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1986-06-10 Interview with William Markesbery, June 10, 1986 UKMC001:1986OH149 UKMC 046 00:44:12 University of Kentucky Medical Center Oral History Project Louie B. Nunn Center for Oral History, University of Kentucky Libraries Medical education ; Neurology ; Nervous system -- Diseases ; Pellegrino, Edmund D., 1920- ; Straus, Robert ; Eiseman, Ben, 1917- William Markesbery; interviewee Richard C. Smoot; interviewer 1986OH149_UKMC46_Marksbery 1:|14(5)|28(2)|41(12)|68(6)|79(5)|91(10)|104(3)|115(7)|139(2)|157(2)|168(3)|180(6)|191(1)|202(12)|219(2)|229(10)|242(11)|253(12)|266(13)|277(3)|288(7)|304(6)|317(10)|330(8)|343(1)|358(5)|377(10)|395(5)|413(5)|430(1)|441(5)|450(11)|462(3)|479(3)|492(3)|515(3)|530(7)|548(14)|564(2)|580(11)|596(8)|609(14)|623(13)|637(9) audiotrans UKMCoh interview SMOOT: Dr. Markesbery to begin, tell me a little bit about yourself, your background, where you are from, when you were born, uh, your educational background, the community environment that you grew up in. MARKESBERY: I grew up in a small town called Florence, Kentucky, which is in the northern part of the state. It was a very small community, perhaps more than two thousand people when I was a child. Grew up with, uh, a surrounding of lots of family members, uh, lots of support systems, uh, in the, uh, shadow of a large city, that is in Cincinnati, Ohio. And, uh, this afforded me I assume a fair amount of security, that is a small city where you have lots of loved ones who pat you on the head every morning and tell you you're okay, try and nurture you and help you development along. I grew up and my mother was a school teacher and my father was a truck driver. I grew up, uh, with one brother, and, uh, he also went to medical school here and was in the second class, and with an emphasis on, uh, uh, hard work in my family, and, uh, a little bit of emphasis on scholarly things, which I rejected and primarily, uh, uh, emphasized sports in my life. And I played around the clock, uh, around the calendar rather baseball, basketball- -baseball, football, and basketball. And my upbringing was no different than most people's upbringing in a small community like that. But living in the shadow of a larger community, it had access to some of the things that Cincinnati had to offer, so just a small town boy. SMOOT: What caused you to become interested in medicine as a field of study? MARKESBERY: Um, I was in this--I signed a baseball contract and dropped out of college and got drafted all in one fell swoop, and, uh, went to Hawaii and did nothing but play baseball and basketball while I was in the service for about a year and a half. SMOOT: Which branch? MARKESBERY: I was in the Army, and, uh, was in special services and did absolutely nothing but play sports and lie on the beach. I met my future wife who came over there to go to summer school, uh, and realized that although I really wanted to play baseball very badly, that there was more serious things in life that, uh, I think needs, uh, commitment from, from people. And so I decided that I'd try to do something more important than play baseball with my life, that may sound a little self-serving; I don't mean it that way. But basically, uh, what it came down to, I thought that, uh, life had a little bigger meaning than perhaps baseball. And this not, this is the way I thought back then anyway. So I decided I'd try to go to medical school and did not have the background for that. Uh, I'd spent an awful lot of my time being an athlete and hadn't studied as hard as I should, so I had to come back and get pre-med requirements. Uh, I didn't have the pre-med requirements, and, uh, learned how to study during that time as a matter of fact. And I was lucky enough to get in a couple medical schools and chose to come here. SMOOT: What had you majored in as an undergraduate? MARKESBERY: I was an economics major. SMOOT: So you received your Bachelor of Arts degree in economics then from the University of Kentucky in 1960? MARKESBERY: Right. SMOOT: Then was admitted to the first class here. MARKESBERY: In 1964, graduated in 1964. SMOOT: What were your impressions of the medical school here? MARKESBERY: Well, it was a very exciting time in 1960. Um, there was enthusiasm on the part of everyone involved. There was a spirit of newness. Uh, it was a very unique atmosphere that we stepped into. Let me tell you a little bit about what happened to us. We came in as a class of forty, and we were supposedly handpicked. I guess they took the best forty they could find, like we always do now. But they were especially careful with that first class I think. And, uh, we were greeted, and each time we changed a course and went to a new course, or when we started, we were greeted and treated like, uh, the only child in a sense. We, we were, we were, uh, given an immense amount of individual attention. And there was only forty of us and a very sizeable faculty; they could afford to do that. They obviously were quite concerned about what kind of positions they were going to make here, and, uh, wanted to make sure that the mold was appropriate for us. And I--they worked very hard, that is the faculty worked very hard. They gave us an immense amount of, uh, support. Uh, they, uh, gave us every piece of information they had. They wanted to mold our attitudes properly, which they did. And, uh, it was a very exciting experience to be in the first class. We all had something at stake. There was no one in front of us to tell us what some of the pitfalls were, and we had to find out on our own. So in a sense the faculty had to guide us and lead us through this maze a little more closely than if there had been anyone else here to help us. As, as we got to be upperclassmen we could give some advice to the incoming classes and, uh, set a standard. So we felt some pressure to, to set a high standard. I think this is uniform, uniformly thought by most of my classmates; it was our role to set a high standard for the place, and we tried hard to do that. And I think we had a very good group of people. We finished with thirty-two and a special feeling of camaraderie with, uh, a small group like that where you knew everyone else closely, knew what his personal problems were perhaps, knew how he was doing in school. And so we monitored each other very, very closely. And that may sound, uh, like overly sensitive to how we were, but I think there is certain truth in that. But I want to tell you that, that early environment that they created was really an excellent one and it showed an immense enthusiasm for what they are doing. It gave us not only the ability to care for patients and a good basic science background; they gave us a, a view of what research in medicine was like. It had a fair amount of emphasis on that as a matter of fact. They gave us a view of looking at the patient as a whole, and not as a disease entity. And I was really impressed in retrospect how well we were educated. Some of us went out to other institutions to, to larger more prestigious institutions, and, uh, those of us that went to on to Vanderbilt or Johns Hopkins, when we encountered each other again tried, uh, to assess how our education held up. And, and I think across the board those of us who went to institutions like that came away saying, "Hey, they did a good job with us." And, uh, that again is not self-serving. I really feel that the people involved in establishing this medical school did an excellent job and they educated us well, because our educations held up with people coming from more well-established and more prestigious schools awfully well. SMOOT: I should ask-- MARKESBERY: Is that overkill on the answer? SMOOT: Not at all, no. MARKESBERY: That's something I have thought about but probably haven't ever expressed, very clear-, especially very clearly there. But I thought about this and I think they did an excellent job, and they need to be told that somewhere along the route. That--those folks that worked so hard in organizing this did it very well, and I'm sure they made mistakes. And we made mistakes stumbling along, and then they changed some of the curriculum obviously after the, uh, first few years, but not greatly. But I think they did just a superb job. And I'd do it again. I mean I could have gone to a different school perhaps, but I think, uh, coming to a new place like this, uh, gave us a different view of medicine and sort of a fresh view. And I'd do the same thing over again. SMOOT: I should have asked you earlier, but did your background in economics seem to hinder you in any way in your proceeding with a medical education? MARKESBERY: No because I actually had gone back to take a lot of pre-med mostly. I obviously had to get the pre-med requirements, and I think my background in economics didn't help or hurt me in any way because, uh, it was my pre-med requirements that they really were most useful, uh, in medical school anyway. SMOOT: Um-hm. Carry on now with what you just said about the spirit and environment that was created by the original team, the members of the, uh, faculty, staff, medical educators et cetera. Who particularly impressed you in terms of faculty, uh, in their teaching styles or something that was done that struck you as especially effective and good for your education? MARKESBERY: Well, let me just preface this by saying one of the things that was prevalent in this medical school at that time was a team approach. There was, um, an immense emphasis on teamwork by the faculty. And we had the feeling that although you might go into physiology or anatomy or pathology and, and get their very vocal views, that this was a group of people that would coordinating well from the top and trying to look at the big picture of our education and how this medical center would develop. So it was done with teamwork and we knew that and we appreciated that as students. So I think that's a very important fact because it, in medical schools we become very focal and very narrow. And we try and pull a student in one direction and, and impress him or emphasize on his education the importance of say the nervous system. And, uh, we try and in, in essence make them kind of narrow, and I think, uh, the administration and the faculty then pulled together to look at the big picture a lot, very well. I was starting to say a lot better; I think they did it very well. Now to answer your question more specifically about people that left an impression on me, one individual that quite an impression was a man named Ed Pellegrino, who was chairman of Department of Medicine. Because of the breadth of his knowledge, um, and we didn't know about hot shot internists when we started. I mean we didn't know who the real, uh, good role models were, but Ed Pellegrino, uh, was a very bright man who knew a lot about a lot of things, and he left a very favorable impression on me, uh, because of his clinical abilities and his administrative abilities, his efforts to do research work, and be a real triple-threater. So I was impressed by that kind of person. Uh, I liked the decisiveness of Ben Eiseman, who was chairman of Department of Surgery, a very decisive man who got the bottom line, who, uh, was able to cut through all the chaff and go to the very essence of the problem and come up with a solution. And I thought that was, was very impressive. Another man that showed great sensitivity and understanding of students and of what they needed to know was Bob Straus, the head of, uh, behavioral sciences. He was a very patient, understanding individual, uh, and although I thought you know behavioral sciences weren't quite as hardcore from a scientific standpoint as they should be, and I think I probably was immature in that regard, I think his handling of students and, uh, his sensitivity to students was something I always remember. There was a man named Bob Benton who taught gross anatomy, uh, who knew his field extremely well. He would never let you think in a superficial manner and always directed you, your thinking, uh, and made you phrase your questions very, very clearly. There was a man who had more empathy for human beings than anyone I'd known probably, subsequently his name was, uh, Bill Neisley (??) the chairman of Department of Anatomy, who had, uh, more feeling for what people were really like and sort of a wisdom. Even though he was a very young chairman, he was a very wise man. And imparted that wisdom to us, it's interesting as I've grown up I can still see gaps in all the people that I really respected and admired closely. I mean I now know that they didn't know everything that I thought they knew back then, but, uh, they still serve as very good role models to me. There are lots of people that left favorable impressions on me but those are, those are some. I'm not sure that's what you had in mind. SMOOT: Is there any one particular one that you could point to, uh, that you grew especially close to or influenced you to take the directions that you took subsequently in your research efforts and your specialization or did that come later? MARKESBERY: Uh, that's--there are several people, uh, but they weren't here and I'm sure you don't want to hear about people at Columbia that influenced me. But there was one lady named Lois Gellman (??), who was a neuroanatomist. She taught here from I don't, twenty years I suspect, um, and subsequently retired. And I was impressed by the depth of her understanding of the nervous system. Obviously I have become a neurologist and a neuropathologist, but I was, uh, deeply impressed by how well she understood the anatomy of a nervous system and what an awesome system this was. And I think she led a number of us and especially me to an understanding of how much detail there is in a nervous system and how much there was to be learned, and, uh, how that might be applied to disease. And, uh, that had a great influence on me. I worked with her in the summer-time doing research, and her thoroughness, uh, the depth of the approaches that she took in trying to understand problems, and her commitment to excellence and her commitment to hard work really served as, uh, a beacon in a lot of ways to, to understanding how you approach problems in research. So I think she had a major influence on me, although I've never admitted that to anyone. I think her approach to problems, uh, and her work ethic, uh, played a, and her, her unfailing commitment to trying to understand the nervous system had, had a major impact on me. SMOOT: Um-hm. Uh, what about your classmates? Uh, who would you point to as being say, a strand one that particularly impressed you with knowledge in their subsequent careers, uh? MARKESBERY: Well there are several people, my classmates that really left a lasting impression on me. Uh, one I probably get dewey eyed about, uh, is a guy by the name of Bob Thralco (??), who was in the first class and, um, had a spinal cord abnormality and was wheelchair bound and subsequently died. And I think he had, we didn't, I didn't know at the time, I think he had something called syringomyelia and subsequently had a tumor in his spinal cord. I don't know the details of that, but here was someone, uh, who was, um, severely impaired, uh, who had the ability to make a major commitment to the rigors of medical school, which were considerable. And we had a group of workaholics in our class. I mean we worked our heads off, and I'm proud of that in many ways because I, the group of hard workers has done well. And, uh, Bob Thralco kept up with all of us, and in spite of the fact that getting to and from his apartment and getting back to work, getting back to the hospital and then back to cubicle areas where we studied, uh, was very difficult for him. And the fact that we had to go out in ice, ic-, on icy streets and very slick weather and without ever complaining, uh, left, uh, a major impression on all of us. And he was, uh, a super human being in addition to being a very bright person who had made a major commitment. And I think the selection committee that chose Bob Thralco did this school a real favor right off the top. There's another person named Bill Maxin (??) who's in prac-, who went to Johns Hopkins for his residency and came back to Lexington to, to, uh, work, and is one of the better internists in this town, if not the best internist in this town right now, left a lasting impression on me because he--M-a-x and M-a-r were right next to each other. We became very close friends and I don't say this because of the close friends. I had immense regard and respect for Bill Maxin because of his ability to reason clearly, his ability to work hard, his ability to remember things well, and his overall intellectual ability was just superb. And underlying all that was just another kind human being, so, uh, a classmate that served as a major stimulus as someone to confide in, uh, and to share what we learned, uh, who was brighter than, than a lot of us, but who worked his head off and had an organized mind and served as a good role model internally for us. Another person named John Hutton who lasted, who stayed for only two years and then went on to Harvard for his last two years, John Hutton came with, uh, I think he'd almost completed his PhD in biochemistry and did major research while in medical school and was probably the brightest person I've ever been closely associated with, I mean extremely bright, um, and, uh, also served as a great role model, didn't have to work as hard as the rest of us because he was much, much brighter, truly a genius I think. I don't know if that's fair, John would probably not like me to say that, but I believe that John was probably the brightest person they're ever going to let in this place. I mean, he was light years ahead of the rest of us, uh, a person that had, uh, a common touch as well but someone who was a pleasure to be associated with. Another person named Joe Christian (??) had his PhD and was also extremely bright and pleasant and, uh, a good friend and, uh, was more mature because he'd been around school a little bit longer and schools and gotten his PhD in agriculture, uh, a common sense sort of guy that you could always, uh, expect, uh, a solid performance out of. He subsequently became head of the Department of Genetics at the University of Indiana and has done very, very well in terms of academic pursuits. There are not very many of us that have gone into academic medicine but from this school in general, but he's one of the more stellar performers, uh, that came out of this place, and one they should be quite proud of. Those are some of my people I thought of. SMOOT: Well you already mentioned that, uh, once you went out, uh, say in your particular instance you went to, uh, Columbia University College of Physicians and Surgeons for your residency position here. Uh, you got back together and compared notes and, saying-- MARKESBERY: Well you know we'd say, how did things hold up at Hopkins and how do they hold up at Vanderbilt and it really came out that the people that went from here did very well in their residencies and, uh, the analytical and how their education held up I think. SMOOT: Why did you go to Columbia? MARKESBERY: Well it happened to be one of the two best places to study diseases and nervous systems, um, and it's a rather long story. I won't tell you, bother with all of it, but I did an elective in my senior year, survey started my senior year, uh, in neurology at Columbia. And, uh, I think they were probably terrified at sending, the faculty here were probably terrified at sending a student from here to an Ivy League school or a very prestigious place and we might fall on our face. And, uh, I sort of had this feeling when I went up there that gee I may be playing above the rim with a lot of people that are better educated and have better foundations than I had and they're in more prestigious, a more prestigious school than I was. So I thought I should work harder and do my best, and it turned out that the group that I rotated through with for my, I think it was a three month elective, two or three month elective, three month elective, uh, they really weren't any different than I was. And my education was as good as theirs. And, um, when I got an A out of that course, which you'd say gee is sort of, uh, traditional when you go away and your visiting student, uh, doesn't hurt their quota of As, but it was a little different than that. In that, Houston Merritt, who was the dean of that school and also the director of the Neurologic Institute wrote back, uh, to the people here and told them that I had done extremely well and he would like and when I applied for a residency there, I didn't know what I wanted. I was either going into neurology or surgery; I didn't know exactly what I wanted to do. And I was just out of medical school and everybody that applies there has at least one or two years of residency after an internship. And I--(laughs)--, ----------(??) applied for a residency after I'd been an intern about a month and I got a letter directly back from Dr. Merritt telling me that, that I could, uh, come and be a resident, and so I was impressed number one that someone of his stature would even remember who I was, and, uh, take me. And so I, I guess the reason I went to Columbia was I had my foot in the door by knowing Dr. Merritt and I got in without having to do an extra year or two of residency, uh, in medicine in a really outstanding program took only people that did that in those days, this was, uh, in '65. And so, uh, in essence I saved a year or two, but that wasn't my reasoning. I thought that gee, um, this was an internationally known extremely well respected neurologist who was telling me that I could come into his program. And, uh, I was very excited about that kind of opportunity from someone of that stature. He was probably the outstanding clinical neurologist in the country at that time, if not the world. And, uh, to be accepted by his program at Columbia was, uh, was, uh, a nice pat on the back for me, so I guess my ego was such that that led me into taking that residency. SMOOT: You stayed there until about 1969? MARKESBERY: Stayed there and did, uh, my neuropathology training after doing my neurol-, my neurology training. I was so I knew that I wanted to go into academic medicine, uh, after about my sophomore year. I was pretty sure that I loved the teaching, research, clinical side of things, and I mean to do it all. And so is this, this the kind of? SMOOT: Yes. MARKESBERY: I mean I'm telling you a little bit about what I'm about rather than about the place. If you're trying to do a history of the place-- SMOOT: I want them both. MARKESBERY: Okay, anyway, um, I've forgotten what the question what I was saying. But nevertheless I, I wanted to do, uh, academic medicine and you needed a fellowship or you needed an extra gimmick, a research gimmick or another tool. And I was really very much interested in diseases. And I think the best way to learn diseases is to do it through looking at the basic causes of diseases and looking at the pathology and the pathogenesis of the diseases. And so I was either going to do neurochemistry or neuropathology and it was very convenient for me to stay at Columbia and do neuropathology in the program that had trained most academic neuropathologists in the country, so I went over into that program for two years and did a fellowship there. And if I'd been smart I'd have gone ahead after that and done two years of neurochemistry, but we had three daughters at that point. We had twins the second time around; we had three children under three years of age and I sort of had to get serious and go to work. So, that's why I went straight into the University of Rochester. SMOOT: How was the University of Rochester? MARKESBERY: Cold, very, very cold up there in the north. It was an excellent opportunity. Um, I stayed there three years, but they gave, uh, me a magnificent start, let me treat it just like a big smorgasbord table and do everything I wanted to do, uh, gave me a magnificent, uh, lab-, a magnificent laboratory, good financial support, um, good research funding, and, uh, offered me a chance to be promoted after two and a half years to associate professor, which they said they didn't do, but I really didn't want, didn't want to stay in the cold, though climate is really what it came down to. Excellent opportunity it was just a matter of not liking that part of the country very much. It was very, very cold in Rochester the first year. The second year we were there we had a hundred and forty-two inches of snow, and I just didn't like that very well at all. SMOOT: So, you left the University of Rochester in 1972 and returned to the University of Kentucky. Who contacted you to return to UK or did you make the initial contact? MARKESBERY: Dr. David Clark, who was chairman of the Department of Neurology, uh, asked me to look at a job. My family was still, my parents were still in northern Kentucky. My brother's in practice there and so in essence this was coming home to a more familiar surrounding. And, uh, I always liked Lexington and, and, uh, I like the spirit of this place. And, uh, I'd been away and, uh, asked me to come back. I had other opportunities at that time, and I've had a number of other opportunities since then. But, uh, this is sort of home to me in a way and, uh, so I came back, Dr. Clark offered me the opportunity to come back in neurology, uh, so, I looked upon it as a chance to be near my loved ones and have my children grow up where there truly are relatives. Uh, we didn't have relatives in New York City or in Rochester; so much of my reasoning was centered around family at that time. SMOOT: Um-hm. You mentioned the spirit, the spirit of the place when you were a student versus the spirit of the place when you came back as a member of the faculty. Had things changed, uh, immensely in your opinion or have they stayed pretty much the same? MARKESBERY: No, they had changed and I, I don't say this in a negative sense. I care about the place or I wouldn't still be here. I've had a number of other opportunities to go to better schools and larger schools and institutions that perhaps offer me different career opportunities, but and I say this and I preface that not to be self serving again but to, to let you know that I really do have, uh, the school's interest at heart and I really truly care about it and I'd like to see it become the number one place in the world, if the truth is known. But, um, I think the spirit of the place, uh, changed because it grew and by the very nature of it, its beginning and being small and intimate it lost some of the, the spirit of intimacy because of the growth that had to take place. I mean the hospital got to be larger, the departments grew, the number of departments became greater, uh, department sizes enlarged numbers of faculty members with different interests, uh, uh, changed the place. The VA hospital changed it, uh, so it lost some of its intimate character. I think it lost some of its cohesiveness, again that's not negative because it was more manageable at a smaller size with smaller groups of students. Um, the structure of funding our research changed. The health-, healthcare delivery systems changed. The demands on physicians changed. The supply of physicians in this state changed. The, uh, aura that surrounds, uh, surrounded a physician in 1960 is a little different than it is now. The respect for medicine perhaps has changed. So all these things had to be taken in context of how you see a medical center change, but I still think there's pride in this place. I think there's a striving for excellence, uh, that was there back in the sixties when it got its start, but, um, because of its growth it has lost some of that feeling that we had as a very small group. And it's, it's much like being the first child when you go home I think is what I'm kind of relaying to you. You go back and there are a lot of other children there and the place is grown, and you're not, uh, quite, uh, as special as you were when you started in 1960. And I think no one has led me to believe that we weren't a special class and they really did care about us. I, I believe that also, but there, there are changes and I think that the fact that people interrelated and intermeshed more closely back then gave it a more of a family feeling than it has now. Again that may sound negative, it's not meant to it's just really describing or trying to describe to you how I saw it then and how I see it now. SMOOT: Um-hm. Do you think that a smaller classes is a better way of, of instruction for medical students? MARKESBERY: Yeah, no question about it. Definitely smaller classes, smaller group teaching is the more advisable. But, um, you know, we had you know you break up a group of forty into, into eight groups of five or five groups of eight or how you want to do it, you get a lot more eyeball contact with your teacher. Uh, you get a lot more, uh, hands-on instruction and I think that's very, very desirable. And that-- in a way that was what was very, very nice about, one of the factors that was very nice about being in, in that first class. SMOOT: Um-hm. But unfeasible now you think? MARKESBERY: Um, more difficult now with larger classes. When you go in and lecture to a group of ninety to a hundred students, uh, you're you know you're using an antiquated system in a way and it's hard to get through to them. And, you can deliver a certain set of facts or a certain amount of factual information in that hour, but you never get the feedback and knowing whether you're getting through to them or not. Ed Magollen (??) has a, in pathology, has a small group that he teaches in it. Each year it's a special treat to get to teach a small group because you can really interact with groups of ten or twelve or fourteen. And you can get feedback, you can have true discussions, find out what they are learning from you, find out what they need to know, uh, and fill the gaps better and do a much, much better job teaching in small groups like that. It's a lot more fun; it's a, it's a real treat to teach in small groups like that. SMOOT: What was the reaction of the faculty and, now your colleagues, then your instructors, when you returned to the University of Kentucky? Were they pleased to have, uh, something of a star? I'll put it in those terms if I may. Um. MARKESBERY: That's an assumption no one else has made or I have made. SMOOT: Subjective, I'll throw that out but I mean after all you had mentioned you'd gone to Columbia and Rochester. Those are high powered institutions and, uh, here you're coming back to the University of Kentucky, which perhaps didn't seem like a high powered institution, at least in the, uh, circles that you were working with. Uh, what was the reaction of the faculty and other medical educators here upon your return? MARKESBERY: I was still just one of the kids that they'd raised. SMOOT: Really? MARKESBERY: It didn't make that much difference where I'd been. I think that, uh, when you go back home, uh, you may grow a little bit but you're still looked upon as someone that they raised. And I often had that feeling, which was not again a negative feeling and, uh, it didn't give me great security. But I think you have to win your spurs about wherever you go, and I think any institution you visit or any institution you become a part of, you have to win your spurs and show them you're the fastest guy in the west all over again. So, uh, I had to come back and prove that I was capable of being on the faculty here, which is fine. I like a challenge and that was exactly how I viewed it. And so, uh, that was fine, a good way, a good approach. They, they were kind but it was still sort of want to see what you're made of, and that's perfectly all right. That's the right kind of challenge, I think. SMOOT: You came here as a professor of neurology, pathology, and anatomy. Is that correct? MARKESBERY: As an associate professor, I was, I had been assistant professor for three years at Rochester and I was hired here as an associate professor one step up, and, uh, then I was promoted a few years later to full professor. SMOOT: So those are various, those departments have changed obviously since your time. Uh-- MARKESBERY: Right, well neurology was not even a department when I was a student here. There was no Department of Neurology. There were visiting neurologists that came in and taught us neurology from, that is to say some of the clinicians out in town. There was one child neurologist here then named Fred Horner who was carrying the load, so neurology was built in 1965, uh, after I left. So I came back to a new department that, uh, had been built after I left, so that was, uh, I had to fit into something that was already ongoing. Um, I was, uh, trained as a neuropathologist and they had one neuropathologist here, but I was given an appointment in pathology and, and sort of helped out in neuropathology. And then when Joe Parker, who was a neuropathologist, left I did all the neuropathology then by myself but still functioned as a clinical neurologist. But I, I had my major appointments at that time in neurology but did all the work for the pathology department, which was sort of my secondary appointment. And they were glad to-- they didn't have to pay me so they were glad to have me do it. Subsequently, I became, uh, uh, a member of the Department of Pathology as my initial appointment. And my secondary appointment was in neuro-, neurology, but that was a shift. It didn't really change much what I did. And, I still continued to do clinical neurology and the neuropathology. So, uh, that was a paper switch more than anything else really. SMOOT: Um-hm. The medical center had been established with certain philosophical goals and objectives in mind, and, uh, first I should ask whether or not you were aware of these philosophical goals and objectives when you came in as a student. MARKESBERY: Not, not really in great detail. I knew one of their major goals was to turn out a good product that is a good medical student. And it was blatantly clear that that was a first priority for them, or at least as we saw it the highest priority. And we knew that they wanted us to come out of here as good physicians and so I knew that priority. I, I didn't know the other priorities and where research was placed and where continuing education for physicians in the community was and things like that, so I didn't know the other priorities really. SMOOT: When you came here as a member of the faculty, were you given a sort of background of the philosophical underpinnings of the institution as it stood when you were brought back, uh, in terms of some sort of orientation as a new faculty member? MARKESBERY: They didn't have an orientation as a new faculty member at that point. Um, I came in and hit the ground running, so to speak, I think they probably handed out some rules and regulations, uh, but I didn't pay a lot of attention to those. And I really wasn't, um, very administratively oriented and I didn't know what the overall goals for the medical center actually were at that time. So I, I was, uh, oriented toward doing a good job in the areas where I worked without being aware of the overall goals much, and there really wasn't an orientation program like they have now, which I think is very desirable. SMOOT: Um-hm. Um, your early research efforts, uh, when you were coming here, Alzheimer's disease, um, aging--this is from American Men and Women of Science--aging of the central nervous system, dementia, all the structure of central nervous system, tumors, neurological degenerative disorders and muscle diseases, correct? MARKESBERY: Yeah, again treating medicine like a big smorgasbord table but I got involved in a lot of different things and I haven't diffused interest. If beyond my family you have to understand, I don't do much outside of medicine. I'm a very narrow person, therefore my major emphasis being on, on my career and medicine and my commitment to excellence in the field of medicine, if I their way of saying that, and to my family. So the fact that I put in eighteen, twenty hours a day in something I think is very exciting, sort of tells you a little bit about what I'm about as opposed to the person who has, uh, broader background, broader education and enjoys a lot of other things. Let me just give you a very corny view of how I see this. I think that this is one of the biggest rip-offs I've ever seen to be paid for doing what I do. And I know that sounds like the, uh, corniest thing you probably ever heard, but I get to teach, I get to do research, I get to see patients, and I even get to do something I'm not very excited about, do administrative work in the aging center. Um, they allow me to do all these things and still pay me to do them, and, uh, I'm going to go to heaven or hell or wherever I end up and look back and laugh and say look I got paid for doing something that's, that's exciting and that much fun. And I really truly believe that or I'd get out very, very quickly, so I think this is all just a big--(laughs)--it's unbelievable that I get paid for doing this, and they let me do all these things. So that's how I view it all, so the fact that I've done a lot of different, I mean I've done a lot of different things, just tells you a little bit about my narrow view of things, of approaching medicine and approaching life. I wouldn't recommend it to anybody because, I, I don't think it's, uh, is, uh, how can I say this, I'm not sure it's that the psychiatric community would say this is a guarantee for emotional or good emotional health and mental health, but for me it is and that just happened to be the way I was put together. When I was a kid, I focused on nothing but sports and I did relatively well. I signed a baseball contract and I didn't make the big leagues. But nevertheless, I was able to make a commitment to things I thought were kind of exciting and fun way back then, so I was very narrow in fact. See I don't have the, you know, have the broad background in literature and music, uh, I don't play golf, and I don't do a lot of things that, that a lot of people do. So I'm a fairly, fairly narrow person, and any questions that you ask me have to be based on the premise that I am terribly narrow, which I see is a fault but it's too late to do anything about it now and I'm so happy with what I'm doing and, uh, excited about what I'm doing that I probably wouldn't change one hair of the whole thing. [End of interview.] Dr. William Markesbery (Medical School Student, 1960-1964; Professor, Department of Neurology, Pathology, Neurosurgery, Anatomy and Neurobiology; Director, Sanders-Brown Center on Aging, Director, Alzheimer's Disease Center, Commonwealth Chair in Aging, 1972-2010) discusses his childhood in Florence, KY, his interest in sports, his decision to enter medical school, and the experience of being a student in the first class of the UK Medical School. He remembers medical school fondly, speaking about his classmates, influential teachers, and the excellent education he felt he received. Returning to UK as an associate professor in the Department of Neurology in 1972, Markesbery discusses the changes from his medical school days and the subsequent growth of the Med Center. insert here