma, who was a very excellent hematologist at the University of Osaka, and a professor of medicine at the University of Osaka, had taken his training in Boston at the Thorndike Laboratory in the early 1920s, and not long after Minot and Castle were first doing their work, and, right at the time that they were uncovering the principal which cured pernicious anemia.
As an aside, an interesting little humorous aside, years later, Dr. Katsenuma told me that all he really saw in the two years he trained at the Thorndike was pernicious anemia, because the Irish, at that time, occupied that whole area around Boston City Hospital, and all of the outpatient department was visits by people of Irish ancestry and north European ancestry, where pernicious anemia is very common. Well, there isn't such a thing as pernicious anemia in the Japanese race, or in the black race. When he got back to Japan, he said he had never seen another case of pernicious anemia since he had been in practice. So that his years of training were not very practical, as far as his specialty, but, of course, it had broadened his concept, and everything.
In any event, he had come to the Boston meeting, and at the Boston meeting the decision had been made, that I mentioned a few minutes ago, of rotating after Europe, America, Europe, America, then the Pacific, and then back to Europe, America, Europe, America. So the Pacific was selected, then, for 1960. Dr. Katsunuma was elected president in 1958, at the end of the Italian meeting. The new president goes in two years before his congress is held, you see. So at the meeting in Italy, we--well, I remember the evening. We went out to the Japanese Embassy with Katsunuma and some other Japanese he had with him, and the arrangements were laid out for the meeting then.
It was then that I became administratively involved in the society, because Dr. Dameshek, after the Boston meeting was successful, asked if I'd be willing to become the new Secretary- General of the society, itself. So having just assumed that post in Italy, I had to help set up the meeting for Japan, which, again, was somewhat of an eye-opener when I got there in 1960, and I went several weeks in advance because the State Department asked me to go lecture in different Japanese medical schools and find out what the state of knowledge was, vis-à-vis basic knowledge in Japanese teaching at that time, because they had no updates since before World War II.
Q: Would you care to comment on what you found when you did this tour of Japan?
Tullis: Yes. As I look back on it, it was an interesting foray for me, very broadening. First of all, we almost didn't go. The State Department had asked, in response to a Japanese request from the Japan Science Council, that I come over and teach. They asked me if I'd be willing to go as a consultant, and that they would pay my way, et cetera, before the meeting that I was going to be there for, anyway. I had responded hesitantly, yes, because, again, you have to put everything in the context of the era when this was taking place. 1960 was the time that President Eisenhower had made his, I think, first Pacific trip. He had gone out to a conference at the SEATO nations in India, or Thailand, or some place. Thailand, I think--or Australia, perhaps. On his way home, he had wanted to land as a peace mission in Japan, and there was such an anti-American feeling that the people, the protesters, lay down on the runway and refused to let the presidential plane land. You probably don't even remember this; it's buried in history, because, you see, this was just ten or twelve years after the end of--well, fifteen years after the end of World War II. There were those that felt that America had been excessive in its use of force in Japan, and that Eisenhower, as a general, represented the military, rather than representing the more peace-loving other aspects of America.
So my wife and my children, who were going to accompany me on this several months foray said they weren't going to go. Any country that didn't like their President they weren't going to go to! And I made a little trip down to Washington to the State Department to express my apprehension about this trip. Was it really safe? The Japanese didn't even want to let an American President in. What would they do with ordinary Americans? The man that was responsible for setting up my trip laughed and said. "Come into my office." He said, "You know, we have contacts in all the countries of the world, and I want to show you what was going on the night of the so-called demonstrations to keep Mr. Eisenhower's plane from landing." He said, "It was only about a hundred or two hundred people involved," and he said, "Here were some scenes taken the same night." And they had secret photographs of baseball games that were going on: Tokyo is very nuts on baseball, and here were people waving American flags, and cheering American baseball players, and he said, "There's really no anti-American feeling at all. This was just a political demonstration to accomplish something in the Diet”--I don't know how to describe the courtesy, the kindness, the friendliness, the total lack of any attitude of aggression towards this country or resentment, and so on that I found.
The trip took me to some eight or ten medical schools on, essentially, all of the islands except the north island of Hokkaido. I would spend from a week to ten days at each of these medical schools, lecturing, making ward rounds, working in the laboratories, commenting on techniques. The knowledge that I had been given of what to expect, even by our State Department, was totally wrong; it was outdated. It was information that had been gleaned before World War II. And this is one of the reasons they asked me to go, of course. They wanted new information. And to my pleasant surprise, I found that there was good science going on there, even at small universities--well, small to us--like the University of Fukuoka, and places of this sort, down in some of the southern cities. They had, apparently, through their contact with Italy and Germany kept their scientific standards quite high. They had good equipment. They had made some of their own equipment. They had good knowledge of the new techniques in science.
Q: This was during the period of World War II that they had been using--
Tullis: --that they had managed to do that. We didn't know that, you see. We thought they were very backward, but, quite to the contrary, they weren't backward at all. They were really quite progressive. And, although I had assigned to me an interpreter for the whole trip, often what I would do is, I would say two or three sentences and then pause for her to translate it into Japanese from English, but often if it was a humorous remark, they'd laugh before she began to translate. I mean, they obviously were able to understand the English, because the textbooks they were then using were mostly English textbooks.
Q: That raises an interesting question: was there any comparable work being done in, for example, blood fractionation, or blood banking?
Tullis: Yes. Yes, there was. Blood banking was further behind than the fractionation, and so on. The blood banking was behind for a couple of reasons. Part of it was just the physiognomy of the Japanese. They're so small, or were at that time before McDonald's hamburgers, they were tiny people as a race, and one could not remove more than a couple hundred ml. of blood without causing a semi-shocklike state, whereas you take more than double that out of the American donors, or donors in most other countries. So that, even up until recently, the standard blood unit was a half pint or less for Japanese blood donors. Secondly, the establishment of these blood donor centers was somewhat contrary to the Japanese interrelationship with their health-care system. For example, although the medicine was good, the hospital management was, by our standards, very primitive. I can give you an example of that: one day, I gave a lecture at the University of Tokyo, and the dean of the school, after my lecture, took me on an official tour. We got to the first ward that I visited, and there by each bed were members of family of the individual who was sick. And the family members gave the nursing care, not the hospital. The family prepared the meals, did all of that, because the Japanese felt, you see, the members of the family knew what Daddy wanted to eat better than the hospital would know. So the family would do all of the housekeeping, the cleaning, the washing of him, the bathing of him, feeding, et cetera.
The only relationship to the health care system would be the specific medicines that the patient needed. So that they weren't in intimate contact, the medical staff, with the patient, as far as such things as, let's say, the donation of blood, because that would be done in a non-health care context. So that there were reasons that blood transfusion was behind.
On the other hand, blood fractionation, which is, again, a protein-chemical thing, was really quite advanced, because the Japanese had studied in Sweden, and they had studied in a number of countries. There were students of Dr. Cohn from here who had already set up satellite units, and so the Japanese were really quite knowledgeable.
Q: What years were these studies conducted in Sweden, for example?
Tullis: During World War II.
Q: During the war.
Tullis: Yes.
Q: And these students--going back to Dr. Cohn once again--these students who came from his labs had set up similar types of experimental plants?
Tullis: Yes. Throughout the world.
Q: Could you comment on that a bit, even though it's a bit of a digression from our discussion?
Tullis: You mean how had they done it? Well, they had--yes, I can comment on that. First of all, most of them were sponsored by the governments of the countries that they came from, which is a difference, again, from American, because the system of medicine, science and everything is under university, and public and private aegis in this country, the health care system. Whereas the health care system in the European countries and the Scandinavian countries, and almost everyplace in the world, was supported financially by the government. So if they decided a fractionation laboratory--take Australia, for example--they just picked out some chemists that they thought would be good people, who were young and could then make careers out of it, and they would send them over here for two years, three years, whatever was necessary, to Cohn's laboratory to train. They'd even buy the equipment in the United States with which to do it, the Sharples centrifuges, and all of this business, and the cold tanks for the precipitation of fibrinogen, et cetera. And they would take the knowledge back to their home country and set up the laboratories, usually university related, but governmentally sponsored.
Q: In which time period did this type of cooperation take place?
Tullis: It took place in the period immediately after World War II, from about 1945 on, because, when it was during the war, it was very much an American operation, because of wartime, not secrecy, but nobody was talking about it, anyway. It wasn't until right after the war that all these other countries sent people over.
Q: Was that in part an influence from the journal Blood?
Tullis: No, not a bit. No. All of the publications from our physical chemistry laboratory were in physical chemical journals.
Q: And those were the journals that had the influence in--
Tullis: That's right. In fractionation, and so on.
But now, then, returning to this Japanese situation. Many of these small medical schools really turned out to have quite advanced work going on. And, from a personal standpoint, I formed friendships and contacts from which I'm still having research fellows sent here to work with me. The most recent one was the son of dean of Hiroshima, whom I worked with for a while on that trip in 1960, and his son just finished three years here; he's now back at the University of Tokyo. So we've had strong contacts over the subsequent years.
Q: Have you, in light of your trip there, continued contact with researchers from Japan--
Tullis: Oh, yes. I've been back several times again to lecture and teach, and so on, and they, here. Again, this brings out another point that you haven't asked about, and that's the language. At the first meeting of the International Society of Hematology, translation was not only helpful, it was essential. One could not converse with these people from other countries, unless one could use the tongue. I can speak enough French so I can be understood. I can speak some German because I had studied it in school as a youngster, and had studied it because one couldn't learn medicine without knowing something about it. But they could not use the English language. Only the people from England, Canada, and the United States spoke English. But after World War II, there had been such a resurgence of publications in America, and to a lesser extent in the United Kingdom, that people throughout the world began to read journals of all kinds, written in English. Now, it is no longer necessary to have simultaneous translations, as all the educated physicians and scientists read, write and understand English. The last congress with simultaneous translation was the one in 1958, in Italy, where there was translation into Spanish, French, German, English. Whoever was speaking, you had to dial the little instrument on your headset. Dr. Katsunuma, who had trained here in Boston but was a Japanese, said to me in Rome in 1948, "I am going to make the Tokyo meeting the first where people have to speak the English language in order to communicate." He was very pro-American. The Japanese papers that were submitted from Japanese hematologists would not be considered for acceptance on the 1960 program unless the Japanese would promise to learn English well enough to stand up and deliver the paper in understandable English. Now, this was not well received, particularly by the French, and to a lesser extent by the Spanish speaking people, because their attitude was--and the Russians who were there, too--their attitude was, "Why English? Why not Esperanto, or Dutch, or something else, or Belgigue, or, you name it?" But Katsunuma said, "No. The Japanese will have to speak English. If you want to have French for some of the translations, for some of the plenary sessions, I'll do that." And he did, for just a very few papers of prominent people who did not want to speak in English. This was during the period of De Gaulle, and De Gaulle was a strong person for raising French back to its glory days, and wanted French spoken by French hematologists. In fact, they were told to speak it. But that meeting then was almost entirely in English.
The Japanese, because this was that same summer that I had a translator, were able to understand most of the speaking I did. They, now, years later, when I go over there, they speak English as well as you or I speak or communicate in English. They write in English. And their Japanese journals--like the Japanese Journal of Hematology, the articles are written Japanese, then there's an English summary at the end of each, because sometimes it's easier for them to understand scientific English than it is to express themselves appropriately in Japanese. The English language adapts itself better to science than it does to their own native tongue, because of the way one has to have characters rather than phonetics. So that now the idea of a translator is unheard of.
And there have been no meetings of the International Society, subsequently, where there's been any translation. I think it's hard for us when we try to maintain competency in a foreign language, but it makes it awfully easy for Americans to go abroad to scientific meetings.
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