"Why I Became a Doctor and a Pediatrician"

The Duke - Walter Reed
Connections in my Life.”
Bill M. Andrews, M.D
Retired Chairman of the Dept. of Pediatrics,
University of Louisville School of Medicine.

This topic, which was suggested by friends and members of the Innominate Society, focuses on the career connections in my life. They began while I was a medical student at Duke and Dean Wilbur C. Davison asked me to abstract both the English and German pediatric literature and also help make corrections for his well-known volume, The Complete Pediatrician. Dean Davison, who was involved in all my major career decisions, once told me about his studying physiology at Oxford under Sir William Osler.

My medical connection with Louisville began through General Henry George Armstrong who came to Duke to inspect Dr. Gauer’s studies in aerospace physiology. Years later, when I participated in The Harvey 500 Celebration at Oxford, I learned that Dr. Gauer had worked in Germany during W.W. II but eventually was the president of the International Association of Aerospace Medicine. Former Surgeon General Henry George Armstrong, a 1925 graduate of the University Of Louisville School Of Medicine, became a key figure in my life. E pioneered the early experiments at Wright-Patterson Field in Dayton, Ohio that revolutionized flight; they led to the use of oxygen and to the development of pressurizing appariti and other precautionary measures that safeguard pilots against the physical effects of modern flying. Some of the major inventions of the Aerospace Medical Research Laboratory, later named for General Armstrong, were the human centrifuge for G-studies, compressurized cabins, and even aircraft toilets. He described new illnesses related to aviation and to space medicine in his well-known books, Principles and Practice of Aviation Medicine, Aero Space Medicine, and Fit to Fly (co-authored by Lt. Colonel Malcolm Grove).

General Armstrong, who is called “The Hippocrates of Aerospace Medicine,” was always impeccably groomed, maintained an excellent posture, and was serious, courageous, scientific, and both brave and patriotic to a fault. He began his final book, The Emerging Death Mystique while he was watching dying patients as a medical student in Louisville; incidentally, President Carter received the first copy. One of my favorite anecdotes is that of a young reporter’s asking him late in life: “Have you been trying to kill yourself all your life?” General Armstrong hesitated, then replied: “If at any time I could have benefited mankind or advanced science, I would have willingly given my life.” Obviously, I felt honored when The Journal of Aviation Space Medicine asked me to write a poetic tribute to him in 1988.

The next link, my Duke – Walter Reed connection, began during my third year of medical school when I asked Dean Davison about a U.S. Air Force senior medical student program and medical training in the military. He answered: “Only the Army has hospitals such as Walter Reed, on of the 30 best in the country.” Consequently, in summer 1956, I went on active duty at Walter Reed Army Hospital as a Second Lieutenant, M.S.C. and had an opportunity to work with General Thomas Mattingly, President Eisenhower’s cardiologist. I even met President Eisenhower. He asked a few of my friends and me: “Are they teaching you anything? And, will I ever have the pleasure of meeting your wife?”

Another memorable experience there was the thrill of meeting the famous W.W.II surgeon, General Leonard D. Heaton. Once, after I drove his brother, Dr. George Heaton, a nationally known minister and Professor at Wake Forest College, to the airport, he said: “I don’t think you can be the kind of person you wish and a lawyer, as you are planning. May God be with you.” I thought about what he said and “did not sleep for a month.” Coincidentally, a week later I saw Dr. Willard C. Goley, who had been General Macarthur’s physician, and who also had taken great care of me when I was a 3 lb. Premature infant. He asked me: “Old Top, have you decided to be a doctor yet? You owe your life to medicine.” His words were constantly in my mind while I translated Albert Schweitzer’s Leben und Denken and realized that I had “a calling” to enter medicine.

During my clerkship at Walter Reed, General Heaton asked about my education and, later, when I was a pediatric residence, invited to me to “scrub in” while he removed the spleen of a little girl with Nieman Pick’s Disease. He skillfully removed the grossly enlarged organ in 6 minute. But, friends told that I had appeared faint and fellow residents said they know that I would not become a surgeon. My association with General Heaton led to my being the only pediatric resident given top-secret clearance and assignment to a STRAC Unit for quick military deployment anywhere in the world. My having graduation from Oak Ridge Military Academy with highest marks. Being in the regular Army, and having some experience in the infantry, medical service corps, and medical corps also were influential.

After completing residency at the Walter Reed Army Institute of Research, I became Acting Chief of pediatrics at Walter Reed Army Hospital when the Chief was away. Once, a 2-year-old male was admitted unconscious with the diagnosis of severe salicylism. Since he was extremely large and would require many exchange transfusions, I decided to try the then experimental peritoneal dialysis that I had heard about at a recent meeting in Memphis, TN. where Dr. Attendorf reported its successful use in dogs. I called him for consultation, discussed the case with kidney and metabolic experts, and, as the hospital commander suggested, with Surgeon General Heaton.  He asked whether I had the requisite permission.  Called the necessary experts for advice?  Personally felt comfortable with the decision to proceed? To each, I replied, “Yes, Sir.” After several liters of dialysis the child started crying for his mother. General Heaton inquired about him for years.

After my tour at the Walter Reed Army Institute of Research, I was assigned to Rodriguez Hospital, Fort Brooke as Chief of Pediatrics and Consultant for Pediatrics in the Caribbean and South America. A few months later, General Heaton greeted me: “I have come to give you a wonderful opportunity to develop the pediatric research unit at the United States Army Tropical Research Laboratory.” I told him I had only one pediatrician and needed six. He responded: “This will be taken care of shortly” and sent five young pediatricians, all of whom later became pediatric professors and chairpersons. Also, General Heaton sent us such excellent consultants as Dr. Alex Steigman, who had been Professor and Chairman at Louisville, and Dr. Albert Sabin who became world famous as the developer of an oral polio vaccine.

When I requested to resign from the Air Force in 1963, I had to report to Surgeon General Heaton before I could be released. In Washington, he pointed out that the Army had made an investment in me and that my achievements and experience would also be of use throughout my life. He emphasized his and others’ personal regret about my leaving active duty because I had the potential to become the Chief of Pediatrics at Walter Reed or at a military medical school, and even, to sit where he then did as Surgeon General. When he asked why I had decided to resign, I told him: “My obsession to study the physiology, metabolism, and care of the newborn cannot be accomplished in the Army.” He answered: “None of us can ever do just what we want to do. Is there another reason?” I said that my wife “didn’t like the Army, one of our four children was ready for school and we had already moved three times in Puerto Rico.” He looked at me sternly and asked: “Where are you going?” I told him, “To the University of Louisville, Sir.” He smiled and said approvingly: “The one place I could never say “no” to. Everything that I have done, have become, or will do has been influenced by Louisville. Do you have time to have lunch with me?” We went to the Army-Navy Club where I sat with him and Admirals and Generals for the only time in my life.

During the next few hours and days, General Heaton told me abou6t his great clinical experiences with notable teachers at Louisville who had prepared him for the ultimate decisions he would make during his career. Also, he told me that he was at Scofield Station Hospital, Pearl Harbor when the Japanese attacked December 7, 1941. Usually, on Sunday mornings he made early rounds so that he could attend church services. But that morning a low flying Japanese plane with its wings flashing suddenly zoomed in and, for the only time in his life, he threw his wife roughly to the ground behind some palm trees. Later, a 50-caliber Japanese bullet was recovered from that tree that had saved them. He then went to the hospital, ordered all officers to return, cleared areas for the wounded, and obtained fluids, blood, sulfonamide powder, and narcotics to care for the wounded. His excellent surgical care and superior results received special recognition that accelerated his career in the military. He became a young Lt. Colonel, January 1942, and was awarded one of the first Legion of Merit medals given for service on December 7, 1941. Later, he was assigned to Woodrow Wilson General Hospital in Virginia where he learned to command the large hospital that became the 160th Army General Hospital that was sent to England and then to Normandy.

General Heaton’s work with the 160th Army General Hospital was his fondest wartime memory. He often said: “Working with such a close group of professionals who produced excellent results under the hardest of circumstances, saved many lives, and sent many soldiers back to fight was more than one should expect.” He was a superb leader and later was in charge of the Army Medical Center at Southampton, England with its 20,000 beds and 2,000 officers and enlisted men and women. They cared for 57% of all United States casualties evacuated to England.

When they started the Army Residency Training Program, Deputy Surgeon General Bliss and Colonel Michael DeBakey, Surgical Consultant to the Surgeon General, assigned General Heaton to Letterman Army General Hospital as Chief of Surgery. He told me he felt unqualified at that time because he was preparing for the Boards and helping to develop the training program. But, he completed his training while he was a Brigadier General and during the Korean War was appointed the Commander of Letterman Army General Hospital by Surgeon Genera George Armstrong who was a Surgeon General for four presidents.

That remarkable man, General Heaton, once told me: “Meeting Colonel Howard Snyderman, President Eisenhower’s personal physician, was a very important event in my life.” Later, General Heaton became President Eisenhower’s personal physician.

Thus, my association with Dean Davison and experiences at Duke determined much of my career, especially the oxford and the Louisville connections. The Duke-Oxford connection began in the late 1950’s when the Dean introduced me to J. Peter Tizard who later became the preeminent neonatologist in the U.K. and the first chairman of pediatrics at Oxford. Also, he introduced me to Sir John Walton who became the dean at New Castle and the president of both the British Medical Association and of the Royal Society of Medicine and then Warden of Green College at Oxford where I am often invited to visit. Those ongoing friendships have enriched my career.

Thus, the Duke-Walter Reed –Oxford-Louisville connection was being completed. It had been abetted by some interesting, fortuitous circumstances and by a number of remarkable University of Louisville Medical School graduates, especially General George Henry Armstrong and General Leonard D. Heaton. My Louisville saga bean in 1964 when I resigned form the Army and joined the faculty at the University of Louisville. At Walter Reed Army Hospital I was influenced to do so by the eminent Louisville infectious authority, Walter T. Hughes, whom I met when he came from the Army Research Center at Fort Dietrick to attend conferences at Walter Reed. At Louisville, the Professor and Chairman of pediatrics, Dr. Frank Faulkner, an authority in child development and twin study research, gave me the opportunity to study and care for the newborn at a salary slightly higher than what I was getting in the Army. Also, Dr. Douglas Haynes, Professor and Chairman of obstetrics and gynecology offered me a joint appointment in his department and laboratory space adjacent to the newborn nursery. Finally, Dr. Robert Spurling, whom I had known when he interned at Walter Reed, Said to me: “Major Andrews, please come to Louisville. We really need you.” I did so with my own five-year plan that has now extended to over 37 years.