8. Internship 1966.

County

This is the next in my biographical series about medical school and medical training in the 1960s. The Los Angeles County Hospital was the teaching hospital for USC in 1966. The College of Medical Evangelists, which later became Loma Linda University medical school, shared the County Hospital with USC until they moved to Loma Linda in 1967. They had a private service at White Memorial Hospital, which is still located in east Los Angeles near County.

The photo at the top is one of County Hospital as it appeared when I was a student and an intern. The elevator building visible in later photos was constructed after I began.

I had wanted to go east for my training as I had ambitions for academic medicine. I spent part of my senior year in Boston to become acquainted with the staff at Mass General and they with me in hopes of obtaining an appointment to the internship. My enthusiasm waned somewhat when I found how poorly the interns were paid, $750 a year. Still, my second choice was Johns Hopkins but my wife refused to leave Los Angeles after her three months in Boston. In some ways, I could not blame her as she had no friends in Boston and no social life but, as the wife of an intern, she would not be so isolated.

I also began with a self inflicted wound in my local reputation. There was medical student newspaper published monthly called “Borborygmi” and I was invited to write a piece about my Boston experience. Here, I have no excuse. I wrote up a piece about Boston and the hospital but I foolishly and unknowingly insulted the Surgery department by making a comment about the MGH interns and residents as “deadly serious men” compared to the “Happy County residents going home early or off to their moonlighting jobs.” I was making a rather ignorant observation about the Medical residents I had seen as a student. I had never seen Surgery residents at work as I had never been on the LA County Surgical service. I did not realize that faculty and staff members would see this and assume I was referring to the Surgery residents. I had infuriated people I didn’t know and should have known better.

After I began my internship, I encountered a few of them and suddenly realized what I had done. Too late. An interesting thing happened a month or two into internship. William Nerlich, the Dean of Students, came by to see me and he asked me if I had applied to other residencies because he did;t think the USC Surgery department would accept me. That damned stupid article again. Now what ?

I quickly wrote a few letters, one to Johns Hopkins which I had already heard had matched me for internship and wondered what had happened to me. I wrote saying that family reasons had prompted me to stay in Los Angeles but I was still interested in their residency. I also wrote to UC San Diego whose chairman was Marshall Orloff.

Meanwhile, as I was wondering what I would do next, the internship was fun. One of my first services was Orthopedics and the chair of that department, J. Paul Harvey, had a reputation as a difficult man to please. I liked the service and, if I do say so myself, I was an outstanding intern. One of our cases, the chief resident, a fellow named Neill Shepherd, got a call from his wife that she had been in an auto accident and he left to see her as soon as the admitting night had ended at 8 AM. Dr Harvey came by and wanted to know where Shepherd was and we told him. The junior resident was a surgery resident named Bob Candy and a friend. Dr Harvey became enraged at Shepherd’s leaving and told us we would have “punishment grand rounds” at 3 PM and we had better all be there. We had been up all night but he was the chief and he was living unto his reputation.

At 3 PM, Neill was back and we all trooped around the wards for our “Punishment rounds.” As it happened, I had spent the day earlier in the week going over every patient and even those in the infected ward and the long term traction ward had been checked with a recent urinalysis and blood count plus all the infected wounds had been cultured and antibiotics checked to be sure they were up to date. At the end of the tour, Dr Harvey took me aside and offered me the Orthopedic Surgery residency. Had I been prescient and realized how much money Orthopedic surgeons would make in the future, I might have taken him upon it. Instead, I declined although my general surgery future was now in doubt.

Eventually, Dr. Nerlich came around to me to say the Surgery Department had decided to accept me if I promised not to turn them down. That was a bit odd but I supposed they thought I might go elsewhere but use the approval from them in some way. Anyway, I did accept and enjoyed the residency although the bad feelings I sensed would never really go away. My internship included an elective period which I used to to spend a month on cardiology. I was thinking of cardiac surgery and thought some cardiology would be of help. I even thought of doing a year of cardiology but never followed through. Much of that experience is covered un my recent book, “War Stories: 50 Years in Medicine.”

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