Memoirs of a 20Th Century Physician by Dale G. Friend, M.D. 1907-2003

Preface These memoirs have been set down before my memory fades in the hope that they will be of interest to the generations that will follow. They span three quarters of the Twentieth Century, the most exciting and interesting of all centuries so far. From earliest years, on an isolated Iowa farm through wars, depression and the great developments in science and medicine, the author has been closely associated with these great events. As a physician who had a small part in many of these stirring developments, I have been urged by friends and colleagues to set down my experiences. 1 Memoirs of a Twentieth Century Physician Dale G. Friend, M.D. 2 Introduction The Twentieth Century is without doubt one of the most interesting, exciting, productive and influential of any previous century. Certainly the world will never be the same as a result of the events and discoveries which occurred during this time. With these great changes as a background, it should prove interesting to experience them through the eyes of a physician who has lived through them. The Century began with the world mostly at peace and it seemed a stable and wonderful place for those with position, wealth and power. Unfortunately, for the great mass of humanity it was not a good time. Poverty, exploitation, and discrimination was the lot of humble people all over the world. Medicine was still mostly an art with few specific remedies for disease. A comment made by the great Harvard biochemist, Lawrence J. Henderson, was much more accurate than physicians were prone to admit. He stated that it was not until 1910 that a random patient seeing a random physician had a fifty-fifty chance of receiving benefit from the encounter. Of course, Henderson, a biochemist, could not be expected to understand what psychiatrists and compassionate physicians had long known -- that even though the physician may not be able to cure an illness affecting the patient and often the remedies prescribed had little or no value, the contact afforded much relief from exaggerated fears, anxiety and mental isolation. This must be so since physicians from the dawn of history have been caring for patients and the profession has occupied an honored position in all societies for many centuries. The terrible blood bath of World War I shattered this dreaming, peaceful world, and things were never to be the same again. A trip through the cemeteries around Verdun and a visit to the shrine of Fort Douamont is a never to be forgotten experience. Some 600,000 young men of France and Germany died there and both nations were the sad losers. Unfortunately, the chance for a real peace was lost and the stage set for future difficulties. In the 1930's came the great depression and there was much suffering throughout the world. Those of us who lived through it will never forget the panic, fear and hopelessness which engulfed society. President Franklin Roosevelt's leadership was never more evident than when in a radio address he said, "We have nothing to fear but fear itself". Although it will be debated by partisans and opponents for many years to come whether Roosevelt and his programs really did anything to shorten the depression, he at least gave hope to millions and set in motion long needed programs which did much to lighted the lot of the poor. An unjust peace and the humbling of a great nation led to the rise of Hitler, the horrors of the concentration camps, and World War II. As a physician in the Army Medical Corps, I had a role in the war that carried me to strange places and created some most unusual experiences. 3 In the midst of all this, certain developments in medicine were occurring that would forever change the physician's role in treating disease. The sulfonamides were discovered as the first effective antibiotic drugs. Later came the epic advent of penicillin and the race was on which has resulted in numerous and powerful antibiotics that at last allowed the physician to combat infectious diseases successfully. The next great event was the development of the atomic bomb, followed by the hydrogen, nuclear power for submarines, nuclear power plants and nuclear power for many other uses. These developments have changed the entire world outlook and never again will human-kind be free from the awful possibility that our civilization could be destroyed in a brief period of time. At about this time, in the early 1950's, the first tranquilizing drugs became available. In our Clinical Pharmacology Division at the Peter Bent Brigham Hospital, the first of this class of drugs, Chlorpromazine (Thorazine), was given to seriously ill patients to control nausea and vomiting. For the first time, this distressful and, at times dangerous, condition could be controlled. It was also immediately apparent that the drug also exerted a powerful tranquilizing effect on anxious, aggravated patients. It proved most useful in controlling the distress of alcohol and drug addiction withdrawal. Thus, the age of the tranquilizers began and soon a whole host of these agents appeared. They soon were in widespread use. Mental hospitals were able to discharge most of their patients and the drugs drastically cut the cost of care for the mentally ill. The years subsequent to 1950 were fruitful not only in drug development, but in many other fields as well. Life support systems made their appearance as well as renal dialysis, kidney transplants, cardiac surgery and new techniques for the early diagnosis of disease. All these advances came in rapid succession. The rise of the age-old problem of drug addiction for the first time became a problem in middle-class homes, the frustration of the Korean War and the Vietnam War and a nation divided were somewhat offset by the good things which occurred, such as the breaking down of racial and sexual barriers and the advent of Medicare for the elderly and Medicaid for the needy. Although great events, some good, some bad, have occurred, on the whole, the Century so far has proved to have been beneficial to mankind. Great strides have been made in treating disease. There has developed more freedom for millions of people throughout the world. There is less racial and sexual injustice and the stage is set for many more improvements. Hopefully, the immune barrier will be successfully controlled, thus making organ and tissue transplants highly successful. It is possible that viral infections will be controlled and that much more effective means for preventing and treating cancer will be developed. 4 Memoirs of a Twentieth Century Physician Chapter One It all began in a lonely farmhouse in Iowa where I was born the third son of Andrew Grant and Ida Jane Jones Friend on September 19, 1907. The Friend family roots in this country go back to the seventeenth century when Captain Isaac Friend and his family from England landed in Virginia. From there, our branch of the family spread to Maryland, Pennsylvania, Indiana and finally to Iowa where my great-grandfather gave my grandfather the money to purchase rich land in Pottawattomi County, Iowa. Grandfather Friend was a distinguished old gentleman, an ex-Civil War soldier who was well thought of in the community. He was very fond of me, as I was of him. I still have among my treasures a love letter he wrote to my grandmother from a battle field in Tennessee. It is beautifully done in acrostic with a letter from her name starting each line. I still remember the long walk he would take me through the woods. Unfortunately, he died when I was still very young. My parents inherited land from both sides of the family, but through bad judgment and a series of floods, the land was sold and our family moved to a farm in the hills where we were safe from floods, but the land was far less fertile. This was the first of several unfortunate moves. Later, drainage ditches were dug and all fear of floods disappeared and the land that my family had owned became some of the richest in the world. My earliest memories are associated with the hill farm. This farm was on a narrow dirt road which split off from the main road from Meeches Hollow (which was a break in the chain of beautiful hills that separate the bottom land of the Missouri River flood plain from the clay hills which are one of the unique and beautiful features of Southwest Iowa). Life for a small boy on an Iowa farm at the turn of the century was full of exciting and interesting happenings. Our farm was isolated many miles along dirt roads from the nearest town, Missouri Valley. Consequently, there was very little contact with the outside world. There were no newspapers or telephones, and rare visitors. Occasionally, the monotony would be broken by a visit from Grandfather Friend, Grandfather and Grandmother Jones, one of the neighbors, or old friends of my parents. Since horse and buggy or a farm wagon over dirt roads for many miles was necessary, these visits were rare occasions. There are certain incidents that remain clear in my mind. One of the earliest was the hungry hawk episode. One day as I was watching a flock of chickens in the barnyard, there suddenly appeared a huge hawk which darted from the sky and pounced on a fat hen. The squawked alarm of the hen brought a dash of the brave guinea hens to attack the hawk, but it flew off with the hapless hen in its talons.

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