Rochester Academy of Medicine
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Rochester Academy of Medicine
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Interviewee: Charles B. F. Gibbs, M.D. Interviewer: James Stewart. M.D. Date: 2/78 Dr. Stewart: I'd like to introduce myself. I'm Jim Stewart, an internist in Rochester since 1951, a mere child compared to our distinguished guest of the morning, Dr. Charles Gibbs, who has been in practice, or in Rochester, since 1921. Charles, you were a native New Yorker from upstate near Watertown, and graduated from Syracuse undergraduate and medical school, interned in Brooklyn Hospital, and came to Rochester in 1921. Dr. Gibbs: That's right. Dr. Stewart: I understand you were really associated with the university before the medical school existed. Could you tell us about your arrangement? Dr. Gibbs: When you start practice. you start at zero. and I was fortunate to meet Dr. Arthur Stokes, who was then working with Dr. Murlin in the Department of Vital Economics, on the top floor of the Eastman Building on University Avenue, part of the university. Dr. Stewart: Were you part-time then or was this your full-time ? Dr. Gibbs: No. I was doing part...well, to get into that. Dr. Stokes developed tuberculosis and had to leave, and recommended me to Dr. Murlin, and through that increment of income, it became very fortunate that I should work starting very soon after I came to Rochester with Dr. Murlin doing experimental work with dogs. Dr. Murlin had been working in diabetes research since about 1916, so he had a story of quite a bit of background to this. We were doing experimental work with dogs. depancreatizing the dogs. making them diabetic, and seeking the hormone which Dr. Murlin felt existed to replace the loss of the pancreas. And so helped to control diabetes. Dr. Stewart: How close were you to finding insulin when Banding and Best published their work? Dr. Gibbs: Well. that's another very long story because Dr. Murlin was hot on the trail of this hormone and we tried to obtain it from the pancreas but just the motion of the pancreas itself produces insulin but also trypsin, which is a very potent destruction... enzyme which destroys protein, so injections of this material would not only perhaps lower blood pressure but would destroy the muscle into which it was injected. So Dr. Murlin had the rather happy idea of perfusing the pancreas, by that I mean injecting the pancreas with a saline solution through the artery and retrieving it through the vein, taking that perfusate as it's called and concentrating it by removing the fluid by vacuum distillation and then using that without the trypsin, and this turned out to be quite successful, and we were able to keep dog #32 alive for something like five or six weeks. Dr. Stewart: Were you working full-time with Dr. Murlin? Dr. Gibbs: No, I was doing part-time. Dr. Stewart: How much time were you spending on that? I was spending about 4-6 hours a day with Dr. Murlin in the laboratory doing respiratory quotients which I disliked heartily, but also working with the animals, which was most pleasurable and most fascinating. Dr. Stewart: You were doing some clinical practice at the same time then? Dr. Gibbs: Doing practice at the time, and I used to bore Dr. Murlin exceedingly by telling him all the exciting things that were happening in the practice of medicine and the unusual cases that I saw, and I'm sure he was very kind and very understanding, but I think.... Dr. Stewart: When you set up in practice in '21, where was your office and were you independent, or were you associated with someone? Dr. Gibbs: No, I came unknown and I'd been in Rochester a day before, and we found a real estate agent, and bought a house on Plymouth Avenue South. At that time, the railroad... streetcar tracks were running down either side of the road. And from there we gradually progressed. Dr. Stewart: Where was your office in those days'? Dr. Gibbs: In the house. on the second floor. Dr. Stewart: Now, what was your means of getting around? Did you have a car in those days? Dr. Gibbs: My uncle had given me a car he had driven for four or five years. which was an old Ford Model T with a... it had a battery on top. Well, the battery didn't work, the starter didn't work, so I sold that and cranked it... so we got around to the Model T at that time. And the snows at that time were much like they are today. It wasn't easy. Dr. Stewart: What staffs... what hospital staffs were you associated with in your early days? Dr. Gibbs: Well, we very soon associated with the Rochester General Hospital and then I had an appointment at Saint Mary's, with the Endocrine Service, which didn't work out very well, but the General Hospital staff service was most important. That was the leading hospital in Rochester in those days, as I recall. That was really a wonderful place. It had a home-like atmosphere and the men there were particularly interesting and helpful. Dr. Stewart: Who were the outstanding practitioners of that day, as you would recall them? Dr. Gibbs: Well, one would certainly think of Dr. Mulligan as most outstanding, and it was he who developed the Sunday noon conference which became quite a noteworthy affair. One can think of your father, for example, who worked with Dr. Mulligan, Dr. Audley Stewart. and Dr. Alva Miller, who was very kind to me and very helpful in consultative work. Dr. John Booth and... quite a number of interesting people, Dr. Albert Kaiser I can't overlook, because Dr. Kaiser was so kind to me at the very beginning. One appreciates these early touches where people refer a case, or ask you to see somebody in their absence or on vacation, and they were a very warm, comfortable, homey, ethical group which I thoroughly enjoyed and still do. Dr. Stewart: The Sunday morning conference, was this later to become the Friday noon conference, teaching conference, that I knew in my early days'? Dr. Gibbs: Yes, that was an awkward time on Sunday noon, 12 o'clock, and the wives complained, and nobody got to church. so that was finally changed to the Friday noon conference. Dr. Stewart: Yes, I was very sorry to see that Friday noon conference drop, fall victim to the many required departmental conferences. It was one you could meet so many of your friends in other branches of medicine. It was an excellent teaching session. Dr. Gibbs: There was a good to and fro, back and forth, and the discussions were sometimes very energetic. Dr. Stewart: Now, tell us a little more about what it was like to practice in the '20s in Rochester. Dr. Gibbs: Well, people are the same. Diseases were pretty much the same. More infectious diseases, perhaps. Calls at that time were about $3.00 a call, and office calls were $2.00 or $3.00 or if more work were done, $5.00, and perhaps first examinations might be $15.00, or if you were real bold, perhaps $20.00, so that money at that time was worth more. Dr. Stewart: In the '20s, and then came the '30s, and what happened then? Dr. Gibbs: Well, things got a little bit slippery at that time. Dr. Stewart: Did you ever get paid in chickens and produce? Dr. Gibbs: No, people were very kind, and had some donations but no, I can't say we had a bag of potatoes at the back door. Dr. Stewart: I recall being at home, and my father having a family that came up with chickens or at Canandaigua Lake, a truckload of produce, which was always very welcome, of course. Dr. Gibbs: Yes, well... Dr. Stewart: What about the treatment of diseases in those days? Ifs hard for anyone practicing now, with all of our weapons to really appreciate the limited number of specific treatments. What were some of the drugs that you really had in the '20s? Dr. Gibbs: Well, of course, we began to have mercury and salvarsan for syphilis and that brings to mind Dr. Goler and his infectious disease hospital, where he attempted to segregate people with infectious diseases. He was also...one can't speak about Dr. Goler without a good deal of reminiscence because he was hot on the trail of infected milk, infected water, and did so much. In fact, I've always thought of Dr. Goler with his clearing of the water and the milk and everything he could clean up, did more for the general health of the community than all the doctors' pills. He used to have a little sign... he was a very critical person, which I think we enjoyed because good criticism is welcomed. He used to have a sign in the front of the Health Bureau, in which he'd put letters of various things, and one quote that I couldn't help but remember was, "Mediocrity is excellence to the mediocre." But, that sort of stung you as you went by, to raise your standards and get out of that trough. He did so much. Dr. Stewart: Dr. Goler) was one of the key people in the founding of the Medical Center here. At what point did you get involved with the Medical School as it was being formed with Dr. Whipple? When did you meet him? Dr. Gibbs: Well, I think around 1927. Of course, I came over via the Department of Vital Economics with Dr. Murlin, so I was sort of in at the back door when this started. so they couldn't do much else but let me come in the front door. That I did appreciate. One of the reasons I came to Rochester actually, was because I had known there was a development ahead for the new medical school here. Dr. Stewart: So that appeared to you... Dr. Gibbs: That was...that was one of the purposes. Dr. Stewart: What sort of a man was Dr. Whipple in those days? What do you remember about him? Dr. Gibbs: I always enjoyed Dr. Whipple. We could always sit down and talk fishing, and that was a way to start. And then you could get into other subjects with Dr. Whipple, and I always enjoyed him just as long as I had contact with him. Dr. Stewart: A remarkable man, certainly. Dr. Gibbs: He did so much for so many. One of the things that stands out, was his pathological conference which he had out in the pathological area... .which we had benches with iron rails and hard seats, and uncomfortable positions, but that's all forgotten when you began to see the display of pathological material, and his questioning and evoking of high degree of interest in whatever he touched. He had a skill in making you stimulated by the things that he displayed and the discussions that went on and the possibilities that it evoked. Dr. Stewart: Yes, I had the privilege of working for six months in pathology when I got back from the Army, and his demonstration of the pathology of the day was certainly an excellent teaching session. Dr. Gibbs: He would do it so simply that you'd think, well, this is not very difficult, and yet you'd get down into greater and greater depths, and pretty soon you'd find that the questions weren't all answered yet. Dr. Stewart: I thought that Dr. Bohrod at the General Hospital, his introduction of the Kodachrome teaching slide in pathology was one of the major contributions to education. Do you remember those slides? Dr. Gibbs: Right, they were such beautiful slides, and his ability to take pathological specimens and blow them up on the screen so that you could see, almost see the glomeruli in the kidney. Dr. Stewart: It was always interesting to me the sort of rivalry there between the teaching methods. Dr. Whipple never did accept, I think, the Kodachrome slide as being any way better, or in fact far inferior he thought, to the live material. This brings up a question about the early rivalries between the Strong Memorial Hospital as it evolved, and the Rochester General Hospital staff. Can you comment on that? Dr. Gibbs: Yes, I think they were stimulating, as a matter of fact. Because each was trying to do its thing to the best advantage, not necessarily seeking to outdo, but seeking at least equal or if possible get a little lead, and those were warm days and the talk of the town and gown was very rife. The criticism, of course, with the new thing coming, that Strong attracted... it was brilliant, it was sparkling, it attracted, it was often said that people on the top level came to the Strong, and the maids and servants were taken care of by the rest of us. Well, being in both places. I think I as able to see some of that, but by and large, I don't think that was a great factor, and gradually it became more and more necessary that each one had not only a dependence on the other, a relationship with the other, but also a help... each one could help the other. Most of the men on the staff at the Rochester General became Assistant Associate Professors of Medicine or in Surgery at the Strong, which helped to integrate. Then the Strong was able to. by dint of its deeper research efforts, contribute to the general interest in medicine, and the staff conferences up here began to be attended by many of the men from the General, so that there was an interplay with medical forces, so the town and gown became gradually gown in the town, and I'm sure after quite a good deal of resistance on the parts of a few, but many people like Dr. Kaiser and your father, and a number of others, could see that the Strong was here to stay, and the thing to do was work with it, and work in conjunction with its efforts to integrate into the community, and so to closely relate the two bodies, both of which has strengths and ambition and purpose and were working. Dr. Stewart: Was there any major difference in the type of patients admitted to the two institutions in those days? Dr. Gibbs: Well, I brought patients to both hospitals and I think that it was a decision on the part of the patient. Some patients with the attractiveness of a new hospital wanted to come to the Strong, and that was fine. And other people, that sort of liked the homey_ atmosphere of the General, and that was fine, too. I think that I worked the same in either place. And felt at home in each place, so I don't think I'm a good... I'm not a "contextual" person. Dr. Stewart: Well, whereas in '51 when I went into practice, there still was occasionally the statement you heard, "Don't go to Strong, they experiment on you." That was one of the popular noises of the day. Was that considered... was that thought widespread in the '30s? Dr. Gibbs: Oh, I think so. I think that research work was going on at Strong and everybody knew about that and we worked on animals, and knew about that. So. I think there was a certain reluctance on the part of some people to enter into that kind of an atmosphere. but the atmosphere of the research doesn't get into the atmosphere of the hospital setting, and I think that most people appreciate that research work is necessary if you're going to learn something, and felt rather warm toward the effort rather than backing away from it. Dr. Stewart: Clinical research nowadays certainly requires a very careful understanding of the patient that he or she is participating in clinical research. Was there any grounds in the early days where patients were used...participating in research projects without their knowledge? Dr. Gibbs: Well, I suppose so, but I think I'm not aware of any distinct detail of that. I'm sure that we used a group with placebo and a group with the other trying to find out whether a particular drug was effective or not. That was well understood and that was part of the process of determining efficacy of drugs. Dr. Stewart: Right. Dr. Gibbs: But I think that it's become much more apparent that people have to know what's going on and I'm sure we've come to a very strong stand on that. Dr. Stewart: The homey atmosphere at the General Hospital was still apparent in the '50s when I joined the staff there. There was a warmth among the people working there. a very great loyalty. I think that was characteristic of that institution, which a newer institution could not cultivate immediately certainly. Dr. Gibbs: It takes time to develop atmosphere and people like Dr. Harry Clough and Dr. Harry Green, oh, made things work. Dr. Clough with his early electrocardiography, and all helped to raise the standards of effort there. Dr. Stewart: Right. Your practice evolved along in general, in internal medicine but you always had a particular interest in diabetes and endocrinology. I recall working in the diabetic clinic here as a member of the house staff. I believe you were the senior attending at this point in the clinic here. Your interest in diabetes continued after your research. What phases did you see that disease go through? Dr. Gibbs: Well, we were... when we finished medicine there were two things I was never going to be interested in... was urology and diabetes. But you know how fate takes you by the ear and leads you around, so that I found myself working in diabetes and of course, you can't work in diabetes without becoming highly attracted to it because of all the things it gets into—pathology, physiology, endocrinology, controlled diet, chemistry—it encompasses the whole realm of one's physical status and naturally with having worked with diabetes, I was able to have diabetic patients so that we really were much interested in controlling diabetes in young people and older people and so on. Of course, the very early days with diabetes were so difficult. Diets at that time were very low in carbohydrate, very high in protein and fat. Now we know that makes things a little worse. We used to use alcohol for a substitute calorie. Some people liked that. The gradual change in diet, trying to find out the proper ratio between carbohydrate and protein and fat. Of course, restriction in diet and keeping people thin was about the only thing we could do at that time. And acidosis was common. Dr. Stewart: And very frustrating, I'm sure. It's difficult to see. Dr. Gibbs: Bicarbonate and fluids, and sometimes people survived and often they didn't. The average life of a youngster at that time was only about 2.2 years, which was terrible. Dr. Stewart: When did you first give insulin to a patient? Dr. Gibbs: I think in 1922. To go back to Dr. Murlin for just a moment, that was the time when the group in Toronto with Banding and Best were able to salt out the proteins of the pancreas and obtain insulin in a commercially usable form, and thereby obtained the credit for the development of insulin. Also to go back just a moment... Dr. Murlin in some of his experimental work, found that when we gave our extract, that there was a little rise in the blood sugar before the subsequent fall due to insulin, and he thought there must be another hormone in the pancreas which produced a rise in blood sugar or mobilized sugar in the blood, and he gave the name of Glucagon to this. Dr. Stewart: Dr. Murlin originated that...? Dr. Gibbs: Dr. Murlin originated the idea and named the substance, which now we use and see commonly used, and find it increasingly valuable in our understanding in the control of sugar. To Dr. Murlin belongs the credit of the idea and the name. Dr. Stewart: Hmm, I hadn't realized that. What... who is the oldest patient still in your practice, going back... do you have any going back to the '20s or '30s in their diabetic management'? Dr. Gibbs: Yes, I have some 40...40-odd-year diabetics who are still able... I remember one woman in the clinic who was in her '70s who had had diabetes for about 45 years. which along in the 1930s and '40s was quite a phenomenal thing, because she'd escaped from the early days by having a mild diabetes, but after about 40-odd years of diabetes, we were able to show that she had very little change in her (high grounds/eye grounds), had good kidney function, didn't have any difficulty with the arteries in her legs, had had no heart trouble and smoked about a pound of Prince Albert in a pipe each month, so we presented her at conference and gave her a pound of tobacco to carry her for the next month, and were quite thrilled with the fact that she had conquered as much of her diabetes as that. Dr. Stewart: Don't know if that was the grace of God, or the Prince Albert, or the skills of Dr. Gibbs? Dr. Gibbs: Wasn't my skill, I'm sure of that! But, she had evidenced her continuity before I saw her. Dr. Stewart: What other memories of the practice in the '20s and '30s have you about the management of disease processes in those days? Dr. Gibbs: Well, it was difficult because we had no antibiotics, we had no sulfonamides, of course, and as I had said before, I think Dr. Goler did much more than all the rest of us put together, but we did the best we could with what we had, and there were analgesics and pain relievers and interestingly enough, aspirin was brought out originally, or hoped to be an antibiotic, and then it turned out not to be, but the analgesic which is used by the ton now. Dr. Stewart: Were there any other specifics in those days? In those days you had morphine for pain, and of course, the opiates, but it's so hard for us to comprehend the lack... Dr. Gibbs: The lack... Dr. Stewart: ...the lack of things. What about IV fluids in the '20s and '30s? Dr. Gibbs: Well, we were just getting into it, and I once wrote a paper which was turned down by the Academy because it wasn't quite that good... just beginning to get into the matter of fluid balance and electrolytes along about 1940, but think of it... people used to. I'm sure. die dry, and that's an awful thing because they couldn't take water by mouth. We did use needles under the skin and suffused fluids under the skin. We did that quite commonly, and that was being done, oh, in the '20s and then we got a little more into intravenous fluids, but didn't until around 1940. at the time of the war that we appreciated the value of fluid balance, and necessity of electrolyte balance. Dr. Stewart: We used to give it by rectal drip, too, as I recall at times. Dr. Gibbs: Yes, nasogastric tube. Dr. Stewart: Did you have to mix up those IV fluids yourself, or were they available from some central location? Dr. Gibbs: They became available. Dr. Stewart: Seems to me I remember Henry Keutmann describing how as a member of the house staff or early staff here he used to go to the chemistry lab and mix up his own saline and intravenous glucose solutions. Dr. Gibbs: That sounds like Henry. He would do it. Dr. Stewart: So strange to us today. Dr. Gibbs: Now they pour in from the back door in great cartons... Dr. Stewart: It's hard to get the plastic catheters out of veins once they are in around... today everybody's on an IV it seems. Any other memories in those days in terms of disease processes? Dr. Gibbs: Well, we saw typhoid fever. I had a chap who had camped on the rim of the Grand Canyon and came back with malaria, there was typhoid fever... there was quite a lot of tuberculosis, there was a scourge at that time, and of course, Iola was a very prominent institution. We thought that they did such excellent work. That was long before any real drug therapy was effective. That was the fresh air and... Dr. Stewart: A year, or two, or three or four or five years in the sanitarium in those days. Dr. Gibbs: Easily, and quite a good many recovered. Undulant fever became quite a scourge. Out in Fairport there was a man who had cattle who died with undulant fever, and we had patients with undulant fever, and we used to test quite commonly for that and some of the low grade, unexplained fevers turned out to be brucellosis or undulant fever. And that was an interesting period. But it was a radical treatment of taking care of the brucella-infected cows that finally wiped it out. And there again, public health stands as a real contributor to the welfare by getting rid of the source. Dr. Stewart: Do you recall the introduction of the specific treatments with sulfonamide? Were you...? Dr. Gibbs: Yes, what a boon that turned out to be, and what we thought we could to with that. It was going to conquer everything. And it did conquer quite a good many things. Dr. Stewart: What treatments were used for infection experimentally prior to that? It seems to me mercurochrome or at least some of the antiseptics were tried. Dr. Gibbs: Well, we had surface antiseptics but things that you could take internally for the effect on bacteria invasion, we got rid of a lot of throat paintings and whatnot after awhile. Those were really sort of superficial ways of relieving rather than curing. There were some intravenous or at least parenteral or oral antibiotics attempts before sulfa came in successfully... . (END OF SIDE 1 OF TAPE #1) Dr. Stewart: It's hard again to think back before the days that vitamins were known. I believe many of the vitamins were described in the '30s, were they not? Dr. Gibbs: Yes, and I was highly interested in that too, because my daughters' stepfather-in-law, Glen King, had the isolation of vitamin C to his credit. Dr. Stewart: Really? Dr. Gibbs: And that was a time when there was... through him I learned a great deal about vitamin possibilities and he was highly interested in nutrition and was sent by the government to places like Guatemala to investigate the difficulties, lack of protein, lack of minerals and whatnot. were hurting the population, but the problem of vitamins became very high and one of the conferences at Atlantic City was devoted almost entirely to what was known about the vitamin sources and complexities that occurred and the lack of them. Pellagra was not unknown with its lack of thiamine, so that gradually we became much more aware of these subtle vitamin sources which mean so much to one's bodily health. Dr. Stewart: Reflecting back on the practice in the '20s and '30s, what percentage of your time did you give to say, house calls, and what percentage of time to office was ....? Dr. Gibbs: I think about half and half As office practice grew and you had less time to go running around town with house calls. Everybody made house calls then. It's becoming a lost art, but it was common at that time. Dr. Stewart: As I recall, my father used to make house calls in the morning and hospital rounds, never started in the office until after lunch. House call lists were very long. sometimes eight and ten a day. Dr. Gibbs: Yes, that was the story. And they were scattered around town so that transportation was an item. Dr. Stewart: Well, the house call still to me is a very valuable way of assessing a person. You learn so much more about the person in the setting of the family and what books he reads and all the rest. It tells you about that patient as a person, in a few minutes in the home. It's a shame that they're not more a part of our practice. Do you still make house calls on occasion? Dr. Gibbs: People who can't get to the office and who are... if it's easier for me to go and see them than it is to drag out and get to the office, I go and see them. Dr. Stewart: I know you used to see my mother, so I know that's true. Dr. Gibbs: And I enjoyed that. But it's, after all, I can't stand it to be in the office... I couldn't stand it to be there all day. I think it's difficult, but you get out and see what's going on around, especially as you say, to see people in their own habitat and how they live. it means quite a lot to understanding the person. Dr. Stewart: Your office was moved eventually from South Plymouth, and v_ ou've been on Goodman Street a good many years. Dr. Gibbs: I think that was Dr. Ingersoll, who was another notable... Mr. Kelber built this building I think in 1928, so I moved over there at that time. So I've enjoyed that building ever since. Dr. Stewart: Dr. Ingersoll was an ear, nose and throat man, and used to take out tonsils in his own private office hospital, or private... Dr. Gibbs: That's right he had a hospital in the building on South Goodman Street. Dr. Stewart: He got into some trouble with the rules and regulations on that, did he not? Dr. Gibbs: I think so. Dr. Stewart: Forced to give it up? Dr. Gibbs: I never heard very much about it, except that he stopped doing it. Dr. Stewart: I think it was the desire to have it under the hospital roof, as I recall. Dr. Gibbs: Yes, yes. For emergency's sake, it was desirable, too, like all laws, they are made because there are difficulties and deficits and so somebody makes a law. Dr. Stewart: He was one of the pioneers I'm sure in this area of ENT. Dr. Gibbs: ...and a very engaging and brilliant fellow. I enjoyed Dr. Ingersoll so much. And Dr. Nash who was with him. Dr. Stewart: My tonsils fell to Dr. Ingersoll's knife back in the old General Hospital. Dr. Gibbs: Oh. yes. Dr. Stewart: Who are some of the other men, I say men because there were probably very few women physicians back in the '20s and '30s. Were there any? Dr. Gibbs: Yes, yes, I think there were three or four in town. Dr. Craig Potter's mother was a notable gynecologist, for example. And there were some others. I think there were three or four others. Dr. Stewart: So women did make their mark in medicine early on in the century. Dr. Gibbs: Yes, yes, of course, Dr. Blackwell, who was the first woman physician. a graduate of Syracuse, that was back in '47, wasn't it, somewhere there? At any rate, think now, how many there are. Dr. Stewart: Can you recall any other stories about one of the more colorful characters of our early days? You mentioned Dr. Mulligan. He was certainly colorful, among other adjectives. I guess one might apply. A very fine surgeon. I do not remember him personally, but I know him through my father's and mother's stories about him. Dr. Gibbs: Well. he was a very interesting person, gruff and austere, but really a very kind person, I think was kind to people fundamentally. He made house calls, but all he carried in his pocket was a little vial of morphine and if people were sick enough to really need medicine. a little morphine would help to allay. He didn't carry a bag, and I think he had a stethoscope in his pocket but I'm not sure of that, but he always had this little vial of morphine if things were really that bad. But just his presence and his ability to calm people's fears and anxieties and postpone the time from the immediate to the future when things would improve was his great asset. He was a good surgeon, too, as I'm sure your father could have testified. Dr. Stewart: He really, he was such a man of commanding presence, there's no question he inspired confidence. Dr. Gibbs: There was no questioning it. Dr. Stewart: He was also a knuckle-rapping surgeon in the Operating Room as you undoubtedly know. Dr. Gibbs: Uhuh. Dr. Stewart: He also had a very great interest in medical history to which interest our medical school library is indebted. His photograph...his portrait stands there at the entrance to our historical section of our library. Dr. Gibbs: Of course, another good surgeon we had at the time for those many years was Dr. Howard Prince, and one has to admire the way he handled people in also rather a gruff fashion, but with great skill. Altogether I've always felt that I was so fortunate in having such an admirable group of physicians in town with skill and with good ethics. And then to come to Strong and to find this group, many of whom came from places—Johns Hopkins. Harvard, and so on. and there was a new color to the life of medicine, and we became so very fond of people like Dr. Corner, and Dr. Bloor I must mention because he was one of the finest. sweetest persons I ever did know, and Dr. Fenn, Dr. Adolph who is still here, and Dr. McCann, and Dr. Clausen was an admirable person. You're thinking, I'm sure of some others. Dr. John Morton, whom I was always devoted to. And Dr. Herm Pearse. Really such an admirable group of people who really worked so well together and with Dr. Whipple, and Dr. Whipple I think kept a rather loose rein, and gave people quite a good deal of autonomy in their own departments. Dr. Stewart: That's not entirely the picture as I recall hearing it, that he may have given some loose reins. but he also had a fairly tight rein on... Dr. Gibbs: Well, that may be... Dr. Stewart: ....on decision-making in the early days. Dr. Gibbs: Well, decision-making early, but I think later he loosened up a little. Dr. Stewart: Well he certainly gave commanding leadership here. I was very grateful for my association with him in my later days in the six months I spent in pathology. Dr. McCann, of course, was head of the Department of Medicine here for must have been about 30 years... I can't recall just when he... stopped in the '50s sometime. What are your memories about Dr. McCann? Dr. Gibbs: Well, I enjoyed Dr. McCann, too, and he was certainly very kind to me. We were able to develop a diabetic clinic here and at the General. And privileges and opportunities to do things and I was still working a little with Dr. Bloor and with Dr. Murlin, so during that time he was very understanding about the other obligations that I did have. Enjoyed him as a teacher. One of the very simple things that he said one time that I recall was apt and namely, that the heart receives a certain amount of blood and discharges a certain amount of blood. And unless those two are exactly equal, either the blood is backed up and fluid is stored in various places or the heart is not doing its best duty so that these very simple things that he was apt in speaking about, would go sort of unnoticed that I enjoyed him for. And you add a lot of other interesting angles, and I think running a Department of Medicine with the gradually increasing demands and the research grants and whatnot, is far from a simple thing. Dr. Stewart: He developed... he certainly had a talent for appointing people all around him with great skill and giving them their head. He never felt he had to dominate the department. I was impressed with this when I was a medical resident, and he often said that he didn't have to know all the facts but he had to have around him people who did. Dr. Gibbs: I always liked that idea anyway. Dr. Stewart: And he was very much of a gentleman. Dr. Gibbs: Yes. Dr. Stewart: Thinking back to the early days, the '20s and '30s, in your association with the two hospitals and the nursing staffs and the care of the patient, what is your memory of the General and the Strong in that regard? The nursing care given'? Dr. Gibbs: Well, you may have other ideas, but I couldn't see very much difference. I think nurses were dedicated to work and doctors were dedicated to their business, get along very well with problems that arise and I felt equally at home in both the General and the Strong as far as care of people were concerned. I didn't seem to have any real struggle or conflict. What was your experience? Dr. Stewart: I agree. I thought the nursing was excellent in both institutions. The attitude of the nursing staff always amazed me at the General Hospital. I was brought up in medical institutions where nurses were respectful but not... when I walked on the wards in General Hospital in 1951, the nurses practically stood at attention. I was not used to that. that treatment. and it rather surprised me. It was a little different here and that was one of the differences, not necessarily in quality of care but in attitudes towards physicians. Do you recall that'? Dr. Gibbs: Yes, I think so. Dr. Stewart: In addition to the hospitals we also have in Rochester the Academy of Medicine which was formed even before your day, in 1900, as the, I guess, the developer of the library for continuing medical education. Dr. Gibbs: Yes. Dr. Stewart: There was no central location where doctors could come and look up journals, so they formed that in 1900. In the 1920s, before the Medical School library was developed, do you recall—was the Academy of Medicine library used considerably? Dr. Gibbs: Well, I think so, because that was about the only source we had for special journals and various books. At that time it was down on Chestnut Street, had a very nice house there on Chestnut Street. But that was pretty valuable property, and it was salable and then the house on Prince Street was purchased and we were there for about 10 or 12 years. until Dr. Kaiser's idea that something better and larger and more acceptable would be possible, and that led to his contact with the (Lyons/Lions) family, and finally the giving of the (Lyons/Lions) home on East Avenue to the Academy, which was such a wonderful thing. At that time. you remember. we had a fundraising and raised enough money so that half of it could be used to build the auditorium as an addition to the house and makes the fine institution there that we now have.. of which we are all so proud. Dr. Stewart: Right. For the record, I'd say it was my father was the physician to the (Lyon/Lion) children, and when Mrs. (Lyon) died, they were wondering what to do with the house. and my father suggested to them that the Academy of Medicine was looking for new headquarters. Dr. Gibbs: Oh. wasn't that wonderful. Dr. Stewart: So, it was out of that suggestion that I think they contacted Dr. Kaiser... Dr. Gibbs: I see. Dr. Stewart: ...and the building was eventually given. The Academy in its early days had rather strict membership requirements. It was an august body that demanded scholarship and presentation of a paper before the group to be eligible for membership. I'm not certain whether this pattern continued very long after it was first founded. In the '20s, were you... do you recall whether this was still required? Dr. Gibbs: I think not or I probably wouldn't have been in it. But I think it was not at that time. But that function and the opportunity to present papers moved on to the Rochester Pathological Society, and I remember giving a paper there, and one could write and express ideas. The Pathological Society was really great fun as well as an opportunity to review some pathological subject or bring pathological specimens and show them, and then afterward the treat was, Mr. (Magg's/Megg's big dish of.... Dr. Stewart: ....ice cream... Dr. Gibbs: Oh, but...the... it's hard for me to think of all the lovely... shrimp, there were big rounded platters of these... and after the talk we would go out and have a wonderful discussion with each other. To go back to the Academy for just a minute... one of the great fields in which the Academy has been very constructive has been the integrating of the doctors, again town and gown. The Strong has always been contributory to the Academy, has had members, has had presence, has had influence in the Academy, and I'm sure it was partly through that sort of a contact that the people found that the doctors at Strong weren't something strange and mysterious but were human beings like everybody else. So I think it's a great integrating force between the two hospitals, although through the other hospitals in the community. It was a time you'd see people you'd never see any other time. Dr. Stewart: I think also the interest of Don Anderson when he took over the deanship in mending fences with the community and with the Medical Society was an important contribution. In reading about, I think in George Corner's. George Whipple and His Friends, that marvelous book about our institution, and Dr. Whipple... it impressed me that Dr. Whipple when he came here said he would not come if he had to be very active in the community committees downtown. and he stuck with that through his many years here. Dr. Anderson came with different feelings about the importance of relating to the community... does that jog your memory? Dr. Gibbs: Yes, I think so. I think that's right. Dr. Stewart: Speaking of other hospitals in Rochester, when did The Genesee Hospital... that was a homeopathic hospital in its early years. When did that shift into the mainstream? Dr. Gibbs: Well, during my time. The transition was gradual. Homeopaths began to use a little more allopathic medications and so the thing was not a sudden change from homeopathy to the other. but rather of a transition. Dr. Stewart: It was still a homeopathic hospital in the '20s Dr. Gibbs: Oh. yes, yes. Dr. Stewart: Of course, in those days, homeopathy was probably less harmful than some of the... it'd be before the '20s, but when organized medicine was purging and puking, homeopathy's treatment was probably the less harmful, and... Dr. Gibbs: Well, not only that, but I think they really taught us the use of hygiene, water for fevers instead of depriving people, sanitation. I defend them strongly because my three uncles—my mother's three brothers—were all three homeopaths. Dr. Stewart: I didn't realize their involvement in sort of public health measures as well. Was that part of their tradition? Dr. Gibbs: Yes, strongly. In other words, back to nature is a homeopathic idea. Mithridates, _you know, was the first homeopath who took a little of each of the known poisons every day so that nobody could really poison him. So he developed a system of antibody resistance to the known poisons of his day. So he was the first homeopath. Tiny portions... Dr. Stewart: Some of the other hospitals that grew up in Rochester. I think I have vague recollections about them evolving around personalities. I think the Park Avenue Hospital was a product of Dr. Barber, is that right? Dr. Gibbs: Yes. Dr. Barber. Dr. Stewart: He left the homeopathic hospital under some... for some reason. What do you remember about him? Dr. Gibbs: Very little, except he was a very engaging person and for a person to go ahead and develop a hospital is quite a trick. And he did it and ran it, and I always enjoyed Dr. Barber. I never knew him too closely, but there it is and still going. Now the Park Ridge, and it just shows how a ferment of an idea can take hold and develop. Dr. Stewart: Maybe you can tell me also about a Dr. Lee. When I was resident in charge of the Outpatient Department here we used to go around and visit nursing homes and various places with the students and house staff on Saturday morning to see where our patients came from, and one of the places we went to was called Dr. Lee's private hospital down on Lake Avenue. And that was the first Pd ever heard of him. What was his history? Dr. Gibbs: Well, that was ...I'm not too clear about all the details, but those things wax and wane, and he waxed for a time, and then he waned and the thing passed on. But he had quite a strong following and his hospital was Pm sure run on a very modest medical basis. but it prospered for quite a number of years. I can't give you many details because I don't think I was ever in the hospital. Dr. Stewart: Right. That's one hospital that I think has gone by the way. Were there any other hospitals that sprang up in Rochester and disappeared during your memories? Dr. Gibbs: No, I think it was a favorable move to move the General up to the north side of the city. The north side really needed a hospital, and now with the Northside General and Park Ridge. the north side is much better. Dr. Stewart: I guess there was a fair development of the Beach Avenue Facility for Children's Diseases. What was that? Dr. Gibbs: Well, the Infant Summer Hospital. Those were notable institutions who took care of a good many children. Dr. Stewart: Was that... I just have vague memories of hearing of this. This was for rheumatic heart disease, or infectious diseases, or what? Dr. Gibbs: Yes, for crippled children particularly. Well, I'm sure that could have a good historical review, because it served a very useful purpose. Dr. Stewart: Well there are a number of hospitals that rise and fall with the changing disease pattern. When I was in medical school, the Good Samaritan Hospital in Boston. a three- or four-story building full of children with rheumatic heart disease, now no longer needed. And our Iola no longer needed, fortunately. Dr. Gibbs: Yes, think of what has happened to tuberculosis. But that also brings up an interesting question of what should be done in hospitals with some of this expensive equipment and each hospital doesn't have to have all the expensive equipment like this. scan that produces information about the various levels of the body but it costs a great deal—what is it, around $350 or so'? Dr. Stewart: $350,000 for the equipment, or $500,000 for the equipment... Dr. Gibbs: Oh, boy, yes... Dr. Stewart: ...and going up fast I presume with the newer generations. Dr. Gibbs: That's right. But not every hospital needs every one of these technical assets. And so that's another reason for better integration of the hospitals and I'm sure that a lot of that is being discussed at the present time, and who should have what. It hurts anybody to give anything up, and this struggle as to who should have the maternity division is an example of how difficult it is to get, to stop anything that is going. Like a law, it's hard to get rid of it once you get it on the books. Dr. Stewart: Well, there's a great pride, even though we have a remarkable example of cooperation among the hospitals and most of them with university affiliation. There's still immense pride in each of our Rochester hospitals. And I think that is a very real factor in wanting the latest equipment in each institution. Dr. Gibbs: You spoke of the affiliation, which I don't think we mentioned but which I think is such an admirable idea. Because it means better understanding between the various hospital groups and hospital Boards and Pm sure that that is a developing thing and could be extended into hospital purchases and hospital—as we were just speaking—of various expensive equipment and organizing patterns of abuse. So I think that's a very forward motion and hopefully will cut down on some of the extenuating costs of things at the present time. Dr. Stewart: How do you feel about the coming, or what's arrived and seems to be increasing constantly in our practice, and that is the government regulations and eventual extension of control into more and more areas of our practice? Are you feeling the constrictions thereof? Dr. Gibbs: You notice it in your writing hand where you sign all the things that you have to sign in duplicate and triplicate. Of course, this is bordered by... again, like any law, there is some reason for it. and of course, these triplicate forms we have to make out for drugs that are reserved. one goes to Albany, one goes to the pharmacist and one stays in your drawer in the desk. Dr. Stewart: It's one of the greatest wastes of money, in my opinion, it seems that really is an unproductive program. Dr. Gibbs: I know, it seems absurd. Well, I think to answer that, the paperwork and the paperwork in the government has become such a notable load that everybody is rebelling. Dr. Stewart: Dr. Gibbs, I think we're running out of time. I think we've covered a number of subjects over your perspective of medical practice, that would make about 57 years this summer. Dr. Gibbs: Don't mention it! Dr. Stewart: That's a remarkable perspective from the days of pre-insulin, pre-vitamin, pre-specific antibiotics, pre-IVs, pre-blood banks, we didn't mention that. But. it's...you've watched medicine evolve in a fascinating way. I've been privileged to watch it in the last 27 years myself. and it's a constant struggle to keep up with some of these evolving, exciting developments. Dr. Gibbs: It surely is. It's a wonderful period in which to live, despite the wars. and difficulties that have been present. But I don't know of any other period in history that would have been any more exciting than this particular period. And certainly in medicine no more rewarding than to have lived in this period of this degree of technical and chemical advance. Interesting enough. the chemical part of the advance is now turning back to nature, and getting back to looking at some of the things in plants, and of course it's been so well known that we've had the opium and the cocaine and the quinine and digitalis, but there must be many more things in nature that nature has been trying to tell us over the years that we haven't known about. Dr. Stewart: And I've known you've been vitally interested in biology and in botany, and have left your mark on Highland Avenue, in your lovely old home there where you planted a very great variety of trees. Dr. Gibbs: We had a little digitalis growing there too. (END OF SIDE 2 OF TAPE #1) (BEGINNING OF SIDE 1 OF TAPE #2) Dr. Stewart: ...I think an outstanding level of medical care to which youve created a fine leadership and example. Dr. Gibbs: Thank you, Jim, I think it's highly overrated but I've enjoyed it. Dr. Stewart: Thanks. Charles. |