Chapter 03: Working for Eleanor MacDonald: the Beginnings of the Texas Cancer Registry
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Description
In this chapter, Mrs. Hermes first explains that Dr. MacDonald was starting a pathology index and punch card system to code medical records. She was not writing any articles or other project aside from MD Anderson’s Annual Report. Mrs. Hermes and her friend Rosemary were hired to fill two 30-day typist jobs and Mrs. Hermes first worked on the pathology index. Dr. MacDonald next assigned her to code medical records. Mrs. Hermes describes this process as well as the coding systems. She explains that the codes that Dr. MacDonald was developing were much more specific for cancer patients than those otherwise available. Work was also in progress for the Texas Cancer Registry and information was coming from people working in the field with numerous hospitals in Texas. She notes that Dr. MacDonald received a grant from the Department of Public Health to fund the registry project.
Identifier
HermesKL_01_20180122_C03
Publication Date
1-22-2018
City
Houston, Texas
Interview Session
Topics Covered
Building the Institution; The Researcher; Overview; Devices, Drugs, Procedures; Building/Transforming the Institution; Multi-disciplinary Approaches; Working Environment; MD Anderson History; MD Anderson Snapshot; Research; The Business of MD Anderson; The Institution and Finances; MD Anderson Impact; MD Anderson Impact
Transcript
T.A. Rosolowski, PhD:
How did you get that job, I mean how did you get transferred?
Kay Hermes, BS:
Well, I applied for it. I was ready to do anything and if I hadn’t learned to type in high school, I never would have found a job. As I said, you can’t do anything with a degree in science or work in a lab. So anyway, Eleanor had two thirty-day typist jobs. She was doing a very interesting project. She was starting a pathology index, and she had designed a very interesting visual punch card which you could type the patient’s information and some identifying information on it, and then you coded this card, and a keypunch operator punched it all. We had an old IBM sorting machine in that building and a young woman who was a whiz at running it.
T.A. Rosolowski, PhD:
Let me stop you right here though, because I’ve heard some of these things described and I really can’t visualize the process. So, you had the punch card, and you take the doctor’s records and then you punch?
Kay Hermes, BS:
Yeah, we did it from the pathology reports.
T.A. Rosolowski, PhD:
Okay, so then you make punches in the card, in the specific way that records that in a visual way.
Kay Hermes, BS:
Right, right.
T.A. Rosolowski, PhD:
Okay. And then a data operator takes that and enters the information into the computer, is that how it works?
Kay Hermes, BS:
There were no computers, there was no such thing as a computer.
T.A. Rosolowski, PhD:
Okay, okay.
Kay Hermes, BS:
The data operator sat with a very basic, what you would call keypunch machine, and she punched the cards, and then another woman was in charge of the sorting machine, and she would sort the data. Of course there wasn’t that much data to sort at that time, because we were starting it.
T.A. Rosolowski, PhD:
So how did the sorting work? Did you say oh, you know, you told the sorter that you wanted all the cards with a particular type of information?
Kay Hermes, BS:
You put the card… Let me see if I can remember that sorting machine. Almost everything, it had to do with eightieth numbers, I think. I think everything had to be within a code of eighty. There was a place to put the cards in, and then all these bins where they fell, and I believe that way that machine operated, I think you probably keyed in what lines you wanted to sort on. For example, if you wanted all the males, all the males would come out in one place. Or, if you wanted everybody with sarcoma, they’d come out in another place. It was a very primitive but good way of doing things, and I’m sure Eleanor had done the same thing in Connecticut.
T.A. Rosolowski, PhD:
Yeah, yeah.
Kay Hermes, BS:
Because the field workers, I’m sure had abstracted all the records of patients with cancer in Connecticut, so that she wrote a very landmark paper on the incidents in mortality, of cancer.
T.A. Rosolowski, PhD:
This pathology project, what was she looking at with this pathology project?
Kay Hermes, BS:
Mostly data accumulation, so that if someone asked—so that if you were able to accumulate enough data, and as the data became available, you could answer one of the doctors or a research person, or someone who would call and say what was the age distribution of all the people admitted in 1944, or something like that. So that it was really an information source more than anything else. At that time, as I remember, other than writing the annual reports for the institution, I don’t think Eleanor was doing-I don’t remember her writing anything else right at that time, when we were there before 1952. She did write the annual report and we all worked on it of course.
T.A. Rosolowski, PhD:
That was 1952?
Kay Hermes, BS:
Well, before that, it was 1951 and ’52, I think. I think she continued to do that for most of her career, putting that together for a long time, until there was an established Editorial Department, which was a long time coming. Anyway, Rosemary, my roommate and I, both took these jobs, these thirty-day typists, and we needed jobs, so let me tell you, we just sat there and never looked up and typed away. Well, the grant that Rosemary was working on ended, and so she had to go find another job, which she did. She went to work for Braniff Airlines as a reservationist, and Elanor had a job for me. I think she was interested in me staying there because I had a degree in science.
T.A. Rosolowski, PhD:
What did she have you do next?
Kay Hermes, BS:
What was our next project? I’m trying to think of all the things we did in the old MD Anderson Hospital. Most of the work I did at that time was coding medical records. Eleanor had devised a code sheet which she called the Anticipatory Code, and she also had devised and anatomic classification for cancer, by sight.
T.A. Rosolowski, PhD:
What does that mean? Can you explain what that means exactly?
Kay Hermes, BS:
Well, at that day and time, the Federal Government, probably Department of—well today it would be Health and Human Services, but I don’t know what it was then. They had a database, but it did not include specifics like it did not identify which lymph node—let’s say the person had lung cancer. It did not identify a difference between hilar and mediastinal nodes, for example, which would be extremely important in later years. So anyway, Eleanor wrote a classification and the classification that was then used was the International Classification of Diseases, Injuries and Causes of Death. Eleanor did not believe that that was adequate to supply the information on cancer patients, so she devised the anticipatory code, which was an eighty-line code, dissecting out most of the clinical and pathologic information on each patient seen. She did have—now I didn’t know these people well, but she did have some workers in the field. I think there in hospitals, in I think in like Charity Hospital, which was called Jeff Davis Hospital in those days, it later became something entirely different, but I think she had the records that she had workers who would go to the hospital and code. Well, we coded it, so they would go to the hospital and do an abstract. Eleanor also had had devised a very good abstract form, so her fieldworkers would fill out the abstract form on each of the cancer patients and it was a major undertaking, because in places like Jeff Davis, and maybe all hospitals at that time, every patient got a new number every time they were admitted, and there were many, many Latin American names which were so similar. The fieldworkers did a very good job of putting all the records of one person together.
T.A. Rosolowski, PhD:
So you could actually follow the progress of the treatment, the disease.
Kay Hermes, BS:
Yeah, they could do the whole thing. I think that was probably the first—those were the first records in the Cancer Record Registry, and of course Dr. Clark had wanted Eleanor to do this in Texas, but of course, he couldn’t supply the funds, so she, she went to work of course, and got the funding through the State Health Department in Texas.
T.A. Rosolowski, PhD:
Okay, so it was the State Health Department.
Kay Hermes, BS:
Yeah.
T.A. Rosolowski, PhD:
Now were these grants, or how did the funding work?
Kay Hermes, BS:
Pardon me?
T.A. Rosolowski, PhD:
How did the funding work, were they grants?
Kay Hermes, BS:
I think it was a yearly grant from the Department of Public Health. I do remember the doctor who was in charge, coming to the office and meeting with Eleanor and going over the project of building the Texas Cancer Record Registry with her. So that was mostly the activity that we did in 2310 Baldwin.
Recommended Citation
Hermes, Kay L. and Rosolowski, Tacey A. PhD, "Chapter 03: Working for Eleanor MacDonald: the Beginnings of the Texas Cancer Registry" (2018). Interview Chapters. 1033.
https://openworks.mdanderson.org/mchv_interviewchapters/1033
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