
Chapter 02: A Clinician Who Seeks Broad Knowledge and Connections with Patients
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Description
In this chapter, Dr. Jaffe describes his family life and education in Johannesburg, South Africa. He expresses his gratitude to his parents, who ensured that he (and five siblings) got a good education, despite the family’s modest means. He also speculates that his caretaking role as the oldest child pointed him toward pediatrics, though he took the opportunity to rotate through all four specialties to round out his experience once he qualified as a physician. He talks about his roles (residency and Chief of Pediatrics) at Bagwanath Hospital for Black South Africans, where he had broad experience of diseases. When asked, Dr. Jaffe confirms that he was deeply affected by Apartheid in South Africa, noting that as a Jew, he felt compassion for the persecuted Black South Africans. He also briefly describes how other Jewish doctors were involved in anti-Apartheid activism. Dr. Jaffe next describes his commitment to working with his patients, noting his insistence over the years that he be called anytime a patient died so he might comfort the parents and assure them they could not blame themselves for their child’s death. Medicine, he notes, is “a hard mistress.”
Identifier
JaffeN_01_20120420_C02
Publication Date
4-20-2012
City
Houston, Texas
Interview Session
Topics Covered
The Interview Subject's Story - Personal Background; Character, Values, Beliefs, Talents; Personal Background; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences; Faith, Values, Beliefs; Evolution of Career; Formative Experiences; Experiences of Injustice, Bias; Faith, Values, Beliefs; Offering Care, Compassion, Help; Patients; The Clinician; Funny Stories
Transcript
Tacey Ann Rosolowski, PhD:
Absolutely. I wanted to start at the more usual starting place, which is with some of the personal background. If you could tell me where you were born and when and where you grew up.
Norman Jaffe, MD :
Sure. I was born in Johannesburg, South Africa. That was 78 years ago, and I knew from the very beginning that I wanted to be a physician. I don’t know why. Perhaps it’s engendered in some of the families. I’m Jewish, and my parents had a high regard for a physician. I think this possibly infiltrated into my concept of life.
Tacey Ann Rosolowski, PhD:
What did your parents do?
Norman Jaffe, MD :
My father was a general storekeeper, and my mother was a teacher. She taught Hebrew extremely well and was very well educated in Hebrew. In fact, she came from Kovno, which is in Lithuania, and there was a very vibrant Jewish community in Lithuania [which] spoke Hebrew extremely well. I have great difficulty now in accepting the fact that I did not exploit her talents more effectively when I reconsider the situation at the present time. My father also appreciated her, though he wasn’t as well educated as my mother. He was an extremely good father and taught—I’m sorry—and did everything he could for his family, and he gave me certain ideals and concepts to follow, which I hope I, in fact, adhere[d] to in the course of my life.
Tacey Ann Rosolowski, PhD:
What are some of those ideals that you learned from him?
Norman Jaffe, MD :
That family is the most important thing[:] to be honest, conscientious, and hardworking, and he was that way. He worked extremely hard. He made a reasonable living but not an outstanding living, and he did everything he could to educate his children. I’m one of six children. I’m the oldest. I know how difficult it was for him and how hard he worked in order to ensure that his children would be educated. In fact, he often made the statement, “They can take many things away from you, but they will not take away your education.” He went out of his way to ensure that we had an adequate and appropriate education.
Tacey Ann Rosolowski, PhD:
And your parents’ names?
Norman Jaffe, MD :
My father’s name was Solly Jaffe, and my mother’s name was Helen Soreson. If you talk about background, I can tell you this much[:] I believe that I have a great deal of gratitude, and I would say understanding, of how difficult it was for my parents to raise six children. My father worked from dawn until dusk and often came home late at night, but my mother was there to ensure that the children were adequately dressed, fed, put to bed on time, and things of that nature. It was a very, very satisfying childhood that I experienced, and I’m grateful for them to the sacrifices that they made. [] They went out of their way to ensure that my education was well rounded. I went to a very good English school. It was a school entirely for boys []. We had schools for boys and girls, and the school that I went to was a very good high school where I was taught the classics in Latin, in English, and [subjects] of that nature. And fortunately, I’m not sure if it was because I was conscientious and hardworking and wished to please my parents, but I got a very good schooling certificate, a first class pass in matriculation with distinctions in Latin and mathematics and [science]. I had no difficulty in entering medical school.
Tacey Ann Rosolowski, PhD:
When did you know that you were gifted in the sciences?
Norman Jaffe, MD :
I think it came naturally. I was always interested in that. In fact, I remember even in what we call Standard 8 or Standard 7 [which is equivalent]to the fourth or fifth grade in American standards—I became interested in van Leeuwenhoek’s discovery of the microscope,. [] I remember taking a book out of the library called The Microbe Hunters. [] That had a major impact on me on how he was able to identify [] the bacteria []. And from there it followed almost automatically that I gravitated to many medical texts and books for the appropriate age at that particular time. I was a voracious reader at that stage as well.
Tacey Ann Rosolowski, PhD:
Were there other books that really affected you at that young age?
Norman Jaffe, MD :
Yes, I liked detective novels, and I liked novels of medicine.
Tacey Ann Rosolowski, PhD:
And working with cancer is kind of being a detective, I think.
Norman Jaffe, MD :
That’s absolutely right. I still like them []. Incidentally, I would draw your attention [to the fact that] I’m currently reading The Leopard [by] an author in Norway. I can’t remember his name now at the moment [Jo Nesbo], but it’s quite a nice, interesting story, and he’s equated to the books that came out of Sweden recently, [for example,] the girl with the tattoo on her—
Tacey Ann Rosolowski, PhD:
The [Girl with the] Dragon Tattoo, yeah.
Norman Jaffe, MD :
That’s right [ ]. Those are very, very exciting and interesting books. They hold one’s attention, and I absorb them very well. Incidentally, just on a sideline and in passing, I’m grateful to my wife, who also reads novels of that nature, and we often have long discussions about [them].
Tacey Ann Rosolowski, PhD:
And her name?
Norman Jaffe, MD :
Her name is Louise, Louise Jaffe. Well, originally her maiden name was Louise Carr.
Tacey Ann Rosolowski, PhD:
Carr?
Norman Jaffe, MD :
C-A-R-R.
Tacey Ann Rosolowski, PhD:
Thank you. Tell me about going to medical school. Where did you go?
Norman Jaffe, MD :
I went to the University of Witwatersrand. Now, that is difficult to pronounce. It is actually an Afrikaans name. It should really be pronounced “Vit-vaters-rand,” which is Afrikaans. I was schooled in both English and Afrikaans. Afrikaans was [a] bilingual language of South Africa at that particular time, so I became fluent in both English and Afrikaans, and I did fairly well in medical school. I didn’t get top marks, but I was in the upper echelon among the first ten or fifteen at the top, and I thoroughly enjoyed medical school. It was a six-year program, and at the very end of it I knew that I wanted to do pediatric oncology. Not really oncology, I’m sorry, but pediatrics.
Tacey Ann Rosolowski, PhD:
Why?
Norman Jaffe, MD :
Because I was one of six children, and I liked children because of my siblings. I guided my siblings, so much so that I induced my brother also to enter into medicine. I couldn’t induce my four sisters to do that. They became schoolteachers and nursery school teachers and the like, but they also had the same ideas and concepts that I was raised with, and each one of them, fortunately, got higher educations and so [forth].
Tacey Ann Rosolowski, PhD:
I was going to ask you if being the first child had an effect, because often you’re kind of a substitute parent in some ways.
Norman Jaffe, MD :
I think it did[.] My wife tells me that I know how to handle people because of the way I handled my siblings. I didn’t do that deliberately. I think it was imposed upon me, but that’s the way it was. I was the first one, so I think I even taught my parents how to be parents.
Tacey Ann Rosolowski, PhD:
I always feel like the first child gets practiced on, and they help the others.
Norman Jaffe, MD :
Yeah, it can also be a reversal situation as well.
Tacey Ann Rosolowski, PhD:
Yeah, that’s true. That is true. Tell me about your residencies, and just kind of take me through the whole professional training track.
Norman Jaffe, MD :
0 After I had qualified as a doctor, I decided that to be fair to myself and to others and particularly to my patients, even though I had the qualities to become a general practitioner and to decide on becoming a specialist in one field or another, it would be appropriate for me to do specialty services in the four major specialties. I had six months of pediatrics, six months of medicine, six months of surgery, and six months of obstetrics and gynecology.
Tacey Ann Rosolowski, PhD:
I noticed that on your CV, and I thought that looked unusual. That was not—did most people do that?
Norman Jaffe, MD :
Many of them did, not most, but many of them did, and I think that was a reasonable way of solidifying your ultimate choice. And having done that, I decided that pediatrics was indeed the specialty that I should undertake.
Tacey Ann Rosolowski, PhD:
Now, I noticed that there were several hospitals that you went to and I’m wondering if any of—what they were. There was Coronation Hospital.
Norman Jaffe, MD :
That’s where I did my internship in medicine and surgery.
Tacey Ann Rosolowski, PhD:
In 1957.
Norman Jaffe, MD :
That’s correct, and then I also did pediatrics in Coronation Hospital.
Tacey Ann Rosolowski, PhD:
And then you went to—?
Norman Jaffe, MD :
Baragwanath. That hospital has now changed its name to the Chris Hani Hospital. Chris Hani was one of the individuals in the apartheid system who was killed in his attempts to overcome the system, and in recognition of his valiant attempts they named the hospital after him. I think Baragwanath derives from the Welsh word which means “bread” or something of that nature. I’m not quite sure. But it was a very good hospital for training.
Tacey Ann Rosolowski, PhD:
But was this an apartheid hospital that—
Norman Jaffe, MD :
It was only for blacks.
Tacey Ann Rosolowski, PhD:
Only for blacks. That’s what I thought. Now what—? Did you see a difference—? How did you—?
Norman Jaffe, MD :
That affected me greatly, incidentally. It affected me because as a Jew whose people had undergone discrimination and difficulties in their lives, I felt it was entirely wrong to subject a black person to similar situations, particularly for Jews to do that, and I think that it was also possible that I might have landed up in jail because of my activities associated in the anti-apartheid system. That was one of the motivating factors, incidentally, which induced me to leave South Africa and come to the United States at a subsequent time.
Tacey Ann Rosolowski, PhD:
Did you take part in activist activities there?
Norman Jaffe, MD :
No, not as much as the others did, and many of my colleagues who did were whisked away overnight by their parents to Israel, to the United Kingdom, to Canada, and some even to Australia because they were in danger of being locked up and sent to jail for their activities. I remember one friend. I saw him in the morning, and he wasn’t there the next morning, and after inquiry, it was revealed that he’s gone on vacation. I subsequently learned that he was taken by his parents to Israel because he was in danger of being prosecuted for his anti-apartheid activities. There were many such young Jews who did that sort of thing, and I do admire them and sometimes envy them because I wasn’t as active as they were.
Tacey Ann Rosolowski, PhD:
What were you noticing at Baragwanath Hospital? I’m asking because when I interviewed Ralph Freedman, who also worked at some black hospitals, he said that because the level of care was so low for black South Africans he saw a wide range of diseases and I’m wondering if you—
Norman Jaffe, MD :
Oh, I did the same, but they were mainly diseases of malnutrition and of poverty, diseases of severe gastroenteritis, diarrhea and things of that nature. I became an expert, incidentally, in putting up intravenous therapy in little children who were dehydrated and needed urgent intravenous fluid. I think the experiences had a great effect upon me not only from a social point of view but also from a medical point of view. I saw many diseases which no one has seen over here. I saw diphtheria, for example, that I don’t think anyone [here] has seen, those membranes, whitish-bluish membranes on the throat. I also saw diphtheria, for example, causing heart failure, which very few know about []. I saw smallpox affecting the skin. In fact, in one of the recent meetings that I attended, a patient with smallpox on his skin was flashed out on the [screen], and no one knew the diagnosis except myself. It wasn’t a touch of genius. It was because I had seen it before. One saw many, many diseases which one doesn’t see over here. These are diseases that are still prevalent, incidentally, in underdeveloped countries, particularly in Africa.
Tacey Ann Rosolowski, PhD:
What about the next phase? Because I notice you were registrar and is that—
Norman Jaffe, MD :
Yeah, “Registrar} is very similar to a “Fellow[ship]” to get one’s higher degree. I did become a Registrar. I did my time, and then I got my higher degree. Now, there is a system in South Africa that once you have your higher degree, in preparation for registration as a specialist, you must leave your specialty for one year. The idea is that you would not be able to talk to doctors to refer patients to you, but you should also get a rounded experience in an allied discipline to the one you have chosen. I chose to do internal medicine to complement this. I hoped that I would at least get some experience with the adolescent and older population similar to those in pediatrics or allied to the pediatric problems. I chose to do this extra year of specialty in a hospital staffed by missionary nuns because I wanted to get experience on how they treated and handled patients and the patients that they saw. This was called Edenvale Hospital. I think it’s in my curriculum vitae. You may see it over there. This was a hospital in Edenvale, which was an allied suburb to Johannesburg. I was given a contract for one year. When I came to that hospital, it was in dire straits. Things were not going well. It was disorganized []. I managed to get some of the problems sorted out and put order into chaos, but it still was not right, so I approached the superintendent, and I told him that I would resign unless certain factors were implemented. I was able to get them implemented. The nuns were very grateful, and they approached me, and they said, “We are grateful for what you have done, and we would like to reward you.” And I said, “You are very kind, but I want to say something to you,” and they said, “By all means.” I said, “You know, Sisters”—we called the nuns sisters—I said, “I’m a Jew, and I’m a little unhappy.” They said, “Why?” And I said, “Because I see you walk around every morning, and you talk a certain language, and perhaps you’re talking about me. I’m sure you’re not, but I still feel uncomfortable. What are you talking about?” They said, “We’re talking Gaelic.” I said, “Teach me Gaelic.” Their eyes lit up, and they said, “By all means.” I would intervene for one moment and say that if I am ever seriously ill I want to be nursed by Irish nuns. They are devoted people. They will do whatever they can for you. They taught me Gaelic. We used to go around in the morning, and I would say, “Dea Is Muraguth,” (God and Mary be with you), and they would respond, “Dea Is Muragath is Patrick,” (God and Mary and Patrick be with you), and things of that nature. In fact, we conducted a good deal of the ward rounds at a later stage in Gaelic. I thoroughly enjoyed the experience. At the end of the one year, when my contract was up, they approached me and said, “What do you want to do?” and I said, “Well, Sisters, quite frankly, I want to go to the United States to expand my knowledge on pediatric neonatology. I’m a pediatrician, and I like doing very early pediatrics, which is neonatology, but I have some difficulty in getting in over there, so I’m not quite sure what I’ll do.” In the interim, I was awarded a contract to be a chief at Baragwanath Hospital, and they said, “Do us a favor. Stay an extra year in Edenvale Hospital, and we will pray to Father Lieberman. Father Lieberman [was] a converted Jew, and we’ll ask him to intervene on your behalf to get you into the United States.” I accepted another year to stay on at Edenvale Hospital and continued my studies in Gaelic and to help out with the nuns []. At the end of the year, I got a note from Dr. [Charles] Janeway, and he said, “I have your application to come to the United States to do pediatric neonatology, but unfortunately, my sponsorship for Americans is oversubscribed. Your mother, who[] you described was born in Lithuania, can get into the United States quicker than you can even though she’s not a doctor.” But he said, “I will hand over your papers to Dr. Sidney Farber, who is a hematology oncologist specialist, particularly [in] oncology. I understand that he’s looking for someone to run his clinic, and since you are now also being given a chief’s post at Baragwanath, he may be interested in you.” I thanked him for it, and I approached the sisters, and I said, “Sisters, look, this is what has happened, and my contract here is over. I am going to become a chief at Baragwanath Hospital, and I will accept it until further developments.” And they said, “Doctor, we have been praying continually to Father Lieberman. We will now write to the Pope in order to proceed further to ask that he [Father Lieberman] be made a saint.” I’m not sure Father Lieberman was ever made a saint, but here is a Jewish boy who [may be] responsible for someone being a saint. Whatever the circumstances, I accepted my post at Baragwanath Hospital as a chief, and three months after accepting the post I got a letter from Sidney Farber to say, “Dr. Janeway has sent me your curriculum vitae, has sent me your applications and things of that nature. I note that you are a chief at Baragwanath Hospital, that you’re doing neonatology, but I need someone to run my clinic, and I’m prepared to sponsor you as an immigrant into the United States.” [Thus] Dr. Farber said he would sponsor me to the United States, and that’s how I landed up in the United States.
Tacey Ann Rosolowski, PhD:
And so you were a fellow in tumor therapy?
Norman Jaffe, MD :
He gave me a fellow in tumor therapy. That was the position that he awarded to me.
Tacey Ann Rosolowski, PhD:
And that was 1966 to ’67.
Norman Jaffe, MD :
That’s correct.
Tacey Ann Rosolowski, PhD:
Can I ask you a couple of questions just going back a little bit? This is normally a question that I ask at the end of the interview, but it seems appropriate to ask it now given your relationship with the nuns and some of the comments you’ve made. To what extent is your faith and sense of spirituality part of what you do?
Norman Jaffe, MD :
I don’t say that I’m extremely religious, but I do go to synagogue, to shul, every week. I put on what are called phylacteries and so on whenever I can, and my wife runs a kosher home and has brought our children up as such. We believe very deeply in our faith. I feel I get spiritual satisfaction from my faith. In fact, I will tell you something. I lost a child at the age of twelve. She had a congenital heart, and I was advised to take her to the Mayo Clinic, where an operation was performed. The operation was a magnificent success, and she died two days later. I know how people feel when they lose a child. I’ll tell you something: no matter what the psychiatrists and psychologists and everyone tell you that you’ll overcome the problem, you never do. It’s always with you, and when I’ve lost a patient, I know how my parents feel. We’re deviating somewhat, but I’ll tell you this much, [] I [] insisted, while I was in practice, that any patient of mine who dies, even in the middle of the night, I must be summoned to that patient’s bedside. I’ve risen from my bed in the middle of the night, 3 o’clock in the morning [at times], to [drive] to the hospital for a dead child so that I can sit and talk to the parents and comfort them and tell them that, above all everything that could be done was done for their child, that they must not feel in any way guilty, or have any other feelings about that situation. I think that it has been of some service to them. And this is not only because of my own personal loss. I think my religious experiences have stimulated me and induced me to do that as well.
Tacey Ann Rosolowski, PhD:
I’m sure that’s enormous comfort. My sister almost died when she was under a year old. My parents were just—they were beside themselves, and they didn’t really get a lot of good support from some of the medical staff, and it was very hard. It made things very hard, so I’m sure your patients have been comforted.
Norman Jaffe, MD :
Well, I hope so. I’ll [also] tell you this much. Some of the greatest relationships that I have had and still continue to have are the friendship and the support I have from the parents of deceased patients. They write to me every year. They come to Houston to see me every year. When I retired, I would say about twenty percent of the participants in the retirement party were parents who flew in from various parts of the country to bid me farewell and to thank me for what I had done. I really felt embarrassed about the situation, that they came from Boston, they came from Los Angeles, Ohio, [and elsewhere]. I appreciated that. Those friendships money cannot buy, and they will be with me forever.
Tacey Ann Rosolowski, PhD:
That’s a wonderful testament to a life’s work.
Norman Jaffe, MD :
Well, I think so, and I hope so, but I will tell you another secret. I could not do the work that I did without my bride, without my wife. We’ve been married fifty years, and she has told me she knows that I have another mistress [medicine]. She has encouraged me when my mistress has called in the middle of the night to go and attend to my mistress, which is medicine. She says, “Your mistress is a hard mistress, but I will support her.” It’s a difficult situation, but I could not do it without her. She is a wonderful woman. There’s a story or an aphorism that behind every famous man there’s a woman pushing. I don’t think I’ve been pushed. I’ve been supported.
Recommended Citation
Jaffe, Norman and Rosolowski, Tacey A. PhD, "Chapter 02: A Clinician Who Seeks Broad Knowledge and Connections with Patients" (2012). Interview Chapters. 1140.
https://openworks.mdanderson.org/mchv_interviewchapters/1140
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