Contributor: Galen Wagner

I learned to know Bess in a very special way during the years after Dr. Stead "retired" in 1967. Bess continued as his secretary until he finally closed his Duke office.

One day in the early 1990's, Bess gave me this picture of herself and Dr. Stead at his desk, just as they were almost every day in the late 1970's. Bess supplied me with the copies of Dr. Stead's papers and correspondence. She also carefully edited every word of "What this patient needs is a Doctor."

She kindly allowed me a taped interview of the "organization of her office." This "Bess and Dr. Stead" story helped me understand how she ran the departmental office for most of the twenty years of his chairmanship.

• Title: Organization of the Desk:

  Bess sorted the incoming mail and placed each piece in one of several stacks. That which she thought she should handle immediately she placed directly in front of her in the "Bess urgent" stack. That requiring EAS's immediate attention went to the "EAS urgent" stack on the right front corner of her desk where his chair was placed. Since EAS would sit in this chair to go through the mail with Bess whenever he came into her office, the "EAS urgent" stack always received rapid action. After considering each document Dr. Stead would A) give Bess a verbal or written response, B) throw it in the waste basket, or C) take it into his office. The only papers he took into his office were those which required his considered response; such as an inquiry about a patient or a request for a recommendation which would be difficult to write.

  Bess placed the remainder of the mail in one of four less urgent stacks at the periphery of her desk at positions equivalent to 10, 11, 12, and 1 o'clock. She had a two-tiered box in the far left corner. The top tier was for outgoing mail and the lower for reference material such as airline guides, maps, etc. Her 10 o'clock stack was for documents which required her action within one to two days, the 11 o'clock stack required her response within two to three days, and the 12 and 1 o'clock stacks whenever time became available. These latter two stacks might later prove to be discardable. Bess would compose and type a response to much of the incoming mail and often EAS would simply affix his signature. If he wished to make changes that was his privilege.

  These meetings between Bess and EAS at her desk were times for informal as well as more formal communication. He depended on her to remember whose turn it was for teaching ward rounds and the other teaching assignments. A few weeks prior to the start of a new medical school quarter, Bess would place her rough draft of teaching assignments on the "EAS urgent" stack. His decisions were made promptly, results were typed and a copy sent to each staff member concerned, including the chief residents at Duke and the VA. He also depended on her to know each of the personnel in the department. They didn't discuss gossip, but only those items which he "needed to know."

  The drawers in Bess's desk were also well organized. There were three on the right and one in the middle. The top drawer on the right held letterhead and envelopes, and the middle drawer held the departmental schedules ("so I could find someone if I needed him.") The lower drawer was for the "EAS non-urgent" stack. Here she put mail that didn't need immediate action or perhaps any action at all. After EAS considered everything in his urgent stack, he would pick up the whole non-urgent stack. Often papers were considered by EAS and then put back in the drawer. If Bess saw that a document went back in the right lower drawer several times she would ask if he was finished with it: He would then make some disposition of it.

• Title: The Office Files:

  Bess considered office files to be primarily of importance for confirmation of past events. EAS did not become involved in decisions regarding filing. When Bess decided that a document merited filing, she placed it in a stack on top of the two drawer cabinet behind her desk. She rarely filed things immediately because there were always other things to be done. When the stack "got too high" she made time to file each document by subject. She knew that the only way to be certain that she would be able to find documents when she needed them was to file them herself. Bess made carbon copies of everything she typed and kept these in the proper subject file. Since she filed only the documents she needed to keep, she never had to clean out her files. She anticipated that they would eventually be divided between EAS' successor and University archives. Filing was by subject such as patients (he had very few private patients), organizations (AAP, ASCI, ACP,) reprints of manuscripts, senior staff, house staff, medical students, and hospital beds. Each year at the end of June, Bess moved the files of the staff who were leaving the department to her inactive file. After several years a 2-drawer file cabinet was added behind Bess's desk. All of the financial documents were kept there and a small adding machine was on top. This was also a handy place for temporarily placing bulky packages.

• Title: Office Space -

  Open space was considered to be of great value, providing a feeling of airiness. "People felt like they were coming into my sitting room and were more likely to talk. The chair in front of my desk was almost like a confessional. In the early years the door between Bess's office and the hall was kept open because EAS respected the "open door" policy. Later when the Baker House corridor got busier and noisier, they decided the door would have to be closed. The door between EAS's office and the hall was kept locked, so everyone including EAS had to enter through Bess's office. The door between their two offices was usually kept open. Bess closed it when her typing noise might disturb EAS, and he closed it whenever he had a confidential meeting. The few times a week when this occurred, Bess did not interrupt except for an emergency.

• Title: EAS's calendar:

  The daily schedule was kept on a 4x6-inch calendar on Bess's desk. He depended on her to take complete control of his time. Even when he was out of the office he would sometimes call back to her to schedule an appointment. She kept these small calendars from year to year for reference and for the archives. EAS and she would often go over the next day's calendar late in the afternoon. Each day except Sunday began with Morning Report with the residents at 8:00 A.M. in EAS's office. Teaching rounds from 10:00 until noon was a constant for EAS through all four quarters. Hypertensive Clinic was on Wednesday afternoon weekly conducted by EAS. He taught Physical Diagnosis to a group of six medical students weekly from January to June. Each week might contain several administrative meetings. At the beginning (1951) EAS instructed Bess that priority for his time was to be: 1-medical students, 2-house staff, 3-fellows, and 4-senior staff; and she followed these guidelines through the years.

• Title: Departmental Roster

  The list of all members of the junior and senior staffs (ordered by faculty rank) was extremely important in the day to day operation of the office. It was normally updated each July and January with interim changes penciled in. The roster was kept handy in the front of the notebook, which contained the departmental schedules. Bess used the roster for mailings to announce meetings and make schedules, and EAS used it when considering promotions, selecting members of committees and candidates for various societies, and for various teaching assignments. These rosters were kept on file and eventually passed on to the new department chairman. Bess continued to squeeze the roster onto a single page even by the late '60's when there were about 130 members of the junior and senior staffs of the department.

• Title: Atlantic City Meetings

  The Spring Clinical Meetings for academic internal medicine were held each year in early May in Atlantic City. These were the major meetings of the year, and Bess was responsible for obtaining substitute coverage of teaching assignments for all who attended. Planning began early in the year and proceeded during the spring. EAS always attended these meetings. The Association of American Physicians was familiarly called "Old Turks," the American Society for Clinical Investigation was called "Young Turks," and the American Federation for Clinical Research was called the "Young Squirts." Membership in the ASCI and/or the AAP required nomination and seconding by two members of the relative association and confirmation by the membership. The vote might be affected not only by the qualifications of the applicant apparent on his Curriculum Vitae, but also by the stature of the primary and seconding recommending ASCI members.

Title: Ladd's Gifts

Ladd Hamrick and Bob McWhorter were Stead house officers together and then founded the H & M practice in Concord North Carolina. Ladd, with Bob solidly in support, initiated a Duke-Cabarrus County co-educational program in 1973. Bob died and Ladd retired from practice. At that time the Cabarrus medical community dedicated the Hamrick Theater in their new Northeast Medical Center to Ladd.

I provided this tribute along with those from others in the Duke and the Cabarrus community during the dedication ceremony.

 Ladd, you came here in mid century
 With your dear friend Bob McWhorter
 And you gave Cabarrus all the gifts you had
 
 To these towns round looms of Cannon
 You brought H & M brand doctors
 But you missed the gothic learning
 In Duke's stones.
 
 How could Mr. Cannon's fortune
 Make a hole in Mr. Duke's walls
 And spill learning down the highway
 You had come?
 
 It took a quarter of the century
 Just to figure out the secret
 And a quarter more to build your
 Campus round, 
 
 Then you went home to your Sarah
 Having spent your raging passion
 And you watched us try to
 Tear it all apart.
 
 But we really only changed it
 To serve another century
 And we're glad you quietly stayed
 Around to watch.
 
 Now you've built a Northeast window
 So that every Friday morning
 You can watch Duke squirm and
 Struggle to survive.
 
 Duke can't fix their walls together
 But they know they're better for it
 So they're opening up their own
 New Ladd-type holes.
 
 Ladd, now we stop to thank you,
 We've loved being on your journey
 Now's the time to feel the pleasure
 Of the gifts your giving's brought you.

The Chief of the Chief (Bess Cebe)

When Bess died suddenly, her dear son, "Pete" and his family from California and Bess' family from Missouri joined Dr. Stead and Bess' Duke family at a memorial service. I provided this celebration of Bess and of her amazing partnership with Dr. Stead.

 Maybe in heaven or maybe in hell 
 Or places above or beneath,
 There's a chief out there with an icy blue stare
 And Bess is the Chief of the Chief.
 They sit at her desk from 8:30 'til 9
 And together make plans for each day;
 'Cause the white pants troupes need two leaders to teach how
 To doctor earth's sickness away.
 One leader is big and walks through the halls
 And the other is small and sits still.
 He goes out among us but we come to her
 Whenever a doctor feels ill.
 'Cause a patient needs a doctor and a doctor needs a Bess
 Still today as through all the old years;
 A calm powerful listener to all of our sins
 In her sitting room's laughter or tears.
 Through Duke's Baker House to the Forest at Duke
 To wherever she's sitting there yet,
 She's the Chief of the Chief and there'll not be another,
 To lead us by just being Bess.

Title: When Bruni Came Our Way (Brunildo Herrero - Chief Resident 1965-66)

Those of us on the Stead housestaff in 1965-66 were so fortunate to have Earl Metz at Duke and Bruni Herrero at the VA as our chief residents.

Bruni died two years ago. Last year Earl returned to lead a reunion for us and to honor Bruni. I wrote this poem to express my recollection of the "Bruni experience."

 
 The outlook wasn't brilliant for the 6A team that day.
 The time was 10 to midnight, and two more were on the way.
 
 The student said he'd worked enough, and had to get some sleep.
 The intern now was getting his, curled up in a heap.
 
 The JAR came on this scene, and shouted, "Life is hard,
 You'd better get your asses up, cause Bruni's on the ward."
 
 All came suddenly alive, some energy they found.
 The Chief they so respected had come to make his rounds.
 
 His white pants were a little tight, his black hair long and wild.
 His voice boomed out with street jive, excited as a child.
 
 "Come on you cats 1, let's walk around and see what's needing done.
 Grab yourselves "black medicine," 2 so we can have some fun.
 
 It's time to let it all hang out 3, there's patients on the way.
 You've stroked it gently in the corner 4 up till now today."
 
 The intern just began this week; he hadn't any clue
 Of what the Chief expected that a Doctor ought to do.
 
 He took us to his patient, admitted just that night:
 "This stroke is tough to figure out, he says he's lost his sight."
 
 Bruni scowled and fumed and snorted; froze the intern in his stare:
 "I see a wonderful gentleman who needs your loving care."
 
 That intern would not be the same: he'd no more treat a "stroke."
 He'd learned from Master Bruni, that doctoring's no joke.
 
 You get your fun by giving care to all who come your way.
 "Since you don't know what caused his stroke", the team heard Bruni say,
 
 "Schmoodiakapoulis 5 should be added to your list.
 Maybe deep in his left fundus is the embolus you missed."
 
 Cause "schmoodiakapoulis" means there's something more to find
 Of why this man has had his stroke, and why he's going blind."
 
 Bruni knows "Big Daddy" 6 chose him, so he has a sacred trust:
 To teach us how to Doctor, so we earn patients' trust.
 
 When our year was over, and honors passed around,
 We interns gave our chief a gift: a hubcap we had found.
 
 Like him, it was a Cadillac; the finest model known.
 And all us interns signed it, cause we'd been "Bruni grown."
 
 Oh, elsewhere in that favored land, night call was one in four;
 And house staff learned about disease; the patient was ignored.
 
 But we, in that far distant time, in Duke's Durham VA
 Learned Doctoring five of seven, when Bruni came our way.

• 1 - respected colleagues
• 2 - coffee
• 3 - to get to work
• 4 - to waste time
• 5 - (Shmoo-dee-ah-ka-poo-lus) almost anything
• 6 - Dr. Eugene Stead