Title: David Challoner
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UFHC 36
Interviewee: Dr. David R. Challoner
Interviewer: Samuel Proctor
Date: June 1, 1999

P: I am doing an oral history interview this morning with Dr. David Reynolds
Challoner at his office. This is June 1, 1999. I am Sam Proctor. We are doing
this as part of the history of the J. Hillis Miller Health Center. I am going to start
off, David, by asking you to give me your full name, and tell me where that
Reynolds comes from.

C: David Reynolds Challoner was the name I was given by my parents. Reynolds
is a family name from my father's side. He was named Reynolds Ray Challoner.
As a matter of fact, the name Reynolds-though it was his first name and he was
called "Rey" came from my grandmother, his mother, whose maiden name and
family name was Reynolds, Lona Reynolds.

P: What is your birthday?

C: January 31, 1935.

P: And where were you born?

C: [I was] born in Appleton, Wisconsin.

P: Tell me your parents' names.

C: My father was Reynolds Ray Challoner. He was called "Rey" all of his life, but
he actually used the nickname for Reynolds, "Rey." My mother was Marion
Below, and that is an old Prussian name.

P: Where is the family from?

C: In the twentieth century, mostly from Wisconsin. My Grandmother Reynolds'
[family], earlier Van Vechten, were first New Yorkers, I believe upstate New
Yorkers, who then migrated to Milwaukee and central Wisconsin. My paternal
grandfather's family were immigrants, primarily from England and Wales, to
agriculture and farming in central Wisconsin in the late nineteenth and early
twentieth centuries. My maternal family, the Belows and the Petters, were
German immigrants to north central Wisconsin in the late nineteenth [and] early
twentieth centuries.

P: What did your father do?

C: My father was an insurance salesman and, later, an administrative executive with
Employers' Insurance of Wassau.









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P: So, were he and your mother both born in Wisconsin also?

C: They were both born in Wisconsin.

P: You went to school, obviously, in Wisconsin.

C: Right. Actually, there was a period of time from about 1939 or 1940 when first,
we moved from Wisconsin where my father had started with Employers'
Insurance at Wassau. We moved to Peoria, Illinois, for a year or two and then
from Peoria to Philadelphia, Pennsylvania, where he opened up the first major
move of this now national insurance company into the east coast. He was a
branch manager opening the activity on the east coast during the early part of
World War II. We then moved back to the Midwest, probably around 1944 or
1945.

P: In 1935, the country was right in the middle of the Depression. Of course, you
didn't know anything about it. Do you know if it impacted your family?

C: I do not know much about it. I have been told that my Grandmother Reynolds'
family, at that time in Milwaukee, were reasonably wealthy and had some kind of
manufacturing or foundry operation which they lost in the Depression. If there
was any significant wealth on that side, it may have been lost. I am not sure that
the agricultural farmer side of the family saw the same sort of impact that you
might have seen in some of the major urban centers.

P: How about World War II? Your father was not drafted?

C: He was not drafted. It was very, very close. I mean, I remember him basically
signing his enlistment papers and then, at the last minute, getting a deferral. I
am not sure what the basis of that deferral was, but he was prepared to go into
the Navy while we were living in Philadelphia. I think the call-up quota was cut
back, and he ended up not having to go.

P: And then, he was married and had children.

C: He was married and had children.

P: Are you the only child, or do you have siblings?

C: I have three siblings. I have a sister, Anne, a brother, Jon, and a younger
brother, Reynolds Ray Challoner, Jr., who we call Renny.


P: Where are they? Where is your sister Anne?









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C: My sister Anne is married to an attorney in Milwaukee.

P: What is her name? Anne what?

C: Anne Whyte. My youngest brother Renny is back in Green Bay, Wisconsin,
where he runs his own business in a large dental supply operation for the state of
Wisconsin. My brother Jon, who is third in ordinal ranking by age, is an
executive with a large construction firm in Concord, California, just east of San
Francisco.

P: Are you the first in the family to go into the medical field?

C: As a matter of fact, yes. I am not aware of any other physicians in the family.
None of my sib[ling]s have done so. None of my children have gone into
medicine.

P: What about your high school career? Where did you go to high school?

C: I went to high school in Green Bay, Wisconsin, [at] East Green Bay High School.

P: Graduating when?

C: Graduating in 1952. I had a wonderful time there. Green Bay was a relatively
small conservative town. Our Packer Stadium was the football stadium for my
high school. It was right next door. That was an interesting time of learning,
with a lot of bright kids in a very well-run Wisconsin public school system.

P: You obviously were a very good student?

C: Learning and education came fairly easy for me.

P: Did you come out of that kind of a household where there was a lot of emphasis
on education, [with your] parents pushing you?

C: I do not really remember my parents pushing me in any sense, in terms of
achievement. I do remember that the value system was that school was
important and that it was important to work hard and do well. There was music
in the home [and] there were books in the home, but I would not call it an
intellectual family in any sense.

P: What about your activity outside of the classroom itself in high school? Were
you a sportsman?

C: I did a little in track. I really was not a terribly good athlete, either in basketball









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or football, though both of
my brothers were far
better athletes than I was.
I did run and I did the high
jump in track, moderately
well.

P: Were you a social man?

C: Yes, I guess you could say that, Sam. I clearly enjoyed working with people.
To the extent that there were high school class officers and a political structure, I
was active in that. I was always reasonably well-organized and able to make
things happen, like planning high school bus trips to go to away football games
and things like that. I did a lot of that kind of group work.

P: Were you already beginning to think about medicine as a career in high school?
Were you taking those kinds of courses?

C: Yes. As a matter of fact, following on your question-were there any physicians
[or] any medical people in the family-there were not, but two of our closest family
friends in Green Bay were physicians. I was both attracted to them personally
and, I think, attracted to the profession by those relationships. One was a Dr.
Oliver Hitch, who was the first ophthalmologist eye specialist to practice in Green
Bay, Wisconsin, coming out of World War II. The other was a Dr. Walter Tippett,
who was a family physician. He actually was our family physician. [They were]
wonderful people who helped create my interest in medicine as early as-oh, I
probably was thinking about it in-eighth grade.

P: Were sciences your strong areas?

C: Yes. I was interested in it. It came relatively easy. I have the kind of track
record that gave me confidence that I could do it.

P: When you finished high school, where did you go to a university?

C: I went to Lawrence College at that time, now called Lawrence University, in
Appleton, Wisconsin. That was where my father had graduated. He had been
there [and] graduated in 1928, had not been a resident student but had been a
townie, if you will, because that was where his family lived (my grandfather).
Because my father had gone there, I was interested in it. They had a
competitive, by-examination, full scholarship at that time, called the Lawrence
College Fellowships. They gave out four each year. I took the exam and was,
within the week, awarded one of those fellowships and then just withdrew my
applications every place else and decided to go there.









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P: Did you have any financial problems? Did you have to work with the
scholarship, or did it cover it?

C: That covered all of the tuition and fees, and my family was able to cover
everything else. So, there were no financial problems. I did not work for
money, except in the summer times.

P: Did you have a car?

C: No, no cars. No cars were allowed on campus at that time.

P: And you graduated when?

C: In 1956.

P: And you were graduated with honors?

C: I graduated with honors.

P: Cum Laude?

C: I took a fairly diverse curriculum. I did my, sort of, minimal requirements to get my
science degree. I did a lot in economics and history as well, just because I was
interested in it. We had an interesting president at that time. In my freshman
and sophomore year, Nathan M. Pusey was the President of Lawrence. He
went to become President of Harvard after my sophomore year. To a very real
extent, Douglas Knight then came in as president. When I was ready to go to
medical school, Pusey remembered me, as you would from a small college like
Lawrence, and was instrumental in convincing me that I should go to Harvard
Medical School, probably the single most important decision of my life in terms of
professional life, because it expanded my horizons. Otherwise, I probably would
have gone to the University of Wisconsin or to Northwestern for medical school.

P: So, Pusey is the one who encouraged Harvard?

C: Correct.

P: Had you applied to other schools?

C: Yes. I applied to both Northwestern and Wisconsin. I think I applied to Yale
and to [Johns] Hopkins.

P: But you had the academic records, so there were no problems there?









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C: No.

P: You made Phi Beta Kappa in 1955?
C: Yes.

P: What other honors came to you as an undergraduate?

C: Well, I had a wonderful time at Lawrence. I received the Junior Spoon as the
Outstanding Junior Male. I received the Spector Cup as the Outstanding
Graduating Senior. I had the highest academic average in my class at the time
of graduation. It was a highly enjoyable and successful college career there. I
basically had my choice of where I wanted to go to medical school.

P: Did you spend all of your time at the library reading?

C: Oh no. No, I chased Jacki around for the my last two years.

P: That is where you two met?

C: Yes, we met there.

P: So, you were not in the library all of the time then?

C: No. I was very active. Again, I was very active in student government. I was
student body president in my junior year.

P: But you were, once again, not a sportsman at all?

C: No. Again, I continued my track in my freshman and sophomore years, but I did
not do that in my junior and senior years.

P: You did not have time.

C: No.

P: Jacki was on the scene.

C: That is right.

P: After graduation did you go immediately to Boston?

C: Yes. I took that summer and went to Sweden. I worked in a paper mill in a little
town by the name of Lilla Edet.









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P: What brought that on? I did not read about that in your records.

C: Green Bay was a paper town.
P: By paper town, you mean the manufacturers went into paper.

C: Yes, the manufacturing of paper. [There were] many, many paper mills in that
area of Wisconsin. Also, [there was] the manufacturing of the heavy machinery
that would make paper [and which] was distributed throughout the world from
Green Bay. There were some customers of the local paper converting
company, a manufacturing company from Sweden, whom we had gotten to know
when they would come to visit the States and stay with friends of ours. They
sent a daughter of theirs, Ulla Haeger, probably at age seventeen or eighteen, to
live with us for a year and learn English, so we got to know the Haeger family
very well. They owned this paper mill in Lilla Edet so then, when I had this
summer time, I went over and lived with them, worked in their paper mill, had a
wonderful summer, and then came back and went to Harvard Medical School.

P: You cannot beat that.

C: No.

P: You left Jacki behind and went off to Sweden. [Both laugh.] You were in Harvard
for two years at the medical school, I have here, from 1956 to 1958.

C: Right.

P: Then, you took a research fellowship.

C: Right.

P: Where was that?

C: That was a fellowship in Cambridge, England, at the Department of Biochemistry.

P: How did that come about?

C: I was intrigued by research and, in my freshman year at Harvard Medical School,
became interested in and by the chairman of biochemistry, a man by the name of
A. Baird Hastings and subsequently then began to just spend some afternoons in
the laboratory of a faculty member in biochemistry, a younger faculty member at
that time by the name Dr. James Ashmore.


P: You become interested then in working?









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C: I became interested in biochemistry [and] thought I would like to do some
research. As a matter of fact, though I had foregone it when I decided to go to
medical school, I decided to enter the Rhodes Scholar competition in my
sophomore year of medical school. In other words, I was really thinking about
taking a break of some kind from medical school and doing some research or
expanding my intellectual horizons, and was the alternate from Wisconsin for the
Rhodes competition. The committee, reported to me by Doug Knight (the
Lawrence president) afterwards, decided that I had plenty of opportunity through
other funding sources, which indeed I did. Eventually, I took a public health
service fellowship, which funded my time in England. That was fortunate
because at that time, if you were a Rhodes Scholar, you could not be married.
They ruled you out. So, in the end, what happened is that Jacki and I got
married in August of 1958. We then took the following academic year-I was
funded by a United States Public Health Service fellowship-and we went to
Cambridge. I was the equivalent of a graduate student at Kings College in
Cambridge and worked in the Department of Biochemistry with a famous
biochemist by the name of Phillip Randall.

P: You had already made a commitment to be a physician...

C: Right.

P: ...but now, you are going into the research area of it.

C: Correct.

P: You never became a practicing physician. Research was always your area of
interest and activity, is that not right?

C: That is correct. Research always intrigued me. I always thought it was
important and that historically, in the development of modern biomedicine in the
United States, we were just entering the golden era of both expanding knowledge
horizons and productivity of new tools in answering biological questions. And,
there was money on the table, the beginning of a huge federal investment in
biomedical research. So, it was a career in which, basically, the sky was the
limit. There was no future angst.

P: I am asking this, now, as a layperson who knows very little about the sciences,
biochemistry, and all of these other areas that intrigue you. Why was this such a
productive era you call the golden era? Money becomes available--what is
motivating all of that? Was it the international situation, the political situation,
the Cold War, competition with Russia, Sputnik?









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C: First of all, that is an element of it, to the extent that the Russian competition
motivated the United States to invest heavily in science, per se. Biomedical
sciences, though not part of that competition-which was primarily in the hard
sciences, the physical sciences, the things that would support defense,
military-the biological sciences benefitted, both by the application of physics and
chemistry to biologic problems by the scientific community, but there also was a
sense, coming out of World War II, that investment in sciences fundamental to
health were really beginning to pay off in terms of public health outcomes, that
we could do things other than wring our hands at the bedside and maybe use a
little digitalis or foxglove. So, there was a public investment for that purpose as
well, not just the halo effect of the Cold War, but a public purpose led by [U.S.
Senator, D-Alabama] Lister Hill from Alabama, Fogarty, and a series of patrons in
the Congress who kept expanding the NIH budget.

P: Was it getting strong support from the White House also, in the Eisenhower era
of the 1950s, and then Kennedy and then Lyndon Johnson?

C: The White House always was reigning in the exuberance of the Congress, and
so, though they were not battling it, they did not take the lead. The Congress
consistently took the lead from the early 1950s onward, and the Bureau of the
Budget, or OMB, would be restraining the Congress, but it was a friendly
restraint. So, the executive branch was behind it as well.

P: The public health support that you were receiving, was that the beginnings of it,
or had there been programs like it?

C: That had been in place for, probably, seven or eight years. As I remember, it
was called a post-sophomore research fellowship with the United States Public
Health Service. It paid $2,400 a year to me.

P: Was this national competition?

C: Yes. You applied everywhere. I do not remember much about that application
but clearly, I had strong support from the Harvard Department of Biochemistry.
As a matter of fact, James Ashmore made the contact with Phillip Randall in
Cambridge to get me the place in the laboratory. But part of the real joy of that
year, the first year of marriage, the wonders of going to a great university like
Cambridge, the opportunity to be a member of Kings College and to participate in
the pomp and circumstance, the riding of bicycles, the wearing of the black
gowns, all of those things--it was a wonderful time.

P: Where did you live?

C: We lived in the downstairs of a row house, in which the eighty-five-year-old









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landlady lived right up the open stairway. We had no central heat. We had a
living room with a fireplace. We had a dining room, which had been turned into
our bedroom. There was sort of a pantry, where we huddled around the coal fire
most of the time and where our hot water was heated. Then, a kitchen and a
bathroom in what used to be, I think, just a storage room, un-insulated off the
back of the house.

P: Were you near that open market area?

C: We were probably ten or twelve blocks from the open market right in the center
of the town.

P: That is a beautiful campus.

C: Yes.

P: I saw it in the summer, not in the winter [both laugh], so I did not endure some of
the hardships that you are talking about now.

C: Yes, and this is the first time that I had spent full-time, twenty-four hours a day, in
research. Obviously, I was not doing any medicine, in that sense. I was a
biochemistry graduate student. Jacki was following up her bent and interest in
literature and spent a lot of time in the libraries at Cambridge, and particularly the
library at Kings College, which had all of the original manuscripts of Rubert
Brooke, which she had an opportunity to study while she was there. So, that
was a wonderful year. I had the opportunity to stay a second year, but I was
convinced by that time that I did want to return and finish my medical degree.

P: So, you came back at the end of the year to Boston? To Cambridge?

C: Right.

P: Cambridge, Massachusetts, that is.

C: Right.

P: And you finished up your last two years or one year?

C: [My] last two years of medical school.

P: I wanted to ask you about the research that you were involved in over there. Do
you want to describe the nature of it?

C: This was a time when we were just beginning to understand the biochemical









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pathways and control thereof, for the metabolism of the heart, for the way the
heart produces energy to do its work. There was a visiting professor in Phillip
Randall's lab for the first couple of months I was there by the name of Howard
Morgan-who returned later to be a professor at Vanderbilt and then chairman of
physiology at Hershey, Pennsylvania-who had devised a rat heart perfusion
technique, which he taught to both Phillip Randall and me. I learned to use that
technique during that year I was there on a question of how insulin might work.
We got a few clues which probably were relevant to later understandings, but our
assay techniques were not sensitive enough to really see what insulin did to
cyclic AMP, which is a metabolic control molecule which was later found to be
very important in insulin metabolism. So, there were no publications that came
from that year, but I then took the rat heart perfusion technique, having learned it
with Randall from Howard Morgan, back to the Joslin Laboratories at Harvard
Medical School, the Joslin Diabetes Clinic. Albert Renold and Joseph Shipp
[Joseph Calvin Shipp, associate professor of medicine, 1960-1971, and director
of clinical research, University of Florida, 1968-1971], who may sound familiar to
you, Sam, [because] he later was a professor here in Gainesville.

P: Yes, I knew him.

C: Shipp had spent that same year at Oxford when I was on sabbatical at
Cambridge, [and he] had come over [and had] seen our heart perfusion
techniques on a visit to Cambridge. When we both got back to Harvard--he as
an assistant professor at the Brigham [Peter Brent Brigham Hospital, Boston,
Massachusetts] [and] I as a third-year medical student--I then began working
afternoons in his laboratory and set up for him the rat heart perfusion technique,
which he then used. He and I published a couple of things together while I was
a medical student and he was at the Brigham, before he came to Gainesville to
become an associate professor of medicine.

P: Are you already committed to a career as a research scientist rather than as a
practicing physician, or does this come later? You are obviously enjoying the
research.

C: Clearly, I was spending time and effort and was intellectually intrigued by it, but I
have to say that I did not finally give up the idea of the practice of medicine until,
basically, I was in my residency. Then, I finally decided that I would practice
within an academic environment but not become a private practitioner.

P: The lure of big money was not a tantalizing goal?

C: There are a couple of ways to answer that. Clearly not, but I think for special
reasons. Number one, the kind of big money implied by your comment was
something that appeared in medicine only from the early- to mid-sixties for the









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next decade. Private practicing physicians always have done well, but the really
big money that took physicians' average salaries to multiples of the national
average salary, that were double what they used to be, the separation between
did not occur until the mid-sixties, until Medicare and a few other things came.
So, that kind of extraordinary wealth was never there, never obvious to me.

P: So, it did not have to seduce you.

C: No, it did not have to. Second, there was at that time, as I implied in some of my
earlier remarks, a sort of unbridled optimism about the future of biomedical
research and academic medicine. This academic health center is sort of one of
the products of that unbridled optimism. So, there was never the kind of
introspective caution about the future in making an academic commitment at that
time that there is today.

P: And there was no penny pinching at Harvard at that time, was there, in the lab?

C: No.

P: You could do what you wanted?

C: Right.

P: Lab assistants and all of those things were available?

C: Yes. I mean, there was not really any problem. The funds were made available
to help support. They gave me a little bit of a salary, which helped to support my
family and our then child who was on the way. So, research was fun and a
desirable thing to do.

P: You graduated from Harvard Medical School when?

C: 1961.

P: Then, you do your residency.

C: Right.

P: You started where?

C: I went from Harvard to the College of Physicians and Surgeons at Columbia
University, Columbia P&S.


P: In New York City.









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C: In New York City, as an intern in internal medicine.

P: Was that an easy placement? Did you get where you wanted to go?
C: Yes. That was my first choice. I was fortunate enough, based on my
performance as a medical student and clearly with the demonstrated research
interest, to be recruited by both Peter Bent Brigham and the Massachusetts
General Internal Medicine Programs, which were also premier programs. I
thought P&S was right up there. I made a decision that I wanted to get some
experience at other institutions. It was a very easy thing in those days to stay
within the Harvard orbit, to graduate from Harvard Medical School, to go to the
Brigham or Mass General for internship and fellowship and, then, to sort of stay
on the faculties at Harvard.

P: Not a bad place to make your reputation.

C: Not a bad place at all. But it was interesting--there was something sort of ingrown
about it, and I made a deliberate decision that I wanted to see how other
institutions did things. That is why I went to P&S. It was a good decision.

P: It was a very good decision. You were in the Big Apple.

C: Yes. I did not have much time to enjoy it.

P: Yes. You were there, now, from 1961 to 1963. For two years?

C: Right.

P: Internship and residency.

C: First-year residency in internal medicine.

P: Now, this is a commitment, this internal medicine, is this the decision that you are
making?

C: Yes. At that time, I had decided that I was not going to be a surgeon, that
internal medicine was what fit best with my biochemistry and metabolism
research interest and its clinical application, and diabetes and other regulatory or
endocrinologic diseases.

P: Now, as an intern and a resident, you do not have much time for research, do
you?


C: No. None at all.









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P: That was lapsing for two years?

C: Yes.
P: What were you doing as an intern and a resident? Visiting inpatients?

C: Working every other night, collapsing at home every other weekend. That was
an exhausting and exciting time.

P: You were really an attending physician then?

C: Well, not attending. I was an intern. I was there in training. The attending
physicians were the faculty.

P: And you were walking around with them, listening to them?

C: I was walking around with them. I was the intern in charge of the ward, and I
would have to report on the progress and problems with the patients on my ward
service to the attending physician.

P: As a resident, were you not more in charge of things?

C: During the residency year, then I had an intern who was responsible to me.

P: Now, you are one year as an intern and one year as a resident, is that right?

C: Right.

P: Is that the situation today? I thought it is a little bit longer than that.

C: No. The full residency is three years.

P: What was it then? Just one year?

C: No. It was three years. Because I go on, then, to be chief resident in Seattle
when I finish at the NIH in 1965.

P: Oh, I see. You were two years in New York, and then you finished up in
Seattle?

C: Right. It was fairly common amongst this sort of academically elite group of
Yale, Harvard, P&S, [and] Penn to do an internship in a first-year residency and
then, because the military loomed large in everybody's life then, to do your
military obligation at the end of one year of residency and then return, after the









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military, to finish your residency and do your specialty fellowship.

P: Is this the development today?

C: No.
P: Today, you begin and you end up at the same institution?

C: You just go seriatim through it right now.

P: What about your military responsibilities? I did not see any reference to that in
your records.

C: When I finished my first year of residency at Columbia in 1963, I then went to the
National Heart Institute, as a commissioned officer in the United States Public
Health Service, and fulfilled my military obligation with two years at the NIH Heart
Institute.

P: Is this the Bethesda?

C: That was the Bethesda experience, and that was 100 percent research. It was
to a position that was called a research associateship, which was highly
competitive and sought after. It was somewhat fondly and non-publicly called
going there as a "yellow beret" because all of our other contemporaries who did
not have the opportunity to be selected for these research positions at the NIH
were going into the military service uniformly.

P: But you were not a soldier in a uniform and under military regulations?

C: No. It was a wonderful experience. I was a commissioned officer, but the only
time I wore a uniform is when I borrowed one from a friend one time so that I
could get a cheap airfare to go home, I think, to Wisconsin to my brother's
wedding. It did not fit very well, and I was panicked that I would run across
some officer I would have to salute at the O'Hare airport and would not know how
to do it.

P: It sounds to me like you did not even have access to the PX.

C: Actually, we did. We were able to use the military PXs around the Washington
area.

P: I can see that you took advantage of everything.

C: Absolutely. That was a period when my independence as an investigator really
began to grow. I was ready to do my own research and was still using the









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perfused rat heart as a research tool.

P: I want to break for just a moment here and get some of the personal data
because Jacki keeps coming into your narrative here. Tell me about Jacki.
What is her full name?
C: Her name is Jacklyn Davnes. She was the oldest of three girls, of Harvey and
Adele Anderson.

P: Born when?

C: Born on July 13, 1936.

P: Where?

C: She was born, I believe, in Kenosha.

P: Is that another one of those places up in Wisconsin?

C: Yes, it is. This is down towards Milwaukee. But, she spent most of her growing
up years in Wisconsin Rapids, Wisconsin, which, again, is a paper town on the
Wisconsin River right smack in the middle of the state of Wisconsin. She was
sent to a boarding school because of her parents' concerns about the quality of
public education in Wisconsin Rapids. For her junior and senior year, she went
to a place called Milwaukee Downer, which was a fine girls' school with a
boarding component from which she graduated. Because her father, who was a
delightful and domineering person, told her there was not any way she was going
to go to Wellesley--which is where the headmistress felt that she should
go--because she would just marry some Harvard man and he would never see
his grandchildren again, he sent her to Lawrence, where I first met her as the
student body president or treasurer at that time in the receiving line at freshman
week. This luscious blonde freshman came through the line, and I shook her
hand, and I noticed her. We started dating several months later in her freshman
year.

P: You were married when?

C: We were married then, in 1958, at the end of her senior year. By then, I was off
at Harvard.

P: Give me the specific date so that it is in the records.

C: August 30, 1958.


P: Okay. Where were you married?









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C: We were married in Wisconsin Rapids.

P: Give me the full names and birth dates of your children.

C: David Harvey Challoner, born December 19, 1959. David is now married [and]
has two children living in Atlanta.

P: What are the names of his two children?

C: The names of the children are Dagny Adele--Dagny is Jacki's grandmother's
Norwegian name-and David Reynolds Challoner, II.

P: What does your son do?

C: My son is in a medical practice management company, and he organizes the
backroom and marketing functions for a large national group of plastic surgeons.
The second child is Laura Reynolds [now] Dawahare. The Dawahare family has
a chain of stores throughout the Central Kentucky/Tennessee area, clothing
stores, where her husband works. She did her M.B.A. at Duke, where she met
her husband who was also doing his M.B.A. at Duke at that time, and he returned
to the family business.

P: And they have two children?
C: They have two children, twins.

P: Names?

C: Sam and Elisabeth.

P: And then your third child?

C: The third child is Britt, and she was born on June 13, 1965.

P: And Britt has a middle name, does she not?

C: Yes. Britt Davnes.

P: What is her married name?

C: Her married name is Garlock.


P: What is her husband's name?









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C: Her husband's name is Steve.

P: Steve Garlock.

C: Right.
P: And they have children?

C: They have two children, Robert and Michael.

P: I understand you have kind of an ethnic mix, as far as your in-laws are concerned.

C: Yes, an interesting group.

P: Kind of a world mixture.

C: Yes. The Dawahares are from the Middle East. The grandfather came to central
Kentucky and was a traveling peddler for the mine company store and had-I don't
remember how many-sons, something like eleven or twelve children. I think, maybe,
eight of them were men, all of them named after presidents. Michael's father was the
youngest of this family, and his father, the peddler, had always said that one of his
children may well be president-he was going to name them after presidents-and
certainly, one of them was going to go to Harvard. Lo and behold, Michael's father
graduated from Harvard University and got his M.B.A. from Harvard and now is the
chief executive of the family business.

P: And will not be president, then.

C: And will not be president. So, this is basically a Lebanese Christian family that came as
peddlers or merchants to central Kentucky.

P: Who made good in the American Dream.

C: That is right. The Garlocks are a wonderful family, based in Nashville, and are Jewish.
Steve's father was a publishing executive in children's literature in New York City for a
while and now is working in a family business in Nashville. [He] has a very successful
hobby, now really could become full-time a professional artist. He is a very skilled
artist.

P: Everybody talks to everybody?


C: Everybody talks to everybody.









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P: That is good.

C: Yes.

P: You said already that they have two children, the Garlocks.

C: Right.

P: So, you have six grandchildren?

C: Six grandchildren.

P: Let us get back now to your own professional career. After the two years, you go to
Bethesda, and that is the National Heart Institute.

C: Right.

P: And you are there from 1963-1965.

C: Right.

P: Tell me again what you were doing there as a research associate.

C: As a research associate, I was a Lieutenant Commander in the United States Public
Health Service. [That] was my rank. I think I was paid about $12,000 a year, and it was
the first year since graduating from college in which I did not have to borrow money to
either go to school or live. We had a house, our own house, which we rented. It was a
wonderful time. I worked in the laboratory of the National Heart Institute. Don
Fredrickson was a senior member of that laboratory. I worked specifically with Dr.
Daniel Steinberg and set up, again, the rat heart perfusion technique in that laboratory.

P: When you say rat heart, you are actually talking about a rat, a rodent.

C: A rat. A rodent. The rodent is sacrificed. The heart is removed and is placed on a
cannula and is perfused with an artificial medium so that you can study the metabolism or
the metabolites that would be taken up by the heart or released by the heart under certain
kinds of endocrine conditions.

P: Now, the laboratory that you were in, did it have a special designation or anything?

C: It was the Laboratory of Metabolism of the National Heart Institute.


P: Okay, and you were there for a two-year appointment?









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C: Correct.

P: At the end of which you had finished your military responsibilities?

C: Correct.

P: So, you leave there, and you go out to Seattle, Washington?

C: Now, I go to Seattle, Washington, again another institutional change. That was 1965.

P: You go to a hospital?

C: At that time, Seattle was not unlike Gainesville, rising like a phoenix, in terms of modern
biomedicine and medical research and academic medical health care delivered. That
institution probably is not more than three or four years older than Gainesville.

P: So, it is a product of the post-World War period?

C: Yes. It had an extraordinary leadership cadre. John Hogness, later president of the
University of Washington and then head of the Institute of Medicine, was the dean. Dr.
Robert Williams, who was the reason I went there, [was] really the force behind the
major upward momentum of that place as chairman of medicine. He had been recruited
from Hopkins, and was probably one of the two or three pre-eminent endocrinologists,
diabetologists, in the world, had written both the definitive endocrinology text and
definitive diabetes text, and was recruiting me heavily to come and finish my research
training and residency in Seattle. I remember, I would be out mowing the lawn in
Bethesda at seven o'clock on Saturday morning, and the phone would ring. Of course, it
is four o'clock in Seattle. He was a workaholic. He would be on the phone trying to
sell me on coming out to Seattle for the next stage of my career.

P: What were they offering you? A laboratory?

C: First of all, I said, I have only had one year of residency; I need a second year of
residency, but I think I have had enough experience that I would like it to be a chief
residency instead of just a senior residency. So, they offered me the chief residency at
King County Hospital.

P: You came out then, as chief resident?

C: As chief resident, and sort of ran the medical service as chief resident in the public
general hospital of Seattle.









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P: A large hospital?

C: Very large, [with] a big emergency room.
P: Like Shands?

C: Much more like University Medical Center in Jacksonville, a city hospital. There was a
Shands-like university hospital also, so there were two chief residents at the University of
Washington.

P: Lots and lots of different patients coming in at all times.

C: Right. The referral hospital was the university hospital in Washington. The sort of
blood-and-guts city hospital which is where I was, was King County.

P: That is where the indigents came and people who were an emergency?

C: Right.

P: So, you saw all kinds of patients?

C: All kinds of stuff.

P: Night and day.

C: Seamen coming in off of the Pacific. I mean, it was really quite an extraordinary and
wonderful chief residency.

P: It must have enlarged your experience tremendously.

C: It did, and it was important that I did that because for two years, I had been strictly in the
laboratory. This was a hosing down, of big time ...

P: Is this not really the first time you became, in a way, an attending physician?

C: Yes, absolutely. [That is] a very appropriate way to look at it. I was responsible for the
administration and
management of the education
in clinical care programs for
this large hospital and its
intern/resident staff


P: Then you said after two years, this is not what I want?









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C: No. Well, I had one year there, which is what I planned. The next year, I went as a
senior research fellow to Bob Williams' laboratory.

P: In 1965, you are in the Kings County Hospital...

C: Right.

P: Then, 1966 [and] 1967, where did you go?

C: I go to Bob Williams' lab. Basically finished up my requirements for specialty training in
endocrinology and diabetes [and] continued my research program, still using the perfused
rat heart, with a group of eight or ten research fellows with Bob Williams at that time. I
mean, if you were going to be an academic endocrinologist, Bob Williams' unit was the
place to be in the mid-1960s.

P: David, I am not sure I understand exactly. Are you narrowing your area of interest now
to diabetes, or is this just part of a larger area of interest and activity?

C: I am narrowing my focus and my training to endocrinology and metabolism, and diabetes
is a subset of that.

P: I see. So, it is not just focusing on diabetes. That just happens to be a part of it.

C: Right. It is one of the clinical disorders that anybody who is a specialist in
endocrinology and metabolism deals with.

P: What other medical areas would endocrinology handle, besides diabetes?

C: Thyroid disorders, adrenal gland disorders, hypertension.

P: But when somebody would be coming to the hospital to use you, they would be coming
because they were a diabetic, or would they be coming because of one of these other
things also?

C: They could be coming from any one of those things, but diabetes just happens to be the
most prevalent disease. The others are somewhat more rare.

P: At this point in your career, if somebody asked you what you specialized in, what would
you say?

C: Endocrinology and metabolism.

P: Okay. You are there for two years in Seattle.









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C: Right.

P: Why did you not stay on?

C: Interesting. Another institution with major figures and acquaintantships. Bob
Williams, who was clearly the most important mentor in my entire professional career,
said, I could probably stay there as a junior faculty member. That was one of those
places, like Duke basketball, has an extraordinary bench strength. [He said] you are likely
to get more growth experience more rapidly by going someplace else. So, he was
instrumental in suggesting that one of the places I should go to look at was the rebirth, if
you will, academically, at the University of Indiana Medical Center in Indianapolis that
was occurring under the new chairman of internal medicine, John Hickam, of Hickam Air
Force Base fame. That was his father. That was a wise decision because there was an
essence of a new department of medicine, a new section of endocrinology and
metabolism, and [it] gave me an opportunity to grow there very rapidly in a way, as a
matter of fact, that I might not have if I had stayed in a place like Seattle.

P: You are hauling your family, though, back and forth across the country.

C: Yes.

P: Was that a hardship?

C: Yes, I think it was to some degree. Seattle was a wonderful professional growth
experience for me, as both chief resident and then senior fellow with Bob Williams. It
was at a time when our children were at that very young stage where they were at home
or, at best, in nursery school or the first year of kindergarten.

P: So, you did not have to be concerned with them leaving friends and that sort of thing.

C: Yes, but the weather in Seattle drove Jacki nuts, in the sense that because it was so rainy
and muddy, it was a housebound time for Jacki and the kids, so leaving Seattle was not
that difficult for her.

P: She was not a working mother? She was at home?

C: She was not a working mother, no. She was very much a full-time raising quality kids
mother.

P: I want to go back for just a moment and put in something on the personal. When did she
graduate, and what degree did she carry?









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C: She got a B.A. from Lawrence in the spring of 1958. Literature was her specialty.

P: Okay. She did not go on to take an advanced degree?

C: No.

P: Did she ever use her college [degree]? Did she ever teach or work in her field?

C: No. As I mentioned, she spent the year while we were in Cambridge, in essence, doing
personal research study in the library of Kings College and attending, monitoring, some
classes there, as I recall. She then worked, just until our son was born, at the Harvard
Student Health Service as a research associate in their longitudinal study, [with] the
Harvard psychology group.

P: But with her training education, she never went into the publishing field or any editing
field or anything like that?

C: No.

P: Now, at this stage where you are making your commitment to go to Indiana, you say Dr.
Williams is the man who advised you?

C: Yes.

P: Tell me a little bit more about him, since he plays such an important role in your career
and life.

C: Bob Williams was a Tennessean with a severe lisp. I think [he] was a Vanderbilt
graduate who ended up as a [Johns] Hopkins medicine graduate, who then ended up at
the Boston city hospital in the heyday of the Boston city hospital's academic
development. He was an expert in thyroid and diabetes, was then, briefly, I think back
on the faculty at Hopkins (but I am not sure of that). Then, as a very young man, at a
time when very young men were going to brand new medical schools in the late 1940s
and the early 1950s, went to be first chairman in medicine at the University of
Washington in Seattle. He was a dynamo. He worked--I don't know how many--hours
a day. As I said, for probably almost a decade and a half or two decades, he kept alive
under his editorship the two major textbooks in endocrinology and in diabetes and
internal medicine. He had a very large research group, and he looked after--in a way
that I could never do myself and never saw anybody else do it--the continued
professional career development of his fellows. He called me once a month or so, just to
keep track of how things were going at Indiana. He continued to push me into all of the
important honorific organizations in the early part of my career, though he was in Seattle
and I was off some place else. He was doing that for all of his people.









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P: So, he was more than a mentor. He was a friend.

C: Yes, who cared deeply about the continued professional growth and exulted in the awards
that his professional progeny brought home.

P: It was as a result of his push or encouragement, then, that you went to Indiana?

C: Yes. He thought that it would be a place where I could continue that kind of growth.
By this time, I guess you might call it political, but the skills and interests that I had in
organizations and people and colleagues and how they worked was beginning [and] in
my own unspoken thoughts about my future, I was thinking that I might in the end be
best doing something in terms of organizations. When I think in retrospect about this,
Sam, it is hard to know exactly how and why. But, I enjoyed being a class officer in
high school and organizing the activities of my class. I was student body president at
Lawrence. At Harvard, I was secretary of the Boylston Society, which was a very
important honor society [and] which, as a matter of fact, had its sesquicentennial as an
organization the year I was a senior, and I put together this national program for the
Boylston Society. When that was over, the chairman of psychiatry at the Mass General,
who was a wonderful professor who I had done some student clinical work with--I had
done a psychiatry rotation in his service--came up to me (he was very friendly), and he
said, you know, you are going to be a dean of a medical school some day. I was sort of
stunned by that because that was a goal that I just had not even thought about. But, he
planted a seed there. There were not any of those kinds of things that were part of the
training life in internship or residency or, certainly, at the NIH. Once I got back to my
first full-time faculty role in 1967 in Indiana, I began to see the academic politics and
national academic organizations and national policy, as it related to biomedical research,
as an interesting avocation in addition to my vocation, with the help of Bob Williams
[and] with the help of John Hickam, who was the chairman at Indiana and a major
national figure. They continued to push me into opportunities for national academic
organizational policy leadership. The first of those was involvement in the American
Federation for Clinical Research, which is the largest organization of clinical researchers
in the country that had an interesting charter. Of the three clinical research
organizations, it was the most junior, the least exclusive, but also had a requirement that
active membership ceased at age forty-five. So, it was an opportunity for the very
youngest clinical researchers, which is what I was then. I was a full-time faculty
member doing laboratory and clinical research, seeing patients, and teaching students. [It]
allowed them organizational and political voices at a national level at a very young age.
The next most senior was the American Society for Clinical Investigation, the Young
Turks, as they were called [because they were] selective. Then, the most selective of all
was the Association of American Physicians, which only has an active membership of
some 200. I eventually became a member of each of those as I went on in my career, but
I got involved in national organizational politics in the American Federation for Clinical









UFHC 36
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Research, first of all, as a counselor of the Midwestern section (my geographic section)
and then was elected to a national counselor role and eventually became president of that
society. That was now an exposure in conjunction with my more senior colleagues from
the Young Turks and from the Association, to put together the annual meeting that was
held in Atlantic City every year of these most senior U.S. organizations at a time when
clinical research was booming. It gave me an opportunity to give testimony before
Congress on issues relating to funding and policy in clinical research as a representative
of the organization, and it gave me the ability, once again, to use my administrative and
what leadership skills I might have had as I rose through the academic ranks to full
professor in the end.

P: David, at this point in your career, when you were just getting ready to go to Indiana, had
you already a list of publications? As author? Co-author?

C: Yes. I probably had fifteen publications at that point, something like that. Then, when
I went to Indiana, that increased, and I had my own individual NIH research grants.

P: You come to Indiana University School of Medicine in 1967. Why did you say this was
the rebirth of the school? Was it an old institution?

C: It was an old institution in Indianapolis that had fallen on some hard times, academically.
It had not moved with the times when most old medical schools were changing from
part-time volunteer faculty to full-time salaried faculty and, therefore, it had been a
community-based, community-taught medical school. It did not have the same kind of
high-powered faculty that were appearing in Gainesville or Seattle or on a full-time
faculty at the University of Iowa. It had practitioners with no modern science base
teaching the medical students at Indiana, and Hickam was the first policy decision
probably made under the chancellorship of Ken Penrod [Kenneth Earl Penrod, Ind U.
provost for med. ctr., 1965-1969; vice chancellor for med. and health scis. State U.
System Fla., 1969-1974], who went on to become chancellor of the S.U.S. Under his
leadership from Bloomington, I think he sort of pushed through a policy change to make
the medical school at Indiana a modern full-timed faculty school, and Hickam was one of
the first recruits to make that happen as chair.

P: So, when you got there in 1967, the changes had already taken place?

C: Yes, were sort of halfway along.

P: If not, it seems to me it would have been kind of a negative prospect.

C: It was. As a matter of fact, it was interesting. As with all things, when institutions are on
their way up, their national reputation trails behind them, and when they are on their way
down, their national reputation tends to sustain them. I was proposed by Indiana as a









UFHC 36
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candidate for a Markle scholarship, which is a very important thing for young faculty.
As a matter of fact, Joe Shipp was a Markle scholar from Florida.

P: Also, I think Sam Martin [Samuel Martin, professor and head of medicine, University of
Florida, 1956-1969] may have been one.

C: Sam was a Markle. Bob Marston [Robert Q. Marston, University of Florida president,
1974-1984] was a Markle. I was proposed by Indiana. I went through the selection
process. I cannot remember the name of the guy who was the director of the Markle
Foundation at that point, but he had very strong opinions. He was still seeing the
Indiana of old and simply said that any medical school that does not have control on
faculty practice and their incomes will not get a Markle scholarship, no matter how good
their candidate was.

P: The institution tarnished it.

C: Yes, that was interesting. That has all changed, remarkably. At any rate, that is the
transition that was taking place at that institution at that point of time under the
leadership of John Hickam.

P: It was changing at about the same time that the University of Florida's medical school
was beginning to get some sort of a reputation.

C: Now, in that regard, since Joe Shipp was my colleague when I was doing research at
Harvard as a junior and senior medical student, and then Joe came to the full-time faculty
in Gainesville, I made several trips to Gainesville before I ever ended up here full-time.

P: Oh really? I was going to ask you a little bit later on if you had ever heard of
Gainesville or Shands, but you had.

C: I had heard a lot about it. In fact, I think this is one of the places where I applied for an
internship, but I do not think I visited. In the end, I finally withdrew it before I made my
decision to go to P&S in New York.

P: I am not coming to a community that has such a lousy air service.

C: [Laughs.] Yes. And this was a place where it was acceptable for a Harvard student to
go, not the premier ones.

P: They were looking for young doctors who were on the cutting edge of moving up to the
top.

C: Absolutely right, and they were attracting them at that point, more so than they are now,









UFHC 36
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even. Maybe we could talk about this [later]. So, I did come to look at the possibility
of coming here as a resident at the time that I, instead, went to Seattle. I cannot
remember who was the chairman of medicine then, but [I] would have come here as a
resident and then, maybe, [would] have done some fellowship work with Joe Shipp but
decided to go to Seattle. Then, when I was looking at where I would go as assistant
professor for my first faculty appointment in 1967 and ended up in Indiana, I came and
also was recruited to look at an assistant professorship here.

P: So, you really had some early contact with Gainesville?

C: Yes.

P: Not early ties but some early contacts.

C: Right.

P: But instead, you go to Indiana.

C: Right.

P: You go there to the school of medicine, not college of medicine?

C: School of medicine.

P: You are there, I understand, as a staff member. What is this Regenstrief Foundation for
Research Health Care?

C: There was a very wealthy box maker in Indiana and Illinois by the name of Sam
Regenstrief. He made cartons for industries in the Midwest. He was interested in
manufacturing process, talked with John Hickam, and Hickam induced him to endow an
institute with some of his considerable wealth. This is a very early time. It was
probably one of the first institutes to look at, sort of, engineering practices, as applied to
medicine. Health systems as applied to medical organizations and how they function.
In other words, health systems research instead of laboratory research. This was an
intellectually interesting thing. It was clearly coming as an important national issue. I
was one of John Hickam's lieutenants involved in that development.

P: So, that was your funding?

C: No. Actually, I had funding from the NIH. Again, health systems research was sort of
a mind-expanding hobby, for someone running a biochemistry lab. I had a joint
appointment in the department of biochemistry at Indiana. I was a professor of
biochemistry as well as medicine. But then, beginning to sense the importance of









UFHC 36
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organizational issues in medical practice, I spent some time working to help get that
institute up and running.

P: You were also involved in the Marion County General Hospital.

C: That is where my staff appointment was.

P: So, you were a practicing physician there?

C: Right.

P: You were in charge of patient care there, were you not?

C: Correct.

P: I mean, sick people come to you and say, cure me, doctor, and you wave your hands
over, and that is it.

C: With whatever powerful nostrums we have available to us.

P: Aspirin.

C: Yes. [Both laugh.]

P: And you were chief of the division of endocrinology and metabolism?

C: Correct.

P: Does this mean you have a double responsibility? Two jobs?

C: Double what?

P: Well, I noticed this. You are a staff member in the Regenstrief Foundation, and you are
working there. You are also chief of the division at the Marion County General
Hospital. Does this mean you go from one place to another?

C: It was all geographically hooked and linked together, so we were working in the same
building.

P: I mean, did this mean that you had an eighteen hour day?

C: We had some pretty long days, yes.









UFHC 36
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P: It sounds to me from the description, and I am asking this as a layman, as though you are
having two jobs at the same time, or two different kinds of responsibilities.

C: Different kinds of responsibilities, certainly. Quite different.

P: Is this unusual for somebody in academic medicine?

C: I suppose, especially the crossover from something that is basically a biochemistry and
metabolism research lab responsibility and funding to something that was an
organizational health systems research organization. That is a pretty broad leap.

P: There is also another "also" in there, because you are a professor.

C: Right.

P: Were you teaching then? Did you have classes?

C: Yes, I was teaching medical students.

P: I mean, did you have a classroom situation? You were up there lecturing to medical
students?

C: I did some lecturing to medical students in biochemistry in their early years. I did some
lecturing to medical students in their pathophysiology in the second, which is sort of the
transition from basic sciences to clinical problems, and then did rounds on the wards,
teaching interns, residents, and senior students.

P: And they are following you around?

C: They are following me around, right.

P: As a professor, and I know that the medical school operations are so different, you do not
give examinations and read term papers and look at blue books?

C: No.

P: No messing around with that kind of trivia, right?

C: Right. [Both laugh.]

P: It is not a history class.

C: Not a history class.









UFHC 36
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P: They do not have to go to the library at all. I thought it was kind of interesting that there
is also a VA Hospital that you were involved in. Was that not so, in Indiana?

C: Yes.

P: Kind of smacks of what they do at Gainesville.

C: Very much the same. All on the same campus, deliberately located there in order for it
to be part of the academic enterprise.

P: Which is true here.

C: Which is true here, and was part of the philosophy by which a large expansion of VA
health care took place after World War II, which was to put them on academic health
center campuses. I just had a consulting appointment there.

P: You did not attend patients there, then?

C: Sometimes, if my medicine assignment was at that hospital for that part of the year, I
would attend patients there.

P: Would you have that kind of a situation then or now? Were you paid? Did the federal
government put money into your pocket?

C: Yes. I got a small consulting fee?

P: But not much.

C: Not much.

P: This was federal money, federal dollars?

C: This was federal money, maybe $75.00 a day.

P: I notice also that you became assistant chairman of the department of medicine and
special assistant to the dean for research and development.

C: Right.

P: What did all of that mean?

C: Well, these were some of my organizational interests that were beginning to come out.
John Hickam had died at that point, suddenly and unexpectedly with a hemorrhaging









UFHC 36
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cerebral aneurysm, and Walter Daly had taken over as chairman of medicine [as] an
inside appointment. So, I then agreed to sort of run the house staff programs for the
department of medicine, Walt being the chairman. So, my title was assistant chairman
or whatever. Steve Beering [Steven C. Beering] was the dean of medicine at that time.
(He is now the president of Purdue.) Steve and I were friends. We both had come to
the faculty together in 1967. The relationship to the dean's office was simply because of
my increase in experience with and interest in national policy issues as they related to
biomedical research and education, so I was kind of a Washington liaison, if you will, for
the dean.

P: So, you did not have the responsibilities of the nitty-gritty, day-to-day kind of things?

C: No.

P: You did not care about budgets and faculty appointments and that sort of thing?

C: No. It was really national policy stuff more than anything else.

P: Was that a big-time responsibility at a school like Indiana?

C: Well, in terms of time, no.

P: But it extended beyond just Indiana. As a national policy, it affected the nation.

C: Yes, it did. But the main foil to make that happen were my activities as a national
officer of the American Federation for Clinical Research. That was where my view of
volunteer time was spent.

P: Now, I noticed you were also a consultant with Eli Lilly.

C: Right.

P: Was that a big thing, or was that a small responsibility?

C: It was not a very big thing.

P: How did they use you?

C: They used me, basically, for clinical research design matters as it related to their diabetes
products, particularly insulin and some new insulin preparations, and how to put together
the clinical research to demonstrate the effectiveness for FDA and licensing purposes and
then, most intensively, to help them put into place and to manage their human
investigation committee functions. I mean, this was the time when all of the new human









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research requirements were being put in place by NIH and FDA, and it was important to
a major international quality pharmaceutical house, such as Lilly, to have a high-quality
human investigation committee function. So, I helped them put that in place.

P: Now, I know Lilly is a big-time operation. Were you in a position to encourage funding
for research in the areas that you were working in?

C: I would occasionally consult with them on specific proposals.

P: On policy, is what I am really wondering, if you were on that level with them?

C: No, I would not say that, at that point, Sam. Not for Lilly's strategic overall position.

P: But they were funding lots of important research, were they not?

C: They were funding lots of research. In fact, they funded some research in my lab as
well.

P: They continue to be involved in activities here, in Gainesville?

C: Lilly? Some. I am not sure who might have the grants now.

P: But not as a result of your connection? [That] is really what I am leading up to.

C: No. It does not have any to do with my connection with Lilly.

P: From Indiana, you go to St. Louis. Why did you leave Indiana? Why did you make that
change at that particular moment in your career?

C: This was sort of the ultimate and, probably, premature test of the idea that had been put
in my head by the professor of psychiatry at Harvard when I was a senior medical
student.

[End Side A2]

P: The point I was making at the end of that other tape before we signed off was that it had
not lived up to Dean Harrell's [George Harrell, dean, college of medicine, University of
Florida, 1954-1965] hopes and dreams, and I raised the questions of why?

C: The so-called isolation of the health campus is not unique to Gainesville. As a matter of
fact, Gainesville, in the end, at this point in history is probably as much a part of its
parent university as most other major academic health centers in the country. Number
one, many of them are geographically separated. As a matter of fact, the next one Dean









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Harrell founded, if you will, in Hershey, Pennsylvania, is completely separate from the
campus of Penn State.

P: That is right. It is a long way away.

C: So, it is a long ways away. Here, we have the great good fortune, even though we are at
the bottom of the hill, [that] we are an integral part of the geographic campus of the
University of Florida. As a matter of fact, that was one of the important reasons that I
thought that Florida would be a good place for me to come, because the relationship with
the parent university, rather than separateness, is a critical priority of mine. Even though
we, and others like us around the country, sit in the middle of the university, especially in
the period of time beginning in the early 1960s, our research funding, the use of clinical
income to support salaries, the unique nowhere-else-in-the-university integration of the
practice, the doing, of our daily profession in the research and education mission of the
university, does make medical centers unique, does introduce a discipline, an
outward-looking nature to the health center campus that the other parts of the university
do not have. Engineers do not build buildings. Lawyers do not do much lawyering,
except for a little private consulting. But in the university, the medical faculty, to carry
on their profession in delivering care to sick human beings, which have to be the absolute
number one priority for that faculty member, at the same time that very large amounts of
money are being generated in the current economic models from the delivery of those
services. So, a certain insularity, even in a place like this, does develop. The faculty
have generally been economically better off than the rest of the university. There are
envy issues. There are a whole variety of things that can create a chasm, but I came
because I wanted to make sure that over the long term, this academic health center would
be as minimally insular, given the realities of the world in which it had to live and
survive economically. That worked to a significant degree. To some degree, also, it
depends not only on the point of view of the vice president for health affairs but of the
president. A couple of anecdotes that may be illustrative. Bob Marston, to a significant
extent, had a cabinet style of government. He did not convene it very often, but he
broadly consulted with his vice presidents on specific issues when he needed to, and [he]
delegated responsibility. Marshall Criser [Marshall M. Criser, University of Florida
president, 1984-1989] was different. Given what he came from, he probably was the
unhappiest man I have ever seen in the presidency. I think within two weeks, he knew
he had made a mistake, that faculty were not the kind of people that he was used to
dealing with.

P: Paula loved it.
C: Yes, I know, and that is fine. We were very close friends with the Crisers and remain so.
Our families were the same age. We spent Christmas holidays [and] ate Christmas
dinners together. We were and are very close. But Marshall was out of the element of
what he is really good at, in the day-to-day operations of the presidency. One of the
things that came up early on during Marshall's realm is that the health center, in









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particular, because it is primarily funded by the NIH which has a far more generous
indirect cost policy than the National Science Foundation does which tends to support the
other university sciences--NIH being primarily the health centers, obviously--was
returning, via University of Florida and SUS policies, a significant piece of change in the
indirect costs that were appropriated back by the legislature to the University of Florida
and that those indirect costs here were being used to support university-wide research.
In other words, the health center was significantly subsidizing the institutional dollars
devoted to research throughout the university because of its success in the NIH-granted
programs. IFAS [Institute of Food and Agricultural Sciences] was not returning its
indirect costs to the university coffers but rather was by some pre-arranged, pre-Criser,
pre-Marston agreement-I don't know-keeping all of its own indirect costs and
contributing not a whit of a poet's tax to the rest of the university. I made a heavy run at
Marshall to equalize the poet's tax, in its simplest sense, across the entire university, that
all of us should expect to contribute our indirect cost funds to help support the Division
of Sponsored Research and to help support faculty research that was not otherwise
fundable by outside agencies in various other parts of the university, and that IFAS
should pay its own costs. I did that rather than insisting that the health center be treated
as IFAS was, and that we get all of our own money back, and we keep it, and we use it
for what we damn well please. I regarded that as a not only symbolic but real
demonstration of the way I expected this academic health center to be a citizen of this
campus. Marshall was unable to get IFAS to agree and, to this day, we have not yet
settled that issue on this campus. But, to this day, the health center remains the major
contributor to the Division of Sponsored Research, its administrative infrastructure, and
its granting programs for the entire university.

P: I thought when Criser got rid of the director of IFAS, he settled that problem.

C: No. [It was] unable to be dealt with. That, I simply give you as an anecdote about my
own personal view of the matter though there is some separation caused by culture and
economics and the performance of professional work, my view of what this health center
ought to be is that it ought to be an integral part of the university. To the extent that
presidential style is not collaborative and cabinet oriented with the senior administrative
leaders of the campus, you lose the sense of participation of the leadership of the units in
the whole.

P: You and Marston got along well together, though, did you not?
C: Oh yes. I got along very well with Bob Marston, very well with Marshall Criser.
Marshall was very lawyerly in his presidency. He would do his best to gather a variety
of facts on a problem from a variety of sources. He did not talk much. Marshall never
talked much about anything.


P: He just listened.









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C: He listened and then he would, like a judge, retire to chambers and write out a
judgement.

P: And never change his mind.

C: Right. I understand the style [and] I understand where it came from, but it sometimes
made dealing with him difficult. The kind of interchange that somebody like Marston
would have encouraged was not the same style. Of course, Bob Bryan [Robert Bryan,
interim president of the University of Florida, 1989-1990] and I got along and continue to
get along famously.

P: You have always been good friends with Bob.

C: We have always been very good friends with Bob. I admire him and his particular set of
skills. He was extraordinarily supportive, consultative, and collaborative with the health
center.

P: He and Kay are among our best friends. We have traveled with them some. We went
to Europe together.

C: Yes. So anyhow, every president sets a ratchet in ways that he or she may not realize.

P: Do you feel comfortable in saying why you and Lombardi [John Lombardi, University of
Florida president, 1990-1999] have not seen eye to eye?

C: I think there is a big difference in style. John, for all of his extraordinary political skill
and charisma, does, in his own way, not create a sense of cabinet and consultation around
him from the diverse parts of the university.

P: I think that is apparent to lots of people.

C: Yes. I do not think I will say any more about it.

P: Well, I do not want you to say anything you are not comfortable with, knowing that this
could be public. That is fine, but I just wanted to try to get as much of the historical
record documented as we could get. Let us go back to your earlier years here, on the
campus, and talk about some of the relationships that you had. When you arrived, who
was running Shands?

C: John Ives [John E. Ives, executive vice president, Shands Hospital, 1980-1987]. Well,
Ken Finger [Kenneth Finger, dean of the college of pharmacy, University of Florida,
1968-1979; associate vice president of JHMHC, 1979-1997] was the acting vice
president for health affairs.









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P: But Ives was really running the show?

C: By Shands, if you mean the hospital?

P: The hospital.

C: The hospital. Ives was chief executive of the hospital. Ken ran the colleges and was
the acting chairman of the board.

P: Yes. Now, what was going to be your relationship as the vice president to the staff, the
deans of the colleges, for instance. You presumably were their boss.

C: I was their boss, in my previous incarnation. I set their salaries. I set the budgets of
their staff

P: You set the deans' salaries?

C: Correct.

P: You appointed deans?

C: I appointed deans. Well, the president is the final appointing power.

P: But, they are not challenging your recommendations.

C: Right. That was, I think, in almost every case just pro forma. So, I recruited the deans.

P: How did you recruit? I mean, were you looking for nationally recognized individuals?

C: The answer to that is, in almost all cases, yes. That is one of the few ways in which
somebody in the vice president's for health affairs role can bootstrap and improve the
quality of the institution, to use whatever his or her national persona might be to attract
new leadership where leadership from outside this organization is needed. I chose that.
I also chose a style, as I said before, not only for my, sort of, immediate staff in the vice
president's office but also for the deans. My choice was to allow currently sitting deans
to continue to demonstrate their abilities. We had a fairly talented group in place when I
came, all of whom have had reasonably successful and long tenures. Over the last four
or five years, we have had a chance to put into place-what I really call now-my group of
deans. To the best of my ability to determine it, they were selected for a collaborative
point of view: that they were not just the dean of a college of health professions or a
college of dentistry but that they were part of a senior leadership group of an academic
health center in which they were expected to collaborate and work together in a way in









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which the resources of the college became resources of the whole and that the enterprise
was to, in some ways, to get back to Dean Harrell's original point of view, [which was]
that the health systems were a collaborative team, that the health professions were a
collaborative team. I think this new group of deans has worked very hard at that, and I
am proud of them.

P: Did you bring any stars?

C: I think Ken Berns is a star. He, of course, knew this place, having been here earlier as a
microbiology chair.

P: We have never been able to attract a Nobel laureate here, have we?

C: Not a Nobel laureate, no. Nobel laureates do not necessarily make good deans.

P: I understand, but I just wondered if we had. They always sound good on paper.

C: Yes, but Ken is a member of the National Academy of Sciences and the Institute of
Medicine and, I think, is an all-star. Actually, all of the current deans-dentistry,
pharmacy, nursing, health professions, veterinarian medicine-were all recruited from
outside of this campus. All were amongst a cadre of national leaders, already deans or
soon to become all-star deans, and they have done so here.

P: So, you have not been disappointed in the staff?

C: Not at all, no. I am proud of them. One of the hardest things in the decision that, after
seventeen years, it was time to do something else, was to not continue to work with this
group of six deans. That was really one of the great joys of the last five or six years in
the vice presidency.

P: When you arrived on the scene here, did you find entrenched groups, cliques that said no,
we are not ... I do not mean to say they said, no, we are not going to cooperate, but...

C: Yes.

P: Afraid that you might get in the way of what they had been doing?

C: Sure. Colleges of medicine are notoriously independent and have, over the course of the
last four or five decades, have been able to enforce that point of view by the fact that they
generate anywhere from 85 to 95 percent of their own money. So, there was a point of
view in the college that the vice president should just sort of stay out of our way.
Unfortunately, one of the sequella of that point of view was the turmoil that was
produced, now I suppose, four or five years ago, when a trajectory of twenty years of









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increasing revenues from clinical income began to flatten out because of reimbursement
policies and a trajectory of parallel-but-always-slightly-below expense increases year by
year, absolutely unmanaged, crossed over. We had a faculty of medicine, quite to its
chagrin, and to some of them, terror, running in the red, a medical school running in the
red here, four or five years ago. That made them very angry and forced immediate
attention, of course, of my office and the president's office to the business affairs of the
college of medicine in a way that had never been the case before. Therefore, as any
business would, we had to take all of the individual fiefdoms of the departments and
bring them together in a common business and common governance enterprise under the
dean of medicine. Allen Neims [Allen H. Neims, dean, college of medicine, 1990-1997;
professor of pharmacology and therapeutics, University of Florida, 1978-present] was in
place at that point. But, there had to be some people to blame for them getting
themselves in trouble, not having any expense control mechanisms in the college, and in
the famous vote of no confidence, they blamed the dean of medicine, they blamed the
vice president for health affairs, [and] they blamed Jerry Modell [Jerome H. Modell,
professor and chairman of anesthesiology, University of Florida, 1969-present]. I guess
there were about five or six of us who had a very negative official vote of no confidence
by the faculty of the college of medicine.

P: And this is the basis for that?

C: The basis of that is that they did not know how to control their expenses, and it was our
fault that they did not.

P: I was getting ready to ask you that a little bit later on, but I am glad you brought it up
now.

C: I still look back on that with some anger but understanding for their naivete.

P: But why did some of them-why did Allen Neims, for instance-resign?

C: He felt he had lost the confidence of their faculty. I mean, there were some leaders in
the faculty who just were angry and negative and, I think, somehow felt empowered.

P: It is hard to believe that anybody would consider Allen Neims to be the enemy.

C: I know. I mean, it was really a shame because, though Allen's careful persona ... there
probably was, let us say, a six-month delay caused by Alan's personality and the politics
within the college of medicine, for departmental autonomy, that delayed the institution of
the corrective expense control mechanisms within the college for about six months, as I
said, over what an incisive sudden surgical response might have been. As a matter of
fact, by the time Allen stepped down and Ed Copeland [Edward M. Copeland, III, The
Edward R. Woodward professor and chair, department of surgery, University of Florida,









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1982-present] took over as interim dean, all of the expense control mechanisms had been
put in place to fix the problem. Now, the faculty was simply faced with the reality that
expenses had to match revenues and that revenues were relatively declining.

P: [Their] expenses had to decline.

C: Right. Their world was different, and they flailed around, and struck out and, I think,
hurt some people in the process.

P: Allen does not seem to be unhappy at all.

C: Oh, Allen is having a wonderful time doing what he is doing.

P: That is exactly what he told me.

C: He is philosophical about it and, I think, did a wonderful job as dean.

C: Yes.

P: Well, you did not get rid of all of the hostility because it continued and blossomed out
again. I was going to ask you if you were able to satisfy these cliques, these hostile
groups that you found when you arrived on the scene?

C: They came and went. The cliques were primarily built around departmental autonomy
and budget secrecy at the departmental level, and we just had to get control of that.

P: What about your relationship, as vice president, with the VA hospital?

C: Malcom [J. Malcom Randall, director, Veterans Administration Medical Center,
1968-1991] and I have always had a close and friendly relationship. I have encouraged
the integration of the VA into the system. I symbolically have always had Malcom
Randall as part of the senior cabinet of the health center.

P: But, have you sat on their boards?

C: No, I do not sit on them.

P: So, Malcom comes here?

C: Yes.

P: And your staff-I mean, the doctors-serve us, just as they have in the past?









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C: Right.

P: But you have no planning responsibility, as far as the VA hospital is concerned.

C: That is a federal function which our faculties serve as their staff.

P: But when they get ready to expand and do all of those things, do they call upon you, as
the vice president?

C: Oh yes. I mean, they have always put me on notice, or the dean of medicine tells me
what is going on, or Malcom comes and tells me what their plans are.

P: Because whatever happens across the road obviously impacts what is on this side of the
highway.

C: Tremendously, yes. And, to my knowledge, they have never gone off on their own and
told the rest of us to keep up with them.

P: It is a good working relationship.

C: We have as good a relationship with the VA as any of these are in the country, and it is,
to no small degree, related to my predecessors' and, in particular, to Malcolm's point of
view.

P: What kind of politics have you, as vice president, had to play on the campus and off of
the campus? I mean, to what degree have you-I do not mean to use the
word-maneuvered, to get along with the people in Tallahassee? I mean, just politics in
general.

C: It has obviously varied from chancellor to chancellor.

P: Start with the Regents, then. What has been your relationship?

C: Well, the relationship with the Regents has been distant. The president is clearly the
figure that relates to the Regents. The Regents, except for the Regents' appointee on the
Shands Hospital board, are not involved in the business of the academic health center.

P: They do not call you, and you do not call them?

C: Yes. I mean, that is basically it. Everything goes through the chancellor or through the
vice chancellor for health affairs. [They] sort of keep track of things, but we really are
quite independent from the Regents. The closest I got with the Regents was in getting
the permission to build the academic research building. That is the building that, as I









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said before, the college of medicine funded and Shands funded and, for its investment in
the building, Shands was given permission to forego the repayment of its earlier loan.

P: Right. That was forty million dollars worth.

C: Right, and that took a lot of conversation with Regents directly. [It] took the leadership of
Marshall Criser with his cronies in Tallahassee from his younger days. Duby Ausley [C.
Dubose Ausley, member, Board of Regents, 1980-1993] was dubious and got convinced.
But, in the end, it was senate leader Harry Johnston and Marshall and I that got the
permission for that through the legislature and signed by the governor. Without Harry
Johnston and Marshall Criser, we would not have the academic research building. I can
get along well with any of the people in the legislature and have, when it was appropriate
for me to be there to say something or do something, but I am not particularly excited or
interested by it, by those kinds of activities, and have chosen instead a far more effective
route for our health center over the years, and that is Gerry Schiebler [Gerold Ludwig
Schiebler, professor of pediatric cardiology, University of Florida, 1960-present]. Gerry
is a gem, is as skilled a lobbyist and denizen of the Tallahassee jungles as anybody that I
know of. Because of that, because of my confidence in him, his ability, his values, and
his absolute understanding of what my expectations were for our institution and our
trajectory, I can trust Gerry as my Tallahassee arm implicitly, and he has not failed me
over the years. So, in essence, I delegated all, except on the state occasions, Tallahassee
relationships to Gerry Schiebler.

P: You did not have a particular relationship with Charlie Reed [Charles B. Reed,
chancellor, State U. System Fla., 1987-1998], for instance?

C: Not a particular one. Charlie and I talked when we had to, but only when we had to. I
think Charlie admired what was going on, what we were doing around here.
P: What did George Kirkpatrick [Florida state senator, 1980-present] do for this facility?
Anything?

C: Nothing. I would really have to say he has been nothing but an irritant over the years.

P: [Laughs.] Bob Bryan speaks highly of him, as you know.

C: Yes.

P: But nobody else does.

C: George has not really helped us. If anything, he enjoys being negative. I mean, I enjoy
George personally, and he and I trade cigars, and we have a wonderful time. But when
the Tallahassee process gets in place, George always seems to have other agendas other
than being our bulldog.









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P: What about the fabulous Senator Jack Gordon [Jack D. Gordon, Fla. state senator,
1972-1992; president, Hospice Foundation of America, 1990-present]?

C: I never saw much of Jack, except in my early years. He kept trying to move us. It was
always sort of related to his history.

P: He visited here on occasion.

C: Yes. We have had him around and [have] explained ourselves to him. As a matter of
fact, Jack Gordon was one of the people we had to convince of the importance of this
transaction for the academic research building. In the end, I believe he was supportive.

P: He really, I think, basically liked the whole set-up here. He just liked to argue.

C: Right.

P: He was, by far, the most intellectual senator, I think, we have ever had in Tallahassee.

C: Agreed.

P: But, you had no personal arguments or conflicts or anything like that?

C: No. I mean, I grew up in Tallahassee.

P: You did not have to go to Tallahassee very much, then, to lobby?
C: Not very much. I mean, Gerry would take me when their testimony or budget or
something like that was needed, or when we were having a dinner for a group or
something like that.

P: You were just a ceremonial president.

C: I was ceremonial.

P: And you welcomed that.

C: Yes. That is fine. What I could really do for the university, Sam, was the Washington
scene. My avocation, from the earliest of these years that we have gone through today,
has been national policy for science, biomedical research, and health care and delivery.
So, it is my relationships and understanding and occasional opportunities for leadership
in the Washington scene that I thought-and, I think, every president that I have worked
with, [even] John Lombardi thinks-is the thing that I can really contribute to the
academic growth and stature of the university.









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P: What kind of a role have you had to play with the doctors in Gainesville, the doctors
statewide, the Florida Medical Association?

C: When I first arrived here, that was still a pretty hot topic.

P: It was a very hot topic, a hotter topic, in earlier years.

C: Yes, and there was an attempt within my first year or two to once again, as I recall, to ask
the Regents to prohibit our faculty from taking any patients who were not specifically
referred by a physician from the state of Florida, in practice, private practice. We were
able to defeat that at the Regents' level and after that, things have been reasonably quiet,
I think. Our relationships with organized medicine at the state level are probably better
than any of the other medical schools in the state, and that is in no small part due to Gerry
Schiebler, again. That was another one of his liaison, or representation, functions that
were critical for our success. Some faculty would be critical of it, but I did not avoid
faculty or faculty issues. I just insisted that they be worked through the hierarchy.

P: Were you threatened with any faculty revolts or rebellions or anything like that, or was
everything just hunky-dory? So far, everything sounds, you know, sweetness and light,
and you are not even in Gainesville yet, when I ask that question.

C: I think, other than that no dean ever fulfills the expectations of their faculty, that we had a
reasonably happy time in Saint Louis. It was a poor medical school. It was on the
make. I think it saw signs of its own growth and success during my tenure. I think that
had a positive feeling for it. It always looked across town and had a sort of
number-two-in-town psyche because of the extraordinary depth and strength and
academic achievement of the research programs at Washington U. I mean, they just
were different places. Wash U. is one of the half a dozen most important biomedical
research institutions in the world, probably. St. Louis University was, and still is, a
community-based moderately research-intense Jesuit Catholic medical school.

P: No great stars?

C: A couple, but not two dozen.

P: Was the hospital, the medical school, doing some great ground-breaking research at the
time?

C: There were some, in a couple of areas, but it was not pervasive. We had a Nobel
laureate, who had gotten the Prize in 1928 or something like that, Edward Doisy [1943
Nobel Prize recipient in Chemistry for isolation and identification of female hormone
estrone], who was still alive when I became dean, as a matter of fact. [He was] very, very









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famous. So, there was a bit of an image. My job was to improve the research
performance of the faculty during that period of time and help the place grow clinically.
So, it was a happy faculty, basically. There was one department that I had to close
down, and that was a very unhappy faculty. That was what was called a department of
community medicine. There were budget problems. [It was] a private medical school.
We probably had the fourth or fifth highest tuition in the country. I cannot remember
the numbers, but let us say we were ten to thirteen thousand dollars a year at that time,
which was a lot of money. Right up there at the top. We had a department of
community medicine which was unable to generate, after its first grant-getting years,
outside support for its activities, and all of our departments had to have significant
outside funding in order to survive. So, I had to close a department of community
medicine which had a lot of innovative service programs in the poor sections of St. Louis,
and that was an unfortunate thing.

P: I can see that did not make you very popular.

C: No, it did not. But, I talked extensively with the university leadership, so I did not
surprise anybody by doing it. They understood the reasons for it. The Jesuits, amongst
other things, are very practical.

P: Did you have much church control? Was there church interference or anything?

C: The answer to that is an amazingly small no. George Thoma, the vice president for
health affairs, was a devout practicing Catholic. As I said, I was the Protestant dean of
the Catholic medical school. The president of the university was a Jesuit. One place
where we might have had a problem was in the abortion issue. That was handled with
great skill by the institution. We did not do abortions in the Catholic university hospital,
as a matter of policy. We did, however, allow our obstetrics and gynecology residents to
get abortion training in affiliated but non-Catholic institutions during our time there. We
basically kept a lid on this very inflammatory issue by fulfilling our obligation to our
students, in terms of educational opportunities and experience, [and] at the same time, not
tarnishing the Catholic requirements on abortion.

P: Were there Jewish members on the staff?

C: Yes.

P: So, they did not exclude them?

C: No, they did not exclude them at all. They welcomed, clearly, the Jewish members on
the staff and, back to my previous point, the heavy number of volunteer faculty from the
Jewish private practicing community.









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P: In the hospital, were the nuns visible?

C: Yes, they still were in several of our hospitals, but it was a very enlightened and, I think,
modern approach that probably has become, maybe, even a little more restrictive since I
left, not because I left [but] just because of the tenor of the times and the way that the
abortion issue has become so inflammatory.

P: It was less so then, I think.

C: Less so, then.

P: Now, it was a happy time, I gather from what you said earlier, for you and the family
living in St. Louis?

C: Yes.

P: The children were doing well?

C: The children did well in school, went to fine schools.

P: And you were happy with the public school system?

C: We used private schools for the kids there, which is sort of a tradition in St. Louis. The
place where our house was did not have a good school district. Moreover, families like
ours tended to put their kids into private schools, either parochial or just regular private
schools. Both girls went to a place called Mary Institute. I think in eighth grade, Britt
shifted to Mary Institute. David went to Country Day School.

P: I gather you had an active, involved, happy social life.

C: Yes, very much so. Jacki quickly became an important leader in the volunteer
community, both around the university and, more generally, in the public. She was the
fund raising chairman for the Arts and Education Council in St. Louis. She did a lot of
things.

P: Were you able to do any traveling, any activity, with the family [in the] summer months?

C: We had begun in Indianapolis, and continued in St. Louis, usually, a two-week or
three-week trip to Sandbridge, Virginia, where, through some personal family
acquaintances, we located a place to rent at the beach, Sandbridge Beach. So, we would
go there as a family group for two or three weeks every summer. That is where we got
to be ocean people.









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P: Which you carried over when you came to Florida.

C: Yes.

P: Well, why did you leave St. Louis? It seems like it did everything that you wanted it to
do.

C: Yes. Well, I guess given the way things went...

P: You were not unhappy there?

C: Not really, to the extent that, if you will, the next stage in professional growth for me [or]
the next kind of opportunity, now having clearly made a commitment to institutional
leadership as the way I would carry out my profession, was the
vice-president-for-health-affairs level.

P: That is a big jump from dean, is it not? I mean, jumping to the situation here was a big
jump from the deanship.

C: Yes, in terms of administrative scope, overall size of budget, expanding beyond simply
the medical care issues to the whole variety of health professions. I knew that either I
would go to take a deanship of a larger medical school than St. Louis University or that
the next step was to be a vice president for health affairs.

P: Were these kinds of opportunities available to a relatively young man like you in the
1970s? Medical schools were expanding and new ones were appearing on the horizon
and so on. Were there job opportunities?

C: Yes.

P: So, you could have had your pick if you had wanted to?

C: I am not sure I would put it exactly that way, but there would have been other
opportunities. It was also a time in which movement between institutions was not
unusual. More and more, we are growing up from inside our own places now, than we
were then. So, movement was not unusual. I was a young person who was looked upon
as having something else ahead.

P: Describe the move and how it all came about and what the lure was that brought you
from St. Louis to Gainesville, Florida.

C: Yes. I clearly was ready. I had been there seven years. Things had gone well. George
Thoma was going to be there as vice president for the foreseeable future so if I was to









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have additional opportunities, it would have to be some place else, and I knew that.
Florida had been in a bit of an administrative turmoil with Will Deal's departure and then
return, with the restructuring of the dean-vice president relationship, the separation of it
again. Marston, I think, had found that the conventional state of Florida, University of
Florida, search process had come up with a dry hole. The vice presidency had been
vacant for what, at that time, was, I think, a relatively unusual period of time, and he was
not completely happy with what the stately search process was producing for him. So,
he basically usurped the process and got personally involved in a way that I think, had
anybody chosen to take a look at it, would have been strictly illegal under Florida rules
and regulations. [Laughs.]

P: Maybe he was setting the stage for Criser becoming president.

C: So, I got a call from Bob.

P: Out of the blue?

C: Yes, out of the blue.

P: And he had remembered you, or had you maintained contact?

C: I am not sure exactly which one of those it was. We had not maintained any particular
contact. He probably got on the phone and started asking around the country, called
hither and yon, and my name, presumably, came up in several of these [places]. Florida
was not, as I had mentioned, a complete stranger to me.

P: I should have known about this. I could have asked him that question in my last
interview with him, last January.

C: That is right. Yes. But anyhow, he broke the search rules and basically brought me
down here as a personal candidate.

P: He called you on the telephone?

C: Yes, and asked me to come down and visit.

P: He asked you if you were interested?

C: Yes. Would I consider? He said, would you consider coming to visit to take a look at
this job? I said, yes, that I would. I knew enough about the place.


P: You had been here twice before.









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C: Yes, and knew people from here and other people who I had gotten to know on the
national scene who had been active from here.

P: What kind of reputation did the University of Florida medical school have? You were
looking at it from a St. Louis point of view, an outsider. You do not know much about
it. Was it a middle school? Was it one of the best in the South? How did it rank?

C: I would say it had come into being in its early years with that initial cadre of
extraordinary leadership with an aura and momentum for excellence in its future that was
almost the equal of the University of California/San Diego, the University of
California/San Francisco, [and] Seattle, all of which were relatively contemporary.
Then, they had this extraordinary group of people that Dean Harrell brought in, and these
were very productive publishing scientists on the national scene. Many of them stayed,
but compared with their schools that were founded contemporaneously, or reasonably so,
the growth here sort of stifled. I have never been able to figure out why the academic
promise of the pioneer group here was never delivered on by the institution in the same
way that it was at UCSD, or some of these other places. It became a good growing, but
not national attention drawing (except in a few cases), academic leadership institution.
It lost its momentum somewhere after the first decade.

P: By the middle of the 1960s, I think that is true. I gather that from the interviews that I
have done. After the first ten or fifteen years.

C: Yes. There was something. Now, it might have been the level of state support.
California was pouring buckets of money into their institutions. But something, either
about the relative isolation outside of an urban area, outside of a media market, in the
deep South piney woods, or a relative inadequacy of state funding.

P: Or all of the above.

C: Or, all of the above contributed to a retardation of the academic growth trajectory that
this place might have aspired to.

P: And then, if Dean Harrell's dreams were realized, in terms of the role of the relationship
of the college to the campus, the role of the faculty. None of those things happened after
the first decade.

C: Right.

P: We got too big or too unwieldy here, or whatever.

C: Yes. So, my view of it from St. Louis was that there was a place I had been to, I had
seen it, and that I knew some of the people from there. I knew some of the people here









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were very good. I knew Marston's excitement about it. His pitch was the growth of the
state of Florida, and his crony Bob Bryan's pitch was that this was still a frontier state,
and you ought to come here because there are just all kinds of opportunities in a frontier
state.

P: Of course, by the time that Marston is recruiting you, Marston has outlived his relative
usefulness here, at the University of Florida. He is just waiting until he gets his
retirement time in.

C: Right, his decade. I knew that he would be around for a year and a half, or whatever it
was.

P: Marston, in many ways, is almost our most underrated president. I got to know him well
and knew, from my contacts with him, what a really important person he was and how
much he did for the university, but I do not know that everybody recognizes that.

C: I do not think they do. I would not have come here if it were not Bob Marston. The
search process would not have brought me here. Bob Marston, as I said, took over the
research process, basically got a rubber stamp out of the committee, and brought me here.

P: I think even today, even with his death and all, I still do not think that they have given
him enough credit for what he did, not only for the medical school but for the whole
university. But maybe with time, that will change.

C: The other thing that he did, as well as his personal style and instincts for academic
quality in the breadth of his scholarly person, is he literally said, there is your health
center; call me when you have a problem.

P: That is a great challenge.

C: Yes, and [he] did not dabble. He chose good people, and he gave them their head, as I
saw it.

P: He brings you to Gainesville, and then what? He brings you to Gainesville to see. You
have not accepted the position yet.

C: Right. I think I even insisted that Jacki come on the first visit, because here, I now had a
spouse who had a highly visible, successful community leadership role in an interesting
and historic city. I had to have her see Gainesville.

P: Gainesville was not St. Louis.

C: No, and Jacki knew, obviously, enough about what I was, what I would be good at doing,









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and just said after being here that we could make our life wherever we wanted it to be.
But, if anybody made a significant sacrifice, in terms of what it was that gave her kicks
and rewards in how she expends her time, she made the big sacrifice in coming to
Gainesville. I came to Gainesville to a large, growing academic health center in a
growing, vigorous state in a growing medical economy, which was going to be an
interesting horse to try to ride.

P: She came to a small southern town.

C: Right. I am obviously grateful for her devotion to what we have done but, in coming to
Florida, she was the one who made the sacrifice.

P: What about your children?

C: Children adjust easily. Interestingly, by then, David had already been in college and then
did some work here.

P: Where did he go to school?

C: He went to Lawrence in Appleton, Wisconsin.

P: He is third-generation, now.

C: Yes. [He] basically finished out here. Laura was already in Duke and then stayed and
did her M.B.A. at Duke. Britt came with us from St. Louis to take her senior year here,
in Gainesville, and that was hard. We gave her the choice. She was in a fine girls'
school in St. Louis, was being prepared to go anywhere, and was soon to be captain of
the swim team and have all those kinds of things that senior high school kids get in
leadership opportunities. We told her she could stay with family friends and finish her
senior year there or she could come with us. The choice was hers. She chose to come
with us. I am glad she did. It was good for her mother. Interestingly enough, we
looked at the private school, and they basically told us she was finished. They said, we
have nothing to offer her for her senior year. She went to Gainesville High School and
took all AP courses and in the end, she will now tell us that, of the five or six best
teachers she ever had in high school, two of them were at Gainesville High School.

P: So, she was not unhappy when it was all over?

C: She was not unhappy. She and Anne Sandeen, Art Sandeen's [C. Arthur Sandeen, vice
president for student affairs, University of Florida, 1990-present] daughter, became fast
and life-long friends.


P: Well, you are almost neighbors.









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C: Yes, we are almost neighbors. So, the kids all did well.

P: Alright. What was Gainesville, [or] what was Marston, offering you? What was going
to be your responsibility, the role that you were going to play here?

C: I was going to be, in essence, the chief executive officer of a large academic health center
made up of six health professions, colleges and the chairman of the board of the Shands
teaching hospital. That was the job.

P: And you held the title of vice president for health affairs, one of three vice presidents at
the University of Florida?

C: In the university. In the role of chairman of the board, the linkage to this now already
separated corporate structure of the university hospital.

P: Had that happened before you arrived?

C: Yes. That was a serendipitous decision by my predecessors that I give them great credit
for.

P: Who did you succeed as vice president?

C: Well, Ken Finger was acting vice president for that long interim period. It was fourteen
or eighteen months.

P: Yes.

C: Will Deal [William Brown Deal, dean, college of medicine, University of Florida,
1964-1989], as I recall, had come and gone. He had held both titles, vice president and
dean, and in the turmoil of his personal life and other things had come back, but had
decided that he would only come back as dean, not as dean and vice president. That is
when the two offices were, once again, separated.

P: You held the position of vice president, just to get it on the record, from July 1, 1982
through August 31, 1998?

C: Right.

P: A long period. You were also chairman of the board of directors of Shands hospital.


C: Correct.









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P: You also held the position of professor of internal medicine.

C: Right.

P: You do not get yourself involved for any reason whatsoever in that, right?

C: No.

P: And there was never any intention--what was that, sort of back-up insurance?

C: Well, yes. That was the faculty appointment, the department in which I have tenure.

P: You got tenure so they could not kick you out, no matter how many people you
displeased.

C: Right, made unhappy. Absolutely. So, yes. That was it. At that point, Sam, whereas
I still had been making clinical rounds as dean of medicine in St. Louis, as an internist or
endocrinologist, I now decided that it was time to completely separate myself from the
clinical environment because of the size and scope of this administrative job.
P: I want you to answer again. I have asked you this question, and I think you have already
answered it, but I want to do it again. What was the lure that caused you to leave St.
Louis and come to Gainesville? What were the particular things that attracted you here?

C: The size and scope of the responsibility, the sense of optimism that real academic growth
and maturation was possible in the Florida environment, in spite of its problems, given
the demography and growth of this state. Unlike [the circumstances at] some of the
institutions in the large urban areas which were already feeling some of the constraints of
decline or [of] plateauing federal research funding or of the market strains of medicine on
the delivery side of their academic health center, [those things] were not likely to be
apparent in this environment, and there really was an opportunity to, once again-because
I did this, I think to some degree, in St. Louis-academically bootstrap an institution
upwards. I was not going to become the caretaker of a fine, old, and already excellent
tradition. I had the opportunity to go to a place where, probably, the potential was there
for academic growth.

P: There had not been a very good history of legislative funding for the university or for the
medical school, although you had Reubin Askew [Florida governor, 1971-1979] as
governor, followed by Bob Graham [Florida governor, 1979-1987]. He was the
governor when you arrive in Gainesville.

C: Right.


P: The forecast on that was not great.









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C: Right. This is a time when much of the physical infrastructure, the bricks and mortar, is
already in reasonably good shape here. In fact, for all of our complaining, this huge
complex is relatively young, structurally, is relatively well-maintained and once you have
the space, kept up by the state formula. We are moving, in the academic health center
business, into an era in which the state is providing very little of the total revenues in
business anyhow. We are expected to build our own buildings and to support most of
our programs from our academic or our research earnings to a degree not seen anywhere
else in the university. This is the national phenomenon, not just Florida. I thought
there was, given the Florida health care markets, a chance to make enough profit, in
various ways, out of faculty clinical activities or hospital activities to subsidize the
growth of the academic function.

P: So, you thought the potential was good?

C: The potential was good simply because of the economics of academic health centers, not
the rest of the university. Basically, I was saying, we can do it on our own.

P: In the sixteen years that you functioned here, is that what happened?

C: Hm-mm [yes], I would say so. I mean, I think generally speaking, that is true. Look
around the physical facility. The hospital was completely rebuilt, basically, out of its
own revenues.

P: Right.

C: And significant pieces of other programmatic bricks and mortar came out of hospital
money. The academic research building was funded out of, for the most part, the college
of medicine clinical income, hospital profits, and a small amount of foregone interest, if
you will, in the present-value formula that we created to allow Shands not to pay back
money to the state.

P: That was a sweet deal.

C: Right. The Brain Institute is the federal government, Shands, and to some degree, the
college of medicine.

P: No state money?

C: Correct. So, of all these major facilities that we have built, if you add it up, everything
that is either on the drawing boards right now or that we have built collectively, there has
got to be 600 million dollars in the facilities here, during my tenure. For the first time,
we are going to get state money-I cannot remember where some of the planning money









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came through this year-to get a desperately needed new building for nursing, pharmacy,
and health related professions. That will really be the first major state investment in this
place.

P: Where is that going?

C: It is going to go right behind the parking lot area. It is going to build up the hill towards
the museum.

P: Fill up that last green space.

C: Yes, some of it.

P: I did not think that would last forever. You are moving up toward the museum, now the
old museum?

C: Right.
P: You will take that over eventually, too, I understand?

C: I do not know. I do not have any plans for that.

P: One of the areas, also. Shands had this long-time reputation of being a mismanaged
place, of bills not going out, of service not being very good. I do not know how valid all
of that was, but that was the reputation, the image, that it created. When you came
along, had you known about that, or was this another one of the wonderful challenges
that you faced?

C: I guess I had known a bit about it. It was more trouble than I had thought, but the means
of fixing that had been put in place by my predecessors. That was the separate
incorporation. When Shands was a direct-reporting state agency hospital to the vice
president for health affairs of the university, to the president of the university, as such, it
was like any other state agency: it had to live by the rules and regulations of the state of
Florida. Therefore, its personnel policies were arcane, its purchasing policies were even
more arcane, and it had the inability to generate capital on its own to invest in itself. By
this time, the hospital business and, in particular, the academic health center
high-technology, specialty referral hospital business was becoming a capital-intense,
science-intense, rapidly-moving, cutting-edge business. This happened to be a time
when nursing and other health professionals who were needed to operate a hospital were
in relatively short national supply. Nursing salaries were rising rapidly. For instance,
in order to fill the nursing slots at Shands, you had to put together a salary increase.
Well, that went to the vice president for health affairs. That went to the president's
office. That went somewhere in the Regents' office. That went somewhere out of the
Regents' office in Tallahassee. It would go through six or seven administrative layers.









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You would have, in essence, a market-based service group of professionals who would
then be looked at from the bureaucratic point of view of a state government or a
university, and they would say, why do those nurses need so much money? Why do
they need a raise of 10 percent? Well, a year later, the approval would come down
through that same sequence of events from Tallahassee and by then, the nurses were
behind the marketplace again. So, they had wards that were un-staffed or inadequately
staffed because of trying to run the hospital as a state agency.

P: Too much bureaucracy.

C: Right. The new nuclear medicine scientists would say, we have to have this brand new
GE scanner and put in the purchasing order for it. It would go up through this sequence
of events, and somebody in Tallahassee would say, oh, I don't know; these guys do not
need this GE scanner; I can get them a Picker scanner. But, they have no idea what the
performance criteria were. All of a sudden, a Picker scanner, which would not do the
same thing, would arrive on a loading dock. You just could not be at the forefront of
management. So, Shands was in trouble. Its services were poor. Its support services
were poor. It had closed down wards. It was, at one point in time-and I do not know
[when] exactly-on confidential probation for its hospital accreditation, because of the
poor staffing and nursing and other things. So, out of embarrassment and desperation,
my predecessors, under the leadership of Buddy McKay [Kenneth Hood "Buddy"
McKay, Lieutenant Governor, 1991-1998], who was in the state senate at that time, put
through this bill making it a separate but related, not-for-profit corporation, keeping the
linkage with the academic mission of the university in the person of the chairman of the
board as vice president for health affairs, in legislation language, and the board being
appointed by the president of the university.

P: That has worked?

C: That has worked, probably better than anybody could have hoped for and, I think, is the
model for the relationship of a public university's teaching hospital to the public
university anywhere in the country. Nobody has done as well as we have.

P: Who is on the board?

C: Now?

P: I mean, not names, necessarily. Just positions.

C: During most of my tenure, about half of the people were citizens of Gainesville or of the
state of Florida.


P: But, not the deans [and] not the administrators within the hospital?









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C: No. Half of them were university people of one kind or another, ex officio. One, the
dean of medicine is on it. The vice president is chairman of the board. One other dean
of a health profession college is on it. The president of the university is on it. The vice
president for business affairs of the university is on it. So, it was about half and half.

P: And then, laypeople?

C: And then, lay leadership people from around the state.

P: Appointed by the president or by Tallahassee?

C: Appointed by the president.

P: Any Regents' representatives?

C: One Regent representative, appointed by the chairman of the board of Regents.

P: So, it is a kind of across the board lay-representation and university representation.

C: Right.

P: And that works well, according to what you are saying.

C: I think it has worked very well to keep all of the appropriate constituencies informed [and
to] let them think that they have their person in place, should they need to.

P: They set policy?

C: The board sets policy.

P: And the day-to-day operations?

C: It is run by a chief executive officer who reports to the board.

P: What is his relationship to the vice president?

C: This is, I would not call it a stickler, but a relationship that needs working. It needs to
have constant attention and reworking. When it was a direct-reporting state agency, the
administrator of the hospital reported to the boss of the vice president for health affairs.

P: Yes, which made sense.









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C: Right. When it is a separate-but-related corporation, the administrator of a corporation
reports to the board, as you said. Now, the vice president for health affairs is chairman
of the board; therefore, he is the first among equals, if you will, in helping to set agendas.
But, there now is an un-linking of a direct-reporting relationship between the chief
executive of the hospital and the vice president for health affairs. It is a task of the vice
president for health affairs to keep the executive director of the hospital on the straight
and narrow path of policy and supervision to having the hospital function as a
direct-supporting agency of the university. So, the vice president for health affairs has
to work this academic mission all the time with the chief executive officer of the hospital
in the context of consensus building on the board, whether it is about salary for this chief
executive officer or rewards systems or the straight and narrow path. You now have less
direct control of the university over the organization than you had, obviously, when it
was a direct-report.

P: During the sixteen years that you were in place, did you have any problems with the
director?

C: Yes. John Ives, who was the director when I came, having come out of the Marston era,
was a very independent character and was constantly pushing the traces of avoiding
supervision by the vice president and trying to run things around to the board whenever
possible.

P: That is an interesting way of describing it.

C: Yes.

P: He resented you?

C: Yes. When I finally convinced Marshall Criser that this was an unhealthy situation with
this particular person, and that we had the chance of losing control of the academic
mission. Marshall finally agreed that Ives would be removed from that position. We
did so, but we did so in the face of a board which was-the best way I would call it-an
immature board. I mean, there were some important and very good people on it, but this
was a board we had never had. [We were] now approaching a billion dollar a year
business to run. None of them had ever seen or had been part of the great, private
academic hospitals of the northeast or Midwest. They were frightened, nervous, about
this new responsibility of being handed this institution by the State of Florida with such
high visibility and vulnerability, financially. They felt that Paul Metts [Paul E. Metts,
chief executive officer, Shands Hospital, 1987-1997], who was their chief financial
officer at that time--if Ives was going to go, I knew that I could go out on the national
scene and recruit to Gainesville a major national figure in academic hospital leadership to
be our new CEO.









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P: But, they were not convinced.

C: They were not convinced. They were uncomfortable and in the end, the way we got a
transition from Ives was to take Metts, who was their chief financial officer at the time
[and] with whom the board was comfortable, and we lost the opportunity to recruit
nationally.

P: You brought Metts in, or was that just a compromise?

C: It was a compromise. I mean, I brought him in, but he was chief financial officer. The
board sort of knew him.
P: What happened to Ives?

C: Ives went on to a major job in Houston, I think, and is now retired in Gainesville.

P: He is here, I know. I do not know him, but I know he is here.

C: Yes. He is around town. He went on and did very good things. He was a very skilled
individual but was too inclined to increase the separation between the university and the
hospital.

P: Did they make his retirement profitable?

C: Absolutely.

P: He left with a golden parachute.

C: Well, yes, to some degree.

P: Well, everything is limited in Gainesville--it is not too golden.

C: Right. Now, for better or for worse, Metts, to some degree, proved to be a clone of Ives.
So, when we finally were restructuring, now under John Lombardi, the governance of
Shands Hospital (just before I stepped down), rethinking about what the acquisition of
the AvMed hospitals meant, how we needed to reorganize, thinking about how we are
going to affiliate and take more responsibility, fiscal and otherwise, for Jacksonville
University Medical Center, we had to completely re-strategize Shands once more and,
in that, rethink the chief executive officer role. In that search, since the job was
restructured, we were able now, for the first time in the history of the institution-I guess
that was in 1998-to bring in a major national hospital executive with experience
elsewhere.


P: Who is it?









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C: Richard Gaintner [Richard J. Gaintner, chief executive officer, Shands Health Care,
1997-present].

P: I do not know him.

C: At any rate, it has taken a long time, but we now, not only in the academic side of our
business but on the hospital administration side of our business, are recruiting talent from
throughout the country.

P: David, going back to the time that they were recruiting you, were there any promises
made about what you could do, what was going to happen here?
C: Bob Marston told me that he would arrange for Ives to depart before I came, if that was
my wish. My tendency, [as] when I had taken over in St. Louis or when I had taken over
other kinds of things, is [that] I am not one to throw out all of the old china and bring in a
whole new group of people. My tendency is to get to know people, assess them, see
whether they accept the kind of delegated responsibility that I like to give them, and then
make my decision. So, I made a decision to keep Ives.

P: You did not know Ives before you arrived, did you?

C: No, I did not know that much about him. Strategically, in terms of institutional growth,
that may have been a mistake.

P: But, that is what you learned afterwards.

C: That is what I learned afterwards. He and Marston had enough trouble so that Bob did
not push me one way or another, but he just said, if you want Ives gone, he will be gone.
I did not choose to do that.

P: Were there any other promises that were made. That is one of them, but you did not do
anything about it.

C: No. [There were] no other particular promises, no new resources.

P: But, you came in with your eyes open of what the problems were.

C: I came in with my eyes open and knew that we would have to do it ourselves in this state.

P: I want to ask you about your appointment by President Reagan [40th President of the
United States, 1981-1989].

C: It happened because I had good Republican party connections. It happened because we









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used some connections in Washington, including some lobbying connections to bring the
issue up with the administration. We used some Republican donors from Florida who
were friends of the university, who were friends of the Reagan White House, to put the
proposition forward. In the end, then, I talked with some White House staffers and was
asked to serve as chair of the President's Committee on the National Medal of Science.

P: But, you had no personal friendship with Reagan or Nancy.

C: No. This was just because I was a figure who had appropriate Republican connections.
P: That is all it takes.

C: Yes.

P: So, you got invited to the White House.

C: Yes, for the medal ceremonies. That was fun.

P: No state dinners?

C: No state dinners at the White House. We had our own Presidential Medal of Science
dinner in the State Department Reception Rooms.

P: Oh, are those not magnificent? I have been there.

C: Magnificent, yes.

P: Now, what is this Presidential Medal of Science?

C: Well, it is as close as we come in the United States to giving out the Nobel Prize. Unlike
the Nobel Prize with a specialty designation each year, the National Medal of Science is
given by the President and goes anywhere from six to ten U.S. citizen-scientists of great
career achievement. It is awarded by the President.

P: Who nominates them?

C: They are nominated in a very sweeping process that goes out to deans and university
administrations and research foundation administrations throughout the country, asking
for nominations. Then, there is a filtering process that leads up to the committee's final
recommendation to the President.

P: So, they are appointed annually?


C: Yes, once a year.









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P: And you were appointed for two years?

C: I think it was a three-year appointment. It carried over into the Bush [George Bush, 41st
President of the United States, 1989-1993] administration for a year or so, I think.

P: Let us talk about the growth of Shands while you were in place, because there was giant
growth. But before I do that, there is one area I want to get out. What role did you play
in fund raising? Did you work with the Foundation closely? Dick Smith [Richard T.
Smith, professor emeritus of pathology and pediatrics, 1958-present; former director of
the Foundation] was not yet the director of the Foundation when you arrived. Ardene
Wiggins [J. Ardene Wiggins, present fellow/former director of the Foundation] was here.

C: Ardene was in place when I came.

P: And Bill Stone [William K. Stone, director of university development, 1979-1985;
associate director of development for planned giving, 1973-1979] was here.

C: Correct.

P: Then, Bill leaves and goes off to Harvard, and Ardene retires. Then, Criser comes in
and appoints Dick Smith.

C: For a period, yes.

P: So, you were here before Smith took over?

C: Right. My relationships with the Foundation people have been excellent all along.

P: Did they use you?

C: It varied to some degree, based on who was in charge of the health center part of the
operation. A fellow by the name of Mike Poston [Michael Poston, director of health
center development, JHMHC, Shands Teaching Hospital, 1983-1996; asst. vice president
for health center development, 1990-1993] was hired shortly after my arrival here. He is
now at Bowman Gray [Medical Center, Winston-Salem, N.C.], in charge of their fund
raising program. Mike and I worked much more closely together than some of the
subsequent incumbents in that position. So, it has varied all over the lot, but I do not
mind fund raising. As a matter of fact, I am quite good at it.

P: Did they want you to find good people with good money?


C: Oh yes, sure.









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P: There is no reluctance on your part to do this?

C: No, though I think in our set-up here, the president is obviously the most important figure
in fund raising. It depends on who is being teed-up at the moment, whether it is one of
the health center deans who is most appropriate to go along or whether it is somebody
that I might have a particular relationship or skill with. We work very hard to build-as a
matter of fact, starting in my tenure-something called the board of overseers at the health
center. That came about because Prime Osborn [Prime Francis Osborn, III, Jacksonville
attorney] was the Regents' representative on the Shands' board when I arrived. In
conversations that Prime and I had, he talked to me about the importance of private fund
raising. He talked to me about the importance of a health center focused development
support group, and it was with Prime Osborn's urging on and Mike Poston's efforts that
we put together the first board of overseers, probably, in 1983 or 1984. I do not know
whether that is going to carry over into the next administration or not, but that has been a
very important fund raising group for us, in some ways like the state agriculture council,
but these were not physicians. There were physicians on it, representatives from each of
the colleges. But, it was really a group of state citizens who, for one reason or another,
in many cases because they might have had health care here, were interested in the health
center.

P: Because of your national connections, can you point to any huge gifts coming in from
corporations or individuals outside of Florida?

C: Not directly in which I could say I brought this money in, but what I put in place was an
environment and a point of view which I believe facilitated the success of various
relevant parts of our faculty. For instance, it was my point of view when I arrived here
in 1982 that this was a solid, but not outstanding, medical research faculty, which had
some greatness in certain areas in the past but was far more focused on, sort of,
individual laboratory research grant success, the individual NIH entrepreneur, than large
program project or center grants, which was the way the organization's both funding and
success was moving in biomedical research, nationally. We had never had a Markey
Foundation grant here. We had never had a Howard Hughes grant here. So early on, I
put together a small group, a cadre sort of think tank of various folks-Allen Neims,
however, was one of them from the beginning-in which we began to think about how to
re-torque our faculty and define what our strengths would be in national competition,
other than one laboratory and one proposal. Clearly, neuroscience was one of those
areas that, serendipitously, we had strength in. Al Rhoton [Albert L. Rhoton, Jr., Keene
Family professor and chairman, department of neurological surgery, 1972-present] was
here. Al Rhoton was a great fund raiser. Al Rhoton got a bunch of the early eminent
scholar chairs. We brought in important spinal cord researchers because of that money.
We had an important neurology group here. By accidents of history, we had a near
critical mass in the neuroscience in Gainesville. That was not true in some other









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specialty areas. So, unlike a Harvard or a Columbia, we could not be all things to all
people. We had to choose where and how our resources would be put together to
strengthen a national position, and there were winners and losers in the faculty in those
kinds of choices. So when, all of a sudden, the Brain Institute RFP opportunity opens up
from the Department of Defense-which was not our doing; the University of Miami
created that, as a matter of fact; you may remember that-we were prepared with a
neuroscience group and Bill Luttge [William G. Luttge, professor of neuroscience,
University of Florida, 1971-present; director, Brain Institute, 1996-present] as its, sort of,
whirling dervish facilitator to go forward with a proposal that ends up, now, in this
multi-hundred million dollar Brain Institute we have here, because of the strategy that we
put in place to select and focus based on local strengths. Probably, my national
reputation did assist in getting the attention of the Markey Foundation and the Howard
Hughes to our institution.

P: So, some of this money is the Howard Hughes Foundation?

C: Some of it is, yes. We have certain Howard Hughes money here. We are not a full
Howard Hughes partner.

P: I understand.

C: I know that personal contacts and others I made gave a platform for our faculty to make
their presentations. So, I set an environment.

P: Would you consider that one of your great achievements then, here?

C: Yes, I think so.

P: You are very proud of that.

C: I am very proud of that. The Brain Institute is the symbolic outcome of that reshaping of
a major research approach to strategy.

P: That enhanced Shands' reputation as a major, major operation in the country.

C: Right.

P: Are there other campuses, other medical schools, that have Brain Institutes?

C: Yes. There is one at Columbia. There is one at Harvard. There is one, I think, at the
University of California-San Francisco. They vary in their focus, but I would say that
ours has got its own unique focus.









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P: Are you going to let Christopher Reeves [movie actor paralyzed in an accident] walk and
dance again?

C: Oh, it would be nice, would it not? I wish he did not have such high...

P: Expectations?

C: Well, expectations and such a natural attraction to the Miami Spine Institute. Again, it
has been difficult to get attention to things here in Gainesville. Being in a big media city
like Miami is a great asset.

P: I know that you get shot in Miami. That does not happen here, in Gainesville, at all.

C: Right.

P: There was tremendous building expansion during your sixteen-plus years here. Talk
about that a little bit. I know that is a big broad-based question.

C: Yes.

P: In addition to the Brain Institute.

C: This is, by any national standard, a very large academic health center, with six colleges
and its related teaching hospital and the veterans' administration and the veterinarian
medicine. These take big facilities. A lot of it was in place when I came, but Shands
was seriously out of date, in terms of a modem high-tech referral academic teaching
hospital. I am talking about the physical facility of Shands Hospital.

P: Even the dental school did not have windows.

C: Even the dental school did not have windows. Ken Finger, God bless his soul, is the one
who took the eyes out of the dental school. Did you see I am putting eyes back in there?

P: I understand. It probably costs you more to put them back in than the whole building
cost originally. [Both laugh.] As a university historian, nobody believes me when I say,
they were able to put up the first two buildings on this campus, Buckman and Thomas
Hall, for $35,000 each.

C: Incredible. So, number one, Shands had to be renovated and expanded in order to have
our core clinical functions work at all, and we had to get out of the subway station
ambiance and confinement of the outpatient clinic facilities in the academic health center
as well, by the expansion of facilities. So, the clinical business drove and funded a very
large part of our new square footage during the time that I was here. But, as I think I









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said earlier, it also was the source in the practice of medicine for money by the medical
faculty in the margins that were generated in the not-for-profit Shands Hospital, and of
the forty million dollars for the academic research building. So, we built a lot, because
academic health centers were, themselves, growing. The demand, especially in a rapidly
growing state like Florida, for our health professional product of the health schools was
growing, and we simply had to fix our facilities, and we were left to do it on our own
because, even though I could demonstrate to the Board of Regents with their own
formulas that we were the most underspaced unit, in terms of our education and research
output-I am talking nothing about clinics-in the entire SUS, as soon as a bureaucrat
would come over and see this mass of bricks at the bottom of the hill, they would say,
how could they need more space? Therefore, we did not get a major building funded on
the PECO list until the new buildings that are coming on the line right now. It has taken
us almost twenty years.

P: That is the new building you are talking about, for pharmacy?

C: Yes.

P: It is taking up the last of the green space.

C: We built a lot of stuff, but we did it on our own.

P: You have run out of land, now.

C: Almost, yes. Actually, I think we are going to still stay this side of the creek back there,
so we are not going up the hill, yet, Sam.

P: Almost.

C: [Laughs.] Almost.

P: I remember when they first decided to locate the school here, they thought they had
plenty of land [and] there would be no problem whatsoever, forever.

C: Right.

P: And then, you have run out of land, now, but I guess there is still room to grow.

C: Yes. We are going to do fine for the next several decades. I am not worried about it at
all.


P: Tear down those dormitories up at the top of the hill. [Laughs.]









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C: Yes.

P: So, there was great growth, as far as physical growth was concerned.

C: Right.

P: Enlargement of the faculty?

C: Yes.

P: The staff has grown tremendously. What would you say, how many people work here
now? How many are on the faculty?

C: If you take the entire medical center including the VA and veterinarian medicine, I think
13,000 people come to work here every day.

P: It is like another whole city, is it not?

C: It really is. If you take the budgets of, now, the new larger Shands health care
system-the medical center academic units, the clinics, the college of medicine, and the
research programs-this is now over a billion dollar a year corporation, as an academic
health center. None of us, of my age and stage, were ever in any way formally prepared
to deal with this kind of economic enterprise. The business of health care, clearly, is the
dominant economic portion of that billion dollars a year and, probably, two-thirds to
three-quarters of what I am talking about is the business of health care. Therefore, it
always is important in an organization like ours that the chief executive of the academic
health center and, in particular, the chief executive/vice president for health affairs, or
equivalent in relation in one that is part of the university, have their eye on the ball of the
academic missions and priorities in order that the business of health care does not
completely distort and run away with the activity. I think that is something that this
institution is going to have to continue to think about.

P: David, this business of distributing the clinics around the city, which obviously has
helped parking considerably, does it work? I mean, I go to these ones. I go to
dermatology. I go to urology.

C: Yes, it works. In a place that is as hard to get to as ours and as unfriendly once you are
in it, putting some of these clinics out to make things more accessible, in particular to the
local community, I think, has been important.

P: It is a lot better to drive out and park than it is to try to get in here.

C: Some of them have varied in their financial success and, in fact, I think we closed some









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of them down that have not met good business plans. The disadvantage, of course, is
that is also then starts scattering faculty and students around town and makes their lives a
little more difficult. But, in this day and age, the patient must come first, or the patient
is going to go some place else and, therefore, access and expenditures on access are
important.

P: I would think it would be cheaper to house them way out there than it is here.

C: Sometimes, it is not. Duplicative support and other services are required when you get a
bunch of small units around.

P: Talk about the Jacksonville situation. I do not know whether that has been good, bad, or
otherwise.

C: When I came, University Medical Center was over there and had an affiliation with us.
They had their own programs.

P: Now, that emerges out of that Duval Hospital, which was almost entirely for indigents, I
remember, in earlier years.

C: And from that came again, for many similar reasons to Shands becoming a not-for-profit,
came the not-for-profit, independent corporation of University Medical Center, which
took on the obligation for the indigents as a contractual matter in becoming a separate
not-for-profit: for eighteen or nineteen million dollars a year, the responsibility for the
indigents of Jacksonville. Over the years, we were increasingly pressured by Roy
Baker, the chairman of the board over there [and] a really somewhat visionary physician,
and by various powerful people in the legislature to become more and more involved in
the Jacksonville operation, academically: quality control, helping them to recruit,
increasing the tightness of the affiliation of their faculty with ours, making all of the
faculty in Jacksonville full-time University of Florida faculty so that there are some 240
or 250 full-time faculty over there now. It has been a bumpy road, bumpy in the sense
that it is only as successful as the chairman or a dean in Gainesville chooses it to be, in
terms of, is it important to their particular program? Are they going to spend the time
overseeing how things go in Jacksonville?

P: Now, before the relationship develops with the University of Florida, who is supporting
those hospitals over there, not only Duval Hospital but also that black hospital, Brewster?
Was this local?

C: Public money.

P: So, from a financial point of view, it was advantageous also to become part of the
University, the Shands operation, not only because of the prestige and the increasing of









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the quality of medical care.

C: Right, and then, we simply had the geopolitics of the state of Florida made it clear, really
beginning with Marshall Criser and all subsequent presidents, that if there was any
constituency for the University of Florida amongst the powerful areas [of Florida] in the
state legislature, it was going to be Jacksonville and Duval County over time, that the
Gator constituency was increasingly dissipating as the legislature reorganized. So, there
was pressure from the president's office to plant an increasingly important University of
Florida flag in Jacksonville through the medical center relationship.

P: Where did you stand on all of this?

C: I was sort of very carefully in the middle. I do not disagree with the strategic
importance. I was pressed, politically, to get deeper into the tar baby over there by
political forces than I wanted to. My fundamental fear, and it remains so, is that, that is
such an economic loser, that the more the University of Florida, the more Shands
Hospital, goes on the line for its economic performance in the current medical
reimbursement climate, the higher the risk will be.

P: So, it is a drain?

C: Given the action of the governor this last week, it is potentially a swamp. As part of the
strategy to help University Medical Center, in which we have very important education
programs and, as I said, 240 full-time faculty who earn their own keep over there, we
agreed that, increasingly, the Shands/University of Florida logo needed to be over there.
As a matter of fact, for a variety of complex reasons, in order to survive economically,
they needed to combine with their neighbor Methodist Hospital to consolidate, to get rid
of administrative superstructure in terms of costs, and to begin to fly the University of
Florida flag over there. A complicated deal has been under discussion for, now, almost
two years, I guess, a major piece of which were the elements of improved funding with
state assistance, because there is state of Florida care for the indigents; there are state of
Florida educational programs going on over there with a variety of financial packages
that Gerry Schiebler helped lobby through the Speaker of the House's office. There was
about a fourteen- or thirteen-million-dollar package, which would allow Shands to take
on more of the financial risk of that organization, and the whole thing fell apart this
week. The governor vetoed all of that stuff. Methodist Hospital said, we are not going
to talk to you anymore. I have no idea. I mean, I think it must have been a very bad
weekend for my successors. I am not sure where we stand today.

P: Certainly, the veto was not good news at all.

C: No, and the reason I use the word "tar baby" is that we basically are in there.









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P: And you cannot get out, now.

C: We cannot get out.

P: You can never retreat.

C: Yes. The fiscal resources are not apparent to me to make that thing work.

P: Unless the state picks up the tab.

C: [If] the state or Duval County picks up some more.

P: What about the threat of the Mayo Clinic?

C: You know, that scared me.

P: That scared a lot of people.

C: I was going to say it scared the hell out of me. Well, it did not really, but I paid close
attention for a while. In the end, it has been neither a particular benefit to our programs
or a particular problem for them. I would lay that to several factors, Sam. Number one,
Mayo Clinic is by its very nature, to a significant degree, supported by the
cash-on-the-barrelhead, walking-well or walking moderately-ill upper class. They do
not slog around in care for the indigents.

P: So, are you saying, will you complement each other?

C: To some degree, I suppose. I wish they would take on an indigent care burden.

P: You need a car to get out there.

C: Yes. They market to a far more silk-stocking crowd.

P: Well, it is much easier to get to Eighth and Boulevard in Jacksonville than it is to get out
to the Mayo Clinic in Jacksonville.

C: Yes.

P: What about this business of all of these clinics and hospitals and health care centers
carrying the blue logo of the University everywhere. I go to Starke, and I see the Shands
sign up there. Are you responsible for that?

C: I was chairman of the board at the time.









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P: I mean, what is going on? [That] is really what I am asking.

C: The answer for the University of Florida and Shands is that as the medical economy in
Florida is developing, a lot of the ways we are organized and what we are doing and the
development of the Shands Health Care System that you alluded to is a product of the
rapid growth in the population of Florida. Though health care here is competitive, it is a
hell of a lot less competitive than it is in Philadelphia or in New York or Boston, simply
because a rising tide floats all boats. To a certain extent, that is also an answer to your
Mayo Clinic question from a couple of minutes ago, why we did not get in each other's
hair. There was just so much new business coming into this market. Now, in that
context and in the--again, I will use the term--geopoliticization of populations of people
controlled by insurers and HMOs, in which an HMO in Miami or Orlando finds it to their
financial disadvantage to refer to a Shands in Gainesville versus just saying, we are going
to take care of this problem here, and we will claim that we are as good as Shands. So,
patients have been more landlocked to their own geographic area, given the new
reimbursement systems and HMOs that are coming into place. Shands could not, in our
view, have survived as solely a tertiary care referral hospital for the next two decades. It
would have seen its census drop, the patients available for research and teaching drop,
and, an entirely new set of arrangements for clinical environments to carry our university
mission would have to be sought, and who knows where the hell they would be? You
might even have found us, sort of, being forced to move major pieces of this operation to
Jacksonville, if we were to solely become a referral hospital. At any rate, we were
sitting here gazing at our belly buttons, trying to figure out a strategy for having a larger
base of patient care activities for the future health of Shands and our education research
programs when, all of a sudden, AvMed, which had developed this local chain of
basically rural hospitals with our hospital here in town, decides that they do not want to
be a hospital business anymore, [that] they just want to be an HMO business, and put
themselves up for sale. Now, if we had a strategy that we wanted to be a larger
geographic presence with more primary care and a larger base of this population in north
Florida to be responsible for in order to do our business, generate revenues, and do
education and research, we had to make a sudden, relatively speaking, strategic decision
that that indeed is the way we were going to try and organize. As a matter of fact, given
the low density of population in north Florida, there would never be another chance. If
we let HCA/Columbia [Hospital Corporation of America-Columbia HealthCare, Inc.]
buy that chain of hospitals, HCA/Columbia would own north Florida, and we would be
forever shut out. We knew that, in order to make our best bet on strategy work, we had
to acquire the AvMed hospitals that were up for sale.

P: So, it was really a life-saving thing.

C: It was a life-saving thing. We made a relatively sudden decision and convinced the
board of Shands, strategically, to put up the money, which was considerable, to buy those









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hospitals.

P: Where did you get the money?

C: The money was debt.

P: What?

C: Debt, issued by Shands, based on Shands' superb financial performance with markets.

P: How much did it cost?

C: Just under 120 million dollars, I think.

P: A huge amount.

C: A huge amount of money. A very big decision, earth-shaking in the ratchet that it has
set for the next fifty years.

P: Is it working?

C: It is working with difficulty, but it is working.

P: Not every one of these facilities is self-sustaining?

C: No. Most of them are now better than they were when we bought them. We found
mismanagement in many of them. We found poor billing and other kinds of
management practices. We found some revenues we were not able to recover because of
the way we found their financial systems. But, my understanding is that, basically, all of
the constituent units are, at the least, now performing on their own bottom.

P: Health care has improved?

C: I would hope so. We certainly are trying to improve the relationships of the professional
practitioners.

P: Who supervises these facilities? Do you have people here who go out and check?

C: Yes. There are chief executive officers at each of the constituent hospitals who are
responsible for the function of that hospital. They use core management and back-up
facilities provided out of Shands: computers, hiring/firing, personnel, and this kind of
thing. Their financial reporting is overseen by the chief executive of Shands Health
Care and the board of directors.









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P: I can see if they are carrying the Shands logo that you could not afford to have
sub-standard health care.

C: Right. We have to be highly protective of the quality image in the University. If ever
there was a town-gown problem in medicine, it is exacerbated by these kinds of creations
of health systems.

P: Here, in Gainesville, Alachua General Hospital is part of the Shands set-up.

C: Yes.

P: But, not North Florida [Regional Hospital]?

C: Not North Florida.

P: It operates independently.

C: Right. So anyhow, this is a big strategic bet, Sam, that the future of this academic health
center required it to reach beyond the Shands Hospital and become, instead, a regional
health care delivery system.

P: Is this a development going on in other parts of the country?

C: In some parts of the country. Some of them are successful. Some of them are currently
very unsuccessful, as reimbursement has taken a nose dive in federal programs. I think
we have as good a chance as anybody at being successful. Again, that is just because we
do not have that much redundant health care delivery capacity in Florida because of our
growing population.

P: David, earlier you were saying that the hospital in St. Louis, a Jesuit-run hospital, is
running into a problem as far as abortions were concerned. Has that been a problem at
Shands? I mean, are there sensitive areas that you cannot get into here?

C: We do not do abortions at Shands, basically, unless they are absolutely therapeutically
indicated.

P: But, you do not have any interference from the Christian Right or anything coming in and
trying to tell you what and how to do.
C: We are sensitive to it. We do not run an abortion on demand service.


P: I understand. Or anything else.









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C: Right.

P: You do not do any sexual transplants or any of those kinds of activities.

C: We have had requests to.

P: I am just kidding.

C: No. Actually, we have been in trouble. There were some people, some influential
staffers in Tallahassee, who came after us about refusing to do sex change operations.

P: I had not thought about that. The abortions was as far as my imagination had gotten, but
I guess we live in the twenty-first century, now, do we not?

C: That is right. No, we have not developed programs of that kind.

P: David, we are now up to 1996. Great changes [are] taking place in your professional
life.

C: Right.

P: What is happening? Tell me as much as you can, for the record, because this will be the
only opportunity I will be able to document this.

C: First of all, a tenure of some seventeen years or so in a job like this is most unusual. It
was not my plan in the first place. I thought I would come to Gainesville [and] I would
be here for, in this job, maybe six, maybe ten years, maximum.

P: I think you would have to be President of the United States or something. There is no
place else to go.

C: [Laughs.] Well you know, Sam, I did not know what would come next, whether I would
go to an older, more prestigious, larger institution somewhere, whether I would be
interested--this was in the back of my head--that, maybe, university presidency would be
a place to go.

P: You were looking for trouble, were you not?

C: Yes. In the context of the latter, number one, within two weeks of accepting the Florida
job, the leadership of the Peter Bent Brigham Hospital in Boston made a run at me to
come as their chief executive. I felt I had made a commitment here [and] would not
have felt good about changing that commitment, having already signed on in essence and,
therefore, made the decision to come on to Gainesville. Halfway through my tenure









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here, I was one of three finalists for the presidency at the University of Iowa, a very
similar sort of institution in its public nature. I had gotten into that late, went for the
on-campus visit, and in the course of meeting with the faculty, ran into a group of
negative people that I just found unpleasant and challenging who basically said to me,
what makes you think, Dr. Challoner, that as a physician, you have any kind of ability to
be the academic leader of a fine and diverse academic faculty, non-medical faculty, like
we have here at the University of Iowa. I was sort of affronted. That is a shorthand for
a very complicated set of conversations. Then, Jacki and I had watched our good friends,
the Marstons, and our very good friends, the Crisers, be president of the University of
Florida, this probably almost most public of all presidencies, I would say. When
Marshall stepped down, there was a constituency of folks here in the State of Florida
outside the University, friends of the University, who knew me, [UF] Foundation people
and others, who came to me and said, put your hat in the ring to replace Marshall. Jacki
and I thought about it long and hard, and we basically decided that we were too private
personalities to deal with the extraordinarily public requirements of this presidency and
did not allow my name to go forward as a potential candidate for this presidency.
Basically, at that point in time, we made a decision that a university presidency, unless it
were a private one somewhere, was not in the cards for us, that we did not want to do it.
So, we stayed on and [we] were having a good time. God knows, the challenges just
kept appearing one after another here, in Gainesville. Finally, I think, given to some
extent, the personal discomfort, if not pain and some anger, with that (in my view)
uninformed knee-jerk faculty vote of no-confidence due to their own economic failures,
you know, there comes a time when you wear out in these jobs.

P: But, there had been no unpleasantness up until that time?

C: No, there really had not.

P: That suddenly came, kind of, [as] lightning out of the blue, did it not?

C: Yes, the nature of it being unexpected.

P: There had been no complaints about this?

C: No. So, I think I began to be more introspective about how much longer did I want to
beat my head up against a stone wall for this group of characters?
P: But, it was just a small little group, was it not?

C: I know. It was a small little group, but they made themselves official. They got
themselves on the front page of the Gainesville Sun, and that does not roll lightly off of
my back or Allen's back or anybody's back.


P: I have those clippings.









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C: So, I started thinking about what should be next. I think I needed to see through,
because it would have been most inappropriate, two things: the reworking of the structure
of Shands Hospital to become the health system, instead of the Shands hospital operating
company, the reworking of the board structure, the revision of the strategic plan, and the
getting in place of the new chief executive to execute that plan. That was completed
with Dick Gaintner's hiring, with Ken Berns coming in and completing the cadre of six
national high-quality deans for the six colleges. I had really put in place all of the
ratchets on the gears for the next five years at this place, and it was time to look to do
something else. Lombardi agreed with me in this.

P: Why did he agree?

C: I think he felt that the time for change was ripe for me and, for some reason, for him. He
never told me.

P: Had your relationship with Lombardi been fairly good up until then? [It was] not as close
as you had been with Marston and Criser, I know.

C: Not as close. I mean, he is just a more distant person.

P: But no conflict?

C: No, I was very comfortable in my personal relationship with John.

P: Really what I am asking is, was it just the situation here, you know, the action taken in
the college of medicine, or did it go beyond that to Tigert Hall?

C: Sam, I do not know. From my point of view, I saw nothing that went beyond to Tigert
Hall, but I do not know. I am a fairly direct person and when asked for background and
explanation, there was not any.

P: So, the president did not say, let us ignore this; we want you.

C: In the case of that, he said, we need to ignore this for the next couple of years and get
through those things that I just described to you that [were] related to getting the deans in
place and the reworking of Shands Hospital. But, for whatever reason, I think the
president felt that, at that point, my string had run out.

P: In other words, he was ready for a change.

C: Yes. Also--now, I do not have any data on this nor was it shared with me--by that point
in time, there were some of the members of the Shands board who were not happy with









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my direction of the transition, and [my] maneuvering to replace Metts and bring in a
national leadership figure. I think they were pressing the president for a change at the
vice president's level because they did not like the way that Metts was being moved
aside.

P: So, there were lots of things coming together at one time?

C: If you are the fire plug for a bunch of these dogs for seventeen years or so, you finally
begin to corrode a little bit. Anybody who is in a major administrative leadership role
finds that you spend political currency as you go along, and [that] at some point, you
[have] made enough enemies for one reason or another that something different was
desirable. Now, that decision having been made, then what is best to do? As I made
clear from the very beginning, my really fun hobby all of these years has been science
policy in the national arena, and I have been lucky to be in places like the National
Academy and the IOM where those things were happening. The University of Florida
does not have a science policy activity, as many mature universities do in the Northeast
and Midwest. The State of Florida does not have a science policy infrastructure, in
either the executive or legislative branches of state government, to inform the state's
policy and investment decisions as it relates the importance of science to the future of the
state. It is our hope, therefore, that we will use this commitment that the president gave
me as an opportunity to develop a Science Policy Institute, first of all, as a convening
function for University of Florida faculty who have an interest in the same hobby and
may go to Washington in one venue or another to do it there and come back home to their
faculty roles, as I did for many years [and] to, second, be an inviter, through my network
of acquaintances and contacts, of major national figures to this campus to facilitate a
conversation on campus on science policy issues. Thirdly, if we can bring this off--and I
will be working on this over the course of the next year or so--to create an understanding
in the governor's office and in the legislative leadership as to the fact that there is a
science policy enterprise at the University of Florida that can help inform state decision
making and help get the right people. If we cannot do it here, to help the state decide how
best to improve its science position in the national scene from its below-average setting at
the moment.

P: Do you know the governor [Governor John Ellis "Jeb" Bush, 1998-present]?
C: I am acquainted with him. I am going to go see him this summer.

P: I wondered how receptive he will be to this third point that you are making, the
recognition that there is an agency available for cooperation and advice.

C: I hope to interest him.


P: Do you have an appointment with him soon?









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C: Yes.

P: Okay.

C: By the way, John Lombardi has been extraordinarily supportive and has made this
transition to this new responsibility as easy and appropriate as he could.

P: Well, he certainly let you keep your great salary. I noticed recently, when they listed all
of these big salaries...

C: I was not there.

P: ...and they had Mark Barrow [Mark V. Barrow, clinical associate professor, University of
Florida, 1998-present] in as the leader, they did not mention you at all.

C: Right.

P: Mark told me that it all had to do with his selling, that it was not his income at all.

C: Right. I took...

P: A little cut, but not much.

C: Yes, more symbolic than anything else.

P: I know. Your one salary equals everything, the entire salaries, of the history department.
And, you also have a very generous travel budget?

C: Yes.

P: And just look at all of these grand facilities.

C: The office facility is wonderful.

P: When I get back to the rest of the campus and explain all of this, you are probably going
to have--do you remember the storming of the Bastille during the French Revolution?

C: Right. They will be here. The president has made available a university commitment
of--I think it is--150,000 dollars a year to run the office function, to invite in speakers, to
pay travel, to pay my secretary, to pay my travel, for three years. If we can demonstrate
that the thing has got some legs at that point, in terms of outside funding from
foundations or in terms of state support because we are providing a state function, then
this thing will have some legs. I hope that is what will happen.









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P: Then, by that time, if it does not, you can just use all kinds of four-letter words and go to
the beach.

C: Yes. During the same period of time, as a matter of fact, Sam, what really worked out
well is that I was appointed by the Institute of Medicine as its foreign secretary last July
1. Then this assignment to Washington came--it was not an official university sabbatical.
It was an assignment by the president to Washington for six months, from September 1 to
March 1--came up and so, I basically went to Washington and began to take up my, if
you will, my volunteer responsibility for the Institute of Medicine as its foreign secretary,
began to work in that arena [and] used that to help develop ideas and contacts for our
own Institute back here. So, that was a very well spent six months. No matter what
happens here in Gainesville, I will continue for, probably, the next five or six years with
a lot of activities around the Institute of Medicine foreign secretaryship, the National
Research Council, and a variety of other positions that I have in Washington.

P: It sounds to me like you are going to be a busy man.

C: I am. I am traveling almost as much as I used to.

P: What is this conversation you had earlier with Donna Shalala [Secretary, Department of
Health and Human Services, 1993-present] in Washington? Now, that
happened--what--two or three years ago?

C: Two or three years ago, when they were searching for a replacement for Kessler [David
Kessler, FDA Commissioner, 1990-1997] as commissioner of the Food and Drug
Administration. I was approached and had a couple of conversations with her and the
people who were helping her in the search about becoming the commissioner of the Food
and Drug Administration.

P: But, you were not really seriously interested in that, were you?
C: Did I think about it seriously? Yes, I did. Did I ever really get close to doing it? To
accepting? No. I just do not think my personality would fit being a Washington
regulator. I knew I would be doing something different at the university so that the
timing would have been right, but I just decided it was not for me.

P: This program that you are now moving into, this Institute, was this your idea? I mean,
you had been interested in this kind of thing for a very long time.

C: As best I could give account for it, I would say it was a joint development that came up in
conversations between John Lombardi and me.


P: You are going to give him some of the credit, then?









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C: Yes.

P: Good. That is the politic thing to do.

C: Yes.

P: Now, this business of a think tank, what do you mean by that? A think tank type of
operation.

C: It is a glib shorthand, I think, I used for the media, did I not? I mean, I would not have
used that...

P: No, I am just asking that. I am just wondering who is going to belong to this. I
gathered from that, that you are going to gather scientists on the campus and, together,
come up with policy, suggestions, or ideas.

C: Right. I have solicited the entire faculty in just asking whether any of them had any
particular interest or hobby in science policy and got a list of, probably, 100 faculty
members who wrote back one thing or another. My intent is to begin to have a
convening function for them, Sam, to have meetings, to have seminars, to invite them and
to see whether any conversations develop from that and, also, to get a better catalog of
what they consider their expertise to be, so that if--let us assume--that we start getting
some questions from the governor's office or from the legislature [to] look at this piece of
legislation [or] look at that, I will know whether there is anybody on this campus that I
should work with or whether I go to somebody in Washington or at the National
Research Council or wherever.

P: David, you are now sixty-four years old?

C: Yes.
P: How much more time do you think you are going to want to do all of this, remain active?
Five, six, seven more years?

C: Yes. I think so. Maybe longer on a consulting basis of some kind. But, I have no
thought about anything other than full employment until age seventy or so.

P: Now, you still have many activities outside of the University of Florida. You still serve,
I noticed in your listing, on many national boards and commissions and all kinds of
things.


C: Right.









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P: And you are going to continue those responsibilities, are you not?

C: Right. I am going to continue that.

P: What are some of the things that are taking up time and your interest away from
Gainesville?

C: Well, the foreign secretaryship of the Institute of Medicine. My guess is that is, sort of,
a one-sixth time commitment, of various kinds, sort of being secretary of state for the
Institute of Medicine and the National Academy of Sciences.

P: You do not have an office in Washington?

C: Yes, I do.

P: Oh, you do?

C: Yes.

P: Where all of these things come together.

C: Yes. I hold a small temporary office there that I share with the home secretary of the
Institute of Medicine. I intend to stay active as long as they will have me.

P: I have the National Academy of Sciences, for instance.

C: Right.

P: You are still involved in their Institute of Medicine?

C: Right.

P: The National Research Council?

C: Right, the governing board there. That has been very exciting stuff for me.

P: What is this Cordis Corporation that you are involved in?

C: That is an old one.

P: That is non-academic, is it not?

C: Right. Bob Marston was a member of the board of directors of the Cordis Corporation?









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P: Was is it?

C: Cordis is the largest manufacturer of cardiac catheters in the world. It is a medical
device manufacturing company based in Miami. A life-long friend of Bob Marston's
was the founding president. Bob was on the board, actually became chairman of the
board after he gave up the presidency, and then asked me to join that corporate board in
the late 1980s, after four or five years of which, the company was acquired by Johnson &
Johnson, and the board disappeared. It is now a Johnson & Johnson division.

P: Are you still on the bank board?

C: No, I am not on that anymore.

P: You have really received a lot of honors. You have been beribboned over the years in
many ways. What are some of the ones that really stand out? You are on the board of
governor's of your college?

C: Yes. I was on the board of Lawrence University. One of things of which I was most
proud was a selection when I graduated for the Harvard Medical Alumni Award which,
quite frankly, came to me as a complete and stunning surprise at the time of my
graduation from medical school. I think the William Beaumont Award of the American
Medical Association for outstanding contributions to the profession by a physician under
age fifty was something I was extremely proud.

P: The Boylston Society appointment was very of distinction, was it not?

C: Yes. That was a medical student appointment. I think the election to the Institution of
Medicine was important. Those are things which I am very proud of.

P: I was going to say, there are many others that could be added to it.
C: Yes.

P: Well, what kind of a person are you? That is an open-ended question, is it not?

C: Yes. Well, I think I am a creature of my Midwestern background.

P: Politically conservative?

C: Politically fairly conservative, with a very liberal bent when it comes to the importance
of community and support for our weakest. Clearly, I was somehow never meant to
practice medicine, but I am pretty good at gaining the confidence of people and managing
organizations. In some ways, that may be almost instinctive. It is a skill set that I, in no









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way, trained for. I am very attracted to the intellectual life. I like to read widely.

P: You read a lot?

C: I read a lot. Bob Bryan and I are exchanging books all the time.

P: What are you reading?

C: Right now, I am reading Kissinger's last volume of his memoirs. Geez, it is a thick
book.

P: Are you a workaholic?

C: No, I would not say in that sense. I mean, I can take time off. I have learned to take
time off with Jacki. I have learned to go to the beach. With my extensive reading and
professional reading to stay ahead of the game, I am doing some reading or report or
critiquing or something until, probably, nine or nine-thirty every night. I have a cocktail
on the weekend but not during the week. My hobby is listening to music. I learned to
play both the piano and violin as a child but never carried that beyond my teenage years.

P: Are you a TV watcher?

C: Only McNeill-Lehrer. I do not watch TV at all.

P: Do you all go to the movies?

C: Nope. We do not go to the movies. Jacki and I are devoted and committed
grandparents.

P: What about the performing arts center?
C: [We] were in on that from the beginning, and [we] do go to the performing arts series,
and enjoy them, when we are in town. We like the opera, especially. Jacki and I are
real opera buffs.

P: You are, obviously from what you are saying, a very devoted family man, as far as
grandchildren are concerned.

C: Yes.

P: Six of them.


C: Six of them.









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P: And you see them often?

C: As often as we can.

P: How long have you had the beach place? A long time?

C: Ten years, I think, at least now.

P: So, you use it extensively?

C: Yes. We get away on the weekends a lot.

P: Do you and Jacki get a chance to travel much?

C: Yes, especially in the more recent years. When I am going some place and will be gone
more than forty-eight hours, very often she will go with me, if it is an interesting place.

P: Have you had a chance to see the world, then?

C: A lot of Europe, but not much more than Europe. Over the course of the next year or so,
I have an Institute of Medicine meeting in Japan, so we are going to go to Tokyo.
Probably, there will be more foreign travel, now, with the foreign secretaryship, and I
have enough miles accumulated, so she will go with me frequently on those trips.

P: Your health is good?

C: Yes, thank God. I am in very good health. I run about two and a half miles a day.

P: I was going to say, you are so thin. You look like you are about twenty-two years old.

C: Well, thank you.

P: Do you watch your diet?

C: I watch my diet very carefully.

P: You are as skinny now as when you were in high school, are you not?

C: Just about. What I have seen is that there are places in my family tree where overweight
came through and resulted in bad diseases related to that: heart attacks and other stuff.

P: How religious a person are you? Did you come out of a religious household?









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C: I came out of a conventionally devoted Midwestern Protestant household, congregational
or Presbyterian, active in the church, sang in the church choir, active in church youth
groups. [I] have found my own point of view to have been imprinted with a moral and
ethical code that comes very much from that background but have had a more difficult
time explaining a belief in conventional theology because of, probably, some of my
science. I have found, as a matter of fact, one of the more recent books that I just
finished, E. [Edward] O. Wilson's Consilience, to be a very interesting sort of struggle to
use the power of science to understand human ethical behavior organization in a way in
which it can provide some basis for an ethical code. So, that has been a struggle in my
life. I have had a well-imprinted ethical and moral background. If anything, I am rigid
but have had more trouble explaining it philosophically.

P: You do not sound like you are too much of a church goer, though.

C: No, not now. Not really. My family remains so, and I attend with them ceremonially.

P: How about your children? Because you have such a diverse group, you would have to
ask which church or synagogue they go to?

C: Right. They all do what they want.

P: Are your grandchildren going to be raised Jewish, or are they going to be raised in what?

C: You know, we have not really talked about that. They are kind of being raised both at
the moment.

P: Well, we have a granddaughter just like that, so we do not raise any questions either.

C: Yes, it is hard. [I] do not know how to predict where that is going to lead.

P: And I do not really care.

C: I do not, either. Yes.

P: It makes no difference to me.

C: Right. As long as [they] are happy well-adjusted people, that is all I care about.

P: That is exactly right. As you look around, are you satisfied with this world, this country
that your grandchildren are going to inherit?

C: In many ways, no. I am distressed by the tribalism that we currently see playing itself
out in the absence of a global balance of power situations. I wish for my family, my









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children's children, to have a, I think, sound multi-cultural, multiracial society. In the
United States, we seem to still be doing it better than anybody else, for all of our
problems. I certainly would like to see a man in the presidency that I could admire more
than I admire our current President.

P: I cannot understand why you would say anything like that! What have we not talked
about?

C: Boy, I do not know, Sam.

P: That should be documented? I do not want you to leave here and say, well, why did
Proctor not ask me about that?

C: Yes. I think we have gotten everything touched on. Jacki and I will have been married
forty-one years this August.

P: Forty-one years. We have ten years ahead of you. Fifty-one for us.

C: Yes. God knows how you make those decisions, but the way our life has developed
since we were married has been one in which she clearly does things for us that I cannot
do and has bought into my professional commitment in a way that allowed me to do
things that I might not have been able to pull off otherwise.

P: It sounds to me like you have led a happy life, a satisfying life.
C: Yes.

P: Nothing to regret?

C: Oh, always things to regret, but I do not know. I mean, it is even hard to sort that out.

P: We would need another whole afternoon for that, would we not?

C: Right.

P: Well, this has been a wonderful experience for me.

C: Thank you. For me, too. Now, I can hardly talk.

P: Have you remembered a lot of things you thought you had forgotten?

C: Yes.




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