Chapter 01: Early Experiences with Physicians and Illness

Chapter 01: Early Experiences with Physicians and Illness

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Description

In this chapter, Dr. Hill links his choice of career to his own bout with osteomyelitis as a youngster and the care that his family physician provided. He gives an interesting portrait of disease in the thirties/forties–including being anaesthetized with cocaine—and the role of the small-town doctor.

Identifier

HillCS_01_20120214_C01

Publication Date

2-14-2012

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Personal Background; Character, Values, Beliefs, Talents; Personal Background; Professional Path; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences; The Patient; The History of Health Care, Patient Care

Transcript

Tacey Ann Rosolowski, PhD:

I’m Tacey Ann Rosolowski interviewing Dr. Hill, Professor Emeritus, for the Making Cancer History Voices oral history project run by the Historical Resources Center at MD Anderson Cancer Center in Houston, Texas. Dr. Hill came to MD Anderson in 1963 as an oncologic endocrinologist. By the 1980s, his career expanded to include pain management. Dr. Hill retired in 1996.

Tacey Ann Rosolowski, PhD:

I want to make sure that I have your current titles correct. You’re Professor Emeritus and Internist Emeritus in the Department of Symptom Research at MD Anderson.

C. Stratton Hill, MD:

Yes.

Tacey Ann Rosolowski, PhD:

You are also a member of the Pain Research Group at MD Anderson.

C. Stratton Hill, MD:

Yes.

Tacey Ann Rosolowski, PhD:

You’re also Vice President for Health Affairs at the Open Door Mission Foundation for Recovery and Rehabilitation in Houston.

C. Stratton Hill, MD:

Yes, alcohol and drugs, treatment, rehabilitation and recovery program.

Tacey Ann Rosolowski, PhD:

Is this part of the same institution, Director of the Russell M. Scott Convalescent Care Center?

C. Stratton Hill, MD:

Yes, that’s what our convalescent care center is called.

Tacey Ann Rosolowski, PhD:

I want to begin with a little bit of background information, so please tell me where you were born and when and where you grew up.

C. Stratton Hill, MD:

I was born on July 28th, 1928, in Humboldt, Tennessee. It’s in the western part of the state. I was educated in the public schools of Humboldt and did my undergraduate work at Rhodes College in Memphis, Tennessee, a liberal arts college associated with the Presbyterian Church. I did one year at the University of Virginia Law School, decided to switch, and moved over to the University of Tennessee Medical School.

Tacey Ann Rosolowski, PhD:

I noticed that you had started out in a law program. What was that about?

C. Stratton Hill, MD:

At that time, the men who had been in World War II— I barely missed World War II, and every one of the veterans were coming back and going to school under the GI Bill. It was very much of a competition to get into medical schools, and they didn’t have nearly as many medical schools as you do now, so I was delayed in getting into medical school. Actually, I wasn’t really absolutely sure I could get into medical school, so I decided I’d try to get a degree in law in the meantime, and that’s what I did. I went to the University of Virginia for law school. Went there at the same time that Robert Kennedy was in school there, in the law school, and so then I graduated from the University of Tennessee, College of Medicine and interned at the University of Texas Medical Branch in Galveston. And following that, I went into the US Air Force and was stationed in Plattsburgh, New York, and did a temporary duty stint at RAF base Greenham Common in southwest England. Following that, I started training at Memorial Sloan-Kettering Cancer Center in New York, which is associated with Cornell Medical School, and I finished training there and was recruited to MD Anderson.

Tacey Ann Rosolowski, PhD:

I wanted to go back just for a second and ask you a couple of questions. First of all, was anyone else in your family involved in the sciences, and how did you end up deciding to go into medicine?

C. Stratton Hill, MD:

Well, I think that was mainly related to me developing osteomyelitis in my left leg. When I was in—I guess it was around medical school—I mean—middle school. (audio pauses )

Tacey Ann Rosolowski, PhD:

Okay, so you said you developed osteomyelitis in middle school.

C. Stratton Hill, MD:

Yeah, I was probably in the middle school range at that time, and it was just when the sulfa drugs were coming out, otherwise that was a severe sentence medically at that time.

Tacey Ann Rosolowski, PhD:

Can you tell me what osteomyelitis is?

C. Stratton Hill, MD:

That’s an infection in the bone. I had known several of my acquaintances there in the little town that had that, and they spent years in bed and had to have the— There were no antibiotics, so they’d keep the bone actually exposed. It had to be dressed with certain solutions and so forth, and that was very disturbing to me. But the sulfa drugs that had just been developed, basically by the Germans, were just coming out. I think I better get some water. Excuse me.

Tacey Ann Rosolowski, PhD:

Okay, I’ll just pause this. (audio pauses ) I’m turning the recorder back on. Okay, we’re recording.

C. Stratton Hill, MD:

Well, the sulfa drugs had just come out, and so I was treated with sulfa drugs, and that made all the difference in the world because the antibiotic course was very short. I didn’t have to go through the surgical drainage, and I recovered and went back to school and so forth.

Tacey Ann Rosolowski, PhD:

How quick was your recovery time?

C. Stratton Hill, MD:

Oh, I was probably in bed a couple of months even then.

Tacey Ann Rosolowski, PhD:

But even so, that was much quicker than—

C. Stratton Hill, MD:

Oh, yeah. Everybody that I knew that had that was in bed for one to two years with this open drainage, and so it was a miracle, relatively speaking. Now, of course, you may or may not—still, osteomyelitis, when you get an infection in the bone—we see a lot of that at the mission where I work, and that’s a big problem.

Tacey Ann Rosolowski, PhD:

How do you get that? How do you contract that?

C. Stratton Hill, MD:

Well, it’s usually blood borne, and maybe sometimes it’s a contiguous infection. It will be a soft tissue infection, and it will involve the bone, but the blood supply to the bone is not all that good, and so it’s difficult to get the drug there. But now it’s a lot better than it was, and you pick up on it a lot quicker. You don’t see that long period of time that may—progressive when there’s nothing that can be done about it.

Tacey Ann Rosolowski, PhD:

How did that experience affect your thinking?

C. Stratton Hill, MD:

I had a lot of contact with the doctor at that time, and also, actually, when I was smaller, I had malaria—relapsing type of malaria—and so I can remember in the days when I would have that in the summertime. They’d call the doctor, and my mother was—she didn’t like to call the doctor because the doctor would come to your house, and he’d sit and talk, and he wasn’t very busy, and she needed to get things done. So he would sit and talk for a long period of time, and she didn’t like that. And I can also remember one time I got cut in the leg, and they took me to the doctor, and he was asleep on his examining table when we went there. So doctors didn’t have a whole lot to do in those days. There wasn’t much they could do anyway. That was in the days when you would—people had lobar pneumonia and they would— In this small town, people would gather at the person who was sick’s house, and you would sit and wait for the crisis. And the crisis was when you either died or you got over the pneumonia yourself. That broke up the infection, and you were able to get rid of all the pus and everything that was in the lungs. People would sit until that was the course of that disease. The doctor didn’t do it. I mean, there’s nothing you could do except to give them support, treat the fever and the symptoms, and try to make them as comfortable as possible. And you hit a point at which you either died or you had this crisis where your body actually overcame the infection pretty much on its own. I mean, you could give them fluids and different things, but it was all nursing care, basically. There was nothing to it. And I remember that at the time, they’d organize, or your friends would organize. “We’re going to sit between 10:00 and 12:00, midnight, and we’re going to sit between 12:00 and 2:00,” or whatever the shift was. I had some contact like that, and then I had relatives, not in the immediate family. Actually, at that time, they would be probably going to medical school or hadn’t even started going to medical school. But I’ve got a lot of cousins that are physicians. And then on my grandmother’s side, on my mother’s side, they all had to do with academic careers. At one time I had my cousin on a program that we put on here in 1984, who was professor and Chairman of the Department of Psychology at Stanford.

Tacey Ann Rosolowski, PhD:

And what is that person’s name?

C. Stratton Hill, MD:

His name was Ernest Ropiequet Hilgard, spelled R-O-P-I-E-Q-U-E-T.

Tacey Ann Rosolowski, PhD:

And the last name again was—?

C. Stratton Hill, MD:

Hilgard, H-I-L-G-A-R-D. They were German. He was from Belleville, Illinois. He became the Dean of American Psychology. He wrote the standard textbooks for—he and his wife. His wife was also a psychologist. They both went to Yale, and they both had PhDs. And when he took the job at Yale—I mean at Stanford—they would not let his wife work because of their rule against nepotism, so she just decided she’d go to medical school and become a psychiatrist. She was a child psychiatrist, and unbeknownst to me— It had nothing to do with me going into pain, but then Ernest—and he was called Jack—and I asked him one day, I said, “Why do they call you Jack?” And he said, “Well, when I left the University of Illinois”—and I think his degree at the University of Illinois was something like chemical engineering, something like that, and then he went on to get his PhD in psychology. He said at that time, before computers, you would line up in front of a card table or something and go to sign up for the different courses. So he said he asked somebody there, “Where do you get in the line for this particular course?” And the guy gave him some instructions or something, and he went over, and he got in the wrong line. And the guy said, “Hey, Jack! I told you to get in this line over here!” And he said, “You know, I thought I liked that name,” and so he just started calling himself Jack. And so anyway, he went on to great heights, and he died just probably five or six years ago. He was 90-something years old when he died. I had him on the program here in 1984. What they did—what he did—he was an experimental psychologist, and they did a lot of work in hypnosis for the treatment of pain. His wife was named Josephine, and she collaborated with another psychologist, and they did pain treatment in children, hypnosis in children. Well, anyway that’s—

Tacey Ann Rosolowski, PhD:

When did you know that you wanted to be a physician?

C. Stratton Hill, MD:

I kind of just thought that was something I’d like to do right after I had that contact and—

Tacey Ann Rosolowski, PhD:

With the osteomyelitis you mean?

C. Stratton Hill, MD:

What?

Tacey Ann Rosolowski, PhD:

With the osteomyelitis?

C. Stratton Hill, MD:

That, and then my association with— And also, I had a lot of sinus trouble, and that was another thing. This was the pre-antibiotic days, and actually the osteomyelitis is a treatment with the sulfa drug—treated the sinusitis. But that’s after I’ve had several surgical procedures.

Tacey Ann Rosolowski, PhD:

You had a lot of challenges yourself.

C. Stratton Hill, MD:

I did, and they put these things that they call windows, and basically it’s just a hole in the sinus so it would drain out. But before they put that in there, they would actually put a big trocar with a syringe and force it through the bone and then pump saline solution and force all of the pus and everything out of the sinuses through the natural opening, which was swollen. They’d have to use a lot of force to do that.

Tacey Ann Rosolowski, PhD:

It sounds painful.

C. Stratton Hill, MD:

And they would anesthetize me with cocaine. And after hearing all these guys out at the mission there that do crack cocaine and all the things you hear about cocaine, I was either too dumb or it didn’t affect me, because I don’t remember anything but getting numb, as far as the cocaine was concerned. But they would take a piece of cotton and put it in your nose to anesthetize the mucosa in order to do this procedure, so I did have a lot of involvement with— And I had severe headaches with that sinus problem.

Tacey Ann Rosolowski, PhD:

Did that experience—I mean—you had personal experience with pretty severe pain. Did that give you a different perspective when you went into pain management later, do you think?

C. Stratton Hill, MD:

I don’t really know. I think making the connection between that would be— I’d have to have some sessions with Sigmund Freud to really figure that out. (laughs) But that’s such a hiatus between my experience— I was in elementary school. I got interested in that because— I got interested in the pain part of it because of two things, I think. One was the fact that I became head of the clinic, and I knew that they were making some effort to see if they could have a pain clinic, and also—and I realized that we didn’t do a very good job with pain at that time. Those were the two factors, and then, of course, I was working in brain peptides in my work in endocrinology. I worked with Roger Guillemin, who subsequently won the Nobel Prize, he and a couple other doctors that had to do with the hormones of the hypothalamus. All of that kind of came together later on.

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Chapter 01: Early Experiences with Physicians and Illness

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