Title: Dana LeRoy Shires, Jr.
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UFHC 49
Interviewee: Dr. Dana Leroy Shires, Jr.
Interviewer: Julian Pleasants
Date: December 18, 2001


P: This is Julian Pleasants and it's December 18, 2001. I'm in Tampa and I'm
talking with Dr. Dana Shires. Tell me when and where you were born.

S: I was born in Coral Gables, Florida on the 22nd of November, 1932. A native
Floridian.

P: Talk a little bit about your early schooling.

S: I don't know how early you want to go. During the war we moved back to
Virginia, part-time in Virginia, part-time in West Virginia where I went to grade
school. We moved back to Florida as soon as the war was over. I went to
high school in Jacksonville, Florida, at Lee High School. Then, unfortunately the
Korean War broke out so I had a detour, spent three years in the United States
Marine Corps. When I got out of the Marine Corps, I came back to the
University of Florida. It was 1954 and [I] started back in school and graduated in
1957 from undergraduate. Went to medical school in 1957 at Gainesville.
Graduated from medical school in 1961.

P: Let me ask you about your experiences in Korea. Where were you and what did
do?

S: I was stationed on a U.S. aircraft carrier. We had a marine aviation squadron on
the carrier and I was in that marine aviation unit.

P: Did you see much action?

S: No, just at sea. The airplanes saw action, but those of us that were on the
carrier didn't see any action in the sense that no one ever took a shot at us.

P: How long were you actually on board?

S: About a year.

P: How did that experience affect you?

S: It certainly gave me an insight into how fortunate Americans were, not only to be
Americans, but to have the opportunity that we had. I got the stimulus to go
back to school. Of course, the G.I. Bill helped.


P: Tremendously.









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S: It was wonderful. I made my decision to go back and go into medicine when I
was in the Marine Corps.

P: Had you had any courses in chemistry or biology?

S: In high school.

P: Did you have an early interest in medicine?

S: Yes. I had an uncle that was a physician.

P: Why did you choose the University of Florida?

S: Well, it was the least expensive, to start with, because we didn't have to pay that
huge out-of-state tuition which was a serious consideration.

P: Talk a little bit about the medical school when you first went in 1961. Obviously,
it had just opened.

S: I was in the second class.

P: What were the facilities like?

S: The hospital of course, what we now call Shands, wasn't there. The basic
science building was there, the library and the old basic science building.
Nothing there now looks like it did then. The first interview I had with the dean,
who was George Harrell, was up in one of the temporary buildings on campus
that were some of the same kind of buildings that were moved down from Camp
Blanding at the end of World War II, which were the Florida Veterans' Housing
where I lived. It was kind of interesting to see George in that situation.

P: Were there many vets in your medical school class?

S: I think over half, yes.

P: What was the curriculum like during the first year? Did they do courses for two
years and then clinical work for two years?

S: The first year, of course, was all basic sciences. We had biochemistry,
anatomy, and neuroanatomy, pharmacology, I think. Maybe it was in the
second year. I can't remember how they all flowed together. I know we had
pathology in the second year. We also had some exposure to patients, [but
they] really weren't patients. We went to different schools. I remember we
went over to P. K. Yonge and did interviews with students. We sort of got into









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the concept of having contact with other individuals where we were more or less
directing our attentions to their lives as opposed to our own lives. We had a
fabulous faculty. I've never seen such a collection of smart people. I guess you
have to give George Harrell credit for that.

P: One of the things I understand that he did is that he wanted to hire young people
who had great potential.

S: Yes, that's correct. [Of] all the chairmen of the departments, I don't think there
were any over thirty-five. That's amazing when you think about it.

P: How do you think he managed to persuade all of these talented people to come
to a medical school that wasn't even finished?

S: I'm not sure. You know that medical schools went through a real
metamorphosis about that period because [at] a lot of older medical schools, the
faculty were people in full-time clinical practice in the community. George didn't
want that, he wanted full-time faculty [who were] totally devoted to teaching one
hundred percent. He completely alienated a high percentage of the physicians
practicing in the Gainesville community by not granting them privileges at the
teaching hospital. They all thought they would have the privileges there and
they didn't get them.

P: I know the orthopedic surgeons had to help locally because apparently there
were not too many in the community.

S: I don't think there were any. I don't remember any in the community. We pretty
well knew the community physicians because there just weren't that many.

P: Most of them were general physicians.

S: Yes, most of them were what we now call primary-care physicians.

P: Isn't that what Harrell wanted? Didn't he want the faculty and medical students
to be general physicians first and then specialists later?

S: Yes. He sold that to the legislature. I'm not at all sure he ever had that intent.
The idea was when we first went there was [that] the program was going to have
us become primary-care physicians in the community as opposed to specialists.
That never happened. We were supposed to have a rotation outside the school,
an elective in which we went with a private practitioner and worked in his office.
That didn't go anywhere either.

P: He always liked to call his physicians humanists. Did you agree with that sort of









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attitude about training?

S: Absolutely, yes. I think we got one of the best medical educations in the world.

P: Did you have much opportunity to do clinical rounds?

S: Yes, [we had] a lot of opportunity to do that. They didn't have a lot of house staff
or residents. You generate those as you go, and there weren't very many. We,
as students, got a phenomenal clinical exposure.

P: More than you would have at a more well-established school?

S: Absolutely.

P: Who were some of the most important faculty members in terms of your training?

S: There were so many.

P: Jape Taylor for one.

S: Jape was [a] tremendous teacher and we were very good friends. Billy
Thomas, Jape Taylor. This is during medical school [that] I'm talking about. I
stayed on as a resident and fellow for a long time. [One of the] people, as a
student, that I remember and respected highly [was] Dr. Jearkewitz. I was his
student. He damn-near killed me, I worked so hard. I also was on the
orthopedic service. What was his name? First chairman [William Enneking] -
he was wonderful, [a] great teacher, still around.

P: Sam Martin was there.

S: I never cared for Sam Martin, to be very honest with you. I thought he was a big
stuffed-shirt and I haven't changed my opinion to this day.

P: Did you like Ed Woodward, who was chairman of surgery?

S: I did, I got along well with Ed. The only one I didn't get along well with was Sam
Martin. I didn't like him. I don't guess he liked me either.

P: Tom Marin.

S: Yes, I liked Tom. He was a good guy and a guy named Virgil Firm who was in
the department of anatomy. I worked for two years as a paid laboratory
assistant in his laboratory.









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P: Was this a referral hospital?

S: It was at that time. You could be admitted directly through the emergency room if
you truly were an emergency case.

P: When did you decide what your speciality was going to be?

S: I think right from the beginning I knew. I considered alternatives, but internal
medicine was always the subject that I liked best.

P: Who did you study with primarily?

S: Bill Thomas, as a student. Bill Thomas and Jape Taylor were my attending.

P: Could you describe a typical day for a medical student in your fourth year?
What sorts of experiences would you go through?

S: I can. We'd get to the hospital usually around 7:00 [A.M.]. Of course, there
was a lot of scut work that had to be done by the students. That was starting
IVs, hanging antibiotics, getting patients ready for surgery. Of course, if you
were on the surgical service, you went with them. Bill Enneking was the
orthopedic surgeon [that] I was trying to remember.

P: He was the one doing all the local work.

S: Then you had all these new patients to work up that were being admitted. You
were lucky if you got off by midnight.

P: How many nurses did you have and where did they come from?

S: I don't know where the nurses came from but we did have some very fine nurses.
Obviously, the nursing school was the same age as the medical school so they
weren't local.

P: What were the research facilities like in the beginning?

S: There was quite a lot of research going on and bright articulate young people
doing research. Of course in those days the NIH [National Institutes of Health]
was very easy to get support from. It wasn't hard to get a grant to study
practically anything if you wrote it up properly.

P: Where did your research interests lie?

S: My research interests almost always revolved around something to do with the









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way the kidney functioned. [I worked with] Bob Cade, who I studied under when
I finished my residency. I did a lot of research in his lab on dogs, studying tubular
function and so forth.

P: Why did you decide to take your internship and residency at the University of
Florida?

S: There were a lot of complex issues [for me] at that moment in time. My father
was dying. He lived in Jacksonville. He just wouldn't hear of my leaving, going
any further away than Gainesville. Jape Taylor made me a deal, I know it was
illegal. They had the matching program. He said if I would agree to list the
University of Florida [as number] one, they'd list me [as number] one so there
would be no issue about my not going there. We agreed to that. It was
obviously [a] verbal [agreement], but I knew you could trust him.

P: Normally, you put your requests down separately and you're not always sure
you're going to get your first choice.

S: Under the matching program, you make the list of who you would like to see:
one, two, three, four, and five. Of course the school lists [preferences], and the
computer figures out how everybody [did].

P: Were there other places you wanted to go?

S: I interviewed at Johns Hopkins, Duke University, the University of North Carolina,
and Emory University for internships. I considered all of those. The way life
goes, my dad died before I finished medical school, so in that sense of the word
it didn't have any impact. It was already decided.

P: Give me a typical day as an intern? Would that be much different from medical
school?

S: Not that much different than a senior medical student except you were a
physician, so you had more responsibility. The day usually started around
7:00-7:30 in the morning. You got off about midnight if you got off at all. We
were on thirty-six hours and off twelve. I slept in the hospital as an intern every
other night.

P: Did you feel like you got good supervision during this period of time?

S: We certainly got a tremendous amount of exposure to very, very sick patients.
The supervision or the teaching was excellent. The supervision wasn't anything
like what we would do today. Today, you couldn't do what we were able to do
then, attending would have to be far more attentive to what the house staff the









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residents and interns, are doing in today's world than they did then.

P: What makes a great teacher of medicine?

S: I think Jape Taylor is a classical example of a great teacher. He always focused
on getting the proper information and the proper evaluation and just was a
brilliant clinician was and still is I'm sure. I know he's retired now. Then there
was Smiley Hill. I know you know Smiley. Smiley and I were very close friends
when I was a student and a resident. Of course, he was single in those days.

P: I've heard people talk about Jape Taylor. There were a lot of people who feared
him because he was so demanding as a clinician.

S: You couldn't slack off on him. Jape was fair but he was quite demanding. He
certainly would let you know if he wasn't happy with your performance.

P: When I talked to him, one of the things he emphasized was that he really liked to
teach at the bedside.

S: He always taught at the bedside.

P: He thought that was by far the best way to help students understand.

S: Exactly, he always taught at the bedside.

P: So you had a lot of hands on experience with him?

S: Yes, I did.

P: When you look at the medical school now, can you give me some sense of its
importance in the university and the community?

S: I think that it clearly is a well-recognized school in the southeast.

P: Was it in the beginning?

S: Yes, it was. Right off from the beginning, because of the way they recruited
such outstanding people and the [quality of the] teaching. There weren't too
many men that went into academia in my class. I guess there were three or four
of us. I've had the opportunity of being at three different medical schools. I
spent seven years on the faculty at the University of Indiana. To me, there was
no comparison. There were two other of my class that were on the faculty at the
University of Indiana. Small world isn't it? One in pediatrics and another in
nephrology. We all agreed that it just didn't compare.









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P: That's pretty remarkable to start a medical school from scratch and achieve
academic respectability.

S: Right off the bat.

P: Did you have any women or African Americans in your class?

S: We had one young lady whose name was Anne Wall. She was at the reunion
this last fall and her name is now Anne Galindo. Her husband was a classmate
of mine. He's dead, I don't know what he died of. He was an anaesthesiologist
and so was she. She lives in Albuquerque, New Mexico now.

P: Did she get along all right in a group of males?

S: Oh God, she was tough. I have a great deal of respect for Anne. One girl in
[the] class. There were only thirty-eight of us, so it wasn't a big class. One girl,
thirty-seven guys. She got along very well. She managed to survive it. There
were times when I'm sure she wondered. Can I tell you a cute story? In those
days we took gross anatomy for a whole year. They've done away with that
idea a long time ago. One night a couple of guys snuck into the anatomy lab,
took the penis off of one of the cadavers, took it over and put it in the proper
position in her cadaver which was a female. She arrived the next day and
everybody is waiting. Anne pulled back [the cover]. They covered them with a
cloth at night and we were not supposed to be disrespectful in any way, but you
get a little disrespectful, I guess, after a while. She looked and she said -
everybody is waiting for some comment she said, I see that one of you guys
left in a hurry last night. [Laughter] I thought, what a great comment.

P: I think she won that contest.

S: I always thought that was one of the classiest remarks I ever heard.

P: Where did you get your cadavers?

S: There was a law, and I think it still exists in the state of Florida, that people can
leave their bodies through the Anatomical Gift Act and then they have no funeral
expenses. A lot of these bodies I think came from coroner's offices where they
didn't perform autopsies. They couldn't be autopsied that was the point.
They had to be intact.

P: What did you emphasize, other than your internal medicine, as a resident? You
are a fellow as well, were you not?

S: I had three different positions. I went through the residency program, then I was









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the chief resident in medicine, then I was the first graduate of the University of
Florida to be chief resident in medicine. I'm proud of that. Then I went on into
fellowship in nephrology.

P: Talk about your time as chief resident. That's a lot of responsibility for a young
doctor.

S: It is, it was a lot more responsibility even then than it is now. You never saw an
attending in medicine after 5:00 [P.M.]. They went home. All patient care fell to
this house staff. You're chief resident for one solid year and you don't have any
alternatives. There are not two of you. There are now I think, in Gainesville,
but then there was only one. I would make rounds every night at 11:00. I'd go
see every patient. I'd go up to the medicine floor, grab a nurse, whoever it was
and say, let's go see the patients. We'd see every patient, see how they were
doing. If I wasn't happy with the care or where they were, I would call the intern
or resident, wherever he was and say, I want you to come over here and take
care of this now.

P: If there were major problems, would you call the attending?

S: I never called the attending. No, I don't think I ever called the attending.

P: How do you learn to deal with the both psychological and physical demands of
working thirty-six hours at a time and dealing with life and death?

S: It's hard. It was very demanding, very demanding. You just suck it up and do
it.

P: Not everybody can do that.

S: That's true. A lot of folks went into less demanding areas, [such as]
dermatology, anaesthesiology, things like that, psychiatry.

P: Some people much prefer circumstances where they're dealing with life and
death where there is some drama and challenge and they tend to function better.
Were you one of those?

S: I enjoyed it. It's the same thing that made me join the Marine Corps. I didn't
join the Army or the Navy.

P: You had to want to be a Marine, right?

S: You do. Believe me, when you get to Paris Island you better want to be one.









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P: You probably wonder at that point why you wanted to be one.
S: I never did and I have had two sons that have both been in the Marine Corps.

P: Talk about some of the more interesting cases or patients you dealt with.
Everybody I talked to always has three or four extraordinary cases.

S: I guess the most extraordinary cases, I remembered their names very well. This
was after I was a fellow in nephrology. I was a fellow there in my second year.
I was there forever. These were people who both, by the way, presented with
the same syndrome which was called Good Pastures syndrome. Good
Pastures syndrome is a combination of rapidly progressive renal failure
associated with pulmonary hemorrhage. They get massive hemorrhages in their
lungs. They always come jointly when you see it. It was described by the
chairman of the department of pathology at the Vanderbilt University during the
flu epidemic the World War I flu epidemic, 1917-1918. We still don't know
what causes it. I've published on this quite a lot. I've got a bunch of
publications on pulmonary hemorrhage. The only thing we could do was to
dialyze these folks, put them on dialysis and try to [help them]. But we mostly
lost them when we saw them. They died, and they usually died very quickly.
Jerri Blackwelder who was a darling little girl, maybe twenty-two. She had two
darling little girls of her own, lived in Orlando. They shipped her up as an
emergency. We recognized right away that her lungs were filling up with blood
and she was on a respirator. Her kidneys were not functioning. We dialyzed
her and I said, we can't take her lungs out because we have no replacement.
Why don't we take her kidneys out surgically and see if she gets better, because
there's a relationship here between the lungs and the kidney. We've got nothing
to lose. It's amazing [that] you could do something like that in those days [it
had] never been done before. We took her as an emergency to surgery and
took her kidneys out. Immediately her pulmonary hemorrhage stopped. We did
a second one. These are the two most interesting patients.

P: You didn't ever know why that happened?

S: We knew that it happened. It's been documented many, many times since. So
we took the kidneys out, she quit bleeding and she recovered. We transplanted
her and she lived for a long time. She died. She got septic and died after I had
gone to Indiana. The other was a guy named Buddy Perron [who] had the
same syndrome. She came first and he came second. He wasn't nearly as
difficult to recognize we thought we could do this and we did. Of course, he
quit bleeding too. Buddy was a member of the mafia from Orlando. When he
finally got healthy enough that he could talk, he listed himself as an unemployed
used-car salesman. He wore all this jewelry. He and I got to be very close
because I took care of him. He rented an apartment in the same building that I
lived in. When he came back to Gainesville from Orlando for his clinics, he









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could just stay close by. You knew, even though he claimed to be unemployed.
His wife was clearly a showgirl from Vegas, [a] beautiful woman. Of course,
later on he told me what he did. I didn't know. I didn't push him. When we did
surgery on him, he had two bodyguards who were armed that sat outside his
room. He'd walk into the clinic and say, here's $10,000. I want you to take it
and do something good with it. I know that your program needs it. I [would
say,] Buddy, I don't know what to do with $10,000 in cash. He said, you'll find
out some way. You can take care of it. He was just that kind of guy. He lived
for quite a long time after he was transplanted. I've forgotten. These guys all
died after I left. I remember Bob Cade telling me that they went to his funeral in
Orlando and the FBI [Federal Bureau of Investigation] was photographing
everybody there.

P: Did you have much of a transplant unit at that time?

S: [We] started it. Bill Pfaff and I did the first kidney transplant together. I was
the internist and the dialyzer and the medication man and he was the surgeon.
First one that was done in the state [of Florida]. That was 1966.

P: Did you have also a dialysis unit at that time?

S: Yes, in the emergency room at Shands. We actually borrowed a room from the
emergency area. We had two machines in there. That's one of them right
there.

P: It does look pretty crude.

S: It's pretty archaic.

P: Did you have enough money to keep up, technologically, with what was going
on?

S: There wasn't much to buy. They were pretty simple machines and they were
pretty inexpensive. The cost of the filters and so forth was expensive. I don't
really know how we managed to get by. Of course, in 1966 the government
didn't fund anything. It was 1972 that [Richard] Nixon [U.S. President,
1969-1974] signed the law that assigned renal failure patients to Medicare
coverage. I don't know how we paid for it, it was always hook and crook. Some
of them had major medical. You know how it goes.

P: When you treat patients, do you always try to use the holistic approach?

S: I think so. For example, here at Life Link, we have our own full-time chaplain
here in our building. We have our own full time Ph.D. clinical psychologist, who









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trained at Gainesville, by the way. She's a lot younger than you and me but
she's a good lady. We have always [used that approach] in our practice. We
take care of 5,000 transplant patients here right now.
P: All those all kidney patients?

S: No, we do hearts, livers, kidneys, pancreas, and lung. All the surgeons that do
all that are here in this Life Link program. We have twenty-some-odd
physicians.

P: I've heard doctors tell me that patients will tell their doctor, particularly when
they're in extremis, things they probably wouldn't tell anybody else in the world.
Why do you think that is?

S: There's a bonding that occurs between physician and patient that's a lifetime sort
of situation.

P: Did you ever have any courses in ethics?

S: Yes, yes we had a course in ethics in med school.

P: How do you feel about all of these new moral issues that are confronting the
medical society, such as death with dignity?

S: Death with dignity I totally and completely support. I think physician-assisted
suicide would be just fine. In fact, we've been practicing that for years, but not
formally.

P: That's neither a moral or an ethical question for you?

S: Not for me. I'm very pro-choice. I guess you're gathering I may be a rather
liberal physician. I'm pro-choice.

P: Do you know if physicians at Shands Hospital performed abortions during that
time?

S: No, we didn't that I know of. We didn't do abortions then. They were illegal.

P: What do you think about cloning?

S: There's no way you can legislate scientific advancement. You've got to be on
the cutting edge so I think the pursuit of understanding [is important]. What
we're talking about with cloning is not making another individual at this moment in
time. We're talking about cloning in a sense to produce stem cells at a very
early point in their development where we might use that to replenish a









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population of cells that are otherwise lacking in a sick individual. It's pertinent, I
have a son who's just visited me who is a Ph.D. from Yale, I'm happy to say. An
immunologist at Guys Hospital in London. He just left yesterday. It's going to
happen. You can't bury your head in the sand. I don't have any problems with
it.
P: What do you think of President George Bush's [U.S. President, 2001-present]
response to this stem-cell research and making a certain amount of these cells
available?

S: I think it's short-sighted, very short-sighted.

P: Would most medical practitioners disagree with him on that?

S: I think so, but I don't speak for them. I only speak for myself.

P: Let me go back and talk a little bit about your relationship with Cade. He talks
about the development of Gatorade. He talks about his former football player, a
security guard who was talking about the football players.

S: That was me, not him. That was Dwayne Douglas. Dwayne and I had
become friends for years before that happened.

P: He has retold your story then.

S: He would tell you, if you pushed him, that it was not him. He didn't even know
Dwayne Douglas. Dwayne and I were having lunch in the Shands cafeteria
and he said to me, we have had this problem of dehydration. There's a part of
this that's easy to understand. I played football in Florida in high school. I knew
what it was like to have to abstain from liquids and play hard. Dwayne was chief
of security at Shands but he also coached the freshman football team. We had
known each other for years, we were having lunch together. It was 1965. He
said, we had a terrible problem with dehydration. This is your field, not mine. I'm
a coach. Why don't you guys come over and take a look at our problem and see
if you can make some suggestions. I said, before we could do that, we'd
probably have to have some idea of what the problem is because I don't know. I
know they're not getting access to proper fluids. He said, if you would be willing
to do that, I'll set up an appointment with Ray Graves. I said, fine, but I'll have
to talk to Bob Cade because he's my boss. I talked to Bob, [who] said, sure,
let's go talk to Coach Graves. Bob never played football in his life or had any
idea what this was all about. He's also a very bright person that's why I said
you have to check his story out because it does tend to change. All this is in
deposition, so it's not a matter of argument. Anyway, Bob and I went up with
Dwayne Douglas and Coach Graves and he said, yes, I recognize we have a









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problem. No, you can't touch the varsity, but we'll let you do anything you want
to with the freshman football team.

P: The problem was the loss of so many pounds through perspiring.

S: Yes, some of them would lose up to twenty pounds.

P: They didn't urinate at all.

S: They had nothing to pee out. They really didn't urinate. You never saw a
player hold up his hand and run off the field to pee. So that's how we got
started. We were allowed to study the freshman football team to get some ideas
and we did. We measured their fluid loses and the different changes in body
spaces. We measured the content of the sweat sodium and potassium
chloride, things like that.

P: Protein, phosphate.

S: There is no protein loss to speak of, but there is some phosphate loss. Well, we
studied all that. As luck would have it, Bob and I had been to the physiology
meetings in Atlantic City some months before and had gone to hear a lecture
given by one of our former residents at Gainesville who was currently in the
university in Boston, working with Dr. Englefinger who was a renowned
gastroenterologist. Sid had done some studies in which he used the triple
lumen tube and he measured the emptying of the stomach and the transport of
fluids within the small bowel and he came up with the basic formula that we used
in Gatorade. He came up with the idea that water is never actively transported
in the body, which we already knew. Water follows a concentration gradient. If
you have a higher concentration of salt over here as opposed to over here, water
will cross the membrane. Anyway, what Sid had studied and shown, we put
sodium and glucose and water together with a little potassium and that was it.
That was it. That's basically where we are today with Gatorade. It hasn't
changed dramatically since then.

P: Part of the problem was that they would not let them drink liquids during the
games.

S: They had an idea that was still there when I played football. If you drank water
while you were in this heat environment and exercising, it would cause you to
have bad stomach cramps. I don't know who came up with that idea. You
probably remember if you were a Boy Scout, when you went to Boy Scout camp,
you couldn't go swimming after lunch for two hours because you were going to
get cramps. Well, that's bullshit. You never hear that now, do you?









UFHC 49
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P: That was a pretty rigid rule.

S: Oh, it was. It was two hours [that] you couldn't go in the water. Of course, it
had no basis in science. Athletic people are very, very superstitious about
things. Sometimes I hate to say it but sometimes rather uninformed.

P: Part of the problem and I'm not sure how to explain this there's a lot of sodium.
If your sodium content goes up, you can get confused.

S: Yes, their serum sodiums were going way up. Normal serum sodium is 140
millequivelents per liter. These guys were going up to 160, some of them,
because they were losing more water than they were salt. Sweat always has
less salt in it than it has water, compared to plasma, compared to your
bloodstream. They were losing more water than they were salt. Their salt was
going way up and their glucose was going way down. They were burning that
up, then they would switch to fats. It was fascinating stuff their lipids were
high, their glucoses were low, their sodiums were high.

P: If your sugar content goes down, it affects your mind as well. You've got low
sugar, high salt. You'd throw an interception pretty easily.

S: These guys, there's no question that they were playing under the most adverse
conditions, in terms of their human physiology. It's amazing.

P: Apparently, Coach Graves understood a little bit of what you were doing and
ultimately allowed you [to experiment on the team].

S: Coach Graves didn't even know what we were doing.

P: He knew the results.

S: I've got to tell you this, Julian, we gave Gatorade to the varsity on October 10,
1965. In the first football game that the varsity used it, that was against LSU
[Louisiana State University], I was on the bench passing it out. Graves didn't
even know because when we said to the manager, whose name was Jim
Cunningham, we said, we've got to talk to Coach Graves. He said, no, we're
going to give it to them. It's going to be hot and ugly and LSU is a good football
team. We're just going to give it to them. Graves won't even know. I swear
he said that. We gave it to them and Graves never knew what we were doing.
He's still concentrating on the game. You know, you see those guys on the
sidelines. He wasn't paying a damn bit of attention to what we were doing back
there on the bench, which was sitting down by every player when they came out
and said, here, drink this, drink this.









UFHC 49
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P: At first some of them didn't like the way it tasted.

S: There have been all [those] rumors, they didn't like the way it tasted, they poured
it over their heads. Let me tell you something, they were damn glad to get it
because it was awful hot that afternoon.

P: Is it true that they performed much better in the second half, had more stamina?

S: Oh yes, there's no question. That's not proven. How could you prove that? It
was our observation that they did. They went on to have a fine football season.
Of course, Graves was later on told what we were doing and he said, okay. It
obviously didn't hurt us and it's great.

P: Where were you making this up?

S: In the laboratory at Shands.

P: Did you just put it in milk bottles, what did you use?

S: We actually put it in milk cartons because we could take it over to the dairy farm.
The university had that dairy farm division. I don't know if they still do. I bet
they do. They could put it in little milk cartons for us. Everybody wanted to help
the team so they didn't charge us for doing that.

P: Where did you get your glucose?

S: We bought it. It wasn't very expensive because there wasn't that much in it.
Bob said in one interview that I saw recently that it cost $40 for the ingredients. I
don't know what he meant by that. If he meant that was for one game, or [what].
It did cost some money, I don't remember how much and I truly don't know how
we paid for it. I can't remember.

P: A lot of this has to do with electrolytes.

S: Everything is cheap that went into it. There's nothing expensive. I guess the
most expensive thing would be the glucose.

P: If your electrolyte balance gets out of whack, that's going to affect anybody's
performance. Leave alone, football players on a hot afternoon. It's just
compounded. Who decided on the name, Gatorade?

S: Actually Jim Free, who is a retired nephrologist who lives in Clearwater, one of
my closest friends, Jim and I were classmates in medical school together. Jim









UFHC 49
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came up with the [word] Gatoraid. We were told that you couldn't use that
because the FDA [Food and Drug Administration] prohibited that. That would
classify it as something other than a cola or soft drink, so we changed it to ade.

P: When did you set up Gatorade, Incorporated?
S: We used it into 1965. We sort of dropped it. We were comfortable [that] we'd
proven our point. We had the expense of making it and time and so forth and
we had our other projects going on. We didn't make it for the university at the
start of the 1966 season. I guess after the first week of practice, Coach Graves
said, get that stuff regardless of what it costs us. So the second year Graves
paid for it, or the Athletic Department paid for the production of it. After that
year, which was the Heisman Trophy [college football award] year for Steve
[Spurrier] [University of Florida football quarterback, 1964-1966; head coach,
University of Florida football team, 1990-2002], it got a lot of attention. People
were literally asking, what the hell are the Gators doing drinking milk on the
sidelines during the game? Nobody would ever drink milk at peak exercise.
Curiosity got going. We had numbers of inquiries from different athletic
departments, [from] coaches, etc. etc. about how they might get the product.
The next step that we went to was go to the university. We went to see Dr. Lee.
I don't remember his first name, but he was what now would be [called] the
director of sponsored research. We said, we have this product, we have a
substantial interest outside of the university in obtaining the product, could we
work something with you guys so that we could produce it? He said, no, we are
not in the soft-drink business and we don't have any interest in that. That was
that, as far as we were concerned. Coca-Cola got in touch with us, a variety of
different people. This company Stokley Van Camp which was in Indianapolis,
Indiana, had observed it because they were originally from Tennessee. In fact,
at the University of Tennessee in Chattanooga, the field house there where they
played basketball games was the Stokley field house. It had all come from down
there in Tennessee. One of the Stokleys was there and saw the Gator
basketball team drinking this product and he asked what it was. They said, well,
it's Gatorade. Then he got in touch to see whether there was a possibility that
they might be interested in making it. [End of side 1, tape A]

P: At what point did Stokley decide that they would make a contract with you?

S: It was, I believe, in May of 1967.

P: What did that entail?

S: What we actually did was set up a trust which we still have, the Gatorade trust,
and all of those of us that were the inventors, the four of us, signed over all our
rights to the trust in return for so many shares of the trust. We worked out a
contract with Stokley for them to pay us a royalty based on sales, which is still in









UFHC 49
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effect.

P: At that time, you had probably no idea that they would sell so much Gatorade.

S: We had no idea that they would sell what they've sold. No idea at all.
P: When you did that trust, was everybody equal?

S: Yes.

P: Cade could probably have taken a higher percentage.

S: No, I don't think he could have because it was not really Bob that was doing all
this work. Bob is a terrible businessman. It wasn't Bob that was going and
visiting and promoting and meeting with the attorneys and so forth. Bob didn't
want to do it. He said, we ought to found our own company. I remember telling
him, Bob we don't have the talent, we don't have the time, we don't have the
fiscal wherewithal to found a company to compete, because anybody can make
this stuff. It's no mystery how you make it. We had quite a lot of arguments
with Bob about whether or not we should sign a contact. The three of us that
were left literally voted him down and said, we're going to do this.

P: Did you have a formula, what exactly did you sell to Stokely Van Camp?

S: We sold them the name and the formula. We also signed a contract that we
would support them in terms of our knowledge in their promotion and sales. We
understood how it worked and they didn't. We did that. I was the number one
[person] that went and traveled. I went to the University of Indiana and took a
position there on the faculty so I could be right next to Stokley.

P: Were you involved in all the different flavors and that sort of thing?

S: Well, we didn't have but two flavors then. We had orange and lemon-lime.
There are twenty-six some-odd flavors now. That's all come in recent years.
You know the funny part is the lemon-lime, which is the product we developed,
still accounts for more than half of all sales.

P: That's still the number-one flavor.

S: Still [accounts for] more than half [of current sales]. All the rest are less.

P: Did you have anything to do with the development of this drink, Go?


S: Yes.









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P: What was the origin of that?

S: That was right after Gatorade. Bob thought we ought to have something. That
was a high-energy drink that he wanted, that he thought we should develop. It
wasn't complicated. It was just taking chocolate milk and putting more protein in
it protein and carbohydrate. We actually set up a Go trust in Indiana and
Stokley paid us some kind of a fee to have the exclusive rights for some period of
time, but they never did develop it.

P: Talk about the fact that once this got started, once Stokley began producing
Gatorade, then all of a sudden, now the University is in the soft-drink business.

S: Right. They liked to think they were.

P: The argument was that the research had been done on University time, therefore
they originally wanted to get control of all of it, did they not?

S: Oh yes, they wanted it all. They were in a very awkward position because they
had refused it officially. That was number one. Number two, they weren't very
smart. That's just fair. You work there, I don't, but I love this place. They
didn't realize that all of us, including Bob Cade, were fully funded from the NIH.
We weren't getting any money from the University. None of us. That's how
they got at us, is they went to the NIH. They said, these guys didn't ask your
permission to market it, they did [ask] ours. The NIH was really our primary foe.
It wasn't the university, although the university was trying to manipulate us
through the NIH. Anyway, we filed a lawsuit against the NIH in Indianapolis in
federal court. That was the court that settled on the 80-20 percent division
which I signed off on right away. I thought it was fine and fair.

P: The university gets twenty percent and the trust gets eighty percent.

S: Right and that's the way it is. We work together very well now.

P: It was in litigation quite a while, was it not?

S: I think about seven years.

P: That is a tremendous cost if you keep going with that kind of litigation. Lawyers
are expensive.

S: It was expensive, yes it was.

P: I think probably even at this point, nobody had any idea what twenty percent was
going to ultimately be worth. Do you have any idea what that twenty percent









UFHC 49
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over the years has amounted to?

S: No, but those figures are I'm sure available. I don't know. I can't
remember.

P: Can you give me a ballpark figure?
S: I've seen it somewhere quoted but I just can't remember it. It seems to me like
this last year, it was $7,000,000 in royalties, that the university had.

P: The figure I've seen was $26,000,000.

S: I think it's more than that, I'm pretty sure it's more than that.

P: The total for the last thirty years. That means that each of you would have
gotten the equivalent amount. That turned out to be a fairly good little
experiment didn't it?

S: Sure did.

P: Go never took off.

S: No, it never has.

P: Did you make any other attempts at other kinds of drinks?

S: Bob came up with another one. Bob has this ability to forget that he's got all
these signed documents saying that he won't develop another product in
competition or as a derivative of Gatorade, etc.. Back [in] about 1990, [Bob]
came up with another drink that he called TQ2, that's Thirst Quencher 2. He
formed a corporation and he was going to market this. Of course, you can
imagine that Quaker [Corporation] was having a seizure. He's got a contract
with us. Anyway, you probably know about that. We went to court and he lost.

P: That's been the end of that.

S: He had to sign it over to Quaker. Quaker got TQ2. Of course, they just bagged
it.

P: Talk about your career once you went to Indianapolis. You were an associate
professor of medicine at the University of Indiana. You were there seven years.
Then you come back to south Florida. Why did you decide to come to south
Florida?

S: The gentleman who was my direct superior there at the University of Indiana









UFHC 49
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came to the University of South Florida as chairman of the Department of
Medicine.

P: This was really sort of at the beginning of the South Florida Medical School,
right?

S: It was. I was on the initial faculty, the founding faculty here.

P: You were in the second class of Gainesville Medical School and the founding
faculty of South Florida so you've been on a lot of beginnings.

S: Yes, I have.

P: What was it like when the South Florida medical school got started?

S: It was fun. We had a wonderful time. We were sort of short-handed because
we didn't have nearly all the sub-specialities covered that we do today. I was
basically recruited to come here and start the transplant program. That was my
primary responsibility and I stayed with the University from 1972 to 1989 or 1988.
I left because I had started Life Link as an organ recovery program. It was
getting bigger and bigger and I needed either to stay at the University and devote
my time there or come and devote my time here. I decided this had much more
opportunity than the school did. I've never been sorry.

P: You started the transplant program there. Did that include all organ transplants?

S: Yes, we started with kidney, then we went to heart, then we went to liver, then we
went to pancreas.

P: What was the status of the technology at that time? Did you use heart-lung
machines and did you have a fairly decent success rate?

S: Um-hum. [Yes].

P: Did you use Jarvik later?

S: I can't tell you. We have three full-time cardio-thoracic surgeons here at Life
Link. I don't know what they do.

P: What about the new artificial heart?

S: We haven't had any experience with that. We have used the Jarvik. I'm
familiar with some of that. We brought in the guy from the University of
California [at] San Francisco. Wonderful man, he was the chief of their cardiac









UFHC 49
Page 22

transplant program there for ten years. He's now here with us full-time. His
name is Frazier Keith. We brought in two younger gentlemen, one from the
Cleveland Clinic and one from the University of Pittsburgh.

P: The Cleveland Clinic has a reputation of being one of the best, if not the best.
S: Pittsburgh also. They all came from great programs.

P: When you were chairman of nephrology, how did technology, particularly the
technology of dialysis, change over the years?

S: It has changed, there's no question about that. I don't know that I am an
authority on it. We have much better equipment now, much more sophisticated.
I'm not sure we're doing a hell of a lot better job with dialysis now than we were
twenty years ago, though. Mortality rate is still incredibly high in the first year.
Where we have truly made our advances in the care of sick patients with kidney
disease is in transplantation. We do two hundred kidney transplants a year
here.

P: What is the life expectancy, usually?

S: It's hard to answer that, Julian, I'll tell you why. Our one-year patient survival is
ninety-three percent with a functioning kidney. Those are mostly cadaveric
kidneys. So that's damn good in anybody's book, it's right at the top. We're not
using the same drugs we used three years ago. We're rapidly advancing in new
immuno-suppressive agents. It's hard to say [what the life expectancy is].

P: Has rejection of the organ always been a problem?

S: Rejection has always been the primary problem. We've really got rejection
pretty well treated. The problem is the side effects of some of the drugs that we
administer to avoid rejection have their own problems. We're constantly making
progress. [In] our liver program, we'll do about one hundred livers this year, our
survival rate there is also very good.

P: Talk a little bit about how you got the idea for Life Link.

S: It was real simple. We were doing all the kidney transplants at the time, that
was all we were doing. That was 1982, maybe 1980. I came in 1972. About
1979 or 1980, we were doing all the kidney transplants at Tampa General. We
were doing about forty a year. The first thing that happened was the surgeon
who had come with me was very unhappy with the workload that he had. That
was number one. [It] just didn't have an organization going and I was busy with
dialysis and teaching. He went to the administration and said, I think Dr. Shires
should take over as the director of organ transplantation at Tampa General.









UFHC 49
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They came to me, they said, would you be willing to do this? I said, yes, I'll do it
if that's what John wants. What we did is we set it up so our nephrology group,
the four of us, took care of the transplants. We admitted them, took care of
them. John put the kidney in and that was his total role. A couple years later,
the hospital came and said, we're just not getting enough tissue. We're not
getting enough organs. We need to reorganize the organ recovery effort.
Would you agree to direct that? I said, in my usual stupid way, yes, I'll do that.
I have one demand and that is you have to give me an assigned parking place in
the front of the hospital because I'm going to have to come and go a lot more
than I do now and I'm not going to fight for a parking place. That was not a hard
thing for them to agree to. That was the only thing they gave me. We got
started and we ran it under the hospital for a couple of years. In 1982, I decided
we need to get bigger and faster. What we found is [that] we were bound up
with all of the political crap that goes on at the county hospital. It wasn't different
than the university. So we took Life Link out with the blessing of both institutions
and set it up as a non-profit 501(c) foundation. That was 1982.

P: Where did you get the funding?

S: We borrowed money from the bank. The board all signed, joint and several.
We borrowed $100,000. This year, our budget is over $50,000,000.

P: How long have you been in this current building?

S: Just over two years. We built this building.

P: How many staff and medical personnel are there?

S: In Life Link we have just under four hundred employees.

P: How many of those are physicians?

S: Twenty-one or twenty-two.

P: Do most of them perform transplants?

S: They all have some role in the transplant effort.

P: You do the transplants at Tampa General?

S: All the transplants except for the children. We do the babies or the little ones
over at All Children's Hospital in St. Petersburg.


P: Where do you get your organs?









UFHC 49
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S: [From] Florida, Georgia and Puerto Rico. We do all the organ recovery in
Georgia, we do all the organ recovery in this area of Florida and we do all the
organ recovery in Puerto Rico.

P: Where do you get most of them, from accidents?
S: From young people primarily, who obviously meet an unexpected death. I just
did one hundred charts this afternoon. I have to sign off on all of them. There
were suicides, there was one guy had a subarachnoid hemorrhage. A lot of MI
[myocardial infarction]. A lot of different reasons. They all have to get to the
hospital in a viable state. You can't pick them up off the road.

P: They have to sign the proper papers, or the next of kin has to sign the papers.

S: Yes, you have to have family permission.

P: Tell me the process of harvesting an organ. Once you've harvested, what do
you do. Let's say you harvested new kidneys.

S: Usually we get two kidneys, a liver, and a heart.

P: You usually take all those, right?

S: A lot of times we get the pancreas as well as the lungs. We can get six or seven
organs out of a single individual.

P: What do you do with them, specifically?

S: We have the immunology tissue-typing lab, which is here in this building, where
we determine the genetic compatibility of that potential donor with all the people
that are waiting for these organs. First local, regional, and then national.

P: Do you have a waiting list?

S: There's a huge waiting list.

P: With what criteria are people listed on the waiting list?

S: There are a whole bunch of factors that are used to assign an individual where
they happen to show up on the list. Obviously if someone is critically ill, that's
first, to the extent that we can get that person done.


P: At some point if they're too ill, they are not operable.









UFHC 49
Page 25

S: If the surgeon says this is not a case I can do, we won't do it.

P: I was just thinking about when Mickey Mantle [professional baseball player]
needed a liver.

S: [In] Mickey Mantle's case, I knew the surgeons that did it. I can address that. I
think where they went wrong with that case, and it wasn't intentional, [was that]
he was very ill and he qualified to get that particular liver. When they opened
him up to remove his bad liver, it was cancerous. That's where they should
have stopped because it was spread beyond the liver.

P: They shouldn't have put in the new liver.

S: They should have put that liver in someone else and just sewed him back up.
That was a decision made at the table by the surgeon that did it.

P: Do people ever attempt to trade in body parts?

S: No.

P: It's pretty well-regulated, is it not?

S: It's totally regulated. All these little stories that you hear about people waking up
with the sutures in their side when they've been too drunk to know what
happened that's all bullshit.

P: You don't waylay any people.

S: That's not true. The one that really hurt was [a rumor] that got started down in
Central and South America that Americans were kidnapping or stealing children to
utilize them for organ donors. That led to a couple being stoned to death down
there a few years ago. [They were] Americans who went down to adopt a child,
had nothing to do with organs. We do all the organ recovery in Puerto Rico and
I actually was at a meeting when one of the Puerto Rican physicians stood up
and said, I know for a fact that this is going on. Where did he get that?

P: You do one hundred liver transplants and two hundred kidney transplants each
year. How many heart transplants do you do each year?

S: This year we'll probably do between fifty and sixty hearts.

P: You mainly do kidney transplants.

S: Because you have two kidneys. That gives you [many] more [organs]. You get









UFHC 49
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two kidneys from a donor instead of one.

P: I notice that a lot of this is father to son or vice versa.

S: Not with hearts.

P: I mean with kidneys.

S: With kidneys we have live, related donors and we do that with livers too. There
are live, related liver donors, particularly from parent to child.

P: Does that make a better match?

S: It's a better match but the rejection is not nearly the problem with the liver as it is
with the kidney. It has a different set of antigens.

P: What's your future plan for Life Link? Are you going to expand it?

S: We're growing pretty rapidly. We've had a pretty rapid growth. I'm trying to
think. We had about a twenty-percent growth factor this last year in terms of the
number of patients that we cared for, the number of organs recovered.

P: What are your main interests outside of medicine?

S: See the boat? That's my only interest outside that and skiing. I love to ski. I
have a home in Colorado as well as one here. That's where I met my current
wife. She was a patient of mine out there.

P: That looks like a forty-foot boat.

S: It's a fifty-footer. [A] fifty-foot Gulfstar.

P: Do you sail in the bay?

S: Yes, I go out in the Bahamas and places. I like to go on long trips.

P: What are your charitable interests?

S: Well, what about them? I don't know. My favorite charity is Metropolitan
Ministries here which tends to the homeless, and the Salvation Army. We have
a foundation here at Life Link called the Legacy Fund that I've contributed
several hundred thousand dollars to. Jim Free, who is my colleague I told you
about, gave $600,000 last year to the Legacy Fund. The Legacy Fund basically
[provides money for] the drugs and things patients may not be able to buy for









UFHC 49
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themselves after they've been transplanted. As you know, the drug bill can be
very expensive. It's a charitable non-profit [fund], independent of Life Link, per
se.

P: It is mainly for transplant patients?

S: Yes, it's organized and we control the board. We'll always control the board.

P: Do you give support to the University?

S: Both the University [of Florida] and the University of South Florida.

P: When you look back on your career to this point I know you're not finished -
what would you consider to be your greatest accomplishment?

S: You know, I truthfully don't know. I think Life Link is probably my greatest
accomplishment, but on the other hand, if we hadn't had Gatorade funds to help
us get this thing rolling, we maybe would not have it. It's all intertwined, isn't it?

P: Do you have any other personal or professional goals at this point?

S: No, I'm perfectly happy where I am.

P: Is there anything else that we haven't touched on that you would like to talk
about?

S: No, I can't think of anything. I've got eight children.

P: That's a major item.

S: My daughter is a physician here at Life Link and my son is executive director of
the organ and tissue bank out at Waters where we placed 16,000 tissue grafts
last year. Of course, I've got another son that is the Ph.D. immunologist.

P: Do you do a lot of tissue transplants as well?

S: We procure a process and place grafts for bone and skin and all those sort of
things. We have huge program.

P: You harvest bones as well?

S: Bones and skin, ligaments, tendons, ribs, jaws. We have a huge inventory. We
place about $1,000,000 a month worth of those kind of things.









UFHC 49
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P: Who do you place them with usually?

S: All over the country.

P: Do you place any at Shands?

S: I don't know whether we actually have anything in Shands or not. I can't tell
you. We place things [in] all the local hospitals and then Orlando and Atlanta. I
think we do all the business in Atlanta.

P: Where do you maintain all of these organs or tissues?

S: It's out on Waters Avenue. It's an almost 50,000 square-foot program out there.
They're all freeze-dried.

P: Do you have a large number of people who monitor those tissues and organs?

S: There's a lot of people out there. As I said, we have almost four hundred
employees, right at four hundred and a budget of over $50,000,000 a year now,
so it's gotten big.

P: I want to thank you very much for your time. I appreciate it.

S: I hope that I've answered some of your questions.

P: You have, indeed.

[End of interview]




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