Title: Waldo Fisher
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UFHC 43
Interviewee: Waldo Fisher
Interviewer: Nina Stoyan-Rosenzweig
Date: September 12, 2001


S: This is Nina Stoyan-Rosenzweig and I am conducting an interview with Dr.
Waldo Fisher at the Health Science Center on September 12. The time is 1:06
p.m. and we are going to get started by asking you questions about where you
are from and when you were born.

F: I was born in Philadelphia, Pennsylvania in 1930. [I] grew up in the Philadelphia
suburbs, most specifically in Swarthmore. How much do you want me to say
beyond that?

S: If there is anything you want to add.

F: Perhaps I will point out something interesting, I was a dyslexic youngster. When
I was in third grade I still was not reading and at that time there was a lady who
was doing her Ph.D. thesis in reading disability at Johns Hopkins University,
[named] Margaret Rawson, and she was developing a cohort of students who
were dyslexic matched with non-dyslexics and I had the opportunity being put in
that cohort. The thesis was that if you taught dyslexic children intensively, their
learning [disability] could be overcome and they could progress academically.
This was the first study of that sort that was ever performed and there was a
great opportunity for me in it. I had daily tutoring for a number of years and it
worked.

S: How did your family identify that you were dyslexic or was this something your
teachers noticed?

F: It became evident that I was not reading and my father was a professor at the
University of Pennsylvania and my mother was heavily involved in educational
work, she had her master's degree. They picked up on this and I actually do not
know how the contacts were made with Margaret Rawson but they were.
Things moved ahead from that point. I [learned to read and] around fifteen [or]
twenty years ago I received a national award for achievement of dyslexic
individuals. This was awarded by the [Tri-Services] National [Institute of]
Dyslexia in Washington [D.C.].

S: That is interesting given the timing you said it was the first study and was not
widely recognized at that time. In a sense you are lucky in having parents who
were able to recognize the problem.
F: It runs in the family. One of my sons is severely dyslexic, [but] he has done well.

S: Clearly, you have as well. Once you went through that education, did that









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enable you to compensate? From that point onward did you have any problems
in school?

F: I think dyslexics always have a certain amount of residual problems. [It is] the
nature [of] dyslexia. You learn to deal with that.

S: You learn how to compensate. Did you go to high school in Philadelphia or in
Swarthmore?

F: In Swarthmore, I went to a private Quaker school for my grammar school [the
school in Rose Valley] and then from there to high school in Swarthmore [and]
from there to college.

S: You said your father was at the University of Pennsylvania, was he a scientist?

F: No, he was a professor of industrial relations.

S: At what point did you become interested in science and medicine?

F: I have always been interested in medicine. I cannot remember when that was
not a goal. It focused more clearly when I was a undergraduate at Wesleyan
University where I graduated with a scientific prize, high distinction and Phi Beta
Kappa [prestigious academic honor society]. Then [I] went on to the University
of Pennsylvania for my medical training. It was interesting, at the period of time
when I was at the university as a student, I worked in the laboratory in the
summers and then [after graduating] went into my internship and first-year
residency. The thing that depressed me during that time was that in rounding
with the attending physicians, what they were telling me was, with the exception
of infectious disease, which was moving ahead at that point, pretty much
everything was what they heard when they were students. Things were not
moving very much in the 1950s in the advance in medical knowledge, with the
exception of infectious disease, and that discouraged me and sent me back to
the research career. That seemed to me that was the place where one needed
to work.

S: When you were at college as an undergraduate obviously you knew you wanted
to study science, you were a pre-med all along and you graduated from there
with some sort of faith in science and the progress of medicine, presumably.
Was there anyone at college that was particularly influential in shaping your
interests or were they already firm?

F: They were pretty well established, I worked very closely with one of the
professors in the chemistry department, John Sease, and did my senior research
with him.









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S: What made you choose Wesleyan? As someone interested in science, was it
particularly strong or was it tradition?

F: Wesleyan was and still is a very challenging and exciting undergraduate
institution. I was a bit of a slow developer in terms of social aspects [and] a
school with a smaller enrollment seemed like a logical place to go. I had several
applications out and Wesleyan invited me to come and the rest was history.

S: You went to Penn [University of Pennsylvania] for medical school. How did you
pick Penn?

F: It is a good school, well-recognized, [I had] family involvement with the university
for years, of course my father was there [and] my mother got her [master's]
degree at the university. It was a logical place to go. It also was an incentive
because [of having] someone in the [family as a] faculty member, my tuition [was
waived].

S: I was going to ask you how you paid for medical school. You started your M.D.
in 1956.

F: No, I graduated in 1956.

S: You started in 1952, and you said earlier that you felt like there was no progress
being made in the field of medicine. At what point did that become obvious?

F: During my internship.

S: During the medical school years, how did you feel about that education?

F: First year [of] medical school was a real disappointment. I had been in an
honors program at Wesleyan [and] we were dealing with concepts in exciting
tutorials. The first year of medical school we spent learning anatomy, and if there
is anything that is dull, it is anatomy. I was also doing biochemistry, which I
found interesting. About two-thirds of the way through that first year I went to
the professor of biochemistry whose name will come up again, Samuel Gurin. I
told him I decided, after all this drudgery, that maybe medicine was not really
what I wanted and I would rather switch to a Ph.D. program and he persuaded
me not to. I owe him many thanks for [persuading] me to continue the M.D.
program.

S: So the first year at least was all memorization it was anatomy.

F: Anatomy was the primary course, chemistry and anatomy were the first year. I
enjoyed the biochemistry, the anatomy was dull.









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S: What about the second year after you got through with that?

F: It became more interesting.

S: It sounds like you are more interested in the questioning and discussion than in
just the memorization and that is what made it fun and interesting. What did you
do then in the second year? How did the curriculum change, did you start
seeing patients?

F: No, we really did not see patients until the third year. We were getting into
pathology, physiology of disease and so forth and that became more interesting.
I also had established a laboratory base [and] spent my free time in the
laboratory with Professor Gurin.

S: Did you do laboratory research as an undergraduate?

F: Yes.

S: What sort of projects were you working on then?

F: I was working on the separation of lycopenes these are color compounds in
tomatoes. We were separating them by chromatographic methods, which were
new at that time.

S: So your interests have tended to be more in biochemistry?

F: Yes. Consistently so.

S: A typical day in medical school would vary depending on what year it was, let us
just say in the second year, what were you doing? Is it still basically all
classroom work?

F: All classroom work.

S: At what point did they start you on the more clinical aspects? In the third year?

F: Yes, in the second year we spent a little time on physical diagnosis and that sort
of business, as they still do. Third year was the start of clinical years and they
were the standard rotations of clinical specialties.

S: I know that you have a Ph.D. and you said that early on you were really thinking
that the M.D. was not for you. You finished your M.D. and went on for your
Ph.D. At what point did you make the decision to do that? Did you decide









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while you were still in medical school?
F: I did my internship and residency in a hospital affiliated with the University of
Pennsylvania, Presbyterian Hospital. We had some very fine clinicians there,
one of them was a man by the name of Jake Crellin who was a pulmonologist.
He and I developed a very close relationship; he became sort of my mentor
during my house staff-training. I was there only one year as an intern and one
year as a resident, but during my residency I was appointed chief medical
resident. That gave me some extra responsibility and Crellin tried to get me
interested in pulmonary medicine and would invite me to the pulmonology
seminars in downtown Philadelphia in one of the elite clubs, [the] Union League.
[We would] have a couple drinks, talk about pulmonology and so forth. During
that residency he arranged for me to go to Saranac Lake to the Trudeau
Sanatorium for a couple months [for seminars] in pulmonary medicine. [This] was
another exciting experience; [however, I reached] my decision to go back to Sam
Gurin once again. [He had] kept in communication, and he was chairman of
biochemistryy at Penn. He [arranged an National Institute of Health] fellowship
and I went back to being a student once more.

S: That was in what year?

F: That must have been 1957.

S: You graduated with your M.D. in 1956 and you did a year of residency?

F: I did an internship and residency, so maybe it was 1958. During the first year
back at the University of Pennsylvania I came down with tuberculosis it was
common in medical personnel and I spent six months with my feet up recovering
from tuberculosis.

S: Was that caused by your exposure to patients with tuberculosis?

F: Undoubtedly.

S: You said that you were working on a pulmonary specialty or with someone who
was a pulmonologist. Were you then exposed more to TB [tuberculosis]
patients?

F: I do not think so, just run-of-the-mill patients that come through the hospital.

S: There was medicine available, antibiotics available for treating TB did you go
through that course of treatment?

F: Yes, I was sick enough that I was not able to do much of anything at that time.









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S: Did you rest and recuperate in Philadelphia or did they send you off somewhere
else?

F: No, they sent me to my parents' home.

S: Did you have any permanent weakness or anything like that? This was
obviously before drug-resistant TB.

F: Yes, fortunately.

S: Did that experience give you any particular insights into medicine or sickness or
treatment?

F: It certainly introduced me to the concept of being a patient. I do not think I could
make much more out of it.

S: As a patient who is also a physician, you knew how to maximize the treatment
and things like that.

F: Yes, but it is good for physicians to have the experience of being patients.

S: They can understand how patients feel and what treatment they appreciate.
When you came down with TB, was that during your internship?

F: [It was] after my residency, when I was back at [the University of] Pennsylvania
as a Fellow in biochemistry.

S: That was from 1959 to 1963, so you had started graduate school.

F: Yes, I was in sort of a mixed-status type of situation. On one hand I was a
graduate student, [but] on the other I was a post-doctoral Fellow M.D.

S: I noticed that you had your M.D. and Ph.D. and I was wondering originally if that
was the joint M.D. Ph.D. program?

F: No, [it was] sequential.

S: When you went in, were you working in the medical school on medical research?

F: Yes.

S: So it was basically the same people, the same atmosphere?

F: Yes, in the biochemistry department, and I was working with Gurin. Sort of an









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interesting aside during the time I was working with [and] doing my thesis with
Dr. Gurin, [he] became dean of the College of Medicine and closed his
laboratory. I was his last graduate student. I got kidded about that a number of
times.

S: They said that you drove him out?

F: That is right, but we started a project on lipoprotein structure. The thesis was
that [since] proteins of lipoproteins were [insoluble in] water, maybe they had
some fatty acids attached. We [went] looking and it turned out they did, and that
was the thesis. He started me in my lifetime career of lipoproteins a
[fascinating] study. [My Ph.D. thesis provided an example of] how science
actually progresses.

S: Do you want to talk a little bit about how science progresses?

F: I published my thesis in [the scientific journal] Science in 1964. About fifteen
years later I attended a meeting of the Heart Association a conference on
atherosclerosis. A young investigator from NIH got up and presented exactly
the same work, word for word, method for method. I knew him quite well [and]
he knew nothing of my work. There are two interesting things, Medline began
scanning literature in 1965 and [research] that occurred before 1965 [never got
referenced]; he never saw [my paper]. [Thus] he confirmed my work without
knowing he did, but the other interesting thing is that the hypothesis upon which
one approaches a problem changes with evolution in science. When I
undertook my study, we were fascinated by the fact that the protein was
aggregated and we could not get [it into] solution. When he undertook his study,
progress had moved ahead, [so] in his hypothesis [he was proposing] the
possibility that fatty acids attached to a protein would signal the direction [of] the
protein's metabolism, [and that] has [been] proven. He attacked this [research]
with one hypothesis [and] I attacked it with another, and we both came out with
the same findings, but they were interpreted in a different context.

S: That is interesting. Have you read [Thomas S.] Kuhn [author of the influential
The Structure of Scientific Revolutions] and the whole idea about paradigm shifts
in science and that sort of thing? One of the things that seems to drive science
is technology and what sort of questions you can ask, what you can actually see
and what you can answer. Is that your sense too?

F: The same questions get asked in a different context as new methodologies
permit. That is certainly very true.

S: Let me go back and ask you a little bit more about graduate school. You were
saying at one point that you went to the Union League. Were there any women in









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your department at that point in time? I know the Union League does not let
women in.

F: How do you know the Union League?

S: I am from Philadelphia.

F: Oh, are you? I did not realize that.

S: I grew up in Center City.

F: Oh, did you? Did [you get] your education in Philadelphia?

S: I did, my undergraduate degree is from Brown, but I have a master's degree in
biology from Penn.

F: You do? Congratulations. I did not know that. At the Union League at that time
women were only permitted on the ground floor that was [a] bastion of male
[chauvinism].

S: Were there any women in your department then?

F: When I was a resident, we had two women, but they were not interested in
pulmonary disease.

S: I was just curious, I know the reputation of the Union League, so that question
popped up. You were interested in biochemistry and your experience with Dr.
Gurin pointed you towards lipoproteins?

F: Yes.

S: You were saying at that point it was not even clear that there were fatty acids
associated with them. What was his major area of research, proteins?

F: He had a long career in many different areas, at the time that he and I were
working together he was pushing [ahead in] two areas. One was cholesterol
biosynthesis, which was a very hot topic at that time. The student who was
working in that area was synthesizing geraniol and farnesol [and] substances of
this sort, which have subsequently turned out to be very interesting, as we got
prenylated proteins with these. Ligands attached to the proteins determine the
way proteins move in the cell. The other area that he had [an] interest in was
the one in which I was working, though he had not worked in lipoproteins before,
so we both delved into that together. There is an interesting followup to that.
After I came [back], when I was still a student of his, we used to chat a good bit.









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One of his experiences that influenced me was when one day he came in and he
told me he had gotten a call from NIH and they had reviewed his grant. They
thought what he proposed could not be done on the amount [of funding] he
requested, so they were going to double his grant. [That is] one of those things
that we can dream about [but] long-since past. He told me on another occasion
was that he was going to be dean for four years and [after] that he was quitting.
I [was] here [at UF] when that four-year period came up and I went up and talked
to Sam. He was developing an interest in marine biology and he agreed to
come down to be interviewed here. George Davis I do not know whether his
name rings a bell with you or not he was a member of the National Academy of
Science. He held a position in [the UF] administration and he was interested in
Sam coming [here]. Sam went off [for] a [terminal] year of sabbatical from Penn
in which he went and visited a whole series of [marine] laboratories around the
country and then he came down here. He had been here a year or two and he
got to know Whitney of the [Helen Hay] Whitney Foundation. They became
interested in the university developing [a program in] marine biology. Sam Gurin
was the one who got the Whitney laboratory going. If you go back and look at
the history of the Whitney laboratory, it was Sam Gurin, working with Whitney,
[who got] the funding for it pushed through. He was eventually given an
honorary [doctoral] degree by the University of Florida for this work [when] he
retired.

S: How long was he here then?

F: I guess about ten years.

S: That is interesting, it sounds like he was influential, and set you in the direction of
your research, but was also a friend and a colleague.

F: Yes, we had become very good friends over the years.

S: After you did your research, you got your Ph.D. in 1964. Were you doing any
medicine at that point or it was all lab work?

F: I spent a half-day in the clinic just so I could remember how to wear a
stethoscope.

S: How many years of course-work did it take to get your Ph.D.?

F: I mixed the course-work with the research. We did not do a lot of courses, [the]
philosophy at that time was that a Ph.D. was a research degree and you [had]
better know research, you needed a few basic courses and that is what we did.


S: Did you do any teaching at that point?









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F: Yes.
S: What did you teach?

F: Lectures to the medical students.

S: Biochemistry mostly?

F: Entirely.

S: Was your tuition also paid for in your Ph.D. because of your father?

F: No, that was all taken care of through the fellowship. I also got a second
fellowship while I was there, [a] Pennsylvania Plan [Scholarship].

S: That covered your whole period of getting your Ph.D.?

F: [Let me give an] aside [here] in terms of how faculty compensation goes in a
university. When I was in my fellowship, I was getting a stipend of $6,000 a
year. My father was professor of the Wharton school [of business] heading up
the program of industrial relations. His salary from the university at the same time
as a senior professor [was] $6,000, [although he supplemented it with
consulting].

S: That is amazing, especially at Wharton, Wharton professors' salaries have to be
fairly competitive with what they could earn in the private sector.

F: He consulted [to support his family].

S: That is really remarkable, was that the difference between the fields of medicine
and business at that point?

F: Those who get into an academic institution progress through the ranks and
salary does not get escalated very rapidly. We see that here, that is one of the
problems the university here has.

S: To bring in people you have to give them a good offer, but older faculty are
affected by salary compression is that the term?

F: That is exactly the term.

S: How long was your father at Penn?

F: Many years, he started out his career, then got his Ph.D. there and stayed.









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S: Did you have siblings?

F: No.

S: Did you do a second residency after your Ph.D.?

F: I went back into clinical medicine. I went to Peter Bent Brigham [Hospital] and
spent one year there as a senior resident. That was a great year. I was
married at that point. I lived in Wellesley and commuted to work. We were
on-call every other night and stayed in the hospital, and the other nights we
would get out around eight or nine o'clock. The excitement of the institution was
[in] the people with whom you worked. They really had a superb group. [There
were] young physicians at the level of intern [or] resident and it was just
exhilarating, and that is how clinical medicine should be.

S: Was it also just being in Boston?

F: I never saw Boston in that year. I spent a lot of time in [the hospital] doing my
medicine, [it was] a second home for me.

S: This was Harvard and they really were attracting an exciting group of people and
you said that is the way clinical medicine should be. What characterized it?
What was their attitude toward medicine or how did they practice that made it so
exciting?

F: We were heavily involved in our patients. I said we worked every day and every
other night, and you saw your patients from the moment [they] came in the
hospital right through until [they] left the hospital. We had a group of attending
physicians who were very much abreast [and] querying in terms of their fields of
interest. There were a lot of new things happening at that hospital and if it was
not happening there we were very much aware of it elsewhere. That was the
time when Bernie Lown had just developed defibrillation methodology and they
were setting up the first coronary-care unit and patients were being defibrillated
when they had ventricular arrhythmia and we were all a part of that. John Merrill
was pushing hard with renal dialysis, they were just starting hemodialysis.
Peritoneal dialysis was the mode we used. I got my name on a paper in a train of
authors [when I had a patient] who came in with ethylene glycol intoxication
ingestion [and] renal failure, and we carried that patient through thirty days of
peritoneal dialysis and that was a new record. Merrill was also involved in the
early kidney transplant. There was all this sort of activity, and you had Sam
Levine who was a cardiologist, a great eminence at Peter Bent Brigham, and he
was the guiding spirit in cardiology. We had a good group.









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S: At that point, it sounds as if medicine had started taking off?

F: Yes, it certainly had.
S: We were seeing much more research and exciting developments in areas other
than infectious diseases.

F: I was feeling that I had made the right choice.

S: What do you think sparked that change from the 1950s when you said there was
really no advancement, to the 1960s?

F: It was a consequence of some very far-sighted and magnificent members of the
Congress, who saw what the future potential could be, and put [up] the funding.

S: So a lot of it was funding?

F: Yes, indeed.

S: After you had your Ph.D., you made the decision to go back and practice. Was
that something that you knew you were going to do?

F: No, I never went into practice. I stayed in academics and finished my Ph.D. and
I went back [to the Brigham to hone my] clinical skills.

S: It was hospital work, it was never private practice but it was clinical in the sense
that you were seeing patients.

F: Yes, [after coming to UF,] I was seeing patients in a structured setting, that is [I
saw them] one afternoon a week in clinic and two months of ward-rounding and
also a couple of months of endocrine attending [each year]. The rest of the time
[was spent] in the laboratory, the major thrust of my work has always been in the
laboratory.

S: In your residency were you specialized in cardiology or pulmonary medicine?

F: It was a general medicine residency, but George Thorn was chief of medicine
and, as you may know, Thorn was a very preeminent endocrinologist and the
exposure we had [emphasized] the endocrinology. When I came down here the
first year, as a young faculty member, I worked with Dr. W. C. Thomas, Jr. Dr.
Thomas was the one who recruited me. He took me under his wing as sort of a
Fellow in endocrinology in the first year I was here and improved my skills. I
never had a full endocrinology [fellowship], it was [on-site] training.


S: That works just fine.









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F: Yes, it worked fine for me.

S: That does take us to your coming to Florida. When did you start at Florida?
You came right after your residency.

F: It was 1965.

S: Had you applied elsewhere or did Thomas just come up there and bring you
down?

F: When I was at Brigham, George Thorn had several of his residents come to
Florida. Joe Ship and Walter Oppele and a couple others. I went out and
applied to a number of different institutions. My wife persuaded me to send a
letter to the University of Florida. I would not have done so, but her brother was
in practice in Daytona Beach. I got offers from several different places. The
University of Vermont offered me a position there at a salary of $7,000 a year. I
was invited to stay in Boston at the Joslin Foundation with a salary of $6,000 a
year. I got an offer to go to the University of St. Louis with a salary [that was] a
little better than that. [When I came down to] the University of Florida in March, I
left the Boston wintery weather and [was] put up on campus. It was a beautiful,
warm day, spring was in the air. I chatted with the people here and they invited
me to come down, and offered me a stipend that was magnificent at that time -
$17,000.

S: As opposed to $7,000 at some of these other places.

F: [It was for a job] as an assistant professor of medicine. You are aware of what
the salaries are now, with salary escalations. I should diverge a little [and] talk
about recruitment. Are you aware of the role that Cedar Key and Bessie Gibbs
keeps playing on recruiting faculty at the college of medicine?

S: No.

F: When George Harrell [founding dean, University of Florida Medical School] was
recruiting his initial faculty, he utilized the facilities down in Cedar Key at the
Island Hotel. The Island Hotel was managed by Bessie Gibbs. Bessie Gibbs
had been a Rockette up in New York and [then] she came down here. I do not
know whether she was southern originally, but she took over the running of the
Island Hotel and she was a woman with charm. She had a southern
graciousness but she also had a southern, north Florida cracker-quality to her.
The [recruitment] pattern that was established was that after the negotiations had
gotten to a certain point, [Dean Harrell] would take them down to the Island Hotel
and she would put on a magnificent dinner with hearts of palm [salad] and all the









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rest of it. The final negotiations would take place in that relaxed and delightful
setting.

S: I guess Harrell was no longer here when you came. Were they still using Cedar
Key? No, that had come to an end.

[End Side Al]

S: The University of Florida recruited you and the contrast with Boston was quite
great. You started with a salary that was far in excess of what was offered
elsewhere?

F: Well, [more than] in Boston, but you know, Boston never offers anything.

S: You came down as a professor of medicine?

F: Assistant professor of medicine.

S: And also in biochemistry?

F: After I had been here a few years. That came later.

S: When you started, what were your responsibilities?

F: Basically, my responsibility was to get a laboratory going and establish a
research program.

S: So they brought you in with a focus on doing research?

F: Yes, definitely.

S: Were you seeing patients or teaching also?

F: As I said, I spent two months on the medical attending service, some
endocrinology, clinics, and consults.

S: Was the teaching mostly bedside teaching or were you lecturing and doing
classroom work as well?

F: I got involved with the biochemistry department fairly early. I guess I had been
here a year or two and obviously this was where my work was going, and they
gave me an appointment in biochemistry. I taught for a number of years, I
taught the medical students lipid biochemistry.









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S: Were they doing lab work?

F: This was a year where medical students worked in a laboratory. Some of the
students, as you would expect, I managed to corral into my own laboratory. That
was always fun and quite productive in some cases.

S: This was not animal research, this was more biochemical research.

F: There was work with animals in terms of obtaining tissues and so forth.

S: And then analyzing them.

F: [We] gradually [moved] from animal studies into human studies as our work
progressed. In the later years here it was all human research.

S: You said the students were mostly medical students but you got them into your
lab. Would they then go on for a graduate degree or would this apply just to
their medical career?

F: We had a course here, experimental medicine, probably you have heard about
[it]. The course in experimental medicine terminated during the Vietnam War
when students wanted to focus on what was "relevant" to their careers. We
moved that [course] into a program in medical student research, and I ran that
program for about a decade. I gave you a paper that describes the program.
That program was a lot of fun, we had a very active program. I do not
remember now how many students would be involved at any given time, but I
think it was twenty or thirty students. The program functioned at a series of
different levels. The students would apply for fellowships. They had to write [a
short research] application. [If] they got funded, [and their research progressed,]
they had the opportunity of coming and presenting their work in a monthly
[student] research conference. The students who worked [and] moved ahead
well were funded to present at national meetings and a number of them [wrote]
papers and co-authored them. The program was under my direction for about
ten years and it was in this context that I was able to get a number of students
working in my laboratory.

S: Did these students choose to be part of this program? Did they then tend to go
on into medical research or did they end up at university hospitals?

F: Do you know Dr. Gold here at the department of psychiatry?

S: No, I do not.

F: Mark Gold was one of our students and he came back as a professor of









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psychiatry. We have had some students [go into] research [but most into]
clinical [fields]. The important thing was not whether they went into research [or
not], but [rather that] in the course of an individual's progression through his
career after he leaves medical school, he loses his didactic teaching and keeps
abreast by reading the journals and so forth. By having spent some time in a
laboratory, one learns how to appreciate [a scientific report and] how science
progresses. This is the emphasis of the program. We were not trying to turn out
scientists, we were trying to turn out physicians who [would maintain their
competence].

S: Physicians that keep up with the medical research and know how to read the
journals.

F: Exactly.

S: Does that program still exist?

F: It still exists. I have not been closely enough associated with it recently to
comment on it.

S: Let us go back and talk about Florida in 1965. Obviously Harrell was gone.
What was the medical community like here?

F: In the Health Center?

S: Yes.

F: Sam Martin was heading up the program here. Dick Schmidt was chairman [of
medicine]. Schmidt was a neurologist, [but neurology] and medicine were all
one department at that time. That was before they split. We had maybe a dozen
members of the faculty in the department of medicine. Each Monday morning
the faculty [of our department] would come together in a conference room and
we would talk about things that were germane to [our] academic [mission]. I do
not remember how many medical students we had, it could not have been over
sixty, and we got to know the students. A side point just to give a feeling for
the number of faculty in the college of medicine for several years either Edward
Woodward [chief of surgery] or Bill Enneking [chief of orthopedics] would throw a
party at their home and invite all the faculty at the college of medicine and we
would all be there. You cannot house the whole faculty of [even] one of the
departments now.

S: It has grown so much. It was a lot smaller. Do you think of that as being a plus
in a sense that people communicate more?









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F: Yes, I think [we] communicated with people [from more] departments, more
broadly-based.

S: It was more people-interactive than.

F: [People] reacted across departments.

S: I know that Harrell, when he was recruiting, really tried to get young people who
were rising stars. What was your impression of the general quality of the
faculty?

F: Good.

S: You really were excited about your time at Harvard, was it as exciting here?

F: It was a very different environment. The excitement down here was in
developing a new program. The excitement up in Harvard was [in] a program
that was well-established.

S: It had all the research. What were the facilities like? By the time you were here
the hospital had opened and many of the buildings had been built.

F: We had the basic hospital unit which of course is now [a] wing. That was there
and the facilities were very comparable, [it was] nicer than the facilities up in
Harvard since they were new. I had laboratory space which was carved out in
the basement and the endocrine division was more or less located in one area.
Billy Thomas had the office which I now have, we had Ted Bird, Joseph Ship and
Gerhard Freund and I guess that was our group at that point. Thomas certainly
was very competent, a gentleman and a very good clinician and endocrinologist
with a research interest, he set a pace for the [division]. Ship was here for a
number of years, having come from [the] Brigham [and] developed a program in
diabetes. He was very ambitious and he moved on. The space I ended up in
was shared with Gerhard Freund down in the basement, [and] after a while
Freund moved out and across [to] the VA [Veteran's Administration Hospital]
[and] got his space there. We utilized the space in the basement where there
were few interruptions along the way.

S: After time you were focusing more on biochemistry and less on endocrinology.
Did you physically move out of the lab?

F: No, endocrinology was my clinical interest, my scientific interest with the lipids
fitted within endocrinology. My original grant when I came down here was
actually an extension of the work I had done as my Ph.D. thesis. I [recently] had
an occasion to look back for some reason, [and saw] the grant had funded me for









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a research technician and equipment to set up a laboratory, centrifuges and all
that stuff. The first year included all of that with $16,000.

S: Did the university take overhead at that point?

F: Yes, and my salary was all paid by the university and we understood very clearly
at that point that the responsibilities of a faculty member included research and
that was part of [the] salary. I never quite got over that philosophy.

S: The University should be paying the salary part of it? That it should not be
coming out of your grant money then?

F: The grants should fund the research, the technicians and so forth, but your role
as a professor in the department included your scientific work.

S: Did they have expectations for how much you should publish every year?

F: [You were] certainly supposed to be productive. Often the laboratory was moving
along and at a certain point a young Ph.D. [candidate came] in, and [was] given a
part of a project he thought was to be his thesis. When I went into Gurin's
laboratory, Sam sat down and we talked about research and he said, go figure
out what you want to do and come back and talk to me in three weeks. I went out
and fussed around, read the literature and tried a few experiments and came
back. We talked and he told me that was very good. He sent me off on three
different tracks, I spent a year before I got started with the thesis, but it was
excellent training. When I came down here I was carrying on some of the work
that I did there [at Penn], but the real interest that I had was in lipoprotein
structure. I came down in 1965 and the first paper I finally published was in
1971. [If] you [saw] that sort of thing now, the roof would fall in, but it is a good
paper and [my work] progressed very nicely and so forth. It took that long to
really get a project defined from scratch. When I was doing my Florida State
Board [exams] I had to go down to Miami and spend several days there taking
exams for the boards. During the afternoons I would sit out on the deck of the
old Deauville Hotel and contemplate research. [I] read up [on] genetic disorders,
and that seemed like a reasonable [place where] I would be able to find some
structural differences in lipoproteins depending on what the genetics were. [I]
formulated [my] hypothesis, went into the laboratory and it worked out very nicely
but it took five years to get that study to the point of [writing] the first paper. The
academic career has changed [since] I got into it.

S: The expectations and the amount of the grants has changed. Was it easier or
harder to get grants then?

F: I think it was easier, there was [relatively] more money around. Grants were









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small and they [could be funded].

S: Were there fewer people competing for them as well?

F: I think so. How many graduate students does a laboratory turn out in a lifetime?

S: It usually seems like there are [between one and] four or so in a lab at any given
time.

F: And over a career of thirty years? We have populated the world with Ph.D.s.

S: There is just a lot more competition.

F: I [trained] three Ph.D.s [and] I felt I had done my share.

S: How many people did you tend to have in your lab at any given time?

F: It varied from one technician to four or five people depending on what phase of
the work was [going on].

S: When you started out with your research, you were characterizing the
lipoproteins?

F: Basically.

S: Did that involve sequencing the protein or more along the lines of figuring out
things?

F: No, [ours were] hydrodynamic studies [using the] ultra-centrifuge. [We were]
characterizing different classes of lipoproteins and how they related to each
other. Once we have them physically characterized, the next question [that]
came [was] how these [lipoproteins] are related, if at all. Just summarizing the
career briefly, [it] was first characterizing lipoproteins and [then] looking at their
metabolic relationships.

S: In the first paper that you published, was it about the metabolic research?

F: No, that was on the physical characteristics. Physical characterization was my
major thrust well into the 1980s.

S: When you started, were you designing the protocol and the procedures for doing
that as well?

F: Yes, we started from scratch.









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S: Creating the new procedures takes all the time. Then, once you have it down, it
gets easier.

F: You had to [recruit] patients who you are going to work with as subjects.

S: What sort of patients would you choose? Were these people that had
cardiovascular problems?

F: There were patients with high cholesterol and triglycerides. When we started
this fractionation in lipoprotein [was just being perfected].

S: So there were no HDLs?

F: We were beginning to understand HDLs [high-density lipoprotein], LDLs [low-
density lipoprotein], and VLDLs [very low-density lipoprotein] [as lipoprotein
families], but then when you talk about the protein components, the apoproteins
were not characterized at that time. I got my first grant in 1966 and my last
grant terminated in the year 1996. [I had] continual funding throughout that
period. I take some satisfaction in that.

S: I would like to talk a little bit more about your research and research at the
university in general. I know that is sort of an interest of yours the research
creativity at universities or institutions. We can talk about the quality but also the
creativity of their research. Would you say there was a creative faculty when
you first came here?

F: Yes, we had a very productive and distinguished faculty. As part of the
heritage of this institution, while you still have some old-timers around, [it would
be good] to get a record of what major contributions were made as a result of the
work of the faculty in this institution. I think the institution has to be measured in
terms of its teaching and the medical students who go out into practice, though it
is very hard to actually measure the quality of the work that they are doing. If I
look at some of my colleagues from [my] Peter Bent Brigham days, some of them
have made a name for themselves, [but] surprisingly not that many, which is a
little disappointing. We talk about the productivity of an institution in terms of its
teaching programs and service, whatever that includes, but really you measure a
institution by the quantity of the science. If you are going to do a history of this
institution, I think a major part of it ought to be the quality of the science that was
done here over the last fifty years in terms of what really caused major
paradigms and paradigm shifts.

S: Do you have a sense of that yourself? Were there periods when there were
different levels of creativity or anything like that? Can you tell me whose









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research you think was most important?

F: No, I cannot sit down and just tell you that off the top of my head. I think that
would be something that would take some time and [effort of] people pulled
together. That would be a significant effort, but I think it is probably the most
important part of the whole school. If I were going to write [the] archives of an
institution it would be [focused on] the creativity of that institution. There have
been periods where we focused more on the scientific productivity of the
institution, periods where the administration moved away from that area, and
science was played down. We have had some very bleak years where those
who were running the institution had [little] interest in science. The thrust of the
institution was in the direction of clinical work, [and] we turned to Tallahassee for
support. [Although] we have a big clinical enterprise here, one can argue
legitimately [about] whether or not we have lost sight of some of our mission here
by becoming so heavily involved clinically and competitively clinically involved,
that has been the thrust of this institution. If our purpose was defined in more
traditional academic terms, from the standpoint of teaching medical students,
house officers, and academic scholarly achievement. That could have been a
thrust here, [and] we would not have been caught up in the current dilemma that
we are facing [in] trying to maintain an institution because of the tightness of
funding. We would be outside of that. We could affiliate with places like [the]
Mayo [Clinic in] Jacksonville, and other institutions and help them develop the
super-specialities where we could send our graduates. That would have been a
completely different [focus], and I think it would have taken us along a different
path, and it would have taken us out of the pressures that we are in now, where
we are building faculty to go out and earn dollars in order to keep this [institution
a leading specialty medical center]. We would not have had to do that.

S: At what points are you saying that the different administrations focused more or
less on the research? Can you identify the administrations that set it in the
direction it is going now, or was it headed more towards research at one point
and then permanently reduced?

F: Yes, it was an academic institution, initially, that was certainly Harrell's goal, that
was Martin's direction. Who followed Martin?

S: Souter, was he after Harrell?

F: No, Martin was after Harrell, and then Souter. Souter was very interested in
education, and we had all sorts of educational experiments. I know we
developed the Phase A, Phase B, and Phase C programs. [I was heavily
involved in] the Phase A program [that incorporated the] concept [of] integrating
all aspects of basic science together. I must have spent hours working on that,
[and] those were hours that could have been spent in other areas too, but we









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were all involved in this. Parker Small was one of the leaders. The whole thing
evolved [but] we never could sell the faculty, and [after] a few years the whole
thing got blown away. One of the thrusts that I initiated at that time, [that] I take
credit for, was an effort to evaluate whether what we were doing was going to be
of any value. How do you know at the end of a period of time whether you have
accomplished anything? We persuaded Souter to approach the question of
[evaluating] the curriculum, the old curriculum, before we introduced the new
curriculum and [to evaluate both]. We consulted with several people in
education to ask [whether we could evaluate the results of the old and new
curriculum] and the consensus was that we do not want to do that.

S: It is the question of assessment which seems to be argued about still.

F: That is right, though I have not kept abreast of it. Once I heard that what we
were doing was carrying out a blind experiment, changing curricula, and in the
end we were not going to know whether we had done anything or not, I lost
interest, and from there on I have never been involved in the curriculum
[planning]. I would not waste my time on it. Over my lifetime, we have gone
through one curriculum to another and people get excited about a course. As
far as I can tell, the only thing that makes a difference in terms of type of output is
the quality of the teachers and the quality of the students.

S: What about the program or the philosophy?

F: The same thing carries over to our admissions policy now, we have an
admissions committee in which the members are very conscientious and they
search their souls about whether to take this type of student or that type of
student. Over the years we wanted students who were going to be scientists, we
wanted students who were going to be primary-care physicians and we wanted
students who were going to do this, and students who were going to do that. A
couple [of] years ago I proposed to the dean that we set up a trial here in which
we would divide our classes, [prior to] admission, and half of them we would
admit under this schedule and the other half we would admit on a statistical
basis. You would see them and make sure they [were acceptable and] did not
have two heads that sort of thing. Once you have screened them, [you would
admit those that were acceptable on a statistical basis], flip a coin. Then we
would follow the two halves through medical school [and] the internship [to] see if
there was a difference. My projection was [that] there would be no difference [in
the product], but I sure got a cold shoulder from administration when I proposed
that idea.

S: Did Harrell do that with the first year?


F: I do not know, I was not here.









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S: He accepted a lot of nontraditional students or those who did not have really
strong academic backgrounds, and then some who did, and it seemed like they
all did pretty much the same.

F: I have told you it still needs to be done.
S: At least on a larger scale, Harrell's experiment was small.

F: Can you imagine the amount of faculty time [that] would be saved in this
institution or any other institution if you could get rid of all of this foolishness with
admissions committees?

S: It would certainly be tremendous, but part of it does seem to me if you are trying
to assess a product, you have to have some consensus on what the product
should be. You have to decide whether you want primary-care physicians or
another type of doctor.

F: Yes, that is going to change, all you would be doing here in the setting I am
talking about is [that] for a given year you would admit students and then you
would measure [their achievements]. Both groups follow the same [curriculum].

S: You are saying that if the flip-a-coin group does as well, then that is how you can
admit.

F: Yes, [see if] their grades, their class average is the same and they get similar
internships and a certain number of them get into residencies and that is as far
as you can carry it. If they did the same all through those six years, what is the
difference?

S: Your admissions policy could be as you said, to have a basis for it with grades
and things like that, but then just flip a coin for the rest of them.

F: I could not talk them into it, maybe I ought to try and talk [Kenneth] Berns [Dean
of University of Florida Medical School] into that. He might be sufficiently
interested.

S: At least talk him into the experiment because it does seem to me, and I think this
is true of education in general, that you get these fads in education and then it
switches over to something else and they have never really decided whether the
first one was effective or not.

F: That is right.

S: With this at least you would have some sort of numbers at the end of it.









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F: We are wasting more time on these sort of things. Faculty time is valuable, what
Souter did when he took us all out of the laboratory and other things and put us
into changing the education was essentially to switch the thrust [of] the institution.


S: So that is when it happened?

F: That is when he thrust in that direction. The thrust in the patient care was really
[with] Will Deal. Will had no appreciation of any of the academic [or] scholarly
pursuits. When I came down here as a resident, as an assistant professor, Will
Deal was one of my first interns.

S: He came back then?

F: He came back as an assistant dean under [Chandler] Stetson. When Stetson
moved up to vice-president, Deal became acting dean and then became dean.
He got into some problems in his social life, left the institution and came back
again. The one thing he accomplished, he talked the legislature into building a
new hospital and that established his reputation. An administrator has to create
a legacy and many of them create legacies by building a building. His legacy
was the hospital and that established him and the thrust of the institution, from
there went in to delivery of clinical care.

S: There is the new genetics institute.

F: Yes, with Berns we began to reestablish an interest in scholarly activities.

S: He is an M.D. Ph.D. as well, so he does have a research background.

F: Yes, [he] still carries a laboratory. He was involved in the development of the
adeno-associated viruses as genetic [vectors]. We have begun to swing back.

S: As to what the focus should be? Institutions can make individual decisions but
you do need to have a significant number who are carrying on research
throughout the country. We talked about the characterization of lipoproteins and
then the metabolism, and that is basically where you were looking. You
discovered the variations in the proteins in different individuals who had different
genetic conditions. What was your work with the metabolism itself.?

F: We got involved [with] in-vivo human studies concerning the metabolic
conversions of lipoproteins from one to another. We introduced the idea that
you can take a radioactive tracer, leucine, and inject it into a [vein] and it would
be incorporated into apolipoprotein and then you define its metabolism. At the









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same time, a group up at NIH had begun taking proteins and labeling them with
radio-iodine and re-injecting them, [which] was an exogenous label and you
would follow what would happen there. The first patient we studied was an older
lady with profound myxedema. We talked amongst ourselves, [then] we talked
to her and she agreed and we got some radio-labeled leucine which was purified
for use in tissue [culture] work and we [injected] some into her arm, and drew
blood thereafter. [The] IRB [Institutional Review Board] [was unconcerned]. She
was the first study patient and then we followed that up with another patient who
was a diabetic. I went on a sabbatical in 1971 or 1972 up to NIH with Chris
Anfinsen, Anfinsen, you know, got the Nobel Prize. I spent a year doing protein
chemistry with him but I took this metabolic data with me, and he introduced me
to Mones Berman who was developing this concept [of] compartmental modeling.
Berman had my data and the data from the first study done with [radioionated]
lipoproteins [by Bilheimer and Levy], and using both sets of data we developed a
compartmental model of lipoprotein metabolism. Within the next two or three
years that became the standard approach to [representing] lipoprotein
[metabolism]. From there on I kept a close collaboration with Berman and, after
he died, with his colleague Loren Zeck.

S: Was that the paper that came out in 1975?

F: [Yes].

S: There was something in your bio-folder where they were talking about a 1975
paper that was really important for characterizing the metabolism, but maybe
they had the date wrong. They had presented it as the seminal paper, it was in
your bio-folder that they have up in the publicity office, it was a press release.
They have a folder on all the faculty so any time your name is mentioned in a
newspaper, they underline it and put it away.

F: I have never seen such a folder.

[End Side A2]

F: One of the interesting tidbits in the history of this institution which I would like to
see if you can confirm, though I have been told repeatedly, is that when the
College of Medicine medical-science building was being built, the architects had
decided that they were going to [mount the buildings on] pilings. They were
going to pay so much [per piling]. They did not realize that they were located
over a sinkhole, and when the builder came in and he drove the first piling, it
disappeared in a sinkhole, but he is getting paid so much per piling so he just
kept [driving] pilings [in], one right after the other.


S: And they just kept disappearing.









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F: I think they had to go to court and get an injunction to stop him from...

S: From continuing to just throw the pilings into the sinkhole.

F: I have heard that tale several times and as you talk to some of the old-timers
[you should ask them about it].

S: I will ask if anyone has heard about that.

F: Do you know Henry Hinkley?

S: No.

F: I do not know whether Henry is still living or not, but Henry Hinkley was the
person in the physical plant who headed up this institution, [the] building of it. [He
is] just a delightful gentleman, and you ought to find out if he is still living,
because he is certainly right at the upper age of it, and get an interview with him.


S: He would really know about the building?

F: That is right, all that stuff.

S: All the details about the facilities. I will certainly check with him.

F: If you find that story is corroborated, I would love to know because I have told it
several times tongue-in-cheek.

S: But you would like to know.

F: I would like to know whether I am telling a true story or not.

S: I was curious about your work with that patient who was diabetic. Why did you
select him? Was it because he would let you work with him?

F: No, he was one of those I screened initially and he had an LDL which separated
nicely into several different classes. If I wanted to find out about the metabotic
relationships of these, he was a perfect patient to work with.

S: Was that related to his diabetes or just some other aspect of his metabolism?

F: One of the things that came out of our early work was the demonstration that
LDL can be fractionated into different classes. I do not know whether you know









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this or not, but there is a lot of interest now in light LDL and heavy LDL. That all
came out of what we did, once we characterized the light component of LDL and
the heavy component of LDL. We did this in a small number of patients and that
was published along the way. Perhaps the paper you are talking about [that]
was published in Metabolism would summarize all the field at that time [1983].

S: I think that was probably it.
F: Up in Montreal, [Alan] Sniderman was following this up in a different direction, he
was looking at hyper-apo-B patients, [LDL] with high concentrations of apo-B
[and] low cholesterol [content]. He was relating these to coronary artery
disease. [Our findings were] picked up then at Berkeley and [Lawrence]
Livermore laboratory in [Berkeley, California]. The laboratory out there at
Berkeley invited me out to give a seminar, [and they] got interested in the work
and picked up and carried it from there.

S: You got involved also in various drugs, for treating people?

F: No, I never did any drug work.

S: In assessing their effectiveness?

F: With one exception, the first of the stations, Mevacor, we were interested in
patients with hypercholesterolemia and we posed the question of how the
metabolism of apo-B [would be] changed if you treated these patients with
Mevacor. We did that and we published a paper on the metabolic changes
associated with Mevacor in patients with hypercholesterolemia. That was the
only drug study we [did], we did do a study with fish oils in hypertriglyceridemic
patients. I think that probably is the most definitive study on the effects of fish
oils [on lipoprotein metabolism].

S: What were your findings?

F: Do not let us get into all that.

S: Are you sure?

F: Yes, you do not want to know.

S: I would be interested, and I am sure the person reading your history would be
interested as well.

F: Why do not we come back sometime and we will do that sort of thing. You get
me talking in that area and you will be here longer than you [planned].









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S: Your interests have been much more in research, but what are your senses
about the practice of medicine in general and whether that has changed, or how
that has changed?

F: Yes, it has changed very dramatically. If you go up to Saranac Lake, [to] the
Trudeau sanatorium, you will see a statue of Trudeau and under a quotation from
Trudeau, which is in French and I cannot do the French. The basic [idea] of it is,
the role of the physician to cure rarely, to alleviate suffering on occasion, to
comfort always. When I started out in medicine, what we did most often was
comfort, there were some disorders where we could affect the course of disease
and there were some we could cure. As medicine has changed over the years
we have increased the ability to cure, we have increased the ability to alleviate
suffering and we have less time for comforting. At the present time with the
pressures of funding, comforting has [faltered]. Some of the old-timers go in and
sit down and take a patient's hand and talk to them briefly I should not say
old-timers we certainly have a group of young house staff physicians who are
aware of this role, but it is difficult.

S: Is that because of time?

F: Sure.

S: Are there more demands on a physician's time in terms of the variety of things
that they have to do, or do you think they are forced to see more patients
because of insurance?

F: The technology involved in medicine at the present time is very demanding.
When you have a patient hooked up to a bunch of wires and [tubes], you are not
spending much time comforting the patient.

F: Leigh Cluff, do you know Leighton Cluff?

S: I am actually going to interview him on Friday.

F: Oh, are you? He gave grand rounds last week and his subject was "the lost art
of caring" that was the subject of last week's grand rounds. I am sure he will
talk about that. It is very right, we have lost the time to provide the sort of caring
we used to provide.

S: Now that physicians can cure, there is less of a focus on caring.

F: If we can cure them that is fine, you do not need worry about the caring if you
can cure them. You have got appendicitis or pneumonia we treat you, your
pneumonia [is cured], we do not need to care to you too much, but when you









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have [a problem] that is ongoing, [it is a different case].

S: Or if it is terminal.

F: Then you need to.

S: To what extent does insurance drive that?
F: I think economics is driving it, the insurance industry certainly is [the] prime
culprit in this area. Medicare is doing the same thing, Medicare is almost worse
than the insurance companies. [With] the reimbursement, Medicare is very poor.

S: Physicians have to see a lot of patients?

F: They are scurrying and scurrying.

S: This goes back to education and selecting students, is it possible to select
students for their ability to care for patients?

F: Of course, that has been one of the criteria, but when the medical student comes
in to an interview, they are especially interested in presenting that side of their
personality. I think the students attracted to medicine are generally caring. By
the time they have incurred a $100,000 debt for their medical education and they
have gone through all of the technical training and they see where medicine is
going in the future the technical aspects of it, you [do not have] time for it.

S: So you think they actually lose whatever desire to care they had?

F: I think they maintain it in principle, but the practice gets lost.

S: Let me just play devil's advocate, I majored in biology as an undergraduate and
the pre-meds were all so competitive. It seemed to me that process is so
competitive getting into medical school now that competitiveness was part of
what was being selected for rather than compassion.

F: Sure, I do not doubt about that. We selected for a group of individuals who
could do well on the scholastic aptitude tests, they were quick learners, they
could learn something [and] memorize it, they could retain it and they could hand
it back, and they can do well in an interview.

S: They are selecting for competitiveness, but you are also saying that at least the
caring side does get re-emphasized at some point in their career.

F: Very much so. In the interview process the competitiveness is not played up, it is
the ability to meet whatever criteria the interview committee decides they want









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our physicians to be.

S: I read at one point about a lipid clinic, had you started that?

F: No, Peter Stacpoole started it, he and I [worked] together but he was the one
who initiated it. Peter came and joined the institution in 1980 and his interest
when he came was twofold. One was in lactic acidosis and dicholoracetate and
the other was in lipid metabolism. We established a collaboration which was a
lot of fun and very productive over the years and [many of] the patients that [we]
had used in [our] studies, [we] had managed to glean from [the clinic].

S: You had a consistent group of patients then. Were you working with students in
that clinic?

F: Sure.

S: I know that at one point you won the research prize in clinical science. What
was involved in that or how was that assessed?

F: I do not know. I was not part of the committee that awarded it, but for many
years [the College] awarded two research prizes to the faculty. One was for
excellency in basic science and the other in clinical research. I guess they liked
what I did, I have been involved in clinical research for many years. [One
program that Dr. Stacpoole and I developed involved] students, during the first
year of biochemistry, [in] the CRC, doing [a] clinical experiment. You are aware
of that program?

S: Yes.

F: That was something that Peter and I developed. The first three to four years
that the program ran was pretty much under my direction, with Peter participating
very actively.

S: When did you retire?

F: Officially last October.

S: Were you still doing research up to that point?

F: No, I closed my laboratory in 1996. I closed it primarily for one major reason
and that is that I had been asked to do so much clinically that I found I was no
longer on top of what was going on. I discovered that the technician, whom I
had worked with for years and had a lot of confidence in, really was not turning
out quality work and I was not picking up on it.









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S: You were not there to supervise.

F: That is right. I had thirty years of funding with [NIH], it was time for someone
else to have the chance.

S: That brings up a point, you said they were giving you more and more clinical
work, so they had been increasing your clinical load. You had talked about this
shift away from the basic science toward the clinical work. Was that how it
impacted you? You were forced to do more work with patients?

F: Two things, I was acting division-chief for three years which took time, and then I
was also in a division which generates very little income. An endocrinologist
does not generate [much] income. Therefore, the direction of the division has to
go in [one of] two directions: either [faculty] have to see a lot of patients or else
they have to bring in a lot of grant money. We had an administration at that time
that was particularly interested in bringing in patient money, and I was pushed
[toward spending] more clinical time attending [on] wards and clinics and so forth.

S: What were you doing when you were seeing these patients?

F: It was internal medicine.

S: It was just the whole range of treatments, conditions, and things like that.

F: I have always had an interest in lipids and I guess I have been the person the
department turned to for the lipid areas.

S: Then you retired last year, but you said before the interview started, that you are
too busy to be retired. What are you doing now?

F: I come in here and participate in CRC activities and [I am] still a member of the
Advisory Committee, and review grants for them, various sorts of things. [I attend
grand rounds and conferences. But] the major part of my time is devoted at
home.

S: This is the conclusion of the interview with Waldo Fisher.


[End of Interview.]




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