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SAMUEL PROCTOR ORAL HISTORY PROGRAM at
the University of Florida
ORAL HISTORY PROJECT
UNIVERSITY OF FLORIDA
MONOLOGUE: Arthur B. Otis
DATE: January 7, 1977
ARTHUR B OTIS
UFHC 4A
UNIVERSITY OF FLORIDA, HEALTH CENTER
MONOLOGUE: ARTHUR OTIS
DATE OF MONOLOGUE: JANUARY 7, 1977
This is a monologue by Dr. Arthur B. Otis and it is part of the University
of Florida Health Center Oral History Project. Dr. Otis is currently a
professor of physiology at the Health Center.
Dr. Otis joined the faculty in 1956 after having served previously on the
faculty of John Hopkins and, before that, the University of Rochester.
Otis accepted George Harrell's invitation to join the faculty because he
liked the idea of teaching at a new school and he was impressed by
Harrell's enthusiastic nature. Classes were small thus a good rapport was
established between students and teachers.
Otis speaks well of Harrell, the College of Medicine's first dean, and
Russell Poor, the first provost. He feels Poor's strength lay in
representing the College's interests in dealing with politicians and the
state legislature. Overall, Otis agreed with Harrell's educational
philosophy and his design of the Health Center. He feels Harrell gave his
department chairmen enough freedom and discretion in running their
departments. Harrell left the University, Otis says, because he no longer
found the job as dean a challenge. He was at his best when he was design-
ing a new medical school; not running an established one.
I'm Arthur Otis, and I came here in 1956. Until early 1956,
I had never heard of Gainesville, and I was probably not really
aware that there was a medical school forming here. The first
recollection I have of.it of it.was in my office at Johns Hopkins when
person came in and introduced himself as Tom, who was already at
Gainesville and had already joined the establishment here, and he
told me that they were looking for a professor of physiology, and
asked me if I would be interested in being considered as a candidate.
I told him I'd be willing to look into it. Somewhat later in the
spring, I was invited by Geroge Harrell to come here.
I left Baltimore one morning, and had an uneventful flight
to Atlanta, but planes weren't taking off from Atlanta for Jacksonville,
because of the weather, so I spent about eight hours in the Atlanta
airport. I had been scheduled to arrive in Gainesville at three or
four o'clock in the afternoon and, as it turned out, I didn't get
here until 10:30 in the evening.
There was an incident on the way from Jacksonville to Gainesville.
We did finally get to fly from Atlanta to Jacksonville, but the trip
from Jacksonville to Gainesville had to be made by Greyhound bus, and
part of the way along the route, there had been an accident. I looked
out, and there was this big tractor-trailer truck turned over on its
side, with half of it blocking the highway. It seems the driver had
swerved trying to avoid a hog, which had crossed the road. So, we
didn't arrive very early that day.
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The next day we had an opportunity to talk with George
[Thomas] Harrell [Dean of the College of Medicine, Professor of
medicine], who told me all the plans, and showed me the skeleton of
the building, which was rising out of the mud here. I was very
impressed with Geroge's enthusiasm about this new school, both
the physical plant, which he obviously loved, and his general
philosophy that he stated about it. It looked like an exciting
new venture. Eventually, after my return to Baltimore, he called
me on the phone, and offered me the position as chairman of physiology.
I thought about it some more, and accepted his offer. I think I
did it largely because it was a new school, and because George
Harrell's visionary outlook made it seem exciting.
It certainly was, in the early days, quite an exciting thing.
It's much more appealing, I think, to start a new school than it
it to go to an old one. At least the problems are somewhat different
then; one also can feel that any mistakes he makes are his own. He
doesn't have to spend time repairing someone else's errors.
I actually came in the first of July in 1956. The building
was not yet ready, but we had to make plans to be able to teach a
course in physiology the following January. So, the summer was
spent mostly ordering materials and equipment for the laboratories.
I had gotten two staff members during the spring. Melvin Fregly,
who is still with the department, and Ernest [Bevier] Wright, who,
retired a few years ago [Fregly came as an assistant professor. He
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is now a graduate research professor]. I had known them previously
at the University of Rochester. [Wright came as an associate professor
He was a full professor at the time of his retirement.] They fitted
in very well. So there were three of us on the staff the first
year, and we brought with us two graduate students. Ernie Wright
brought John P. Reuben, who had been a graduate student at Rochester.
I brought Stephen M. Cain. These two eventually became the first
Ph.D.'s from the health center graudate program. They are now
professors of physiology, Cain at the University of Alabama in
Birmingham and Reuben at Columbia University in New York City.
We were able to move in the new building, in October of that year, and
it really was an empty place, with the three of us and our two graduate
students roaming around with no equipment at all. But it shortly
began to arrive, and we formulated our course for the first-year
students, and by the time January rolled around we were able to keep
one step ahead of them, during that semester. I think, in many ways,
this was probably the most fun we ever had, doing all of this for the
first time in a brand new space, with new equipment and new students.
I don't know who was more apprehensive about the situation, the
faculty or the students, but we all worked very hard together.
During the first year or two here, the faculty was mostly
basic scientists, as the clinical faculty, with the exception of a
few, were hired only later, since they weren't needed, so to speak,
until the students got through their first two years, which was
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largely basic science. Those departments heads who were here
constituted the executive committee which met on a weekly basis, and
which served as the admissions committee and almost everything
else at that time, since we didn't have a large enough faculty to
draw many members from. We were an executive committee, admissions
committee, curriculum committee, and everything else.
There were some special problems that arose during the first
year. I mentioned we had two graduate students in physiology, and
other departments had some graduate students with them. But we had
no approved graduate program. A good deal of our: first half-year
was spent in presenting a plan for a graduate program and getting
it approved through the office of the graduate school. Dean [Linton E.]
Gringer [Dean of the Graduate School] was sympathetic with our
position, but it was difficult to convince him immediately that we
were really capable of mounting a graduate program on such short
notice. It became apparent right away that no single department had
enough strength to convince the graduate school that it should have
a graduate program, so we pooled our resources, and developed the
graduate program in Medical Sciences, with majors possible in the
separate disciplines. This scheme has since worked to our advantage
in many ways. Since the departments in general have been relatively
small, andhad small graduate programs, individually, we might have
had some problems in convincing the higher authorities that we were
really viable. But since we had a pooled program, it is clear that
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when viewed from this point, we did have adequate numbers of Ph.D.'s
being turned out. Our graduate programs have been quite small, but I
think they have been good. In physiology, nearly all of the individuals
who have been granted the Ph.D. degree are engaged in some occupation,
and have appointments that are consistent with their training.
Most of them are on faculties of other medical schools. So, we're
quite pleased that they all continue to be productive in one way or
another, and contribute to the medical science or to the biological
sciences in useful ways.
In the early days, it was possible to know each of the medical
students more or less personally; and for the first year or two one was
able to know where the various individuals had gone, what they were doing.
But, over the course of the years, some of these things get quite
blurred. I now have difficulty knowing, if I meet a medical student,
a past medical student, what his name is, in the the first place, and
what year he was in school. These events of sort of coalesce at
various times.
For several years, we maintained the same original group depart-
ment heads, and then, for various reasons, they gradually began changing,
so that a majority of them have now been replaced by others. This is,
of course, a natural occurrence. Some of them left, I think, for
what they considered better opportunities, some of them perhaps left
because they felt conditions here weren't as good as they had expected--
perhaps they were disillusioned in some ways, which I think is always sad.
I'm happy to see a person leave a place while he would still like
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to stay, so to speak. But at any rate, for various reasons,
people do go.
Of course, George Harrell left after, I've forgotten exactly
how many years, maybe ten years here, and he went to establish yet
another medical school. I think George's real driving interest was
building something new. He, really was dedicated not only to the
medical school as an institution involving medical education, but
he also thought a great deal in terms of the physical plant. This
was a special interest of his, the design of the building, and he
essentially knew where every brick was in the building, and what
it was there for. I remember he walked into our stockroom, a little
room off our stockroom, and there was a space under the bench there
that was a cart for transporting apparatus sitting out in the middle
of the floor. He said, "Why, this space under here was designed to
hold that cart." After that, we tried to keep the cart in that space,
because it bothered George's sense of propriety if things weren't
where he planned them to be. He really enjoyed planning the school,
especially,the physical plant, and also, I think, philosophically.
But I believe that he became somewhat frustrated, or perhaps even
a little bored at the problems of running the thing on a day-to-
day basis after the newness had worn off. I think that made the
opportunity to build another place, that Hersey, especially, attractive
to him. But he certainly had a great influence on the early development
of our institution. Although he had quite positive ideas about
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medical education, he left his department chairmen very much
on their own in developing the curriculum and the educational
methods involved. He was willing to express his opinion about
things, make suggestions, but he never was in any way, dictatorial.
He let us go our way, and I think we're all grateful for..this.
And he supported us well in all our endeavors.
Another man who was involved with the development of the school
was Russel Poor :[Spurgeon], who was the first provost of the
institution. He contributed in other ways. I think there was
friction between him and George Harrell. Geroge may have
been concerned that Russ was doing things without telling him
about them. But, I think, Russ Poor contributed in many ways,
especially in dealing with legislative and other political
figures. I had a notion that he was able to talk with them in
their own language in a quiet and subtle sort of way to get things
for us that might otherwise not have been possible.
For about ten years the curriculum went on, basically-the same,
philosophically, at least, as it was initially. There were minor
adjustments that had to be made such as when the institution
changed from a semester system to a trimester, and then to a quarter
system, but these were mainly a matter of arranging the calendar
rather than any fundamental change in their philosophy.
But then, in the '60s, there began to be much ferment about
changing the curriculum, and this seemed to be some sort of a disease
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which swept all over the country. I never really understood the
origin of it, but everyone seemed to feel that the curricula should
be changed. It never was very clear to me why these changes were
essential, but the changes were made, and I tried to go along
with them, because, personally, I never felt that the curriculum,
per se, was very important. The curriculum is sort of an arrangement
of things in the calendar, basically. The thing that is important
are the teachers and the students, and how they are able to get
along together. If the curriculum makes it easy for them to
benefit from each other's presence that's fine. If it makes
is difficult, then that's a disadvantage. But I have felt that a
great deal of time is. spent on developing a new curriculum, and
there are some good aspects to the changes that have been made,
but I think that the changes could have been made more efficiently.
I think that a great deal of time has been wasted by people
having to spend hours at committee meetings at which nothing very
productive happened. The discussions centered so much on the
mechanics of education, and very little on the substance. I think
that is wasteful of the talents of the people involved. I know
that, in our own department in the early days, we did spend a lot
of time together as a department, as a committee, discussing the
matter of teaching physiology to students, but the things we were
discussing were physiology. We were teaching each other so.
that we would all be adequate to teach physiology to the students,
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but with the new curricular developments, people spent at least,
if not more time together in discussions, but the discussions
rarely involved content or science. They involved the mechanics
of doing things, which I thought were largely a waste of time.
A teacher, I think, in general, only knows how to do certain
things and whatever curriculum you may devise, a given individual
goes about doing what he can do. It's pretty hard to change it.
This isn't to say that they are not useful techniques, and that
the various media that are available are not useful, but ther6m.s
nothing magical about them. They don't in themselves add to the
store of knowledge, and they can only be used to help transfer
information.
It appears now that the curriculum, having gone through
this upheaval, is gradually settling back to something resembling
a more classic curriculum. If there is concern among my colleagues
that the standards of education have dropped in recent years, and
that we're turning out an inferior product--I'm not sure that this
is so. I think the product may survive all of this. Students are
a very resi client lot, and they'll somehow manage to get an education
in spite of what you do to the curriculum. I think, on the whole,
the quality of the students maylhave improved over the years--the
average quality, at least. We certainly have a larger pool to select from,
relatively.
Initially, I think, the school had a fairly clear philosophy
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for educating physicians, which George Harrell expressed very
clearly. I'm not sure that we ever followed this philosophy completely,
but at least it was stated, and it gave one some guidelines to follow.
I'm not sure that the philosophy currently is as clearly stated,
and one might have to observe carefully to see what is underlying
all of our activities. I'm sure there is something there, but I
think we have no clear voice stating it, perhaps. I think that
many of our faculty, perhaps, devote less time to thinking about
the problems of medical education for the school as a whole than
was true initially. Initially, I think we were all somewhat
concerned with the overall education of the medical student, but
as the place got larger, and as the individuals in various departments
developed more oustide interests, they felt their stake in medical
education was rather a restricted one, and didn't bother to be concerned
with the problem as a whole.
The faculty forum, which was an informal meeting of anyone
on the faculty who cared to come for lunch in one of the small
dining rooms off the main cafeteria. This indeed was a forum
where anyone was free to sound off on whatever he wished to, whether
it was a matter of curriculum, or economics, or anything else
which might be pertinent or even not pertinent. This, I think,
was a very good thing, because it did allow everyone to speak
his peace, and no one was held to any. It was informal, and
no one was held to any commitments, as a result of what he may
have said here. Somewhere along the way, it was decided to formal-
ize this, and to have a faculty council 1 complete with a set of
bylaws, and Robert'-s Rules of Order, that sort of thing. This went
on for a few years, but gradually it seems to have eroded, so
that during the current year I don't think it has met at all. I'm
not sure the reason for this; I think, perhaps, it was founded with
the thought that the faculty could have more direct influence on
the administration through this formal organization. I think, actually,
it didn't have any more influence than it did when it just voiced
its opinions in the formal group, and I think that people found
out that it isn't all that easy to assume authority. That group
[the faculty], can have a great deal of power if it wants to work
for it, but it is more than a matter of just attending a formal
meeting, and passing a resolution, and leaving it at that.
So this faculty group, and the general faculty, I'm sorry
to say, doesn't seem to even try any more to do things as a group.
I don't know what the future may hold for that; we shortly will
have coming up the possibility for all the faculty to vote on
unionization. How they will vote, I don't know. But,-I-
have a strong feeling that any faculty group that supports the
union is going to end up feeling rather disappointed about the
results. That's my opinion. I may underestimate the power of the
union to produce good things. But I personally thing that the
union actually has no place in a academic institution, for philosophical
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reasons and also from a practical point of view. I don't think
it can develop enough power to amount to anything.
I think one thing that has impressed me over the course of
twenty years is the increasing complexity of administrative processes.
This is due,, to the many sources of funds which are available to
the support of medical education and research and, in this institution,
to an increase in its size. However, it seems to me that the
administrative procedures have become harder to manage, more complex,
than they were initially. It seems that no matter how hard the
administrators seems to try to simplify things, they only succeed
in making them more complex.
I recall my first experience as a medical faculty member was
at the University of Rochester where George Whipple was dean and
professor of pathology. He managed to run the medical school by
sitting on his stool in his laboratory, and occasionally looking
over his shoulder. Those days, I'm afraid, no longer exist,
the deans of medical schools have a full-time job, and even
with several associate deans and assistant deans, they feel
constantly hurried. The whole business of medical education, and I
suppose of the university operation in general, is very complex
administratively. I somehow can't help feeling that it's
unnecessarily so, and that if one could blow the whole thing up
and start from scratch, you'd develop a simpler system.
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The future in medical education, I suppose, is related to the
medical problems of the future. The influence of technology here
has had a tremendous impact. With modern, technological developments
and the availability of new drugs, the cost of medical treatment
has become unlimited. I think forty, fifty years ago there
were relatively few things that could be done for sick people.
With some diseases, one just tried to make people comfortable, and
let nature take its course. But with modern technology and modern
drugs, the possibilities of treatment are almost unlimited, and
certainly the costs are unlimited.
Now this makes one wonder how universal health care can be
administrated. It's ceratinly going to involve tough decisions
on someone's part, because there are just not enough resources
available to give everyone all of the possible treatments and
care that he might receive. Someone has to decide how these
resources are spent. Whether it's to be done on an individual,
economic basis, or whether there's judgement to be made as to
what is best for the health of the nation in general. These are
hard decisions I think no one yet has really faced up to. But it
ceratinly does offer an important problem, part of which has to
be shared by medical education.
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