Q: Has that, possibly, resulted in other changes in national styles of research, and approaches in hematology in other countries? Was it just a question of the language, itself, or was there something else that was transmitted?
Tullis: I don't think so. In fact, I think one of the tragedies of our improved communications is that we may end up with only one or two international languages, which would mean the world will lose something, just like it did when cuneiform script was lost, and so on, and Sanskrit, and other languages that have disappeared. For example, on another occasion, I went to China, to lecture on hematology at the request of our State Department. The Chinese language is even less adaptable than the Japanese to modern speed of communications. I remember when making rounds at the University of Taipei hospital, and, again, the professor of medicine would hand the chart to me and then the student, or house officer, would present the case, and I would then discuss it, and they would make notes. When I looked at the charts, they were all written in English, yet no one, at that point, could understand me well in this Nationalist Chinese medical school. I asked why were they able to write in English. He said, "Well, they have to in order for us to get the records done in time." And I said, "Well, what does that mean?" He said, "Well, have you ever seen a Chinese typewriter?" Do you know this? Well, I won't bore you with it--
Q: Oh, no, please continue. It's--
Tullis: "Well," I said, "why, no; as a matter of fact, I haven't." And he said, "Well, we'll go down to the basement, and I'll show you one." A Chinese typewriter: each tray of type has 2000 figures in it, and here was a girl seated, with five trays of type above her knees, and a single key, like a Ouija board, that she would move around over the type until she was centered over the figure--the hieroglyphic of the Chinese character that was to be printed--and then she would touch the thing, and the key would pick up the character, print it, and drop it back down again. And if the word, the symbol she wanted to use was not in that tray, she'd have to pull the tray out and put another tray in. Perhaps, to type a page, it would take her three-quarters of an hour, because there were no phonetics whatsoever, entirely the characters. Now, the Japanese, when they assimilated the Chinese language hundreds and hundreds of years ago, put some phonetics in with it. And if you look at a page of Japanese science, in a scientific journal, you'll see dots, dashes, squiggles, dots, a couple of points, you know, and then, a character. Well, maybe there would only be one or two characters on a whole line of type, because the rest is phonetic, just like shorthand for the secretary who takes dictation, so that they could adapt with IBM typewriters, that only had about twenty key rows on it, as opposed to this laborious Chinese system. But my point is that the Chinese characters, they're beautiful artwork--I don't know whether you've ever studied them, beautiful artwork. If you ever try to make a Chinese character, you can only put your brush down in one spot to start to make it, you know, and end up at the right spot, so it doesn’t smear. It's an art form that's going to be lost, I'm afraid, because it's not compatible with a newspaper every hour, that sort of thing.
But in any event, pardon that. It's part of the background.
Q: Were there, through this international contact, were there any new types of developments that took place in the Orient and the Pacific region that might not have? Were there new problems that were broached? Particularly, now, dealing with Japan. Or did they pretty much continue along research programs that had been established previous--
Tullis: I think the way they handled the new science that they were learning from America, as opposed to the morphologic science that they had learned from Germany, was the way they handle microchips and automobiles, in the present environment: they learned how to do something, then they did it meticulously, and they did it efficiently, and then next they did it inexpensively. That's the way they approach problems. They engineer the problem to something that can be handled well.
For example, they got into the fractionation game along about 1950, and by 1960 the Green Cross in Osaka was one of the major fractionation facilities for making various plasma fractions, and so on. Now, they bought out Abbot's Division, out on the West Coast here, and created a company they call Alpha Therapeutics, an excellent company, but it's an extension of Green Cross from Japan. That's their way of doing business. There isn't so much original thought as more efficient use of tools they have learned from somebody else.
Q: Did the international contact facilitate more students studying in the United States, as opposed to other central--
Tullis: Yes, but again, we were very naive in our attitude that they didn't have many students. For example, at that 1960 Congress, the first one in Japan, under Katsunuma's presidency, I had no idea there would be many hematologists of Japanese origin. Well, it turned out that the well established, already well established; Japanese Society of Hematology had seven hundred members! And this is a country we didn't think had any hematology in it! That was many more, you see, than dreamed of for the United States. I haven't even gotten to the American Society yet. The American Society, at that point, was only two years old, and nowhere near that big.
Q: That's very interesting. Were there other countries within the Pacific region, or in Asia, in which hematological research was being developed?
Tullis: No, not research, certainly--except clinical research. There was a lot of work on the nutritional anemia in India, where poor nutrition is so endemic. There was good work on the parasitology of blood, in terms of the malarial infestation of red cells in places like Thailand. Then in Australia, of course, there was good, classic, university-type work, but that was so small numerically as far as their total population that, again, the number of persons working in science was pretty small. But it was good work, what was going on.
Q: Was the work being done in these countries, at least as far as hematology goes, the extension of work done in previous colonial powers? For example, with India.
Tullis: Yes, I would say so. Within most of southern Asia, yes?
Q: And has that changed over the last period of time, in the sense of--
Tullis: Yes, they're doing their own operations, now. India, for example, has a comparable institute of health, like we have at the NIH, with good basic science in it. They're playing catch-up ball, but they're catching up.
Q: And did this International Society of Hematology contribute to that at all?
Tullis: No. I think the biggest--well, I shouldn't say no, because there was not any place where I had enough observations to say that. But I should go back to say that we determined--"we” now being the
International Society of Hematology--several things: first, that when we saw what was going on in Japan in 1960, that we should split them off with their own division, and give them autonomy, thinking they would increase faster--which has proved to be the case. So, the new constitution, which I helped write along about 1964 or so, set up a third division, we no longer call them hemispheres, but a third division of the International Society for the Asian-Pacific area. Everything from Australia through India, even including all the way to Israel, and including all of China, if it wants to come in, and Japan, India, Thailand, et cetera. Then, we began to--"we” again being now the Western Hemisphere division, or we now call it the American Division, the North and South American division of the International Society of Hematology--again, to concentrate on North and South America.
So I set out to, in my role as Secretary-General for this part of the Society, make regular visits, frequently, to South America, to meet with hematologists and to listen to their problems, to understand their problems--not as an American, but as a representative of an international organization. I regretted I had to speak English; I didn't speak Spanish. I wish I could have, because I think I would have been able to be more effective, but I did this, and had to raise the funds independently, because the International Society had no money. But I was able to raise money through various sources, pharmaceutical firms, and things of that sort, to pay for these peregrinations. I would go down and meet with the individual societies, and try to elevate their standards, and so on.
Q: Is there anything else that you would like to add further on contacts with the Japanese hematologists?
Tullis: I think not. They're particularly good in coagulation, I will say that. The next President of the World Hemophilia Association is Japanese, Dr. Abe. Those fields of hematology that they have gotten into they've done very, very well in.
Q: Was there any contact made with the African nations at any time?
Tullis: Some, but very limited. Again, that was not part of my area of responsibility, so I can't speak definitively about it. I have met a few hematologists from some of the countries that had good clinical practice in medicine, in the armed forces, and so on, of France and England, and in Belgium, parts of Africa that had previously been underdeveloped or controlled. In some of those, there were some very good, young black hematologists whom I met and was impressed by. But as far as the quantity and quality, and so on, at the local level, I can't answer.
Q: Were there any major shifts in the content, the scientific content, of the congresses held of the International Society of Hematologists?
Tullis: I would answer, “No." I think it still pretty much fulfills a role of trying to keep basic science as the forum, but presented in a manner that gives an opportunity for people at the practical level to apply it in their practice. For example, at one of our more recent meetings in Hungary, Budapest, the summer before last, there were people there from Eastern Bloc countries who obviously had not themselves been privileged to have worked in basic science, who still were very interested in knowing what was being presented in such a way that they could translate new advances into their practice of hematology.
There again, as an aside, even in Budapest, the only official language of the congress was English, for all the Russians, and everybody else.
Q: Speaking of that, within an individual Society, were there ever reflections of international political dissension? Did that ever surface?
Tullis: Oh, yes. Bound to be, but relatively minimal.
Q: So the basic attitude was that it was a congress of scientists in practicing hematology?
Tullis: Yes. Right now, there is--I won't mention the personalities involved--but there is a real discontent in the South American countries over the probable person who will be selected as the next president of the International Society when it comes to America. Not that he isn't perfectly good, because he's superb, but there is somebody else whom they felt better able to relate to, that they were pushing strongly to have become president. But these things have been kept in bounds, under control, and so on.
Q: Is there anything further you'd like to add on the International Society?
Tullis: No. I think it's been a powerful force and a good force. And it's been able to be done, which took some doing, but all of this has been accomplished with no budget, essentially, no fixed big overhead of administration, like you would have for the UNESCO, or Red Cross, or something like that. The two Secretaries-General operate on a shoestring budget. The dues is--I can't remember, I think it's five dollars a year we pay, and that's not even enough to hire a secretary for the man who's running the office. But usually, it's a man who can draw on other secretarial support he has from his grants, or whatever else, practice, or something else. Then the cost of the individual meeting is assumed totally by the place where the meeting's going to be. For instance, a meeting, to put it on today, an international meeting costs the local congress committee a minimum of $500,000! A minimum! Because there are some people you have to give free transportation to. You have the cost of the meeting rooms; you have the cost of the exhibit halls, and the publications and reprints, and getting the talks lined up, and writing the people, and so on. It costs a minimum of $500,000 for each meeting. There's no way to pay for that except by going to the local committee and then they figure out what the local costs will be--this has nothing to do with room and board, just the cost of the scientific sessions--and then they charge an admission fee equal to what it will be, less whatever they're going to take in revenue from display people, commercial display people, and so on. So it's a lot of responsibility, but we've done it, and without ever having any large overlay of administration.
Q: Is there any journal that performs a role as international communicator of--
Tullis: No. This has been repeatedly discussed as to whether we should ever have an international journal, and again, we have felt not, because the international society is an amalgamation. It's more a confederacy, you see, a confederacy of different states, each having its own society, each having its own journal, and we don't want to play favorites.
Q: Are there journals comparable to Blood, in other words?
Tullis: Oh, yes. So that each person moved ahead with his own journal.
Q: I'd like to now switch to the subject of the American Society of Hematologists, and, perhaps, if you'd recount a bit of the background that you provided yesterday.
Tullis: In the beginning--when I say, "In the beginning," I mean back, 1945 to 1950, there was nothing but the informal Blood Club, in this country, that served as a forum for people working in the field. Many of us felt that was adequate because we were hesitant to let hematology become overly rigid and crystallized, and we also did not want it to become a society of practitioners, of the practice of hematology. So we used the journals, and used the forums of our subspecialty societies--again, physiology, biochemistry, physical chemistry, et cetera, and the ones that were clinically oriented in hematology used existing journals, like the New England Journal of Medicine, and the Journal of Clinical Investigation, and so on. But we began to realize we were wrong, and at the time of the 1956 meeting, largely catalyzed by Dr. Dameshek and his vision, and to a lesser extent, Henry Stratton, who always liked to see societies form, because he had a ready circulation list for his journals, and so on. And I say that humorously because I used to say it to him: "Here's 1800 new subscriptions, Henry, because such-and-such a society has been formed."
Q: He actually started eight journals; is that correct?
Tullis: I don't remember, but he started subspecialty journals in heart, and so on. Many different ones. Rheumatology, et cetera.
But at the international meeting in 1956, at the Somerset Hotel here, just a few blocks from where we're talking, we had an informal lunch during the ISH meeting. There were ten or twelve of us there, who said, "We need to do this." The logical place to do it was here, since the city was Boston, and I already had organized an administrative office for putting that Congress on. So they said, "Please, would you be willing to sort of pull this together, and see if there is a need?" So I said, "All right. If I can be shown there's a need, I'll be willing to be the organizer of it."
I put an announcement in Blood, that said, “If anyone is interested, we tentatively plan to have an organizational meeting at the Harvard Club in 1958 to precede one day before the meeting of the American College of Physicians,” which was meeting here at that time. I knew that would at least bring the clinical hematologists to the city-The American Society of Hematology, of course, didn't exist, but the letters I got back--and I just used my postal address--were warm enough for the concept that we went ahead and rented the Aesculapian Room of the Harvard Club down on Commonwealth Avenue, for two reasons: both because Aesculapius was one of the original Greek physicians, and more importantly, this was a small room that was set up for a society I belonged to called the Aesculapian Club, which meets there, and has about fifty members. It's a small room, but it could comfortably seat fifty members, which I thought would be about right.
This meeting was scheduled for an April Sunday morning, and I took the secretary from our research laboratory and went down there and set a card table up. Before eleven o'clock that morning, we had overflowed the room, and I had gone downstairs and moved everything-- gotten the management to let us move into the Massachusetts Room, which holds about 150 people, and is adjacent to the Aesculapian Room, And there were at least 150 people who showed up that day for a very small scientific program which I had scheduled and for an organizational meeting.
We decided to start that day with a preliminary constitutional committee and officers of the, if you will, society to be formed, because it was still very informal. They asked me to be the interim president of the organizing committee of an American Society of Hematology, At that point, there were several things that had to be done: first of all, the constitution, which I asked Dr. Israel Davidson, now deceased, who was from Chicago, to organize that; and we had to incorporate so that we could go after grants. That meant that we had to be tax-exempt, so we had to become a charitable organization in Massachusetts.
[End of side one of tape three; beginning of side two of tape three.]
--a humorous aside of that is, I went to my next door neighbor in Newton, who's a lawyer, Richard Lovell. I said, "Dick, would you do this free, because we have no money, we don't even have a society." He said, "Yes, but it has to be three people." So it was Dick Lovell, myself and my secretary who were the original incorporators of the American Society of Hematology. We then had to petition the state for a charitable review. And about six months later at my research laboratory which was then the Harvard University Laboratory of Blood Preservation and Characterization, and was located in Jamaica Plain--one day I was sitting there in the laboratory at a bench, working, and this big, burly policeman came walking in, and he said he was looking for the Society of Hematology. I said, "What?" And he said he was looking for the American Society of Hematology--I can't repeat his accent--and so I said, “I'm the American Society of Hematology, and my secretary, here, is the other incorporator.” So, he said, "Well, where are your offices?" So, I said, "Well, we don't have any." So, he said, "Well, where is the bar?" And, I said, "Where is the bar?" He said, "Yes. You mean you're not going to have a liquor license as part of your tax-exempt status?" Apparently, the Chowder and Marching Societies of New England have all incorporated over three hundred years in a tax-exempt, charity format, and then they can have a liquor license without paying a fee, and all of this. He couldn't believe that this was an organization that was really going to do some serious work, even though it was charitable! It was very amusing. But, anyway, that was the American Society of Hematology for its first couple of years.
Then we had the actual first meeting down in Atlantic City, at the Chalfonte Hotel in 1958, and there were 350 people that came to that. And it was my privilege to be elected at that time as the regular president of the Society, and we set up--although that was another spring meeting of April--we set up the rotational schedule for December meetings because, when I looked at the calendar of scientific events, the first week in December was the only week that there wasn't some conflicting meeting of national importance. So we scheduled it for the week right after Thanksgiving, and it's been on that schedule.
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