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The Indianapolis Literary Club 2006-2007: 128th Year

Leonard A. Scheele: Hoosier Sage of Science and Public Health

Essayist: Stephen J. Jay M.D.

Read on Monday, October 16, 2006, at the regular meeting of the Indianapolis Literary Club, Park Tudor School, Indianapolis, Indiana

“Salk vaccine is hard to make and no batch of vaccine can ever be proved safe before it is given to children”

Leonard A. Scheele, U.S. Surgeon General, Atlantic City Convention of the American Medical Association, June 8, 1955 (NYTs June 8, 1955)

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“The world cannot be allowed to exist half healthy and half sick.”

Leonard A. Scheele

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“These efforts to prevent suffering and bring health to the world’s people will ultimately be a decisive factor in winning world peace and happiness.”

Leonard A. Scheele. Public Health and Foreign Policy. Ann Am Acad Political and Soc Sci, 1951;278:62-72

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Acknowledgements:

Many persons helped me search for historical information regarding Leonard A. Scheele; I am grateful to them all. Most of my research was during the period 2005-2007.

I am particularly indebted to Dr. Scheele’s son, Leonard A. Scheele, Seattle, Washington, and Dr. Scheele’s daughter, Maria S. Laforge, Kensington, California, who shared personal remembrances of their father as well as unpublished references, images, and insights into his life and work.

The following individuals answered many of my often arcane questions and provided valuable documents and references for my research:

Otis R. Bowen, M.D., who graciously helped me in the history of Leroy E. Burney also responded to my request for his recollections of Leonard A. Scheele, Burney’s successor as U.S. PHS Surgeon General.

Anika Williams, Federal Documents Librarian, Reference and Government Services Division, Indiana State Library, Indianapolis, found important information concerning the Scheele and Vogely families in Fort Wayne, Indiana, including Leonard Scheele’s German-Swiss ancestors. She provided primary references including census records and marriage licenses as well as newspaper articles about Scheele’s professional career in the U.S. Public Health Service. (http://www.statelib.lib.in.us/index.html)

Dwight Strandberg, Archivist, Eisenhower Library, recommended several collections that contained valuable information regarding Scheele’s service in WWII and activities in the Supreme headquarters Allied Expeditionary Force (SHAEF). He also searched for interactions between Scheele and Eisenhower.

Lisa Florio, Reference Librarian, Summit Free Public Library, Summit, NJ, found an important news account from December 27, 1962, of Dr. Scheele’s involvement in the Cuban prisoner exchange following the Bay of Pigs invasion.

Carolyn G. Hanneman, Archivist, Carl Albert Center, University of Oklahoma, Norman, OK., found correspondence between Senator Robert S. Kerr, Senator of Oklahoma (1949-63) and a constituent who opposed the reappointment of Scheele as Surgeon General. There was correspondence between Scheele and Kerr: Scheele thanked Kerr for including the Commissioned Corps of the Public Health Service in legislation on survivors’ benefits. Archivist Ms. Hanneman also found in the George Howard Wilson Collection a radio transcript (1950) between Scheele and a member of Congress regarding air pollution. A Democrat, Wilson was elected to the Eighty-first Congress (1949-1951) as a representative of Oklahoma’s Eighth Congressional District. Wilson was on the Committee on Interstate and Foreign Commerce, Subcommittee on Public Health, Science, and Commerce; he and other congressmen were charged with considering legislation for a national health program.

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Courtney Smith, Oral History Research Office, Columbia University, New York, introduced me to the “Notable New Yorkers” site where all of the Mary Lasker transcripts were available online. I was unable to find Leonard A. Scheele in this data base, but Ms. Smith pointed out an “embarrassing” error that listed Scheele’s name under “Sheely or Shealy.” This material (about Leonard A. Scheele) offered unique insights into a visionary philanthropist and her interactions with a prominent public health official, Leonard A. Scheele. (http://www.columbia.edu/cu/lweb/digital/collections/nny/laskerm/index_names.html)

Dale C. Smith, PhD, Professor and Chairman, Department of Medical History, Uniformed Services University of the Health Sciences, Bethesda, MD, directed me to references to Scheele’s involvement in public health in World War II in North Africa and the European theatre.

Dustin J. Wunderlich, Director of Media Relations, Valparaiso University who, with the University Archivist, Mel Doering, offered information regarding the origins of Scheele Hall on the Valparaiso campus. The Hall was named in memory of Mrs. William Scheele, the mother-in-law and mother, respectively, of the late Rev. Ewald H. Mueller and Mrs. Joan Scheele Muiller from New Jersey. Wunderlich and Doering were unable to establish any relationship between this Scheele family and Leonard A. Scheele’s family in Fort Wayne, Indiana.

Maureen Gaff, Research Center Supervisor, Historical Genealogy Department Research Center, Allen County Public Library, Fort Wayne, Indiana, discovered early references to Leonard A. Scheele’s family, his early schooling, and professional career of his father Martin F. Scheele, a prominent pharmacist. She located census information for the Scheele and Vogeley families and references to local high school yearbooks that contain images of Leonard A. Scheele: The Caldron, 1923, 1924, 1925, and 1926: The Annual of the Fort Wayne Central High School. Newspaper articles that referenced the Scheele family were found in the Fort Wayne Evening Sentinel, Fort Wayne Sentinel, and Fort Wayne Journal Gazette. The Allen Co. Public Library’s Digital Library contained photos of Fort Wayne Central High School. (http://www.acpl.lib.in.us/genealogy/index.html.)

Katie L. Daniels and her husband purchased the home at 1238 Oak Street in Fort Wayne, Indiana, that Martin F. Scheele, Leonard A. Scheele’s father, had lived in since the early 1900s and in which Leonard spent his youth. Mrs. Daniel’s remembrances of “Doctor Scheele” (Martin F) and the medical materials that he had stored in the basement of his home provide unique insight into the life of this Fort Wayne pharmacist who stirred the interest of his only child, Leonard, in a career in medicine.

Nancy Eckerman, Archivist at the Indiana University School of Medicine Ruth Lilly Medical Library, provided valuable insights into search strategies and archival resources for my research on Scheele.

Dina Kellams, Associate Archivist, Office of University Archives and Records Management, Indiana University, provided information regarding the holdings of Indiana

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University Library and Lilly Library for Oscar Ewing, administrator of the Federal Security Administration under President Truman and an Indiana native and Indiana University graduate and benefactor. She searched (successfully/unsuccessfully XXXXXX) for correspondence between Ewing and Dr. Scheele and any correspondence involving Ewing where Leonard A. Scheele was mentioned.

Kathleen Cruikshank, Political Papers Specialist at Indiana University Lilly Library, Bloomington, Indiana, and Barbara Truesdell, Assistant Director, Center for the Study of History and Memory, Indiana University provided access to papers of Oscar Ewing, who, as Administrator of the Federal Security Administration, supported the nomination of Leonard A. Scheele for U.S. PHS Surgeon General in the Truman administration. They were unable to find correspondence between Ewing and Dr. Scheele.

Paul G. Anderson, Associate Professor of Communication an Archivist, Becker Medical Library, Washington University, St. Louis, reviewed correspondence between Edmund Vincent Cowdry (1888-1975), professor and cytologist at Washington University Saint Louis, and Leonard A. Scheele in the 1940s regarding their interaction at the 4th International Cancer Congress in St. Louis.

Robert G. Burney, Washington, D.C., son of Leroy E. Burney, who succeeded Leonard A. Scheele as U.S. Public Health Service Surgeon General in 1956, kindly provided personal remembrances of his father’s relationship with Dr. Scheele.

Stephen Plotkin, Reference Archivist at John F. Kennedy Presidential Library, helped me gain access to oral histories, the National Security Files and President’s Office Files as well as the Louis Oberdorfer papers that include materials relating to the “Cuban Prisoner Exchange.”

Sharon Kelly, Reference Technician, John F. Kennedy Presidential Library directed me to library holdings related to the Cuban prisoner exchange in December 1962.

Leah Jansen and Jennifer McCloud provided excellent technical assistance in processing digital images in preparation of this research for publication.

End Acknowledgments SJJ

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Leonard A. Scheele: Hoosier Sage of Science and Public Health Essay read before the regular meeting of the Indianapolis Literary Club October 16, 2006, Park Tudor School, Indianapolis, Indiana.

Introduction

This is the second in a series of presentations of Hoosiers who became leaders in public health in the United States at mid-century. At a meeting of the Club April 21, 2003, I presented an essay entitled: “Burney’s Burney” that featured the life of Leroy E. Burney from Decatur County, who rose to preeminence in the Eisenhower administration as the 8th U.S. Public Health Service Surgeon General. (1,2,3)

This evening, Leonard A. Scheele will be our focus: a mentor and predecessor of Burney, and a central character in the remarkable story of the dramatic post World War II (WWII) expansion of the health sciences and public health in America.

Early Life

In the 17th century, at the confluence of the Maumee, St. Joseph’s, and St. Mary’s Rivers, the village Kekionga, was the capital of the Miami nation. “Mad” Anthony Wayne drove Chief Little Turtle from Kekionga and built Fort Wayne in 1794. (1-3) The city was incorporated in 1840, and only about twenty five years later Leonard Scheele’s grandparents were part of a wave of German and Swiss immigrants to this part of middle America.

Scheele’s maternal grandfather, Andrew Vogley, was a blacksmith and carriage maker. (4,5) Scheele’s father, Martin, was a druggist who married Minnie Vogely in 1902; they had one child, Leonard A. Scheele, who was born at home at 1238 Oak Street in Fort Wayne on July 25, 1907. Scheele’s mother, Minnie, had been reading about a famous and colorful character, a physician, Major General Leonard Wood, who commanded the Rough Riders in the Spanish American War; Minnie liked the name “Leonard” and gave it to Scheele. (4) In 1920, Scheele’s namesake was narrowly defeated in his bid to become the Republican nominee for president of the United States. (5)

Young Scheele attended Central High School in Fort Wayne where he excelled, showing brilliance as a scholar and a leader. (6) His father was a respected pharmacist and in 1910 became an officer in the re-organized Dreier Drug Company, the oldest pharmacy in Fort Wayne and founded in the 1840s. (7) Young Leonard Scheele was first introduced to medicine as he worked in the pharmacy for his Dad who urged his son to consider becoming a physician. (8)

From these modest beginnings in the Midwest, Scheele would indeed become a doctor, not a practicing physician, but ultimately the nation’s physician. (9-11) He would become a prominent cancer researcher and would be appointed Director of the National Cancer Institute (NCI); he would serve with distinction under General Eisenhower in WWII; he would become the 7th U.S. Surgeon General and oversee historic advances in the Public

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Health Service (PHS), serving longer that any Surgeon General in the past 60 years, other than C. Everett Koop who served an equal time; Scheele would manage the introduction of the Salk polio vaccine in America; he would lay the foundation of modern health science and public health. And, after his long tenure as Surgeon General, Scheele would lead one of the nation’s major pharmaceutical companies. Then, in a time of international crisis, Scheele would be called upon by the President of the United States to help negotiate with Fidel Castro the release of Cuban exiles captured in the failed Bay of Pigs invasion.

Medical Education and Early Years in the Public Health Service

Leonard Scheele’s early interest in medicine blossomed at the University of Michigan where he obtained a B.A. in 1931. (1,2) Scheele had met his future wife Miss Frances K. McCormick in 1928 when he was a freshman at the University of Michigan. (3) She was studying dentistry in Detroit, and Scheele moved there and received his M.D. degree, cum laude, in 1934, from the Detroit College of Medicine and Surgery-now Wayne State University School of Medicine.

One of Scheele’s professors, Dr. C.C. Young, sparked his interest in public health; and when an officer from the PHS and Detroit Marine Hospital visited the school, Scheele’s interest in preventive medicine and public health was piqued; he competed successfully for an internship at Chicago’s Marine Hospital, and on July 2, 1934, he accepted a Commission as Assistant Surgeon in the U.S. PHS. (3)

Scheele was assigned to quarantine duty stations at Angel Island, San Francisco and San Pedro, California, Honolulu, Hawaii, and Centerville, Maryland. His talents were recognized by Surgeon General, Thomas Parran and Dr. Joseph Mountain—two pioneers in public health.

The National Cancer Act of 1937 had raised cancer to a national priority, and Scheele was sent in 1938 to Queens at the New York City Memorial Hospital for Cancer and Allied Diseases (now Sloan-Kettering) for clinical training. For two years he engaged in cancer epidemiological research as part of early efforts to determine the cause of cancer. (4) On his return to Washington, D.C., Scheele, only 32 yrs. old, was appointed in 1939 officer in charge of the new National Cancer Control Center in Bethesda, the first public health cancer control program at the National Cancer Institute (NCI). But, his career was about to be interrupted.

Military Service in World War II

It was common practice for the PHS to lend its officers to the Armed Forces. Within days of the attacks on Pearl Harbor, Scheele was assigned to the Office of Civilian Defense under New York Mayor Fiorello H. La Guardia. (1)

In the late summer of 1943, Scheele was sent by the Army to Charlotte to the School of Military Government in a class of 75 men who were trained over four months how to reestablish government in enemy countries of Germany and Italy as well as in friendly

7 countries the Germans had overrun such as France, Belgium, the Netherlands, Austria, Denmark, and Norway. (2) Scheele was selected with a group of specialists to go to Algeria to assist in the planning for the invasion of Italy. (3) He and another officer were singled out for a top secret mission to Algiers, where General Eisenhower was planning the invasion of Sicily and Italy. Their job was to personally deliver a cargo to the Algiers command that included several large wooden boxes containing plastic models of Sicily, with the latest deployment of enemy soldiers, radar sites, ammo dumps, tank parks, barracks, and other data. On this flight, they also carried numerous boxes of 8”x10” negatives from the reconnaissance cameras of the squadron of planes of President Roosevelt’s son. These images were to be turned into maps for U.S. General George Patton and the British general who invaded Sicily. (2)

As the invasion forces moved from Sicily to Italy, Scheele moved to Naples and there was instrumental in quelling an outbreak of epidemic typhus by using a newly developed insecticide that killed plant lice; it was found to also kill human lice that transmitted typhus. (2)

In 1944, Lieutenant Colonel Scheele was selected by Brig. Gen Julius Holmes, Eisenhower’s American G-5 officer, and Brig. Gen Frank McSherry of the 155th Army Group to join the newly formed Supreme Headquarters Allied Expeditionary Force (SHAEF) in London under the command of General Eisenhower. (3-5) His job was to begin planning for civil affairs and military government in Germany and the liberated countries of northwestern Europe. (5,6) Scheele moved with the SHAEF headquarters from England to Versailles; while there, Scheele’s daughter, Maria, remembers that her Dad’s offices were in an area that had once been the stables at Versailles. (7)

Scheele served as Chief Medical Officer of the SHAEF G-5 Government Affairs and Public Health Section until April 1944. (8) Then General Warren Draper assigned Scheele to head the Preventive Medicine Section –Draper and Scheele were the first two officers of the PHS assigned to SHAEF and to the Public Health Branch. (9)

Information regarding the public health status of civilians in Italy, Germany, and other occupied countries was obtained from allied spies as well as civilian health officials, including those in enemy territories. Scheele sent information on the location of public health data repositories to allied air forces so they could avoid these buildings on their bombing runs. Scheele’s goal was to preserve as much of the enemy’s public health infrastructure as possible in order to prevent civilian chaos and epidemics at war’s end. In August 1945, Scheele met with one of his collaborators, Dr. Pierret Director of the International Office of Public Hygiene (precursor of the WHO), who told Scheele he refused to leave his office in Paris, telling the Germans that only the nations that elected him could do this. Pierret survived and protected vital health information by stashing public health documents in a haystack. (10)

Reflecting on the effectiveness of the public health mission in Europe during WWII, Scheele noted in 1951 that by preventing epidemic typhus in Italy and Germany,

8 thousands of lives of concentration camp prisoners were saved due to the collaboration between SHAEF public health section and the war-disrupted civilian health services. (11)

Toward the end of the war, Scheele moved with the SHAEF headquarters from Versailles to Rhiems until the Germans surrendered. At 02:41 on the morning of May 7, 1945, at the SHAEF headquarters in Rheims, France, the German General, Alfred Jodl, under orders from German Admiral Doenitz, signed the unconditional surrender documents for all German forces to the Allies. The document included the phrase, “All forces under German control to cease active operations at 2301 hours Central European time on May 8, 1945.” (12)

In the hours leading up to the German surrender, Scheele attended a buffet dinner and General Eisenhower briefly stopped in, and when he departed he said: “Keep the party going; they will agree, and I’ll come back and celebrate with you.” Scheele related this story in an interview in 1981 with his grandson, who had a class assignment in World History; Scheele concluded by saying: “They did and he did.” (2)

From Rhiems, Scheele moved to Frankfurt where the partition of Germany and Berlin were planned. His final six weeks were spent in Berlin under the command of General Lucius Clay. Near the end of WWII, Scheele was appointed director of the Health, Welfare, Education, and Religion Division of the Allied Control Council in Berlin. Scheele knew German from his Swiss grandparents, and he debriefed Nazi physicians at the end of the war. (13) Scheele’s final job took him with General Clay to Potsdam; Scheele was appointed as a consultant to the Potsdam Conference. (14)

Dr. Scheele’ staff worked with repatriation of thousands of slave laborers used by the Germans, from Poland, Lithuania, Latvia and Austria. He visited all German concentration camps and coordinated these repatriation efforts with the United Nations Relief and Rehabilitation Administration. In July 1945, Scheele met at Dachau with Col. Paul A. Roy, Commanding Officer of the Dachau Camp to discuss public health needs of liberated prisoners and civilians. (15)

Scheele received numerous awards for meritorious service in WWII, including: the U.S. Typhus Commission Medal for his work in preventing typhus in the civilian populations of Northwest Europe during 1944-45 (16); and the Legion of Merit (USA) for outstanding work in controlling communicable diseases in the European Theater of Operations; he also received the Croix de Guerre with Palm (France); Commenda nell’Ordine dei SS Maurizio e Lazzaro (Italy); the Order of Public Health (France); and the Order Carlos Finlay of Cuba. (14)

In reflecting on the role of pubic health mission and its officers in WWII, General Eisenhower stated: “their task was difficult but vastly important, not merely from an humanitarian viewpoint, but to the success of our armies.” (17)

Public Health Service

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On his return from Europe, Scheele was appointed Assistant Chief of the National Cancer Institute (NCI) in 1946, and through his skillful diplomacy in Congress achieved a fourteen-fold increase the NIH budget; the following year, 1947, he was appointed Director of the NCI and Associate Director of NIH. (1,2)

U.S. Public Health Service Surgeon General

When Surgeon General Parran, a legendary figure in public health appointed by President Roosevelt, retired from office, President Truman appointed Scheele Surgeon General on April 6, 1948, the 7th U.S. Surgeon General in history. (3-10) Scheele was expected to shift the emphasis at the PHS from Dr. Parran’s “spectacular crusade” against Syphilis and toward greater attention to research.” (11) Only 40 years old and the youngest surgeon general in the nation’s history, Scheele’s star in public health was indeed rising, and before his career in the PHS had ended a decade later, he would serve two presidents during a period of the most dramatic expansion of health sciences, health care services, and public health in U.S. history. (12-13)

At the time Scheele was appointed Surgeon General, the PHS was part of the Federal Security Agency (later replaced by the Department of Health Education and Welfare, and today the Department of Health and Human Services), and another Hoosier—Oscar R. Ewing-- from Greensburg, Indiana, was his boss. (1) In an oral history interview with Oscar Ewing in May 1969, Ewing said he recommended Scheele for Surgeon General and commented that “The president knew Scheele and was very happy to appoint him.” (14)

Scheele’s success as Surgeon General was attributed to his many personal and professional attributes: his consummate administrative skills, his quiet, thoughtful, and friendly demeanor, and his excellent relationships with Congress and the private sector. Scheele was described as “A tall man of pleasing and commanding appearance…an affable, able administrator…” He had light brown hair and dark blue eyes (1,2), “a man who never seemed to hurry—or to waste a minute...one of the few men who will eat soup and talk on the telephone simultaneously” (13) An associate said of Scheele: “In 10 years I don’t think I’ve ever heard Leonard Scheele raise his voice.” (13,15)

Dr. Scheele oversaw the massive expansion of biomedical research and education after WWII. The PHS dealt with major, sometimes controversial problems. Scheele worked closely with prominent congressional leaders, particularly Senator Lister Hill and Representative John Fogarty who became champions of the NIH. (8)

Scheele’s activities and programs were many and varied. Following decades of research in the Midwest, including, Indiana, the PHS endorsed fluoridation. Scheele’s public announcement on April 24, 1951, giving unqualified recommendation for fluoridation of public drinking water, enhanced the credibility of the PHS and elevated the role of Surgeon General Scheele as the spokesperson for health in America. (12,16)

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Other issues on Scheele’s agenda included: venereal diseases and tuberculosis control (17-19) and research into the relationship between smoking and lung cancer. (20) Scheele introduced new programs to control water pollution, air pollution, and ionizing radiation. (21-24) He worked with the Broadway and film star, Eddie Albert, to use TV for public health. (25)

Health care needs were not being adequately addressed in the burgeoning U.S. population recovering from the trauma of WWII. President Truman re-introduced a controversial proposal from the Roosevelt administration for national health insurance (Wagner- Murray-Dingle Bill) in 1947-8. President Truman gave the job of promoting the plan to his Secretary of FSA, Oscar Ewing, who approached his fellow Hoosier, Scheele, to assist him in the effort. He asked Scheele to go on television with him and debate the AMA, who staunchly opposed the idea as “socialized medicine.” Scheele declined Ewing’s offer, stating that the office of the Surgeon General could not engage in partisan politics and maintain credibility with the American people. Ewing accepted Scheele’s refusal. (8) Many believe that Scheele’s success and longevity in the position of Surgeon General was due to the care he took in avoiding partisan politics. (26-29) Scheele’s daughter, Maria LaForge, said: “No one knew Dad’s politics.” (30) And, Scheele’s son, Leonard, said, “The strongest feature he had was that he transcended politics…” (31)

Scheele inherited several major programs that his predecessors initiated but that were delayed by WWII: the Interior Department’s health bureau for American Indians was transferred to the public health service in 1954; the Department of Defense’s Armed Forces Medical Library was transferred and renamed the National Library of Medicine in 1956. In addition, the President appointed Scheele to head the U.S. delegation to the World Health Organization (WHO) from 1949 through 1953, and Scheele served two terms as President of the organization. (32-35) Scheele was critical, however, when the U.S. failed to join the WHO; he said: “no communicable disease respects a national boundary.” “…We are not immune because we are Americans.” (36-38) President Truman promoted America’s role in world health as an essential in fighting Communism, and Scheele suggested that promoting public health would make developing countries more economically productive and would promote democracy. (39-40)

Scheele became widely recognized as America’s physician and was highly respected by Democrats and Republicans alike. But two issues were to become Scheele’s legacy as Surgeon General—the organization of the new research institutes at the NIH and the introduction of the Salk polio vaccine.

National Institutes of Health

From 1948 to 1956, Scheele oversaw the establishment of five new institutes at the NIH. (41-42) In 1947, Mary Lasker, a prominent philanthropist, suggested to Scheele that a national heart institute be established similar to the NCI. (41,43-48) Working closely with Mary and Albert Lasker and Congress, Scheele obtained funding and on June 16, 1948, President Truman signed the bill to establish the new National Heart Institute.

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Following this success, Scheele obtained approval and funding for other centers: National Institute of Dental Research (1948); National Microbiological Institute (now the Allergy and Infectious Diseases Institute); the National Institute of Experimental Biology and Medicine (renamed in 1950 the National Institute of Arthritis and Metabolic Diseases); and the National Institute of Neurological Diseases and Blindness (1950). Finally, in 1953, a 500 bed Clinical Center to link basic research to clinical care was established at Bethesda. (41,49) This remarkable expansion of the nation’s biomedical research foundation under Scheele’s watch has never been replicated and stands today as a milestone in the history of health sciences in America and the world.

Polio and the Salk Vaccine

By the early 1950’s Scheele’s stature and visibility as a public figure in health and science were established. But the polio challenge in the mid-1950s would forever define his career in the public’s mind. (1,2)

The controversy that erupted shortly after the release of the Salk polio vaccine in 1955 was a threat to the credibility of the PHS and researchers. (3-5) The Eisenhower administration was vulnerable to public scorn. In 1953, President Eisenhower had elevated the Federal Security Agency to the Cabinet and Oveta Culp Hobby, a Democrat and friend of Eisenhower, was appointed Secretary of the new Department of Health, Education, and Welfare (DHEW). She became Scheele’s boss and a central figure in the controversy. Let’s explore this interesting saga in American history.

The first polio epidemic reported in the U.S. was in 1894 in Vermont. When the public learned that President Roosevelt had the disease, attention was focused on finding a cure. The National Foundation for Infantile Paralysis (March of Dimes) had been created in 1937 by President Roosevelt and in 1938, the entertainer, Eddie Cantor, coined the term “March of Dimes” and urged Americans to donate their spare change to fight polio. Modern fundraising for health charities was born, with poster children and celebrities.

Research to find a cure for polio had begun in earnest by the 1930’s and it was funded primarily by the National Foundation not the government. (6) By the 1950’s, the stage was set for the introduction of a polio vaccine in America. Scheele’s efforts would receive both accolades and condemnation, and to this day the internet is laced with anti- vaccinationist’s vilification of the government and Dr. Scheele’s actions in managing the so-called “Cutter Incident.”

The introduction of the Salk polio vaccine brought together the charismatic leader of the National Foundation for Infantile Paralysis, Basil O’Conner, with vaccine scientists, including Jonas Salk and Albert Sabin, the pharmaceutical industry, Congress, and the DHEW.

In 1954, the number of cases of polio in the United States was at record levels, with 38,741 new cases reported, 1,620 deaths, and 18,000 cases of paralytic disease. (7). Field trials of the Salk vaccine produced by the pharmaceutical houses, Eli Lilly and Parke

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Davis were conducted by the University of Michigan and involved 2 million children. (8)

At 9:00AM on April 12, 1955, in a packed auditorium at the University of Michigan, Dr. Thomas Francis, Jr., reported the successful results of these trials. (3,9) Dr. Francis’s report was the number one news story of 1955. (3) Four hours after his report Secretary Hobby announced licensing agreements with six manufacturers: Cutter Laboratories, Berkeley, Eli Lilly, Indianapolis, Parke-Davis, Detroit, Pittman-Moore, Zionsville, Indiana, Sharp and Dohme, Philadelphia, and Wyeth in Marietta, Pennsylvania. (10) Surgeon General Scheele and Secretary Hobby announced to the American public that the vaccination of children would begin. The date of this press conference was ten years to the day of F.D.R.’s death from polio. On April 23, in the Rose Garden, President Eisenhower, with Dr. Scheele and Secretary Hobby in attendance, recognized Dr. Jonas Salk as “a benefactor of mankind.” (11)

More than 10 million doses of vaccine were administered, with 90% going to elementary age school children around the country. Scheele’s son Leonard received his vaccination with his classmates shortly after the vaccine was released. (2,12) Then trouble started. (3,4,13,14) First, there was paranoia among the public and policy makers over the adequacy of supplies of vaccine to meet the enormous pent-up demand of the public, including those unable to pay for the vaccine. (1,8) Second, within two weeks, on April 26, Scheele’s staff received reports of six cases of polio contracted by children vaccinated with Cutter vaccine. Shortly before noon on April 27, Scheele urged Cutter to temporarily recall all its vaccine. (8,15) Since it was known from earlier trials that the polio vaccine was 60-90% effective in preventing polio, it was not clear if the Cutter vaccine was the problem or whether these cases occurred by chance. (8) Scheele immediately convened scientists, pharmaceutical company researchers and public health experts to review the Cutter data. On May 7th Scheele issued a public statement ordering the postponement of all polio vaccination while the review was taking place. (1,8) On May 14, Scheele reassured the nation that “No national health emergency confronts this country today.” (16) Scheele informed the public that the PHS “did not feel in any way that there is reason to challenge the effectiveness of the Salk polio vaccine or the validity of immunization programs now underway throughout the country.” (1)

On May 25, Scheele recommended that the manufacturers change procedures for testing polio vaccine. (17,18) The changes were accepted the next day. (8) On May 27, Scheele announced the revised standards and said their purpose was “to make a good vaccine better.” (1,3) Eli Lilly Co. was the first to get its vaccine approved using the more rigorous standards. (19)

The media attention to the Cutter incident exploded, and Scheele met tough questions from Lawrence Spivak on Meet the Press. (19) Scheele’s daughter, Maria, who was 9 yrs old at the time remembers that Spivak took her aside before the interview and told her he was going to ask her Dad tough questions but that he liked what her Dad was doing. (20)

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Between April and June 1955, 69 children out of a total of 409,000 who had received Cutter vaccine had developed polio, an attack rate greater than expected. (8,21-23)

Scheele instituted major changes including a Poliomyelitis Surveillance Unit at the Centers for Disease Control; a national reporting program for the states; and a Division of Biologics Standards at the NIH. 1,24,25)

The public remained confused and alarmed as the story dominated headlines. The New York Times said that “the air of victory” surrounding the Salk vaccine had become a stench of “confusion, conflict, and doubt.” (26) Finger-pointing was rampant. (27) “Democrats accused the Republican administration of “horrendous mistakes… bordering on criminal negligence.” Paranoia over the predicted lack of supply of vaccine heightened. (28) Senator Lister Hill proposed legislation, that Secretary Hobby opposed, to provide free vaccine to children under age 19. When Senator Goldwater equated “free vaccine” with “socialized medicine, Hobby responded that “it was socialized medicine by the back door, not the front door.” (26,29,30) Salk blamed the drug companies, and Basil O’Conner of the National Foundation for Infantile Paralysis blamed government and the manufacturers. (31-33) When asked by the media what went wrong, President Eisenhower parried with a “no comment” but speculated that government scientists may have tried to “short-cut a little bit” on safety tests in response to the unprecedented demand for the polio vaccine, an indirect swipe at the aggressive crusade of Basil O’Conner and the National Foundation. (34)

The DHEW Secretary Hobby came under intense fire. (35,36) At a Public hearing Hobby stated: “No one could have foreseen the public demand for the vaccine.” This comment drew “hoots of derision.” (37,38) There were calls from some scientists, the media, and the public to abandon the trials. (39) But most children had tolerated the vaccine and data was beginning to show that overall polio cases and case rates had decreased. The question was stark—should a vaccine that kills children, albeit at a very low rate, continue to be administered even if the overall incidence of disease and death was decreasing?

After several weeks of uncertainty, Scheele reported to the nation that the unexpected polio cases among in children who received the Cutter vaccine was most likely caused by a technical problem with the process of formalin inactivation of the live virus. (8,39-41) Further, Scheele said the tests in place to determine the presence of live virus were not sensitive enough to detect small amounts of residual virus. When rigid protocols were followed, however, no live virus was found in the vaccine.

By this time, seventy-one cases of paralytic polio had been reported and eleven deaths in children who had received the Cutter vaccine. (42) Scheele announced that the vaccine was as safe as it could be and that the vaccination of American children would continue. (39) It is interesting to note that although this tragic incident came to be known as the “Cutter Incident,” polio cases occurred in children vaccinated with vaccine produced by other companies but at a much lower level. (43)

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Secretary of Hobby and her Special Assistant for Health and Medical Affairs resigned within two months of the incident; she said she needed to care for her ailing husband. Scheele, on the other hand, weathered the storm despite some calls for his resignation. He even received death threats. Rep. Charles Halleck from Indiana, however, rose to Scheele’s defense in Congress. (44) President Eisenhower’s confidence in Scheele was solid and Scheele was reappointed. (45)

A careful review of the history of the so-called “Cutter Incident” reflects the skill with which Scheele and his administrators and the scientists and companies managed the problem. Errors were clearly made, in part, because of the very short time frame involved in transferring a small research process in Dr. Salk’s laboratory to a full-scale commercial one, involving mass vaccinations. Scheele and his associates agonized over the events; he commented that “It was a tragic time.” (46) And, Scheele’s daughter, Maria, said her Dad was devastated by the incident. (47)

But, by year’s end in 1955, the overall success of the Salk vaccine was clear: paralytic polio had been decreased, with an overall protection rate of about 75%; hospital admission rates for polio decreased 52% among 8-year olds and 40% among 7 year olds; there was a 17% decrease in polio rates in the total population. (48,49)

On June 10, 1955 Dr. Scheele issued another report on the Salk vaccination program. (8,50) Scheele stated that: “events in the traditional course of scientific development that would have covered years were telescoped into months and, as a result, both successes and failures have been magnified. In the long run, however, the nation and the world will surely have gained from efforts to speed the availability of an effective immunizing agent against the disease.” In November 1955, Scheele reported that children receiving Salk vaccine showed a 67-90% fewer paralytic polio attacks. (51) and Jonas Salk reported that in a seven state study Salk was 69% effective; he noted that among vaccinated children there were only 58 cases in 1.5 million but among the unvaccinated children there were 325 cases in 1.8 million. (52)

Reflecting on the significance of the polio vaccine introduction in 1955, Scheele presciently noted that “Principles utilized in the development of the Salk poliomyelitis vaccine offer promise in solving the baffling problems of virus diseases…forthcoming biologics may be applicable to the control of mumps, measles, influenza.” How right he was. (53) In May1956, one year after the Cutter Incident, Dr. Scheele and Dr. Jonas Salk spoke at the meeting of the American Medical Association and said that with mass vaccination of children the dream of the “final conquest” and elimination of polio in the United States could be realized. (54)

Retirement and move to the private sector

On August 1, 1956, after eight years as Surgeon General, and twenty-two years in the PHS, President Eisenhower accepted Leonard Scheele’s resignation. (1-3) Scheele, whose job paid $17,000 a year, said he was quitting “in the interests of providing more properly for the future security of my family.” (1) Although there has been speculation

15 through the years that Scheele resigned because of the “Cutter incident,” no evidence supports that contention. (4-6)

Upon retirement, Scheele assumed the Presidency of Warner-Chilcott Laboratories Division of Warner-Lambert Pharmaceutical Co. in Morris Plains, New Jersey; in 1960 he became Senior Vice President of Warner-Lambert, President of its Research Institutes in the U.S. and Canada. (7)

Even though he had left government service, Scheele was frequently called upon by the government to consult on various national and international health issues. Scheele went to South Korea for the U.S. Army and visited field hospitals near the fighting front with North Korea. (8) But the call Scheele received in 1962 would be perhaps the most interesting and important call in his career.

Bay of Pigs

On April 17, 1961, anti-Castro Cuban exiles from the U.S. invaded Cuba —the Bay of Pigs debacle had begun, and when hostilities ended on April 21, more than 1,200 prisoners were being held by the Castro government. Their release was a priority but for months little progress was made. The U.S. Government would not intervene directly to negotiate a prisoner release but instead a solution was sought in the private sector. (1) Robert Kennedy, then U.S. Attorney General secretly contacted a private lawyer, Mr. James B. Donovan, a Harvard Law graduate, a friend of the Kennedy’s and well-known for his work as an OSS prosecutor at Nuremberg, a court appointed defender of Col. Rudolf Abel in 1957 and the negotiator of the most spectacular spy swap of the cold war- --Soviet spy master Rudolf Abel for U-2 pilot Francis Gary Powers on a bridge in Berlin in February 1962. Donovan and a small contingent of staff made contacts with Fidel Castro and negotiations began August 1962.

Castro initially wanted to trade the prisoners for farm tractors but this plan was scrapped a year before. (1) Castro then demanded pharmaceutical products, baby food and cash. A plan to collect drugs, store, and ultimately ship medicines, whose value was $53 million at market value or $17 million actual cost, was developed. There were additional pledges of $2.9 million in cash. (2) But, negotiations lagged. Pharmaceutical companies were reluctant to proceed unless President Kennedy expressed support for the operation which he did in early December. The Red Cross agreed to accept drugs as contributions to charity and help deliver them to Cuba. Attorney General Robert Kennedy on December 7 and 9 met with the drug and food industry to gain support. The pace of negotiations quickened.

At this time, Leonard Scheele was President of Warner-Chilcott Laboratories and as the nation’s former physician, a medical doctor, and an expert in public health he was ideally suited to allay Castro’s concerns about the deal. President Kennedy asked Scheele to join Mr. Donovan’s negotiating team. (3-5) Scheele’s daughter, Maria, indicated that this happened suddenly and with secrecy. (6) Scheele had known both John F. Kennedy and Robert Kennedy. The Scheele’s lived four houses from Robert Kennedy on O Street

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when Leonard Scheele was Surgeon General. Ethyl Kennedy would take the Scheele’s young son, Leonard, to play at the Kennedy Hickory Hill estate in McLean, Virginia. It is not clear whether Scheele knew Donovan previously.

Donovan and Scheele soon met with Castro; Castro liked Scheele, in part, because Scheele’s former title included “General.” Castro liked to call Scheele “General” Scheele. After 20 months of difficult negotiations a deal was at hand. (7) After reviewing the final list of drugs over night, Donovan and Scheele flew on Air Force 1 on Thursday morning, December 20, 1962, to Havana. The next day Donovan called Washington that he and Castro had signed the Memorandum of Agreement. The mood had changed. Scheele was one “of four Americans personally escorted by Castro on a fast-moving auto tour of Havana” including a “visit to the late Ernest Hemingway’s home.” (5)

But, early on December 22, Castro wanted to inspect the drugs and sent three Cuban doctors to Miami; they were met by Scheele and other U.S. representatives, including the Red Cross. (1) The final agreement called for an exchange of $53 million worth of baby food, drugs and medical supplies, for the 1113 prisoners that were to be released beginning Christmas eve. (4,8) The supplies were inspected by Scheele and the three Cubans at Opa-Locka, northwest of Miami, and then were taken to Port Everglades where they were loaded onto the SS African Pilot bound for Havana. (2,9) Castro met the ship in Havana the next day and the prisoner exchange began. It was Christmas Eve.

On April 21, 1963, Dr. Scheele announced that James B. Donovan had secured the release of the last group of Americans remaining in prison in Cuba, about 22 men. (10) Seven months later on July 3, 1963, the last of the medical supplies reached Cuba. By then Donovan had negotiated the release of approximately 8,000 additional prisoners not involved in the Bay of Pigs invasion. The total cost of the operation to the U.S. was about $29 million most of which was a tax loss to the government as a result of the drug company’s arrangement. Donovan’s mission for the prisoners was accomplished, and he had protected the President from potentially negative publicity for dealing with Castro.

Dr. Scheele’s daughter said that her Dad received a personal letter of congratulations for his efforts during this critical period from President Kennedy. (Personal communication October 15, 2006.)

Scheele’s final years and legacy

After a long and distinguished career in public health and in the pharmaceutical industry, Scheele retired in 1967. He remained a consultant to Warner-Lambert for the rest of his life.

Through the years Scheele received numerous awards, honors and honorary degrees. (1) His wife of 47 years, Frances McCormick died in 1976. Several years later Scheele remarried and lived for years with his second wife, Veronica Becsey, at the Watergate in Washington, D.C. (2)

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On Friday January 8, 1993, at age 85, Leonard A. Scheele died of pneumonia at George Washington Medical Center. He was survived by his wife, Veronica, by three children from his first marriage, and six grandchildren and a great-grandchild. (3,4)

Dr. Scheele left a remarkable legacy. In 1989, at the celebration of the Centennial of the U.S. PHS Commissioned Corps in Washington, D.C., Scheele, then 81 yrs., was asked by then Secretary of the DHHS, Otis Bowen, “Doc Bowen,” to offer reflections on his service to the country. (5) On January 4, 1989 at Masur Auditorium of the NIH, Scheele said three things gave him the greatest satisfaction:

• Creation of the National Library of Medicine on the NIH grounds (6) • Approval of the polio vaccine which marked the beginning of the era during which the disease was eradicated in the U.S. • Being granted the appropriation by Congress to build the Clinical Center at NIH.

History suggests another important legacy should be added to Scheele’s modest list; perhaps more than any Surgeon General, before or since his tenure, Scheele raised the formerly obscure position of Surgeon General to national and international prominence by speaking clearly and forcibly on issues of public health. (7-28)

It is remarkable that during the most active phase of development and growth in research, health care and public health in the United States, spanning the period between F.D.R. and John F. Kennedy, two Hoosiers—Scheele and Leroy Burney (the subject of an earlier essay)-- would serve as the “nation’s doctor”. Both Scheele, Burney, and other Surgeon’s General have spoken eloquently about the critical importance of the position of Surgeon General in America. But, many historian, pundits, and public health experts today believe the position of Surgeon General has been diminished in authority and stature. (29) When I personally interviewed Dr. C. Everett Koop in 1996, he shared these concerns with me. (30)

Leonard A. Scheele’s vision sixty years ago of a world in which advances in the public’s health were informed by research has inspired generations of scholars, researchers, educators, practitioners, and policy makers who daily toil in the fields, planting the seeds of research and expecting harvests of relief from human suffering from disease. Scheele today would admire their commitment to this noble cause; but he would be dismayed that the inequality of health among peoples of the world and the often unexplained disparities in access to quality health care among peoples he witnessed as a young public health officer in the 1930’s, continues to plague us today.

Dr. Scheele’s words spoken long ago continue to echo today: “The world cannot be allowed to exist half healthy and half sick.” (31-33) Scheele would no doubt congratulate our modern day successes from research and public health but urge us to higher goals for the least among us.

Thank you. Stephen J. Jay

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Leonard A. Scheele: Hoosier Sage of Science and Public Health Essay presented October 16, 2006 before the Indianapolis Literary Club, Park Tudor School, Indianapolis, Indiana.

Bibliography

Introduction

1. Jay SJ. Leroy E. Burney: A Hoosier pioneer in public health. Traces of Indiana and Midwestern History. 2004;16:16-25. 2. Available on line at Indiana University Purdue University at Indianapolis (IUPUI) Digital Archive (IDeA): http://hdl.handle.net/1805/578 (text) and http://hdl.handle.net/1805/577 (bibliography) 3. Slocum CE, Campbell WW, Robertson RS. History of the Maumee River Basin from the earliest account to its organization into counties. Allen County Indiana. Vol. II. Indianapolis: Bowen & Slocum.1905.

Early Life

1. Valley of the upper Maumee River with historical account of Allen County and the city of Fort Wayne, Indiana. Madison, Brant & Fuller, 1889. 2. Woehrmann P. at the headwaters of the Maumee: a history of the forts of Fort Wayne. Indianapolis: Indiana Historical Society. 1971. 3. Young M. Little Turtle (Me-she-kin-no-quah). Greenville, OH: Calvin M. Young. 1917. 4. LaForge (Maria: daughter of Leonard A. Scheele) personal communication to Stephen J. Jay May 12, 2006. 5. Bollet AJ. A physician almost becomes president of the United States. Medical Times. July 1988, p. 77. 6. The Caldron, 1923-26. The Annual of the Fort Wayne Central High School. Allen County Public Library Foundation, Fort Wayne, Indiana. 7. Old Drug House is reorganized: Dreier Drug Company is incorporated—capital stock, $30,000. The Weekly Sentinel (Fort Wayne, Indiana) Wednesday, November 16, 1910, p. 1. 8. The Reminiscences of Leonard Andrew Scheele. March 22, 1963, in the Oral History Collection of Columbia University. 9. Alverson H. Health for all. Indianapolis Star Magazine. September 19, 1948, p. 8- 9. 10. Furman, Bess. Bess Furman (Armstrong) papers. 1962-69. Chapter 19: Research institutes flourish as Wagner legislation dies. Chapter 20: Licensing of Salk Vaccine. Surgeon General Leonard A. Scheele 1948-1956. (Part One and Part Two) Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD.; MS C 202, Box 22. 11. Mullan F. Plagues and Politics: The story of the United States Public Health Service. New York: Basic Books, Inc. 1989. pp. 116, 128, 131, 133.

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Medical Education and Early Years in Public Health Service

1. Leonard Andrew Scheele (1948-1956) (Internet). Washington: Department of Health and Human Services (US), Office of the Surgeon General; (revised 2004 Apr 23; cited 2006 Mar 2). (about 4 screens). Available from: http://www.surgeongeneral.gov/library/history/bioscheele.htm 2. LaForge (Maria: daughter of Leonard A. Scheele) to Stephen J. Jay June 22, 2006. Scheele (Leonard A.). Biographical Sketch. August 15, 1967. In Maria LaForge (Scheele’s daughter) private archives, Kensington, CA. Four pages, typewritten. 3. The Reminiscences of Leonard Andrew Scheele. March 22, 1963, in the Oral History Collection of Columbia University. 4. LaForge (Maria: daughter of Leonard A. Scheele) to Stephen J. Jay June 22, 2006. Scheele (Leonard A.). T.J. Kennedy to L.A. Scheele (Letter) with attached handwritten notes by Scheele: Early NIH History: Period of Roosevelt presidency. In Maria LaForge (Scheele’s daughter) private archives, Kensington, CA. 10 pages (4 typewritten).

Military Service in World War II

1. LaForge (Maria: daughter of Leonard A. Scheele) to Stephen J. Jay June 22, 2006. Scheele (Leonard A.). T.J. Kennedy to L.A. Scheele (Letter) with attached handwritten notes by Scheele: Early NIH History: Period of Roosevelt presidency. In Maria LaForge (Scheele’s daughter) private archives, Kensington, CA. 10 pages (4 typewritten). 2. LaForge, Clark (grandson of Leonard Scheele; World History School Project) Living History—Dr. Leonard A. Scheele. (Interview by correspondence with Dr. Scheele) January, 1981. Private Collection, Maria LaForge, Kensington, California. Hand written responses to seven questions by Dr. Scheele; transcribed by LaForge. 3. Williams RC. The United States Public Health Service 1798-1950. Washington, D.C.: Commissioned Officers Association of the United States Public Health Service, 1951. p. 698-9. 4. United States. Army Medical Service. Medical Department United States Army in World War II: Organization and administration in World War II. Editor-in-Chief, John Boyd Coates, Jr., Office of the Surgeon General Department of the Army, by Blance B. Armfield. Washington, D.C.: Department of the Army, 1963. Chapter VII: The Mediterranean Theater of Operations, Organizing for Public Health Activities. pp. 294-297. 5. United States. Army Medical Service. Preventive Medicine in World War II. Volume VIII. Civil affairs/military government public health activities. Editor-in-

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chief: John Lada; editor for preventive medicine: Ebbe Curtiss Hoff. Office of the Surgeon General, Department of the Army, Washington, D.C., 1976. p. 298, 415. 6. Surgeon General Scheele hard to ruffle. Galveston News, May 23, 1955. 7. LaForge (Maria: daughter of Leonard A. Scheele) personal communication with Stephen J. Jay, April 6, 2006. 8. United States. Army Medical Service. Preventive medicine in World War II. Editor-in-Chief, Robert S. Anderson; editor for preventive medicine, Ebbe Curtis Hoff. Volume IX Special Fields. Governmental and other supporting agencies and institutions: U.S. Public Health Service. Washington, Office of the Surgeon General of the Army, 1969, pp. 584-585. 9. Williams RC. The United States Public Health Service 1798-1950. Washington, D.C.: Commissioned Officers Association of the United States Public Health Service, 1951. p. 701-08. 10. United States. Army Medical Service. Preventive Medicine in World War II. Volume VIII. Civil affairs/military government public health activities. Editor-in- chief: John Lada; editor for preventive medicine: Ebbe Curtiss Hoff. Office of the Surgeon General, Department of the Army, Washington, D.C., 1976. p. 476-7. 11. United States. Army Medical Service. Preventive medicine in World War II. Editor-in-chief, John Boyd Coates, Jr.; editor for preventive medicine, Ebbe Curtis Hoff. Volume VII. Communicable Diseases: Arthropodborne diseases other than malaria. Typhus Fevers. U.S. Public Health Service. Washington, Office of the Surgeon General of the Army, 1964, pp. 235-39. 12. Oklahoma University College of Law: German surrender documents ending World War II. (Available on line at URL: http://www.law.ou.edu/ushistory/germsurr.shtml. 13. LaForge (Maria: daughter of Leonard A. Scheele) to Stephen J. Jay May 12, 2006. 14. Williams RC. The United States Public Health Service 1798-1950. Washington, D.C.: Commissioned Officers Association of the United States Public Health Service, 1951. p. 710. 15. United States. Army Medical Service. Preventive Medicine in World War II. Volume VIII. Civil affairs/military government public health activities. Editor-in- chief: John Lada; editor for preventive medicine: Ebbe Curtiss Hoff. Office of the Surgeon General, Department of the Army, Washington, D.C., 1976. p. 503. 16. Gets Typhus Group’s Medal. New York Times. Jan 19, 1946. 17. United States. Army Medical Service. Preventive Medicine in World War II. Volume VIII. Civil affairs/military government public health activities. Editor-in- chief: John Lada; editor for preventive medicine: Ebbe Curtiss Hoff. Office of the Surgeon General, Department of the Army, Washington, D.C., 1976. p. 27-28.

Public Health Service

1. Alverson H. Health for all. Indianapolis Star Magazine. September 19, 1948, p. 8- 9. 2. Furman, Bess. Bess Furman (Armstrong) papers. 1962-69. Chapter 19: Research institutes flourish as Wagner legislation dies. Chapter 20: Licensing of Salk

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Vaccine. Surgeon General Leonard A. Scheele 1948-1956. (Part One and Part Two) Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD.; MS C 202, Box 22. 3. Scheele named surgeon general of U.S. Public Health Service. Monthly Bulletin Indiana State Board of Health. 1948; 51 (No. 3): 60. 4. Furman B. Health assembly called by Ewing. At Truman’s request it will set 10- year national goals at sessions May 1-4. New York Times February 15, 1948. 5. Furman B. Parran retired; Scheele is named. New York Times. February 13, 1948. 6. Parran removal, job nature linked: Ewing says public health post should be rotated—lauds surgeon general’s work. New York Times February 14, 1948. 7. Senate backs Scheele. New York Times. February 26, 1948. 8. Mullan F. Plagues and Politics: The story of the United States Public Health Service. New York: Basic Books, Inc. 1989. pp. 116, 128, 131, 133. 9. Health chief. Indianapolis Times. February 18, 1948. p4, c. 3. 10. Parran out, Scheele in. Science. February 23, 1948, p. 45. 11. Fighter for Health. (Dr. Leonard A. Scheele) U.S. News and World Report, March 5, 1948, p. 40-41. 12. Leonard Andrew Scheele (1948-1956) (Internet). Washington: Department of Health and Human Services (US), Office of the Surgeon General; (revised 2004 Apr 23; cited 2006 Mar 2). (about 4 screens). Available from: http://www.surgeongeneral.gov/library/history/bioscheele.htm 13. Surgeon General Scheele hard to ruffle. Galveston News. May 23, 1955, p. 5. 14. Oral History Interview with Oscar R. Ewing. By J.R. Fuchs, Chapel Hill, North Carolina, May 1, 1969. Truman Presidential Museum and Library. Available at online URL: http://www.trumanlibrary.org/oralhist/ewing3.htm#top 15. Blakeslee, AL. Errors to Light: Inadequate reporting on vaccine preparation is revealed by surgeon general. The Kansas City Star, June 7, 1955, p. 3, 9. 16. Fluoride campaign sought by Scheele. New York Times. October 27, 1951. 17. Case-finding drive to war on syphilis. New York Times. June 10, 1949. 18. Syphilis declines 20% in 27 months. Surgeon General Scheele says sharp decrease came despite 30% rise in examinations. New York Times. February 3, 1949. 19. Denver hospital hailed by Scheele. Its aid is vital to the federal tuberculosis program, U.S. Surgeon General declares. New York Times. January 17, 1949. 20. Oshinsky DM. Polio: An American story: The crusade that mobilized the nation against the 20th century’s most feared disease. New York, NY: Oxford University Press, 2005. p. 222-4. 21. Government spurs poisoned air study. New York Times. October 4, 1949. 22. 9 billions needed for water purity. Nation-wide survey indicates a lack of 10,000 plants to conserve health of U.S. New York Times. May 7, 1951. 23. Water problem aired. Dr. Scheele says safe supply is major need for health. New York Times. September 12, 1951. 24. Mrs. Hobby asks pollution fight. New York Times. December 8, 1954. 25. Altschul A. “Julius Caesar” to be televised in full. New York Times. February 13, 1949.

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26. The Reminiscences of Leonard Andrew Scheele. October 16, 1967, in the Oral History Collection of Columbia University. 27. Scheele LA. Anniversary Program—150th year U.S. Public Health Service: The past and future of the Public Health Service. Am J Pub Health and the Nation’s Health. 1949;39(3):293-302. 28. Satcher D. The history of the Public Health Service and the surgeon general’s priorities. Food and Drug Law Journal 1999;54(1):13-20. 29. Truman health plan is opposed by Taft. New York Times. July 29, 1949. 30. LaForge (Maria) personal communication with Stephen Jay, June 10, 2006. 31. Obituary: Leonard A. Scheele, MD. JAMA 1993;270:2749. 32. Health delegates named. Scheele to head U.S. group at world meeting in Rome. New York Times. June 5, 1949. 33. World health gains praised by Scheele. New York Times July 23, 1949. 34. Point 4 plans told for aid on health. They would put 300 experts in field—Scheele lists 11 types of U.S. help. New York Times. April 11, 1950. 35. U.S. medical official gets world health post. New York Times. May 8, 1951. 36. Senate backs Scheele. New York Times. February 26, 1948. 37. Furman B. Dr. Scheele sworn; backs world unit: new Surgeon General favors U.S. joining health group, now blocked in House. New York Times. April 16, 1948. 38. Health programs in wide expansion: U.S. expenditures to increase ninefold by ’49, Dr. Scheele tells allied drug trades. New York Times. July 2, 1948. 39. Rusk H. Promotion of world health essential in fight on Reds. Vast-gains are shown as result of U.S. aid to peoples in many nations. New York Times. November 13, 1953. 40. Health of world found improving. New York Times. May 6, 1952. 41. Scheele LA. Dr. L.A. Scheele (draft) 8/82. Prepared in response to request by Thomas J. Kennedy, Jr., M.D, Director, Planning and Policy Development, Association of American Medical Colleges (AAMC) for an oral history session taping August 9, 1982. Ten page handwritten and six page typewritten comments. In private archives of Maria LaForge, Leonard A. Scheele’s daughter, Kensington, CA. 42. National Institutes of Health (NIH Almanac). U.S. Department of Health and Human Services, Public Health Service. Bethesda: NIH. 1972 and 1983. 43. New York Hospital Gets Cancer Grant. New York Times. December 13, 1947 44. U.S. Cancer grant hailed as study aid. New York Times. September 1, 1947. 45. 181 centers push fight on cancer. New York Times. November 24, 1947. 46. Rusk HA. U.S.fight on heart disease backed widely by citizens. New York Times. July 11, 1948. 47. Rettig RA. Cancer Crusade: The story of the National Cancer Act of 1971 (1977). Washington, D.C.: Joseph Henry Press, 2000. P. 23. Available online: http://www.nap.edu/books/0309070821/htm/R.1:html 48. Oppenheimer GM. Becoming the Framingham Study 1947-1950. Am J Pub Health 2005;95(4):602-610. 49. Furman B. U.S. clinic center to cost $40,000,000. New York Times. June 30, 1948.

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Polio and the Salk Vaccine

1. Furman, Bess. Bess Furman (Armstrong) papers. 1962-69. Chapter 19: Research institutes flourish as Wagner legislation dies. Chapter 20: Licensing of Salk Vaccine. Surgeon General Leonard A. Scheele 1948-1956. (Part One and Part Two) Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD.; MS C 202, Box 22. 2. Surgeon General Scheele hard to ruffle. Galveston News. May 23, 1955, p. 5. 3. Engel L. The Salk vaccine: what caused the mess? Harper’s Magazine, Vol., 211, No. 1263, August 1955, pp. 27-33. 4. Oshinsky DM. Polio: An American story: The crusade that mobilized the nation against the 20th century’s most feared disease. New York, NY: Oxford University Press, 2005. 5. Mullan F. Plagues and Politics: The story of the United States Public Health Service. New York: Basic Books, Inc. 1989. pp. 116, 128, 131, 133. 6. 2 authorities ask calm in polio rise. O’Conner of March of Dimes, Scheele of Health Service issue joint statement. New York Times. August 2, 1949. 7. The Salk Polio Vaccine. Dwight D. Eisenhower Presidential Library and Museum, Abilene, KS. Available online at URL: http://www.eisenhower.archives.gov/dl/salk/salkdocuments.html. 8. The Lancet, Vol. CCLXVIII; Volume One, Jan-June, 1955, Editor TF Fox: Editorials regarding poliomyelitis: Polio Vaccines, April 23, 1955, p. 851-2; Poliomyelitis Vaccine, April 23, p. 857-8; Poliomyelitis Vaccination, May 7, p. 956; The Poliomyelitis-Vaccine Controversy. May 14, p. 1018-19; Poliomyelitis Vaccination, May 28, p. 1121; Poliomyelitis Vaccination, June 4, p. 1175-6; The Outlook for Poliomyelitis Vaccination, June 11, p. 1207-8; Poliomyelitis Vaccine, June 18, p. 1270 9. Kaempffert W. The Year in Science: Outstanding achievments include the Salk vaccine and Atoms-for-Peace progress. New York Times. Jan 1, 1956. 10. Furman B. 6 vaccine makers get U.S. licenses. Government clears the way for quantity production of Salk preventive. New York Times. April 13, 1955. 11. The President congratulates Dr. Salk as “a benefactor of mankind.” New York Times. April 23, 1955. 12. LaForge (Maria: daughter of Leonard A. Scheele) to Stephen J. Jay May 12, 2006. 13. Furman, B. President set to take over Salk vaccine if necessary. New York Times. May 5, 1955. 14. Texts of surgeon general’s statements on the polio inoculation program. New York Times. May 9, 1955. 15. The Salk Polio Vaccine. Dwight D. Eisenhower Presidential Library and Museum, Abilene, KS. April 29, 1955. Cabinet Paper—Privileged. The White House, Washington. The Salk Vaccine., 5 pages. Available online at URL: http://www.eisenhower.archives.gov/dl/salk/salkdocuments.html. 16. Text of Scheele’s statement on vaccine. New York Times May 14, 1955.

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17. Blair WM. U.S. orders study of vaccine polity by more experts. Scheele calls meeting today—O’Conner asks release of Cutter test data. Hints result is vital. Also implies that “politics” is involved-3-day delay in program is indicated. New York Times. May 24, 1955. 18. Kaempffert W. The Year in Science: Outstanding achievements include the Salk vaccine and Atoms-for-Peace progress. New York Times. Jan 1, 1956. 19. Scheele confirms live virus report. “One instance” in Cutter shot in Utah is discovered –study under way. New York Times. June 6, 1955. 20. LaForge (Maria: daughter of Leonard A. Scheele) personal communication with Stephen J. Jay, April 6, 2006. 21. Texts of government statements on polio vaccine. New York Times. May 25, 1955. 22. Blair WM. Eisenhower sets Salk shot goals. Pupils in first two grades will be treated by August, his statement says. New York Times. June 1, 1955. 23. Scheele affirms faith in vaccine. In TV talk, he explains that all children do no get immunity to polio. New York Times. June 8, 1955. 24. Leonard Andrew Scheele (1948-1956) (Internet). Washington: Department of Health and Human Services (US), Office of the Surgeon General; (revised 2004 Apr 23; cited 2006 Mar 2). (about 4 screens). Available from: http://www.surgeongeneral.gov/library/history/bioscheele.htm 25. A.M.A. on polio vaccine. New York Times. June 12, 1955. 26. Oshinsky DM. Polio: An American story: The crusade that mobilized the nation against the 20th century’s most feared disease. New York, NY: Oxford University Press, 2005. p. 227. 27. Krieger J. A safe polio vaccine after anxious months. Report of difficulties in aftermath of great medical discovery. New York Times. June 12, 1955. 28. Stepped-up fight on polio is urged. Public Health Service asks states push vaccination throughout the season. New York Times. May 3, 1956. 29. Blair WM. Mrs. Hobby terms free vaccine idea a socialistic step. Charges “back- door” policy---“means test” assailed by senate democrats. New York Times. June 15, 1955. 30. Fowle F. U.S. feeling lag in polio vaccine. New York Times. March 12, 1956 31. O’Conner charges U.S. gives no light on Cutter shots. Says public needs Dr. Salk’s version—Demands copy of report by Scheele. New York Times. June 1, 1955. 32. Blair WM. Leaders divided on vaccine study. O’Conner and Scheele split—report softened after protest by scientists. New York Times. June 11, 1955. 33. Report on polio. New York Times. June 12, 1955. 34. Blair WM. Eisenhower sees polio’s early end with Salk shots. Speculates “great pressure” may have made experts “short-cut a little bit.” New York Times. May 12, 1955. 35. Blair WM. Eisenhower hails Mrs. Hobby’s job; says she may quit. He calls her work on polio “magnificent”—cites health of secretary’s husband. More vaccine delay. New York Times. May 19, 1955. 36. Blair WM. U.S. orders study of vaccine polity by more experts. Scheele calls meeting today—O’Conner asks release of Cutter test data. Hints result is vital.

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Also implies that “politics” is involved-3-day delay in program is indicated. New York Times. May 24, 1955. 37. Kluger J. Splendid solution: Jonas Salk and the conquest of polio. New York: G.P. Putnam’s Sons, 2004. p. 308-10. 38. Furman, p. 22. 39. Blair WM. 3 scientists urge inoculation halt. Ask effort to make “safer” vaccine than Salk product—others challenge view. New York Times. June 23, 1955. 40. Blakeslee AL. Errors to light: Inadequate reporting on vaccine preparation is revealed by Surgeon General. The Kansas City Star, Tuesday, June 7, 1955. p. 3 41. Furman B. U.S. blames its own tests in Cutter vaccine incident. “Inadequacy of virus inactivation” in plant also cited by report—laboratory neither accused nor cleared. New York Times. August 26, 1955. 42. Plumb R. Science in Review: Cutter polio vaccine report highlights difficulties in dealing with viruses. New York Times. August 28, 1955. 43. Blair WM. Mrs. Hobby terms free vaccine idea a socialistic step. Charges “back- door” policy---“means test” assailed by senate democrats. New York Times. June 15, 1955. 44. Halleck CA. Capitol Report. (Salk Polio Vaccine) Vidette Messenger, Valparaiso, Indiana. May 25, 1955. 45. Scheele named again. Will head U.S. Public Health Service a third time. New York Times. March 6, 1956. 46. Scheele LA. Dr. L.A. Scheele (draft) 8/82. Prepared in response to request by Thomas J. Kennedy, Jr., M.D, Director, Planning and Policy Development, Association of American Medical Colleges (AAMC) for an oral history session taping August 9, 1982. Ten page handwritten and six page typewritten comments. In private archives of Maria Laforge, Leonard A. Scheele’s daughter, Kensington, CA. 47. LaForge (Maria: daughter of Leonard A. Scheele) personal communication with Stephen J. Jay, April 6, 2006. 48. Furman, Ch. 20, p.23-4. 49. Scheele asks congress to extend polio shot program to July 1, ’57. New York Times. January 25, 1956. 50. Report on polio. New York Times. June 12, 1955. 51. Scheele reports sharp cut in polio. He says children receiving Salk vaccine show 67-90% fewer paralytic attacks. New York Times. November 8, 1955. 52. Experts support 3-shot polio dose. Rule against cut to one—Salk pleased by results of parley in capital. New York Times. December 8, 1955. 53. Furman, Ch. 20, p.21. 54. A.M.A. on polio vaccine. New York Times. June 12, 1955. 55. Scheele resigns as health chief. Surgeon General led nation through vaccine crisis. New York Times. June 30, 1956. 56. Dr. Scheele resigns. New York Times. July 1, 1956. 57. Weingroff RF. June 29, 1956: A Day in History: Celebrating the 50th anniversary of the Eisenhower interstate highway system. (Available at http://www.fhwa.dot.gov/interstate/thisday.htm as retrived on May 7, 2006. 58. Leroy E. Burney. Obituary. New York Times, August 4, 1998.

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59. Editor’s Note. (Retraction concerning LA Scheele resignation) New York Times. September 15, 1998. 60. Folsom lauds Scheele. To urge reappointment. New York Times. December 21, 1955. 61. LaForge (Maria: daughter of Leonard A. Scheele) to Stephen J. Jay June 22, 2006. Scheele (Leonard A.). Biographical Sketch. August 15, 1967. In Maria LaForge (Scheele’s daughter) private archives, Kensington, CA. Four pages, typewritten. 62. LaForge (Maria) personal communication with Stephen Jay, June 10, 2006.

Retirement and move to the private sector

1. Scheele resigns as health chief. Surgeon General led nation through vaccine crisis. New York Times. June 30, 1956. 2. Dr. Scheele resigns. New York Times. July 1, 1956. 3. Weingroff RF. June 29, 1956: A Day in History: Celebrating the 50th anniversary of the Eisenhower interstate highway system. (Available at http://www.fhwa.dot.gov/interstate/thisday.htm as retrived on May 7, 2006. 4. Leroy E. Burney. Obituary. New York Times, August 4, 1998. 5. Editor’s Note. (Retraction concerning LA Scheele resignation) New York Times. September 15, 1998. 6. Folsom lauds Scheele’ To urge reappointment. New York Times. December 21, 1955. 7. LaForge (Maria: daughter of Leonard A. Scheele) to Stephen J. Jay June 22, 2006. Scheele (Leonard A.). Biographical Sketch. August 15, 1967. In Maria LaForge (Scheele’s daughter) private archives, Kensington, CA. Four pages, typewritten. 8. LaForge (Maria) personal communication with Stephen Jay, June 10, 2006.

Bay of Pigs

1. Louis F. Oberdorfer, John B. Jones, Mitchell Rogvin, (interviewees) recorded interview by Francis J. Hunt DeRosa, (interviewer) June 2, 1964, pp. 1-23, Cuban Prisoners Release Project. John F. Kennedy Library Oral History Program. 2. Newsweek. The Brigade’s brave men. January 7, 1963; Long Voyage Home. December 31, 1962. 3. Ex-U.S. Surgeon General joins Cuban ransom talks. New York Times. December 21, 1962. 4. Cubans say fear kept them docile. Freed families tell of life under Castro restraints. New York Times. December 29, 1962. 5. Summit has major role in POW swap. The Summit Herald (NJ) Thursday, December 27, 1962, p. 1, Number 32. 6. LaForge (Maria) Daughter of L.A. Scheele. Personal communication with Stephen J. Jay, October 15, 2006.

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7. Johnson Haynes (with Manuel Artime, Jose Perez San Roman, Erneido Oliva, and Enrique Ruiz-Williams) The Bay of Pigs: The leaders’ story of Brigade 2506. New York: W.W. Norton & Company, Inc., 1964., p. 332-33. 8. Obituary: Leonard A. Scheele, MD. JAMA 1993;270:2749. 9. Wise D, Ross TB. The invisible government. New York:Random House, 1964 10. Robert Kennedy asserts unity is Cuban exiles’ greatest need. New York Times. April 22, 1963.

Scheele’s Final Years and Legacy

1. LaForge (Maria: daughter of Leonard A. Scheele) to Stephen J. Jay June 22, 2006. Scheele (Leonard A.). Biographical Sketch. August 15, 1967. In Maria LaForge (Scheele’s daughter) private archives, Kensington, CA. Four pages, typewritten. 2. Obituary: Leonard A. Scheele, MD. JAMA 1993;270:2749. 3. Daniels LA. L.S. Scheele, 85; Served 2 Presidents As Surgeon General. New York Times, January 12, 1993. 4. Smith JY. Former U.S. Surgeon General Leonard A. Scheele, 85, Dies. The Washington Post, January 10, 1993. 5. Otis R. Bowen to Leonard A. Scheele. July 12, 1988. Scheele’s typewritten outline of comments made at the Public Health Service Centennial Celebration at the National Institutes of Health, January 4, 1989. Personal communication with Maria LaForge, Kensington, CA, May 12, 2006. 6. United States Army Medical Library. Annual Report submitted by Frank B. Rogers to Major General George E. Armstrong, Surgeon General, U.S. Army: For the calendar year ending 31 December 1951. Washington, D.C.: Department of the Army, 1 March 1952. 7. Conquest of diseases. Dr. Scheele notes gains in rapid pattern changes. New York Times. November 29, 1956. 8. Scheele LA. Anniversary Program—150th year U.S. Public Health Service: The past and future of the Public Health Service. Am J Pub Health and the Nation’s Health. 1949;39(3):293-302. 9. Scheele LA. Negro health week and the health of the Negro. National Negro Health 1949; 17(3):5-6. 10. Scheele LA. We are moving forward: A social hygiene day report on progress in venereal disease control. J Soc Hygiene 1949;35(3):110-13. 11. Scheele L. The Donora study. Industrial Hygiene Newsletter. 1949;9(11):3-16. 12. Scheele LA. A general view of cancer research. Bull NY Acad Med 1949;25:671- 97. 13. Scheele LA. Congressional Series #46: Dr. Leonard A. Scheele, Surgeon General of the Public Health Service, speaks on air pollution. The Carl Albert Congressional Research and Studies Center, George Howard Wilson collection, Box 16, Folder 8. University of Oklahoma, Norman, Oklahoma. Available at: http:www.ou.edu/special/albertctr.

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14. Scheele LA. Modern trends in prevention and treatment of tuberculosis. Public health—fifty years from tomorrow. Trans Annu Meet Natl Tuberc Assoc. 1950;46:393-400. 15. Scheele LA, Current Experience in Multiphasic Health Examinations. Am J Pub Health, 1951;41(6):635-39. 16. Scheele LA, Sebrell WH. Medical research and medical education. Science 1951;114:517-21. 17. Scheele LA. Public Health and Foreign Policy. Ann Am Acad Political and Soc Sci 1951;278:62-72. 18. Scheele LA. Public health research. Bull N.Y. Acad Med. 1952;28: 833-41. 19. Scheele LA. State of the nation’s health services. Public Health Rep 1952;67:161- 4. 20. Scheele LA. Public Health. In, Interrelations between the social environment and psychiatric disorders. (Papers presented at the 1952 annual conference of the Milbank Memorial Fund. Frank G. Boudreau and Jean Downes, eds. New York: Milbank Memorial Fund, 1953. (Available at: http://ccat.sas.upenn.edu/goldenage/wonder/Archive/Popular/harpers0855.htm ) 21. Scheele LA. A comprehensive program for water pollution control for the Green Bay Western shore drainage basin. Developed in cooperation with the state water pollution control agencies of Michigan and Wisconsin: Green Bay Western Shore Drainage Basin. Water Pollution Series No. 67, 1954. Universal Library: Carnegie Mellon. Available at: http://tera-3.ul.cs.cmu.edu/ 22. Scheele LA. World health; a challenge to medicine. Bull Georgetown Univ Med Cent. 1954;7:206-222. 23. Scheele LA. Control of the environment for the health of mankind. Public Health Rep. 1954;69:626-7. 24. Scheele LA. Control of poliomyelitis through vaccination. J Am Med Assoc 1955;158:1271-6. 25. Scheele LA, Shannon JA. Public health implications in a program of vaccination against poliomyelitis. J Am Med Assoc 1955;158:1249-58. 26. Scheele LA. Progress in prevention of chronic illness. 1949-1956. J Am Med Assoc 1956;160:1114-7. 27. Scheele LA. Summary of medical aspects of automobile crash injuries and deaths. J Am Med Assoc. 1957;163:247-8. 28. Oshinsky DM. Polio: An American story: The crusade that mobilized the nation against the 20th century’s most feared disease. New York, NY: Oxford University Press, 2005. p. 222-32. 29. Mullan F. Plagues and Politics: The story of the United States Public Health Service. New York: Basic Books, Inc. 1989. pp. 116, 128, 131, 133. 30. Stephen J. Jay personal communication with C.Everett Koop on July 24, 1995 during an interview with Dr. Koop regarding tobacco control. 31. Commissioned Corps Bulletin. RADM Leonard A. Scheele served as Surgeon General—1948-1956. Commissioned Corps Bulletin, 1999;XIII, No. 6: 5. 32. Foege W. Keynote Address, Class Day 2005, Dartmouth Medical School, June 11, 2005. Available at http://dms.dartmouth.edu/students/class_day/2005/foege_speech.shtml

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33. Satcher D. Keynote address at the opening ceremony for the centennial of the Pan American Health Organization. Rev Panam Salud Publica/Pan American Journal. 2002;11(1).

End references for Scheele essay. Stephen J. Jay

Leonard A. Scheele: Hoosier Sage of Science and Public Health Essay read by Stephen J. Jay before the Indianapolis Literary Club October 16, 2006 Manuscript submitted for consideration of publication in Traces of Indiana and Midwestern History, Indiana Historical Society Press.

End References Stephen J. Jay MD Essay: Hoosier Sage of Science and Public Health October 16, 2006 Provided in Word doc to Indiana Historical Society Aug 1, 2015.