SELECTIONS FROM THE MEMOIRS OF DR. THOMAS McNAIR SCOTT
the late Philadelphia pediatrician-researcher-educator
The following paragraphs are extracts from the memoir My Century by Thomas McNair Scott, the late pediatrician, medical educator, and medical researcher (reprinted here by permission). Tom's son, Robert, hired me to interview Tom and write his memoir. I spent two weeks in Philadelphia interviewing him and as you can imagine it was fascinating. Tom was in his 90s.
"Delivering babies in the poor parts of Dublin was quite an experience. You went into the room, drove out the chickens, and delivered the baby. Very often the new father would ply you with whiskey. I managed to escape the whiskey. On the first delivery I made, instead of a baby I found a rare condition called a hydaditiform mole, a cancer of the placenta. I was very proud that I recognized it and called the hospital for help."
***
"My fellowship at the Thorndike was to end in June of 1931, but in the spring of that year the recently founded American Pediatric Society held its annual meeting in Atlantic City. Child care as a separate discipline was introduced to America in the mid 19th century by Abraham Jacoby, a German doctor, practicing in New York. Noting the poor care that children were receiving, Jacoby had made the care of children the basis of his practice, initiating such things as pasteurization of milk and immunizations. He must have taught other doctors to follow his example for he was appointed professor of child health at the New York College of Medicine in 1861. From this beginning arose the group of doctors who became pediatricians, but the first pediatric organization in the United States, the American Pediatric Society, wasn't founded until 1928. I had enjoyed my six months' training in child health at the Queen Elizabeth Hospital in London very much so I decided to go to Atlantic City to attend the pediatric meeting. I traveled down from Boston by train, more than an eight hour journey. While at the meeting, I fell in with some students from Johns Hopkins and, seizing the opportunity, I asked them if I could hitch a ride with them to Baltimore. Thus it was that I took part in the discussion of cases at the weekly 'Grand Rounds' with Dr. Edwards A. Park, one of the country's leading pediatricians.
"Shortly after I returned to Boston, I received a letter from Dr. Park, asking if I would be interested in a job as the resident in the pediatric outpatient department. It seems that the resident he'd chosen for Outpatient care had come down with tuberculosis and had been sent to a sanitarium. I quickly replied to him that I was very interested but that I had had only six months' experience in pediatrics. He took me anyway."
***
"Medical knowledge and treatments have changed since the days I was a resident at Hopkins. When I entered pediatrics, for example, the standard of medical care called for treating cases of infants with pneumonia by bundling them up and sending them with devoted nurses to sleep in the fresh air on the roof. Also, at that time, many children had mastoiditis from middle-ear disease, which then required emergency surgical intervention, mastoidectomy. Now both of these diseases are treated, and indeed prevented, with antibiotics, but in those days there were no antibiotics.
"There was a real resistance to change when I was in training. Medicine had a nihilist mind set. While Fleming had discovered penicillin in 1927, and had shown that it killed bacteria in the petri dish, nobody in clinical medicine had taken notice of it. Although Salvarsan, an arsenical, had been shown to cure syphilis in 1903, no other advances were made in the control of infectious diseases until 1935, when Domack discovered Sulfanilimide with its powerful therapeutic antimicrobial action. Then, with the Second World War coming on, clinical medicine rediscovered penicillin and Flory initiated full scale production of the antibiotic, which became available for U.S. Army use only, in the early 1940s. The Army used it to cure syphilis, which was prevalent during the war. After the war, penicillin became widely used and the mindset changed.
"Attitudes toward pediatric patients have also changed. In the 1930s, when I was a resident, children were kept in the hospital for a very long time, to get over whatever illness they had. Their parents were rarely allowed to visit, only once a month, for fear they would introduce infection into the hospital. In addition, in a study of hospitalized infants who were cared for in every way except that they weren't held, most of those babies failed to thrive and many of them died. That study called attention to the importance of touching and love in the care of infants. In the 1950s, a knowledgeable psychiatrist at Children's Hospital in Philadelphia, John Rose, realized that strict visiting rules were a mistake. Thinking that the nurses might object to any change in their routines, he persuaded them to try parental visiting three days a week. The nurses, soon realizing how much more quickly the children recovered, and how much burden having the parents there took off them, came to Dr Rose and asked, "Can't we have it every day?" This major change was not recognized as a real therapeutic advance at the time, and Rose died of complications from diabetes shortly after daily visits became routine at the Children's Hospital. But in my mind, this was a major advance in child care, which subsequently has became standard practice through out most of the world.
"We often discovered things as we worked. Cardiologist Helen Taussig, for example, ran the cardiac clinic for Dr. Park. She saw numerous babies with Tetralogy of Fallot, who were blue at birth for lack of oxygen, because their veins and arteries were transposed. She suggested that if one could surgically switch the vein and artery, these 'blue babies' could be saved. Dr. Blalock, a surgeon at Hopkins, was persuaded to try this operation. It was successful, and the baby being operated on turned from blue to pink. This procedure, the Blalock-Taussig operation, introduced cardiac surgery for babies and Dr. Taussig became known as the blue-baby doctor."
These excerpts from the book STARTING OVER (2007) originally appeared on the Pat McNees website
In 2024 I moved them to the blog 'Telling Your Life Story' so readers could comment on them.