Contributor: Harry McPherson Chief Resident: 1953-1954
The year 1953-54 was an exciting time at Duke in the Department of Medicine. Drs. Stead, Warren, Myers, Hickam and Engel were among the outstanding investigators and educators in the country. There were strong members of the clinical staff - Drs. Rundles, Hansen, Menefee, and Orgain, but also some unusual ones in Drs. McDonald Dick and Hendrix.
I began my chief residency from an unusual setting, having been offered and accepted the position while overseas (Tokyo) in the US Army during the Korean War. Discharged from the service in June 1953, I came immediately to Duke where, while catching my breath, I found abundant responsibilities! Thereafter, never far from the hospital, I lived in a room in Baker House more or less 24/7.
At my first conference with Dr. Stead he told me, "You now have a great opportunity to learn and teach -- the entire medical department is open to you -- make of it as much as you will." The JARs and SARs were outstanding and the new interns challenging. Dr. Stead and staff created an electric atmosphere with the excitement of learning pervasive and often competitive, all to the benefit of superb patient care.
House staff schedules, special coverages, reshuffling always took time, and I worked closely with the "Supreme Scheduler" of all times, Dr. Grace P. Kerby - to this day, I still carry a pack of 3X5 cards in my shirt pocket to jot down changes, needs, dates, etc.! Our major teaching wards were: Osler (white women), Long (white men) and Nott (black men and women). The attendings were strong and demanding with rounds beginning at the stroke of 10:00AM. I attended anyone's rounds I wanted and took the rounds when substitutes were needed.
Of course, the days had begun much earlier with "Morning Report" to Dr. Stead or others at 8: AM: JARs reported briefly on every admission from the night before. Most JARs were prompt and ready, but one young woman with a "pathologic deep sleep, can't hear alarm clock" syndrome was a problem!
Dr. Stead's famous "Sunday School" was an absolute requirement for all house staff. Many times, I was out rounding up the missing links. One house officer gave a formal presentation of a topic of his choosing, followed usually by a lively discussion and interrogation by Stead, Myers, Hickam or whomever, sometimes to the delight or dismay of the house officer on the firing line. This was a very effective training session for the presenter, who obviously learned the most and gained experience in public speaking before a critical audience -- the sweat poured!
Dr. Stead was very interested in psychosomatic medicine, and we had a conference every week or so with a member of the psychiatry staff. The house staff were urged to have one or two patients whom they followed for 6-12 months with psychosomatic illness, usually with intermittent consultations.
Dr. Stead offered the chief resident the opportunity to spend a year in personal "analysis" with Dr. Bingham Dai of the psychiatry department. I accepted and spent two hours a week with Dr. Dai the year after my Chief Residency, while an Endocrine Fellow - it was a most rewarding gift that I shall always treasure.
Dr. Stead had another interest that year, eyegrounds! This led to a weekly or biweekly "Eyeground Rounds" with Stead and Dr. Banks Anderson. Dr. Stead had been amazed at what Dr. Walter Kempner had accomplished with the rice diet, and in the process how much one could learn about vascular and metabolic diseases studied in the eyegrounds. Anyone interested, tagged along and learned.
I couldn't end without mentioning "History Meetings."
Dr. Stead and I met weekly at a late afternoon hour with the house staff in the Medical Records boardroom. We scanned each chart (those that could be found!) of patients discharged the previous week. We looked for unsigned notes, failure to have a CBC, urinalysis, failure to follow up requested studies, presence of valid discharge summary handwritten by intern and a dictated one with letter to referring physician by JAR. Woe to the offender!
There was more, but above all, what a wonderful experience to work with and watch the house staff mature in the presence of those catalysts like Stead, Myers, Warren, Hickam, and Engel in the Duke University Medical Center.