Interviewed November 9, 1988
Concord Oral History Program
Renee Garrelick, Interviewer.
Click here for audio in .mp3 format.-- Efforts to begin prepaid group practice
At the end of World War II, my wife and I had thought to move
into the Boston area rather than the New York area where we had
both grown up because academically it was more favorable and
because you could live in the country and still be close enough to
the metropolitan center and the academic center. We came with
four small children. I came first with two run-about children,
and we slept our first night here in the old homestead across from
the library. When there was no fire in October, we slept on the
floor in the dining room of a house that I bought before the
family ever saw it. The two children and I had breakfast at
Howard Johnson's, a new restaurant in Concord. It had just
started up at that time. Mother and months-old twins arrived
later the next day.
We came to Acton because it was in the country but within striking distance of Boston's medical, academic, and cultural centers. There were only 3200 people in Acton at that time. It was a nice country village with apple orchards, dairy farmers, and truck farmers. A few people worked in Boston, but not very many. It was our intent to become a small group practicing medicine hopefully with a patient-consumer cooperative prepaid medical plan. As time developed it turned out that it was a group of two offices, one in Maynard and one in Littleton, and two hospitals -- Emerson Hospital in Concord and the other what was known as the Mass. Memorial Hospital in Boston, part of Boston University. I was running between two offices and two hospitals. About four years later Dr. Henry Stimpson Harvey joined me because he was also looking for a country practice near a metropolitan center, and we had other similar interests.
The United Cooperative Society was a consumer cooperative of groceries, hardware, coal, and oil started by the Finns who lived in Maynard while they worked at the American Woolen Company. That cooperative started really because the mill workers found that most of their paycheck provided by the American Woolen Company went back to the American Woolen Company because they had to get all things at the company store and other places that took advantage of their sort-of isolation. They got together to develop the cooperative endeavor so that they could control the prices that they had to pay for food and the common household needs. Indeed, they found it made an enormous difference, and the Cooperative Society was extremely successful for at least 10 or 20 years after we came in the 1940's. It really died when most of the younger generation of Finns who had any get-up-and-go got up and left. That left the older people, the diminishing number of Finns and the diminishing number of mill workers as a central core. A lot of people who moved into the area, which included all the towns around Maynard, had an intellectual and ideological interest in cooperatives, but they didn't have the tight-knit cohesiveness provided by the American Woolen Company and by the Finns. So it gradually became less and less loyally supported. At the same time the Stop & Shop, the supermarkets, began to move in, and I think the first one was the A & P and its prices in Maynard were substantially lower than they were in Concord because they were trying to out-compete the cooperative. Well, with one thing or another, competition did prove to be too much for the Cooperative Society, and it succumbed. One of the reasons we came was not only the Cooperative Society but at that time we were looking into seriously and hard at getting pre-paid medical care, but their whole idea of medical economics was very different than even mine as an emerging idealistic dreamer. With four small children, even in 1946, I thought that $8000 a year was pretty meager for a well-trained physician; but the salary of the general manager of the cooperative, which I think by that time was a million dollar a year proposition, was only $5000. They couldn't see paying a young man anything like that figure, so we never came to any kind of an agreement, and the prepayment never materialized until some 30 years later.
There were about five doctors in Maynard when I arrived and most of them with one exception were significantly older than I. Only one of them had any access to Emerson Hospital, and he did not make use of it, so that the medical care provided in Maynard particularly was, should we say, limited. For serious illnesses patients found that they went even beyond Emerson Hospital. They went into Boston because the local physicians, if they referred them to Emerson Hospital, were likely to lose their patients to Emerson Hospital based physicians. Even at that time though Concord and other towns used Boston at least as much as they used Emerson Hospital. Emerson Hospital itself had an ambiguous reputation with the population. There were some who felt that the patients went there only to die or to prepare to die. I don't think that was fair, but it was understandable because since it was limited, people usually got there too late. It seemed to me it was very obvious that Emerson Hospital had tremendous potential. Charlie Duston was a very competent technician and a very competent businessman, and really did a lot to improve the image of Emerson Hospital.
When I first started, my office was on Nason Street in Maynard over the A & P. We came to the area, as I said, because of the possibility of cooperative prepaid medicine. My interest had led me up to the Boston area because I had some medical school training in Boston under Paul Dudley White, the cardiologist, and a number of others; but I had also known several other MGH doctors who had been interested in the White Cross, which was the first prepaid group practice started just before World War II. Dr. Edward Young thought that the White Cross itself was a war casualty, that all the doctors who were participating were eligible for the service; and they got pulled out, and there was no one to provide the service. Therefore, it fell apart. Interestingly enough, he, Alan Butler, Hugh Cabot and several others were called up before the medical society in the early 1940's and were asked why they shouldn't be thrown out of the medical society because they were practicing a socialized, almost communist concept of medical practice. They weathered that, but the drain on the doctor participants yielded to World War II. They were quite interested in my coming into the area with this interest, and so they were very nice. Robert DeNormandie was an obstetrician who lived in Lincoln and was probably the dean of clinical obstetrics in the greater Boston area at that time. He did a lot to help introduce me and my credentials to a blue-stocking population in Concord and Lincoln, so that I garnered a number of families of the cultured, educated, and sophisticated population of those towns. At the same time, it was well known among Finnish mill workers that I was coming equally well-approved, so that I got started fairly promptly. My wife and I celebrated when I had a day that grossed $30 -- that was a big event!
Night calls, it always seemed to me, were extremely profitable to physicians. I sort of deplore the loss of house calls in the present day because it seems that doctors really never get to know their patients if they never go into their homes. In a period of high tech and computerized billing, this separates the doctor from the real essence of medical practice. What we were saying about how sick we are between the ears is ever so manifest. I remember getting called to see a man who had a fever just outside the center of town. He was desperately sick, 103.6 degree temperature and his whole body flaming red and beginning to pustulate. He was a man in his late twenties with chicken pox. He survived, but I learned not only about that but about his children and about his wife, who turned out to be at that time in and out of a sort-of schizophrenic behavior. I learned about how that family lived. It was extraordinary. You go and see people in their homes and they are very different than they are in the office. Night calls were particularly revealing in that way.
I think that medicine has lost a lot because doctors have gotten caught up so much, necessarily perhaps, with high technology which has been developed by the electronics industries, but to the detriment of their relationship with people and the people's family constellation -- all of which contributes to the illness. Yes, I think house calls and night calls were fascinating. It got a little irksome when you got called by the police to make a house call and then as happened to be on one occasion in response to the police having called me, I was hurrying to the house and had one of the town police cars stop me for speeding. That was really annoying, but usually it was a very interesting thing.
There is a very famous caricature cartoon that shows the patient lying in bed with his head swathed in bandages, the doctor standing by the bedside, his doctor's bag opened, the stethoscope drooping out, and the doctor holding a pen and wetting it to his lips as he writes on the white wall behind the patient his bill for his services. He has got a whole lot of things itemized. The point being that the doctor makes his living at the cost of the patient's discomfort. On the other hand, there is no question that an eye-to-eye and face-to-face confrontation of patient and doctor has a disciplinary effect on the doctor's charges and his compassion. If he really finds that what he is asking for hurts the patient because he sees it on his face, then he is able to modify it. The introduction of third-party payments has removed all that. Most people, including the doctors, don't have any idea what the costs are that are being generated in a doctor-patient relationship in the HMO-type of practice.
On the other hand, the fact that big business has moved in and complicated medical care, there is an enormous overhead you have to pay for the business administrators. The high-tech, as I have indicated before, has gotten to be so expensive. If you have an expensive diagnostic test machine in your office, you have to use that machine to pay for that machine, and you have to charge the patient for it. You use it -- sometimes it helps and sometimes it confirms. Usually it does no more than to confirm the doctor's decision on whether the patient does or indeed does not have what the test is supposed to show. It all separates the doctor from the patient. To my mind, that is the essence of medical care and indeed in human relations -- one-to-one sharing of the responsibility of the patient's malady. If the doctor doesn't encourage the patient to meet his misfortune and meet his disease with him, then he is going to have less success and perhaps be another failure. It seems to me if you would list the patient's help in his cure, then you have pretty well insured that patient as a colleague and as a friend and not an adversary that you are going to meet in court over a medical legal practice.
I have always felt that generally speaking a patient that develops medical malpractice has got a basis. It usually is a misadventure in the medical management, irrespective of the fact that the patient also may or may not have had a fatal or a crippling disease; but usually there is a mistake of one sort of another. The reason it gets to court is because there has also been an alienation between doctor and patient. This is particularly true in a complex system whereby the disease is treated by a team of doctors, none of whom address themselves to the care of the patient. They are only treating the disease, and the patient and the family very often feel left out and then they begin to have doubts. Then they begin to ask questions, and there is always somebody to go to and they'll say, "Yes, you have gotten a rough deal." That is what seems to me a major disaster. This is after all the common phenomenon in our socio-economic society anyhow. There is very little trust now. You have to have a credit card. The idea of going in and saying, "I am me, I've been around and you've been around for 20 years, we know each other, we trust each other," is a thing of the past. There is just no more of a warm vibrant community, unity, and confidence, and it is very sad because it lends to the climate of distrust in every aspect of our human relations.
As you know the Acton Medical Associates now has 14 or 15 doctors. While I was there we never got bigger than six or seven. Acton Medical Associates began in 1957 but it was really formed when Ed Bell joined us in 1954. Henry Harvey came in 1952. Two was a partnership and three qualified for a group or an association. We paid $3,000 for the land, it was too much for that piece of property, but I think it is fair to say that it is probably valued at 50 to 100 times what we paid for it now. The building has been expanded, I should say doubled and then quadrupled in size, so I guess it was a pretty frugal and worthwhile business venture.
We felt that group practice was very important. There should be a free interplay between covering for one another. As the group developed the group was interested, even as I had been interested, in having a personal one-to-one relationship, so we always asked patients to choose one of the doctors to be their personal physician, or for the family there would be a family physician. If they, over a period of time, wanted to change that, they should feel perfectly free to do so, but there should be a one-to-one relationship. That survived pretty well even when there were five and six members of the group. We all had our own loyal following, all of whom were perfectly willing to accept one of the others as a replacement for on-call, vacations, holidays, or things of that sort. There was always a one-to-one relationship, and that as I said survived as long as I was there.
I joined the staff at Boston University and in 1948 and did some outpatient teaching three times a week throughout the school year. Then some six or seven years later, since I was a great advocate of country practice and the practicing physician in a semi-rural area having at least a toe-hold in an academic situation, I wanted to promulgate that. So I went and talked to Dean Jim Faulker at B.U. School of Medicine, and he was very helpful encouraging me to start what was called a "preceptorship," which got fourth-year medical students to use one of their elected periods to come out and work with me as preceptor to learn about the clinical practice of medicine in a community that included industrial medicine, school physician, sports medicine, as well as clinical practice in office, house calls, and hospital. The first year I tried to introduce this at the Emerson Hospital there was one member of the staff who was outraged at the damn thing and then talked to all the doctors about the ill-advisability of doing this and suggested that I was just using medical students to spy out my colleagues so I could get the advantage of them. When it came to a vote, the vote turned out to be, I think, thirteen to one. Within weeks the doctors in Boston and in the teaching hospitals all around who had any contact with the Emerson Hospital staff members were asking questions -- "What happened to Emerson Hospital? Why did you lose such a wonderful opportunity?" The next year it got started, and it went for a good 10 years from 1953-1963 as long as I was at B.U., and we really had a fascinating time. Students were very enthusiastic. They proved to be good learners, and they kept not only the members of the Acton Medical Associates, which was growing at the same time, but also members of the staff at Emerson Hospital on their toes. Witness to the fact that even though that preceptorship came to an end, it has since been re-established by younger members of the Emerson Hospital staff so that I felt it was a good thing well worth starting. It was lots of fun -- just lots of fun.
I served on the Emerson staff essentially from 1946 to 1986. I went away for a couple of years in 1978 to 1980 and then came back and practiced more or less on my own but under the roof of and with all the office and nursing support of the Acton Medical Associates, but I did not rejoin the Associates. So I was there for 40 years.
I had a very clear idea, at least I thought it was a very clear idea, of what practice could be when I came to Emerson. I came to Emerson because it was in the country and close enough to be associated with teaching and academic medicine in the city. I came, as I look back at it, with a good deal of self-assurance and confidence in the idea and I made it very clear -- there wasn't any question in my mind. Older men who had been themselves well-trained, many of them at Harvard, took some exception to my being outspoken and my being ambitious in this way. Yes, I was quite outspoken. The laboratory at Emerson consisted of a part-time technician who stopped on his way back home from another hospital laboratory and did the laboratory work for the hospital between 5:00 and 6:30 in the evening. My immediate reaction was, "That's not enough!" I said so. Well, I made a number of other comments which may have touched closer to home. At the end of the year the chairman of the board of trustees caught me in the car at the hospital and asked me whether I thought there was any reason why the board of trustees should reappoint me to the staff. I just stopped in the car and said, "Can you give me a reason why they shouldn't?" He didn't answer, and I don't know what he was looking for when he asked the question. The question or the appointment never came up again.
It is interesting, you know, I never did raise questions that were totally unacceptable or unthinkable by my colleagues. Usually when I raised an issue, there sort of was a startled, electric silence after I asked the question but people would come up to me after the meeting broke up and as we walked down the corridor said, "Don, I am so glad you brought that up ..." I said, "Where were you? I didn't hear you speak up and defend ... "Well, you know ......" And this happened over and over again, but it was a good relationship. Once the Acton Medical Associates got established, just the fact that they were there, my partners really didn't have to speak up because it was known that they were my partners, you see. I almost never asked any questions at staff meetings without having sort of fielded a sense on this subject with my partners and with one or two other people. The staff really did get to be a lot more liberal and a lot more open as years went by. Within the next ten years, not only Acton Medical Associates but lots of new doctors came who were much more receptive to new ideas. Witness to the fact that Emerson is now a very impressive, almost top-flight care at a time when hospitals are having a rough time.
I have gotten in and out of jail I might say on social issues. Yes, I spent a night in jail in Washington, D.C. I was sitting on the sidewalk in front of Mr. Nixon holding him in the light as the Quakers say. That just so happened to have been the weekend before Washington D.C. law and order was expecting the big demonstration in Washington which took place, and so I have always felt that when they picked up something like 100 Quakers that Sunday they did so to serve as a warning to those who were going to come the next week.
If World War II had come much earlier, I wouldn't have been as well prepared to provide service to my fellow man because I wouldn't have completed my formal medical training. If it had come a little bit later, I wouldn't have had the same opportunity to take a position. Most particularly, the fact that I had had my post-graduate training in medicine, so that I was fully prepared to take on a job that the government could use. They could see that they were going to need doctors, whether it was in the military or out of the military. So they made good use of the fact that I was a qualified doctor. When I found out that the American Friends Service Committee were helping conscientious objectors, I got in touch with them and they said, "Go and ask the Civil Service Commission about the Japanese Relocation Camps." They were delighted. Most of the doctors they had were really marginal at best. I said I am a young man and I recognize the word in an emergency and I am ready to go anywhere, do anything and be moved around, and my wife is quite understanding and is willing to cooperate." We went to be troubleshooters for the War Relocation Authority, which was designed under the Department of the Interior, under Harold Ickes who was just a delightful person to work under. He had a vision -- you could feel it even in the ranks way down where we were in the mud of Arkansas, in the desert of Arizona, to provide the necessaries of medical care to the Japanese Americans and the Japanese who had no citizenship that were moved out to the West Coast war zones and were put into these camps.
The physical insult and hurt was far less than the psychological, the economic, and the social isolation -- focusing on them just because they were of Japanese heritage. It was devistating to a self-respecting people who had really made their mark and contributed enormously to the wealth of California particularly as farmers. They were just very good industrious people. Well, in the end it turned out there were ten camps, and I served in seven or eight of them. There was one time I thought I knew more Japanese-Americans on first-name basis than most of the Japanese-Americans in the country and wherever I went it was to go to a place of greater urgency and greater need than where I already was, so it was a great experience. I always felt it was by far the most creative way to spend war years for young men that could be done. By and large almost every young man who lives in the country through an era of war is a war victim. They are scarred for life by the experience they had closely associated with the war, whether they served in the military or not. The compromises, the attitudes of mind are so disforming and so warping from a creative, positive way of life, that it is devastating. I felt by far that this was the least injurious way. As I said, I always felt that I was particularly favored.
I went off to the first assignment leaving Elizabeth and the new baby, a year-old baby behind, and she joined me about three or four months later. We were discussing this the other day with this chap and his boy visiting us today, we were talking about how many of the camps she had been to. And it turned out that she also had been in six. She did one stretch of teaching in the high school, teaching English to the students, one of whom later was a medical school student, and having been taught in high school by my wife was taught in medical school by me. Several others, one who was president of the class told me that he thought that evacuation of the Japanese was one of the best opportunities of his life. It had gotten him away from just the parochial scene in California and he was headed off to an eastern college.
There were those who felt that this was quite a positive experience; but there were a lot of people, particularly the older people, who were much hurt by it, and their self confidence was really shattered. So it was a disaster. But I'm delighted that even 40 years later it has been acknowledged ultimately and ostensibly supposed to be given some kind of compensation.
I was there when the atomic bomb was dropped. We were in Tule Lake, which is the largest and the last of the camps. There were 18,000 in Tule Lake, and we were there for something over a year at the end of the three and a half years. My wife was pregnant with twins and had two runabout children and we got Mrs. Sakari a Japanese born woman who knew very little English but just enough to make do with Elizabeth's help to communicate with one another.
August 5 came, and a train came down the track toward the camp down the valley blowing it's whistle until the steam ran out and the whistle just drooped out and died; and the news came almost instantaneously from up in the camps that Hiroshima had been bombed. Elizabeth turned to Mrs. Sakari and said "Mrs. Sakari, don't you come from Hiroshima?" And she said, "Yes, I do." Elizabeth said, "You have family?" She said, "Two sons, my parents and all my brothers and sisters." Elizabeth said "Oh, dear, perhaps you should go home and be with your husband and family." She said, "No, I take care of the children." By this time the twins had been born, so she got all four of the children taken care of and then she said, "Perhaps I go home." It took time for everybody to begin to understand the full implications of this, and it was a sorry time.
Mrs. Sakari was released because the war was over and went back to Sacramento, and a good friend of hers who stayed in camp working with another family came and checked in on Mrs. Boardman and her four babies. She looked around and said, "You can't do this, you need Mrs. Sakari, I send my daughter." So Mrs. Sakari came back and much to the surprise of the military police who sent word, "There's a Jap out here who says she just got out of the camp and now she wants to come back in, is that all right?" So my wife went out and said it was all right that she was coming to help her. So that was our first intimate association and our first concern with radiation and the nuclear bomb and all that sort of thing.
To my knowledge her family lived in the center of Hiroshima, and we never heard a word. Very little was known about the true dimensions of that thing for five years. Nothing came out of the military. We never knew their fate. We assumed, of course, that Mrs. Sakari lost all her family and her two sons, but we never knew.
We didn't become Quakers until after the Korean War because I didn't want any question for the Selective Service Board about joining a peace church to avoid the draft. It was a special doctors' draft, the Korean War. I got called up and submitted a conscientious objector plea in which I sent a copy of what I had written ten years earlier and said nothing has happened in the intermittent ten years to do more than confirm my opinion. They wrote back and classified me as too old to fight. After that we joined the Friends, and through the Friends we learned about the Quaker Mission Hospital in Kenya. I don't really know why it seemed like such a good idea to both me and my wife to go. They had a doctor that was finishing up and two other doctors that were going three months later, and I said it was obvious they needed some kind of liaison, so I volunteered, having had a splendid time. I enjoyed it so much that I kept talking about it, so that when I got to be 65, my wife thought it would be a good way for me to get out from under the Acton Medical Associates. Given my temperament, she thought that it was unlikely that I could truly retire from the Acton participation staying there, and I agreed, so we went off for two years.
When we came back from Africa, the Physicians for Social Responsibility was being reactivated by Helen Caldicott, the Australian pediatrician at the Children's Hospital, who had been concerned with the uranium miners in Australia. She and her husband both came to teaching positions, but she became very much concerned with nuclear energy, as indeed a lot of people were. The atomic veterans had just come to recognize themselves after a 25 year silence. They were just beginning to be aware of the fact that they had been exposed and that many of them who had no connection with one another, because there was very little buddy activity generated or encouraged among atomic veterans, began to recognize that they were a marked group. It became increasingly apparent that these men had more exposure than was officially acknowledged and that they were sicker than they should be. Their sicknesses didn't fit any category that the Veterans Administration was going to recognize as convincible as service connected. Then it became increasingly apparent that these men didn't really have the kind of disorders, at least some of them, that other people had. Again, here is where time makes a lot of difference. Had I been a young physician, I wouldn't have been secure about being able to tell the difference between malingering or psychoneurotic or opportunistic complaints. After 40 years in a mill town, you really do begin to know how to tell what is real disease, what is imagined disease and what is feigned disease. It was very clear as you reviewed, and I reviewed close to a couple of hundred by now, medical records, that many of these men had an exposure to ionizing radiation of sufficient and significant degree so that they were sure that they had been exposed but not enough for them to have had a recognized and officially acknowledged diagnosis of acute radiation sickness. Many times they would go to see the doctor at the VA or on duty in the military service or subsequently in civilian life and the doctor would say, "You had radiation sickness." But then when push came to shove, it turned out that the records said that the guy had had too much sunburn and too much beer, and that is why he got skin rash, nausea and vomiting, and bloody diarrhea. So the official records more often than not never had it.
Over and over again you would find that the guy who knew all his buddies and had pictures of where he had been at the Nevada test sites would write in and there would be no record of his ever having been there until he pushed and pushed and finally got his lawyer to write a freedom-of-information act letter. Then they'd say, "Oh yes, he was there." After awhile they'd say, "Our records got burned up in St. Louis," or "Our records got lost, mislaid or incomplete, so we will accept any veteran's assertion that he was there on face value if we don't find the records to the contrary." Then it became apparent that these guys were sick and they couldn't really identify what their major difficulty was except that they had never felt quite up to what they should be. There were lots of malingerers, constitutionally inadequate people who were never able to face life. This was different. These guys had specific complaints, and later you could find objective physical findings that didn't fit other categories of disease. This has become so apparent in so many of the records. I think that probably 10% of the hundreds of cases that I have reviewed closely, and have reviewed in general with other people who are concerned with this problem, had this syndrome. It is almost surely got to do with the nature of ionized radiation which does not hit this organ or that organ or this part of the body or that part of the body, but will go through the body and hit at random any molecule in any chemical constituent or any part of the cell. The cell is a great big thing, as big as the human being when you can start thinking in terms of molecules. There are billions of molecules in just the chromosome. The chromosome is only a small part of the nucleus, and the nucleus is only a small part of the cell, and the cell is made up of all sorts of complex things, each of which is made up of molecules, which have got hundreds of thousands of atoms in them, and each of the atoms has a number of circulating electrons. Ionizing radiation pings off these electrons in these atoms, in these molecules, in these fragments of cell, and the guy just doesn't feel right. It may kill the cell and then it gets replaced with fibrous tissue or it may change the protein that makes other proteins, that makes other enzymes, and they are all a little bit off, so you couldn't know what was going to happen. If you'd look, you would find that this does actually happen at very, very, very low levels of ionizing radiation. Most of the x-rays that we have taken, chest x-rays, diagnostic x-rays, are measured in thousands of electron volts; and if you take a series of them, you just multiply them. You can disrupt things with very small amounts. Then it gets more and more complicated, but this has been the problem as I have seen it. I came at it, being a clinician, from a clinical aspect.
I came at it from hearing men tell their stories about what has happened to them. To put their stories together in a cause-and-effect relationship to something that happened to them 35 years ago is impossible, and that is what has been known as the doctors dilemma. But if you see these stories and you see these patterns of disorder happening over and over again, and you recognize the molecular and physical and chemical basis, that that is the way radiation works, then it not only justifies it but it explains why it is the way it is. That is where we are at the present time. This has all been complicated by the fact that since the day after Hiroshima, everything to do with the human hazards of ionizing radiation has been relegated to the Department of Energy. It was originally the Atomic Energy Commission in the military, but now under the Department of Energy, and 27 national radiation laboratories and what is known as the Oak Ridge Associated Universities, Oak Ridge, Tennessee, one of the major radiation facilities government run. The 80 Oak Ridge Associated Universities are the key universities throughout the country that have big nuclear physics facilities, and they are all very well dominated by men who understand what shall and what shall not be disseminated for general consumption. You go to the government documents catalogue and everything you get out of there is stamped, "Cleared, Unlimited Distribution," which means that there are other things that are not cleared. So that I have persuaded, having spent a lot of time studying how radiation works particularly in human tissues, I have persuaded there are a number of very good scientists and health physicists and physicians who are equally assured that this is indeed a fact and that we have absolutely no idea of the degree to which damage is being done. I am not saying it is absolutely destructive. I am just saying the evidence is that it is far more destructive than the general public has been allowed to believe. So that is what I am doing right now.
Almost 20 years ago the high school kids saw their out-of-high school colleagues meet right here across the street on the common in front of the town hall. One night one of the young people that I knew very well shouted, "Dr. Boardman," right from the monument out here, and called because one of his buddies was over there with an overdose, I guess it must have been heroin because he had a respiratory arrest. They got the EMT, and the EMT gave him artificial resuscitation and took him off to the hospital; but it was as blatant as that -- the teenagers collecting night after night out here in front of the town and exchanging and smoking a lot of pot, etc. Two of the younger doctors of the Acton Medical Associates, Jim Longcope, who is now a psychiatrist on staff of Emerson, and Bob Shumacher, who is a pediatrician who went out to the Indian service for awhile and then came back to a private pediatric practice in New Hampshire, got together with some of these young people, who we knew as patients and as contemporaries of some of my children, and we had about 25 enlisted people who came every Tuesday evening to talk about the drug problem. I've always thought it would be a good idea for us to do a follow-up. Well, with 25 that we knew of, the general agreement was that there were at least 50 mainline shooters, intravenous heroin users, in our community. That included Concord, and I don't know how far beyond Concord, Acton and Maynard. We figured at that time that 50 hard-drug users in a community of a few thousand represented a higher incidence of heroin addicts in our community than was reported in New York City. That made us sit up and take notice, and so we started talking about it, and talked to these guys, and talked about how useless it was and what a dead-end track it was on. We never felt, the three doctors, that we really had much impact other than we represented the established community who was willing to talk, listen, and appreciate them as individual human beings. Who's to say whether that had any effect? All I can say is at least one of them got on the methadone and became a lawyer, another one has been in and out of rehabilitation for the next ten or twenty years, one turns up every now and then and reports to me on some of the others, and to my knowledge none of them are dead yet. Of course, here it is '89 -- it is almost another 10 years, it is almost 20 years. One of them really kicked the habit entirely and became a laboratory supervisor in one of the teaching hospitals in Boston, and his sister also was able to kick the habit. So some of them got off it, some of them are still struggling with it, some of them are lost to it. When I came back from Africa, it was ten years from this Tuesday evening group, I asked around if the drugs were any less. Those who were in the know said, "On the contrary, it is probably much worse, it is much more undercover, and it is a much younger group." I never undertook to get involved with it again. Perhaps I should. I thought perhaps somebody else should becoming involved again.
I guess I would say the older I get, the later it gets into the century, the longer I watch the common scene, the more impressed I am with the general lack of interpersonal communication and interhuman compassionate awareness we have for one another, not only in medicine, not only in nuclear energy, not only in the high-tech modern medical management, but in every aspect of human endeavor. I think we are in very precarious times. I don't believe that I am alone. Bill Moyer has been having people provide a world of ideas near midnight for the last month. Everything that those people said sounded very familiar to me and really very ominous. Of course, we all end up on a note of hope. It has got to be better. It is too good to be over with. It seems to me that Albert Einstein was speaking far more profoundly than people have ever understood when he said, "We have got to change our way of thinking." We have got to change our way of thinking, our way of feeling, our way of interrelating, our way of caring not only for one another but for the earth itself and for everything that it stands for. We are making absolutely obscene clutter of the cosmic surroundings of the earth, filling it with radioactive satellites, so it is beginning to look like a used car lot, and we do it with an absolutely pre-adolescent arrogance of ignorance, of not having any sense of responsibility of what we are doing in a very real way to potentially upsetting the total cosmic relationship of this single isolated globe. I feel that this is truly disastrous, and I honestly believe I want to live to see whether humanity can change its way by the turn of the century. I think the year 2000 between here and there is very, very precarious. If we make it to the year 2000, we will have made such compromises with our arrogance that we will bumble along for another 3000 years. I think between here and there is very, very questionable.
I spent a lot of time in the cardiac outpatient department at Boston University School of Medicine, as well as working in the medical clinic, and I was much interested in taking care of cardiac patients along with Jim Hitchcock at Emerson Hospital. I had been doing electrocardiography ever since I was studying at Mass. General as a medical student. Emerson Hospital was ready for a coronary care unit. With Pat Snow and some of the nurses in the east wing, we designed cutting windows and mirrors to make an intensive care unit where the nurses could sit and see each of six beds from where she sat. Then we got American Optical oscilloscope for cardiac monitoring for these patients, and we were in business. Charlie Keevil wrote it all up, and it was one of the key features of Emerson Hospital's contribution to community health care.