[Dr. Debakey Remembers... the evolution of the National Library of Medicine 1942 - 1997]

[A Conversation: Michael E. DeBakey, MD, Chancellor Emeritus, Baylor College of Medicine  and Donald A.B. Lindberg, MD, Director National Library of Medicine]

[Donald Lindberg]: My name is Don Lindberg and I'm the Director of the National Library of Medicine. I’m delighted that, today, our guest is Dr. Michael DeBakey, Chancellor Emeritus of Baylor College of Medicine, and a member of the Board of Regents for the National Library of Medicine.

Dr. DeBakey, you have been a good friend of the National Library of Medicine and of me for many, many years, and I'm really pleased that you're here.

[Dr. DeBakey]: Thank you.

[Dr. Lindberg]: In this case we want to talk a little bit about the history of the National Library and the very significant role you played in it. So I'm equipped with some props. Now this particular prop, you haven't seen before.

This is a brick from the old old redbrick building where the library was many, many years ago. And this, I know, is where you first encountered the library. Can you tell a little bit about that?

[Dr. DeBakey]: Well, in World War Two, I was brought into the Army as a Captain, and I was assigned, at the request of the Chief Consultant of Surgeries, Rankin, my friend Rankin, who was Chief Consultant of Surgeries to the Surgeon General of the Army, in Washington, to come up and work in his office.

And so, you know, I had had no military medical experience whatever, and suddenly I’m thrust into this position where I had to prepare documents and policy issues, and I didn’t know anything about it, so I'd have to go down to the library and learn.

So I got to using the library a great deal,  I spent a good deal of time down there, and I got to know the library very well, and after a while I developed a sort of affection for that library, browsing through the books.

At the end of the war, I became concerned about the future of that building and the library itself. It was the greatest collection of medical literature in the world and it was not being properly taken care of.

I felt more and more that this was a national treasure, and, unfortunately, I felt that the Army was not able to maintain it.

And this was evident from when I asked about the building, because I'd hear, you know, "this old building" with a roof that leaked when it rained, they had to put tarps on over the stacks of books, it had an outhouse.

[Dr. Lindberg]: Did the outhouse work pretty well?

[Dr. DeBakey]: [Laughter] Poorly. So I asked, "Why haven't you gotten a new building?” And the Surgeon General says to me, "Well we've been putting in a request for thirty years, and we're just unable to compete with tanks."

So that impressed me with the fact that it no longer belonged in the armed forces, in the Army. And I started making indications that it ought to be a national treasure, it should be outside of the Army, and at first, of course you can imagine, there was a considerable amount of resistance.

And two things that happened that made it later possible, one is that the medical task force of the Hoover Commission was headed by a man by the name of Tracy Voorhees,

and I got to know him during World War Two because I worked under him, even though he was in the Master General's office, in a publication called Health, at that time it was called, which was done by the Surgeon General but went through the Master General's office, so I got to know him quite well.

So when he became Chairman of the Task Force of the Hoover Commission, he asked me if I would work for him virtually as an executive of that task force.

So I came up and spent, oh, nearly nine months up here in Washington, fulltime, took a leave of absence at the University, Tulane University then, and really virtually prepared a report. And I prepared, in that report, a recommendation about the National Library of Medicine, among other things.

And I was fortunate because, when he asked me to go with him to meet with Herbert Hoover, to brief him on the report, I went up to New York with him, Herbert Hoover was staying in the Plaza Hotel there and...

[Dr. Lindberg]: At the Waldorf?

[Dr. DeBakey]: I mean the Waldorf Hotel, and he had an apartment, we had lunch with him, and he was reading through the report and he said, "You know how many task forces I’ve got?"

And Tracy Voorhees said "No, sir.” He said, "Well you know, I've got about fifty task forces, if everybody came in here with twenty or thirty recommendations, who’s going to read this report?"

He asked us to "Give me the single most important recommendation.” And I immediately blurted out the library.

[Dr. Lindberg]: Good for you.

[Dr. DeBakey]: And fortunately that went into the report, and then it was picked up in Congress after the report came out, by Lister Hill in the Senate and John Kennedy in the House, and they began working on the legislation and really got quite a good support.

Just before the National Democratic Convention was to be held that year, the in the mid-50s, '52, '53, something like that, '54, '55, I forgot. Anyway, the people from Chicago in the House and Senate began to lobby for having the library built in Chicago next to the AMA, this, of course, was the AMA lobbying for it.

We wanted it in Washington, and so Lister Hill called me on one occasion and said, "The House Speaker, Sam Rayburn, from Texas is holding it up for that reason."

He didn't want to have a quarrel before the Democratic Convention. And he said, "Is there anyone you know who has some influence on Rayburn?"

[Dr. Lindberg]: And by that time, had you moved to Texas?

[Dr. DeBakey]: I had moved to Texas by that time, that's right. Well, I didn't have very much influence on Rayburn, but I did suddenly realize, when he told me about the Democratic Convention,

that I had operated on the husband of the Secretary of the National Democratic Party, her name was Dorothy Riedenburg, so I called her and I asked her if she would persuade Rayburn,

because Lister Hill said, "We have the votes, if we could get Rayburn to let the bill come through, we could get the bill approved, get the library bill approved."

And I explained to her the situation, and she said, "I'll see what I can do."

The next day, she called me and she said, "Rayburn said he would do it.” And that's how we got the library.

[Dr. Lindberg]: That's pretty interesting. Well, I have to say, I think the Library belongs in Washington, in Bethesda, and has done real well.

[Dr. DeBakey]: Oh, absolutely.

[Dr. Lindberg]: Actually, you've told me on one other occasion that the site of the library was a golf course or some such thing. And that you actually kind of surveyed that site, didn't you, as well?

[Dr. DeBakey]: Well, we came out here, actually, the Board of Regents, once it was established, after the bill was passed and it was approved.

[Dr. Lindberg]: Maybe I should show you this picture of the Board as a reminder. There you are, replete with a mustache.

[Dr. DeBakey]: Yeah, you see me in a mustache. Yeah, this is Rogers, who was our first Director, and this is the Board of Regents at that time.

And we came out here to look for a site and there was an old golf course in this general area. We thought this was a good site for it, virtually as a part of the National Institutes of Health complex, which we felt was desirable, to be in the complex because I think it is a part of a research activity.

The library's compilations and literature is essential to any research activity, so it’s a very important place for it to be, and I think it has prospered for that reason, too.

[Dr. Lindberg]: Oh absolutely, sure. That was a wise decision. Pity you lost the golf course, though.

[Dr. DeBakey]: Personally, I think this is a very good use for the golf course. Much better than it was originally.

[Dr. Lindberg]: Well, you probably remember him better than I, because he was an old man when I first met him, but here is a picture of Senator Lister Hill.

[Dr. DeBakey]: Yeah, he was a remarkable man, Senator Lister Hill, who really became a powerful force for medical research and medical activities, and he himself actually became interested in medicine because of the fact that his father, in fact, that’s why he's called Lister, his father was a general practitioner in Alabama.

And his father was quite a, I think, an active person in the field and had a sort of sense for history. He was very impressed with Lister, particularly in terms of the development of the concept of asepsis and antisepsis, one of the first to use it in this country,

and admired Lister so much that he named his first son Lister Hill. His father was the first one to do a successful repair of a heart wound in this country.

Rehn in Germany had done the first one in 1895, and his father, 1901, 1902, something like that, operated on a young black boy who had been stabbed in the heart, in the atrium, and he did it on a kitchen table, somebody else holding a kerosene lamp, and it was successful.

[Dr. Lindberg]: What was their approach to anesthesia?

[Dr. DeBakey]: I think he used chloroform, I’m not sure. It’s in the report review. He wrote a report of it.

[Dr. Lindberg]: I think we'd better give a little more progress to that story, that’s remarkable, I didn't know that Senator Hill was that connected.

[Dr. DeBakey]: I think he and Fogarty, Fogarty was in the House, Lister Hill was in the Senate, the two of them teamed together so beautifully and had a tremendous impact upon the development of the National Institutes of Health.

[Dr. Lindberg]: Now there's another person that I think about in this teamwork, this is a picture from a little bit later period, but this is Mary Lasker, isn't it?

[Dr. DeBakey]: Yep, that's her, there she is, and that's so typical of her, striding, I’m sure, with me. She was, you know, making me tag along, she was striding, I'm sure, to have some lobbying effect on Congress for medical  research.

And she was responsible, another thing, from a library standpoint, she was really responsible for Lyndon Johnson appointing the Commission for Heart Disease, Cancer, and Stroke.

[Dr. Lindberg]: Wow, I didn't know that.

[Dr. DeBakey]: Yes, she was responsible for it, and as a consequence of that Commission, the whole concept of the Regional Libraries was established. That was an essential part of the Commission’s report, the Regional Libraries,

and that was one of those things that was picked up by Congress and supported very actively, and, of course, had tremendous impact on the country.

[Dr. Lindberg]: For many year, and in a different context, but on more than one occasion, I've heard Claude Pepper, Senator Pepper, refer to Mary Lasker as an angel on Earth, he was very devoted to her. Was he part of this, at the time?

[Dr. DeBakey]: Yes, he was a great supporter, too, of medical research, and the library.

[Dr. Lindberg]: Now, I have a picture and again, you don't need these remembrances as much as I do, but this is a picture of the White House, I guess this is the Rose Garden.

[Dr. DeBakey]: That's exactly right, that’s the picture of the Rose Garden, of when the Commission for Heart Disease, Cancer, and Stroke was established.

[Dr. Lindberg]: There's President Johnson, and there you are in the center.

[Dr. DeBakey]: Yep, that's me. Right there.

[Dr. Lindberg]: You'd gotten rid of the mustache, by that time.

[Dr. DeBakey]: Yeah, by that time, I’d gotten older. I didn't need the mustache.

[Dr. Lindberg]: Now, that was a hard thing to do, that commission, and he asked you to do it in a hurry, as I recall.

[Dr. DeBakey]: That's right, he wanted it completed in about nine months, and we did.

[President Johnson]: Before this year is gone, over a million productive citizens will have been killed by three murderous diseases. Seven out of ten Americans who lose their lives this year, will be the victims of heart disease, or cancer, or stroke.

[Dr. Lindberg]: He did, he did. But maybe it was a good idea to put the heat on you.

[Dr. DeBakey]: Yes, I think it was. As  a matter of fact, we met regularly, and I spent more time up here than I did at home, during the time that commission was in operation.

And I think, looking back, I have to say that among the various things we reported, the Regional Library probably had the most impact, the Regional Medical Library Program.

[Dr. Lindberg]: I think so, too. As you and I discussed in another interview, the Regional Medical Program was your idea, it was something you put in the commission report, something I found tremendously exciting, but that didn't last, incredibly, and the Medical Library Assistance did.

[Dr. DeBakey]: Well, it didn't last, I think, largely because it was a concept that the medical profession, in general, didn’t really like because they thought it was leading to socialized medicine, when in truth,

I don't think it would. I think Medicare has more effect than the Regional Medical Program, in that regard.

[Dr. Lindberg]: Yeah, I regret that, sincerely. Now here's, I think, the end of that nine months, where you're giving President Johnson the report.

[Dr. DeBakey]: We're giving him a copy of the report, and briefing him on it, and very interestingly...

[Dr. Lindberg]: In the nine months, you’ve gotten to look younger. Probably that work agreed with you.

[Dr. DeBakey]: Well, it was exciting work, there's no question, and we had a wonderful commission, really. They were dedicated, they really worked hard on it.

We divided the responsibilities among the commission members into a number of subcommittees and they prepared reports and had regular meetings.

And the report itself, the documentation that supports the report, is presented by the various subcommittees, but I must say, President Johnson was very supportive of the report and its recommendations.

And he did his best to try to implement it with whatever legislation he could advance, and he did.

[President Johnson]: We already carry on a large program in this country, for research and health, in addition, Regional Medical Centers can provide the most advanced research and treatment for heart disease, and cancer, and stroke, and other major diseases.

[Dr. DeBakey]: And, fortunately at that time, we had good support from Congress, and they went right along with the recommendations.

[Dr. Lindberg]: I could ask, how often did it meet? How did you organize the work? I mean, it was a big success. Maybe there's a lesson to be learned.

[Dr. DeBakey]: Well, the subcommittees met more frequently than the whole commission, and I would meet with the various subcommittees, as chairman, one subcommittee, then another subcommittee, sort of rotate with them.

[Dr. Lindberg]: Whole bunch meet, what, like three times? Is that the usual?

[Dr. DeBakey]: Oh, more than that. We had a meeting of the commission itself, I think about every six weeks the whole commission met. The subcommittees met even more frequently.

[Dr. Lindberg]: So you kept the momentum up, then.

[Dr. DeBakey]: Yes, oh yes, it was going at a fast pace.

[Dr. Lindberg]: Now, here is a picture from a later time, of Mary Lasker, and you, of course, also Tip O’Neill. What was the occasion there? You were giving awards, probably, Lasker Awards.

[Dr. DeBakey]: These are Lasker Awards and they were being given and Tip O’Neill was there to give the luncheon speech. And he was a great supporter of our activities, too. He was very fond of Mary Lasker.

[Dr. Lindberg]: I was, too.

[Dr. DeBakey]: She was a great lady. She really had a tremendous influence in expanding the research activities of some of the institutes that we now have really stemmed from the initial efforts she made to get them established.

And she would call me from time to time, ask me to meet her here in Washington, and we would walk the halls of Congress, lobbying for these activities.

She was well-received by the congressmen, they all had high esteem for her, recognized her dedication, unselfishness, her willingness to be dedicated to medical research because she felt that was the one way we were going to improve medical knowledge, and control the effect of disease.

[Dr. Lindberg]: You know, one of the big changes within the National Library of Medicine, it seems to me, was the creation of the Lister Hill Center for Biomedical Communications.

[Dr. DeBakey]: Oh, there's no question about it. Although, I think, to be perfectly honest, I think the establishment of the National Library of Medicine has had such a tremendous impact upon the expansion of knowledge and transmission of that knowledge.

And today there's virtually no lag between new knowledge coming out of any kind of research activity, and its application. I think that the basic reason for that is what the National Library has done in providing, taking advantage of the new technology for the transmission of information.

You've got Medline and MEDLARS and GratefulMed, and now the internet, the public itself has all of this knowledge available to it and they are responding to it more and more. I think that this has been a tremendous educational activity that the National Library of Medicine has done.

And so I think it's responsible for more...You know, in the old days, a library was just a collection of literature, of books, often just the preservation.

The National Library of Medicine has done a lot more to make the library a much more active force in the transmission of new information and since, in the education of not only medical communities, even the public itself.

[Dr. Lindberg]: Oh, it's an active force all right.

[Dr. DeBakey]: Definitely.

[Dr. Lindberg]: Maybe I'll ask you this question. You won't be prepared, maybe, to give a definitive answer, but one of the things that comes up at every planning session I've participated in over the last 12, 13 years here is our formal commitment to serve the public through the health professions, because of limited resources.

But, everybody in medicine knowing full good and well that we have a more educated environment and patients and public, of course they should be served, of course they want the information. How should NLM really ideally respond to that circumstance?

[Dr. DeBakey]: Well, I think, as a matter of fact, that the response is going to have to be a positive response because the public is going to demand it, and they're already demanding it.

You know  yourself, on the internet there's an increasing demand and as a matter of fact, the evidence clearly indicates, on the basis of experience with the public and the internet, that there has been some advantage to the public.

They have actually obtained information through the internet, from the library, that has been useful to them. And I think it's important that we find a way to serve the public. It’s one thing to say that this is a library that is concerned with medical literature for the medical community.

But it's gone beyond that now. The public itself is much more knowledgeable, about medicine. You can hardly pick up a newspaper oar magazine or even a television network without getting something about health, because the public is very interested in it.

And I think that's good. I think it's important to educate the public, and I think the library is a very important element in that. So I think that we should be prepared to respond to that need.

[Dr. Lindberg]: Well, as you know, we are doing a kind of set of experiments to find out how good a job we can do in certain areas, AIDS for example, toxicology and environmental health, cancer protocols, those areas.

And I would say that it's very difficult to serve the public as well as we now serve the health care profession. So, we're trying. We’re trying your advice, but it's difficult.

[Dr. DeBakey]: Well, I know it’s difficult, but I think you're going to find that you need to do it, that’s the point I'm making. Because I think the public’s going to demand more and more.

And you saw what happened when the public found out through Ann Landers about the internet. There was almost an explosion right away. And the internet's going to be more and more available.

[Dr. Lindberg]: The internet is a wonderful thing. I’m going to jump ahead a little bit, in another little remembrance here. Here’s another wonderful friend of the National Library of Medicine. Remember that gentleman? Mark Hatfield.

[Dr. DeBakey]: Mark Hatfield, He was given, that's why he’s there with Mary Lasker, he was given the Lasker Award because of his public service to United States medical activities and support of their medical activities.

And he's a great friend of the Library’s, as well. I think it's interesting how these individuals have developed, in Congress, an interest in the medical community and particularly in the support of research and the library, and Hatfield is certainly one of them.

[Dr. Lindberg]: He's been a good support. Mr. Hatfield actually liked books, on top of everything else, and he doesn’t usually let you leave his office without handling a book, or seeing the latest book. He’s a good friend of the libraries.

[Dr. DeBakey]: He certainly is. It was a well-deserved award.

[Dr. Lindberg]: It is indeed. He’s now retired from the Senate, we’ll all miss him.

[Dr. DeBakey]: Well, fortunately, we have Porter, who is still there, and he’s taken over, in a way, in support of these activities.

[Dr. Lindberg]: He's been tremendously helpful. Mike, I'm going to lapse back, in closing, to a photo that I know, most people don’t know the photo exists, and no one but you knows the story behind it,

but I find it really amazing to see a picture of you and President Johnson, and to learn from you that, before the photo was taken, even though you didn't want it to be that way, Mr. Johnson had to wait for you to finish your telephone call. I wonder if you could tell us that story.

[Dr. DeBakey]: Yes, well what happened was, I was waiting to meet him before the briefing ceremony of the report, you see, so I was in the outer office, and he was in the Oval Office, and I was waiting because he was tied up with someone.

So Valenti came up to me and said, "There’s a phone call from New York from a doctor about the Duke of Windsor, and it's urgent and they would like for you to take it right now."

So I went over to talk to the doctor, Finetti was his name, and he was telling me about the Duke of Windsor having an aneurysm of the abdominal aorta, and he wanted to send him down right away.

So while I was doing that, the person who was holding up President Johnson left, so now President Johnson was waiting on me.

But he was very nice about it, and I explained to him what the situation was, and then I had to fly right on back to Houston to operate on the Duke.

But this is a picture, right after, soon as I finished making the telephone call, I came in and I was briefing him, a little bit, on the report.

[Dr. Lindberg]: Wonderful picture, wonderful story. We appreciate all you've done for the library. Thank you very much.

[Dr. DeBakey]: It's really been very very satisfying and a great pleasure for me to see what the library has done, and particularly to see, Don, what you have done with the library because, during your tenure, you have really expanded its activity beyond anything that we had any vision of for the library. It’s really extraordinary.

[Dr. Lindberg]: That's kind of you to say that.

[Music]

[Dr. Debakey Remembers... the evolution of the National Library of Medicine, 1942-1997]

[A Conversation: Michael E. DeBakey, MD, Chancellor Emeritus Baylor College of Medicine  and Donald A.B. Lindberg, MD, Director National Library of Medicine]

[Producer/Director: Bill Leonard]

[Associate Producer/Editor: James C. Charuhas]

[Rostrum Videography: Brian Matthews]

[Technical Assistance: Tom Neuse]

[Camera Operators: Tony Evans, Bernie Lindstrom, Peter Roof]

[Photographs Courtesy: Lyndon Baines Johnson Library; National Library of Medicine History of Medicine Division, Prints and Photographs Collection, Manuscript Collection; UAB Archives,  Lister Hill Library, University of Alabama at Birmingham; UPI/Corbis-Bettmann]

[U.S. National Library of Medicine Bethesda, MD 20894, 1997]