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1987-08-04 Interview with Byron Young, August 4, 1987 1987OH119 UKMC 66 00:51:01 UKMC001 University of Kentucky Medical Center Oral History Project Louie B. Nunn Center for Oral History, University of Kentucky Libraries Young, A. Byron, 1939- -- Interviews University of Kentucky. Medical Center -- History University of Kentucky. College of Medicine -- History Transylvania University University of Kentucky. Dept. of Surgery Vanderbilt University Byron Young; interviewee Richard C. Smoot; interviewer 1987OH119_UKMC66_Young 1:|14(9)|41(3)|55(3)|68(12)|88(5)|111(9)|136(5)|150(10)|167(5)|187(8)|209(7)|221(7)|236(1)|251(9)|264(10)|278(12)|297(11)|309(3)|333(12)|345(11)|363(10)|375(10)|397(2)|408(1)|426(12)|441(2)|459(3)|477(4)|490(2)|508(7)|521(7)|532(5)|547(9)|568(4)|590(10)|604(10)|615(13)|629(1)|650(10)|666(6)|688(6)|713(2)|727(7)|752(3)|764(2)|781(7)|794(5)|815(7)|826(11)|845(9)|872(2) audiotrans UKMCoh interview SMOOT: Dr. Young, to begin, would you tell me a little bit about yourself, the community in which you grew up, the environment that you were exposed to? YOUNG: I uh, was born in 1939 in Richmond, Kentucky and we moved around to a variety of places along--I lived in southern Illinois from uh, the third grade through the ninth grade and then we moved back to Kentucky, and I graduated from Somerset High School in '57, then went to Transylvania until '61 and then was in medical school here from '61 to '65. SMOOT: What did your father do? YOUNG: He was a printer and a lith--a lithographer. SMOOT: Um-hm. And your mother? YOUNG: Housewife. SMOOT: Did you have any brothers or sisters? YOUNG: I have a sister who's married to a uh, farmer and uh, two half- brothers, and one is uh, works for a, uh--Motorola radio--or, or beeper system, and the other one I'm not sure, he works part-time or not at work--doesn't work (both laugh). SMOOT: When you went to Transylvania, um, what did you study? What was your major? YOUNG: Uh, pre-med. SMOOT: Okay. Uh-- YOUNG: I had a minor in philosophy and then--but pre-med was my major. SMOOT: Okay. What caused you to determine medicine as--as a--as a field of--of interest? Uh, I mean your father was a printer; uh, did you have any relatives that were uh, in medicine? YOUNG: Actually, I wa--uh, am the first one in my family that graduated from college, that I am aware of, and I'm assuming that the uh, origin of my becoming a physician, was that in Somerset the uh, uh, preachers, the lawyers, and the doctors were thought of as the most successful people in the community and the ones that were most influential and end up in a small town, which Somerset then was only uh, six or seven thousand. Maybe it was a little bit larger than that, but probably about that size. Uh, those were the role models that lead up--of--of successful people. SMOOT: Okay. Had your own physician uh, in town, uh, influenced you in any way or? YOUNG: No. And--I lived, actually, with my uncle then, and my uncle uh, owned a dry cleaner, and bu--uh, business did not interest me, so I knew I was (laughs) go--going to do something along the--the lines that I have done. SMOOT: Um-hm. Okay. Why Transylvania? YOUNG: Uh, I went to the Christian church and uh, didn't have any money and got a scholarship to go to Transylvania. The church paid for part of my way to go, and it uh--I was very unsophisticated, didn't look at other schools, and uh, that's where the uh, kids that went to college from Somerset went that--they went to the Christian church. Out of uh, a class of maybe a hundred in high school, I don't think more than ten or fifteen went to college, now that's--lands its been so long ago, I might be wrong, but it--it was a small percentage of people going to college, and I think people then went to uh, uh, Centre, uh, or to some church-related school more. I mean, that was a small town, and people would--tended to go to small schools. SMOOT: Well, what was it like going to Transylvania for you? Uh, did you find it a stimulating experience? YOUNG: Uh, that was the best thing that ever happened to me in my life, because uh, I--it was a small school so I got a chance to uh, be uh-- the president of my fraternity and do a whole variety of things that if I had uh, gone to UK or a larger school, I would've never had a chance to-- SMOOT: Um-hm. What was your fraternity? YOUNG: Phi Tau. And uh, at that time, uh, that was the--we were like the best chapter in the uh, national organization. But uh, Transylvania gave me a chance to, being from a small town, to meet a lot of people and uh, develop as a person, which I don't think I would've done at a larger place, 'cause I was intimidated by Transylvania when I first went, and I thought I was a superb student, but I either--uh, I think I got a D in Freshman English, but going from--as an A student, from Somerset High School, finding out college was a lot harder until I figured out how to study and what I had to do. SMOOT: Were any of your professors particularly influential in preparing you for medical school? YOUNG: Dr. uh, Boyarsky, who is the wife of one of our, uh, physiological professors here, and Monroe Moosnick, by far. SMOOT: Now, his brother, I guess, is a physician, isn't he? YOUNG: Um-hm. Yes. SMOOT: Okay. Franklin. YOUNG: But I did not know that at the time. It was, uh, my wife worked for Dr. Moosnick, and Dr. Moosnick was the, uh--oh, the faculty member for the fraternity. SMOOT: Okay. The advisor. YOUNG: The advisor. So I knew him well and took a lot of science courses, and he and Dr. Boyarsky, I think, were influential in uh, stimulating the interest in science and keeping people going and helping them get into medical school and what not. SMOOT: Were most of your friends also pre-med? YOUNG: No, uh, Transylvania, then, only--I don't think more than three or four or five people were pre-med, so they weren't. SMOOT: What about uh, after Transylvania? YOUNG: Well I-- SMOOT: Transylvania surely made you a little bit more sophisticated-- YOUNG: Right. SMOOT: --then you had been. But you chose UK; you decided to stay in Lexington. Why was that? YOUNG: No. Well, the reason I came to UK was that actually I had paid my way through college and medical school, and my mother, every two weeks, sent me five dollars. And so I worked the rest of the time, and s--uh, the reason I came to UK was that I got a scholarship here. I got a job here. And I could get the loans, and the tuition wasn't anything, and so the--the school started at the right time for me, plus my wife was a senior in uh, Transylvania when I came over here, which we weren't married, but we were going to get married. So that had a factor, I suppose, but actually, the s--the reason I--the main factor was the financial one. SMOOT: Hmm, okay. So you hadn't really applied to go to uh, other-- YOUNG: Oh, I applied to uh, Louisville. But uh, I, uh was accepted, it seems now, in a week or two or something after they interviewed here and accepted and didn't uh--I don't even remember--I'm assuming I was accepted Louisville, but I don't--actually, I don't even remember now. SMOOT: Can you explain to me, uh--describe for me that process that you went through, and--being accepted at UK, the interview process, the application process, uh, people that you talked to? YOUNG: Well, I don't think I even went to Louisville to be interviewed. I think this was the only place I even went to be interviewed, as--as--as I recall. And--the best I can--I can remember coming over and talking to three or four people, and uh, being uh, frightened and thinking they were much uh, harder-nosed than the college professors I were use--was used to. I remember taking the MCAT test and I remember leaving not knowing whether I was going to be accepted or not, but being accepted soon after I was interviewed. SMOOT: Apparently you-- YOUNG: It's kind of hazy. It was--I do--don't remember as being anything traumatic, so it was--I don't remember much about it because I didn't have much emotional significance, except being accepted. SMOOT: You remember who you talked to? YOUNG: No. I don't even remember that. SMOOT: Uh, do you recall any mention uh, about where you were from or where you might practice? Uh-- YOUNG: Yes. They played, uh--uh, then everyone--uh, there was a big emphasis on uh, trained people who were going to practice in rural Kentucky, and uh, actually, I had traveled very little, and I--at the time, uh, I sincerely answ--uh, said that I was going back to practice at Somerset and be a, uh, family practitioner and uh--that's what they wanted to hear, and I'm sure part of it--I said what they wanted to hear, but that's really what I felt when I was coming here, too. SMOOT: Okay. YOUNG: At least that's what my perception of what they wanted to hear, but that's what I wanted to do anyway. SMOOT: Okay. Were you offered any financial assistance through a rur-- rural scholarship program? YOUNG: Um-hm. Uh, and I took that uh, for one year, but that's all, because after the first year I--and actually, I used that money to pay Transylvania's tuition and get through, but then end of the first year I decided I did--did not want to do that. I--the--for me, coming to medical school was much more broadening than going to Transylvania, as far as the uh, variety of context. I think I grew more at Transylvania in that four years, but as far as figuring out there was a wider world and I wanted to do more than go back and practice in Somerset, uh--but I don't think I knew that until after I got here. SMOOT: Um-hm. YOUNG: Well, I know I didn't. SMOOT: Um-hm. YOUNG: So sometime during the first year I decided I wasn't going--did not want to be a family practitioner. SMOOT: Okay. What was your first year like, the courses you took, uh, the professors that you were exposed to? Uh-- YOUNG: Let me tell you what I've learned about memories, so--before I answer your question. (Smoot laughs) The--uh--our memories are usually wrong, totally. And uh, our prejudices usually end up being what we remember more than our uh--I mean, if uh--if we go into a situation with a preconceived notion, uh, years later we remember how we preconceived it was going to be more than the reality, but I'm--think it's pretty true. What I--basically, what I did was study the first year, and uh, I saw my, uh, girlfriend on Saturday night, and that was the only time I saw her that I can really remember. And I studied really until eleven or twelve every night and went to bed and--or, or later, and got up and started studying again. In medical school, at least in my mind then, was a lot different than it is now, because we went to class at eight o'clock and stayed in class till four o'clock three days a week or--and then till six o'clock two days a week or vice versa, and then would have class on Saturday morning, and uh, I remember finishing class, eating dinner and studying and that's about all that I ever did. And I think mostly that's what everybody else was doing, too. SMOOT: Did you have much interaction with your classmates? Study sessions? YOUNG: Uh, only, yeah, on--the ones I had the most interaction with were the uh, fellow--uh, there was a group of six or eight or ten of us that had a lot of interaction and we went to uh, uh, eat at uh, Walgreen's one night because they had spaghetti for a dollar. And then the next night we went to uh, Howard Johnson's because they had all the chicken you could eat for a dollar (both laugh). Then the next night we went to someplace else. So we ate at a different restaurant every night, but it was dependent upon what their specials were--and that's--and there was a group of us that ate dinner almost every night that first year together. SMOOT: What about your professors? Uh, did they--did any of them, especially in the first year, make uh, any special impression upon you? YOUNG: The, uh--here's what uh, I think people thought of the school then; I think the general atmosphere--uh, everyone, uh, said that this was new school and that we had a chance to, uh, do things differently, and I think--uh, and I'm not--I don't know how many of the professors believed it, but I think the students really believed that this was one of the best medical schools in the country. And I was sold on this, uh, being one of the ten best schools in the country and that uh, we were getting a great education, and believed it. The uh, uh, faculty then was small; uh, the first class had forty, and my--I was in the second class, which had sixty. There was uh, a lot of faculty participation and a lot of uh, enthusiasm by the faculty. Uh, I remember uh, best, Dr. Schwert, who taught biochemistry-- SMOOT: George Schwert. YOUNG: --and I remember Dr. Yoland, who taught anatomy, uh--I guess, were the two that made the greatest impact on me. SMOOT: Do you feel as though your Transylvania pre-medical training had prepared you adequately for medical school? YOUNG: Yes. The uh, reason I--I had the little quote about memory, because I had--probably a lot of the things of what I say, if they were checked back they would be wrong. But uh, the, uh--about--only about forty-two or forty-three out of that sixty passed the first year. Because the best I recall, is out of our class of sixty, there were about nineteen people or so that got a D or F in biochemistry and a similar number in physiology, and there were quite a few that failed anatomy, as I recall it; so that only forty-two or forty-three out of the sixty passed the first year. So the fact that I passed (laughs) for me--I--that--I think it did stand me in good stand. SMOOT: Um-hm. Um, let's carry it on in a chronological way, if you mind. We touched on the first year. How did things progress? YOUNG: Uh, well let me tell you a little bit more about the first year. Uh-- SMOOT: Fine. YOUNG: The, uh--that's maybe different than--or the way it was, at least the way I remember it, uh, is that there was a high fa--that we--we were admitted to school. One of the problems that--that our--our class had, was that when we were admitted to school, we were told that we would not be admitted unless the faculty thought we could pass and that we were all capable of passing. And actually, I think probably everybody did work extremely hard, but it turned out a third of the class almost did not pass. And the--I think the standards of the medical school then, were very high, because we had uh, recruited a uh, national faculty, most of which were young. And I think the uh, uh, standards of the best schools in the country were being, uh, applied to us. Uh, I remember uh on some biochemistry test getting a thirty-eight or forty-seven or something, and thinking I had failed; and going in and finding out I was in the middle of the class. The uh--and the grading system was different then, the uh--there would be one or two A's, four or five or six B's, and then a whole bunch of C's and D's, which is a little different than now where a B, I think, is more of an average grade; so I remember getting a B and thinking I had done a great job--and I hope all those facts bear me out on--on the way they grade, but that's the way it seemed to me at the time anyway. The uh, second year, uh, I don't remember nearly as well as the first year and didn't make nearly as much of an impact. I remember the, dissecting the cadaver and studying biochemistry and physiology, and uh, I got married the beginning of the second year. Did not study--I didn't study nearly as hard, and it I--I don't remember the second--second year did not make nearly the impression the first year. Just seemed like you studied a lot and went to class and--but I don't, uh, it wasn't anything part--particular about that. SMOOT: Um-hm. Did you develop any--uh, I don't mean to sound flippant, but did you develop any sort of special relationship with--with the cadaver, that sort of thing? You know what I mean? YOUNG: No. I don't--no we didn't, uh I-- SMOOT: People talk about that. YOUNG: Yes, but I don't remember us doing--there was a group of four of us--and I don't remember us doing that. SMOOT: Okay. YOUNG: Uh, by the way, the, um, uh, one of the fellows that I worked with as a student, we remain life-long friends. And uh--that--that were in anatomy together and all of that--and uh, I have had contact over the years with--with uh, one of the other three a lot; but one of them particularly. So you do--did--we formed some uh, life-long friendships, where we have gotten together and kept in contact and uh--sort of like college, you do for t--two or--a few friends. The uh, third year the uh--was when the--we first had contact with patients. Oh, I m--let me tell you about--what I remember about the second year. This is a uh--I'm from Kentucky, so I can give it both perspectives. I remember about the second yea--was when we had behavioral sciences, and the major impression I had on that was that we had people from New York lecturing to us, telling us what Eastern Kentucky was like and what Eastern Kentucky people were like, and most people sat there, uh, not uh, with a great deal of respect for the people we had telling us about it, because most--many of us thought we knew more about Eastern Kentucky people and uh, the public health problems--that, people had lived in that area--because it was about public health, and it was about how poor people respond to their illnesses, and how poor people think, and how Appalachia, uh, people uh, respond to problems -- and uh, we had uh, people who had made their career studying people from Appalachia, but who were from New York or Boston or Philadelphia telling us about it, so actually, there was uh, quite a bit of uh--um, I guess, skepticism--(both laugh)--uh, in hearing those--tha--those-- that is one of the main things I remember about the second year. SMOOT: Well now--you can look back on it now from a different perspective. Do you think that, that was beneficial in any way or did--or--or--was it-- YOUNG: Yes. SMOOT: --because there were really people coming in from outside? Uh, did it give you such a, sort of cynical view of--of the whole process there, that uh, that you didn't get a great deal out of it? YOUNG: No. No, I think we got a--a lot out of it. Uh, I think that we thought we knew more than we did. Is--and be--because we'd lived there and we thought we were experts from living there, and we thought we probably knew more than the people did that were lecturing us; which there--we did not and--have any idea about the true academic part of it--but uh, uh--well I remember uh, this--partly this in the third year, the--uh, in my class, the uh, only resentment I had about medical school was that I thought the professors looked down on Kentuckians-- and as, as students--and as the patients--and did not, uh--we had many people here from New York or other places when the school first started, and they did not conceal their prejudices were--very well about--that Kentucky was, which, happened, I think in part was true, was not a well educated state, not a sophisticated state. But uh, some of the professors transmitted that to us as students, that they felt that way. And they particularly did about some of the patients and the referring physicians, and I remember--uh, I think you-you know something may be true, but if you're the, uh--in that group that those sentiments are being expressed about, it does cause some concern--and I think that was a general feeling of the faculty then, and--and the students. SMOOT: And most of the students were picking up on this? YOUNG: Yeah. I think so. SMOOT: Okay. Could you give me an example? YOUNG: Well uh-- SMOOT: How would they--how would they manifest these sort of prejudices? YOUNG: The uh--some of them would just uh, say that the--about Kentucky, uh, students weren't as bright--and these uh, patients were unsophisticated and I mean--and--which was--was true--and that the, uh--well I don't know if I should cite names, but uh, Dr. Pellegrino, who was very well respected, and as a--a humanist and a philosopher, uh, at least when I was a student, I think he looked down upon uh, uh, Kentuckians and the Kentucky students as not being the equal to those in other places; which I think is probably true , uh, but that, I think was transmitted. And I don't--and I don't think it was just a group of Kentucky students being extra sensitive. I think it--uh, it was--and having the inferiority complex and seeing other peoples, uh--seeing more in what they--their attitudes than what were there. I think that probably was true--and the--the referring--uh, there were at times disparaging comments about the way refer--doctors had--had treated their--you know, incorrect diagnoses or had--they weren't sophisticated enough to treat certain things and the patients, uh, got better treatment here, which, uh--so--some things are certainly better to keep to yourself if you-- SMOOT: References derogatory towards physicians practicing in Eastern Kentucky. YOUNG: Um-hm. Um-hm. SMOOT: Okay--uh, and, of course, the solution was going to come from the uh, graduates of the University of Kentucky's Medical Center-- YOUNG: Well, the other th--uh, aspect that I remember and I--uh, the-- the school was founded to train general practitioners that would go back out in the eastern part of the state and practice. But uh, I--I don't believe the people here when the school started, had a great deal of respect for people who were general practitioners. So that uh, almost all of our class became specialists--or I mean, no--not all, but a high percentage did because the uh, priorities of the teachers were not the priorities of the legislature of the state--and I--I think that's probably still true. SMOOT: Um-hm. Did you ever hear of the sentiment expressed by members of your class, or any of the other classes for that matter, that uh, instead of becoming a uh, practitioner on any level and going back to Eastern Kentucky or some other, uh, less urban setting, that their entrance into medical school was perhaps a ticket, uh, to an urban setting, to a--to a large city uh, or a uh, uh, better uh, lifestyle? YOUNG: No. Uh, I don't think any--I don't remember discussing that. I think uh--I suspect few people, at least uh, or when--I don't think many people came to medical school thinking that. Uh, most of the people that uh, were from Eastern Kentucky, I think, were doing the same thing I was. I think they were planning on going back and practicing in the area. SMOOT: Um-hm. YOUNG: Once they got away from the area and weren't living there, that's not what--I mean, they--they changed. I don't think it's that- -necessarily they were influenced by the faculty, that changed their thinking. I think they just were part of an evolution. When you are going back to college--when you are going to college, you often go home on the weekends and your friends are still there, but medical school you go home less often. Your--what your life's work is going to be, it's--becomes a little bit more immediate to you. You start thinking a little more seriously about where you are going to live--and I--I think it's that, that keeps people from going back. SMOOT: Okay, okay. Obviously, your--your professors exerted certainly a great deal of influence on you and your classmates. Did your class, in somewhere or other, exert an influence on them, do you think? YOUNG: Um, not that I'm aware of. The uh--I think the uh, uh, medical school here, uh, at that time was prob--the best it's ever been. We- -uh, I--I think--I think we had, by an objective measure, truly a group of outstanding people that were here--wer--were there. SMOOT: You are talking about faculty as-- YOUNG: Faculty. Faculty-- SMOOT: --well as students? YOUNG: --no well--well actually--faculty right now. The uh, uh--the group of departmental chairmen were truly nationally known people. The surgery department then, if you're talking about just personnel, may have been the best in the United States, or very close to that. I went from here to Vanderbilt, thinking that UK could not be--was not nearly as good as Vanderbilt. I got down there and realized that surgery department here was a lot better than Vanderbilt's. Uh, and Dr., uh-- you--you probably already heard this, but, uh, Dr. Eiseman, Menguy and S--Spencer and a whole group of those--Char--Charlie Wilson, who was the first neurosurgeon, is probably the most famous neurosurgeon in the United States now; uh, were all here and all of them became very well known people outside our own institution. Uh, Dr. Pellegrino was--is extremely well respected--chairman of medicine. Kurt Deuschle has gone to NYU and uh, uh, Dr. Sweden--a whole group of people were truly outstanding individuals--and I think Dr. Willard somehow was able to hire, and attract the brightest people that were in that thirty-five to forty-five year old age range to come here and start a new school. We had some advantages then because new schools weren't being started. A few years later a lot of new scho--medical schools started. When UK was started, there were not many new schools being started--and um--so I don't--to give--to answer your question, I don't think we influenced the faculty much, because I think we had a uh, group of uh, fairly sophisticated, uh, faculty that was from a whole va--variety of region- -regions from the country. SMOOT: Okay. YOUNG: If we influenced the faculty--I, as a student--from a student's perspective, I didn't see it. (laughs) SMOOT: Okay (laughs). Were there any other factors, perhaps, that made the early experience here at UK, as a student, uh, particularly special for you? Uh, or made the faculty a bit more, uh, productive? YOUNG: Well, you--there's several. The uh, um, legislature then, or at least I had the impression, that the medical school had a lot of money. The budget for the medical school, uh, was a--a separate budget from the rest of the university's--and that Governor Chandler ordered- -organized things so that the appropriation to the medical school came directly from the medical school. Plus there was the interest in Governor Chandler and the legislature, I think, to give a lot of money. And I had the impression that they could not spend all of the money that they had those first two years and had to scurry to spend it all. Plus the uh, hospital, uh, was new; uh, Medicaid and Medicare had not come into existence--or it just--and then in '65 Medi--uh '66 Medicare came in right after that Medicaid or--same. So there were a lot of poor patients that uh, had to come here, s--uh, and we weren't really competing with other hospitals, uh, for private patients and so there was a lot of patients that came here. Plus that was the era when uh, private hospitals did not have sophisticated equipment that university hospitals had--and so we were able to--we were the only hospital doing uh, heart surgery and a whole--a variety of uh, factors; uh, but the uh--I think the faculty was small and the student body was small and it was new--and that there was, I think, a genuine enthusiasm and an energy level that you probably don't get once an institution matures. SMOOT: What made you decide to go into surgery? YOUNG: Uh, Dr. uh, Eiseman and Menguy probably--I mean Dr. Eiseman and uh, Wilson. Uh, I liked uh, everything I went into, and then uh, you know I thought when I went on OB and delivered babies, and I thought boy this is great. And then you'd go to the next thing and think this was great--then you'd sort of--sort it--it out. Came down to whether to go into internal medicine or surgery, and I think I was uh, extremely impressed and influenced by Dr. Eiseman, and Dr. Wilson, and the group of surgeons that were here. SMOOT: You were impressed by the way they uh, worked, by the way they lectured, by--? YOUNG: By the way they uh, conducted themselves, and uh, uh, how they worked, and uh--I thought they were intellectually very stimulating. Uh, but I had a hard time deciding between medicine and surgery. In fact, I didn't know what I--when I decided to do a surgery internship, I almost did a medicine internship. So, (both laugh) but I was much more impressed and influenced by the sur--fauc-surgery faculty than I was the medicine faculty when I was here. And they seemed to be more decisive and uh, I don't know--whatever fit my personality too, was-- seemed to fit in with what they were doing. SMOOT: Um-hm. Is that generally the uh--the uh, difference between uh, medicine and surgery, the uh-- YOUNG: Uh, I think there probably has a lot to--uh, approach to problems and uh, uh, probably the personalities where they mesh with the personalities of the people in the specialty already. SMOOT: I have heard, of course, that uh, that surgeons are a different breed. Now that--that is sometimes meant as a positive-- YOUNG: (laughs) I know, I know. SMOOT: --sense, sometimes otherwise, but (laughs) I have heard that, and uh, I suppose that--that, that carries over into other parts of life as well. YOUNG: Yeah. Uh, well wha--what often happ--the--the--I think the surgery department truly was outstanding here and the--the percentage of students going into a--a field is influenced, of course, by economic factors and--and--uh, nat--and the perceived need in the field. But uh, there will always be--there's a particularly outstanding department; you'll have an--a higher percentage going into one field than the other. It seemed to me there were a lot of people interested in surgery-- SMOOT: Um-hm. YOUNG: --then. SMOOT: Okay. Were there any other professors or any other experiences, while you were at medical school here, that you would point to as being important or influential, or sticking in your mind as uh, significant in some way? YOUNG: Yes. Um, the--when I started getting uh, um, uh--some national perspective was--uh, I we--I went to, uh, Peter Bent Brigham Hospital in Boston for three months. And to show you how unsophisticated I was, I came in and told Dr. uh, Eiseman that I'd decided I wanted to do a surgery uh, externship. At that time we could go spend--do three months working with a family practitioner or whatever. And he said, "Where do you want to go?" and I said, "Wherever you would recommend me," and he said, "Well, what about the Peter Bent Brigham Hospital?" and I honestly had never heard of it and said, you know, "Where is it?" and he says, "In Boston." He said, "Well, fine, I'll call Franny Moore, who happens to be the--he was probably the most famous surgeon then in the United States then. And I had never, never heard of him. (Smoot laughs) And uh, my wife and I went up and piled in her car and I remember having two flat tires driving up there, and getting up there with almost no money, and then looking for an apartment and decided it was going to be--we could not afford to stay there. And ended up luckily, uh, living uh, in a professor's uh, house, who had gone to UCLA for three months. But I remember talking to uh, Dr. Moore, and meeting him the first time. And he asked me who my father was and my father-in-law. And just uh, very innocently, I just uh, told him their names and uh, what--and I didn't really realize until later that he was wondering well do they own this business or are they a professor of surgery here or there. So, the uh, social uh, connections and uh, other factors, being from a small town in Kentucky, didn't really--I wasn't uh--didn't realize that until--so much, until I got there. And that was actually the first time that uh, I had uh r--realized that uh, I could compete on a, uh, level with the Harvard students or maybe even out-compete them, and that the impression that I had gotten from my professors here, was not an accurate one--that uh, the best students here could be--could compete, uh, with the best students at other medical schools. And maybe they thought that all the time, but I--I didn't get that impression. And that was a big uh, ego boost for me to be able to go to Harvard, spend three months and do better than the other students that I was working with. And it was the first time that--I think I would have stayed here and done my internship, but on the way back I asked Dr. Eiseman where I should uh, look for internships; so I stopped at Yale and Hopkins and at Duke and Vanderbilt and--and uh, Western Reserve and went to Barnes, and actually looked at the best places in the country to do a surgery residency. And without doing that I'm su-- I think I would've ex--gone on and done it--to be an intern here and resident and just end up staying the whole time. SMOOT: Um-hm, but you decided upon Vanderbilt. Why was Vanderbilt, uh, so appealing? YOUNG: Uh, I--uh, I guess it was close to home and something like it is here. Dr. Scott, who is the chairman there, spent an hour talking to me. And uh, Duke or Vanderbilt were the two places that I really wanted to go. And uh, I guess, uh--I'm pretty sure that I put down Duke first and Vanderbilt second; so I didn't get into Duke and went into Vanderbilt (laughs). Like I--I'm pretty sure that's how I ranked them. SMOOT: Okay. Uh, was that just uh, by your own impression, uh, of the institutions or was that-- YOUNG: You know, you--you-- SMOOT: --from what you knew about them? YOUNG: Well, you go--uh, Dr. uh, Eiseman, you know, had said, "Here are the places I would recommend." "I'm going to write a letter to you and here are the best places in the country." And so I went to Michigan too--I just--I went to the places and uh, the uh--how the people decide where they are going to be an intern or resident is: you go spend a half a day and talk to eight or ten people, and you walk around the hospital, and you leave trying to figure out where you--and you've decided whether you are going to spend the next five years there or not. So it's not a--it's a--well I remember going to uh, Dr. Eiseman, finished at Barnes, and uh, I thought I would go there and get a royal reception and they barely spoke to me. And at Vanderbilt they--and at Vanderbilt and Duke they were much nicer than any other place. And so, I don't know, I--you uh--I didn't think there was probably much difference academically in several of these places. So you get a feel for how nice they are and what the weather is like that day and whether the buildings are new or old, or whatever. SMOOT: So ex--so describe for me, if you would, Vanderbilt. Uh, in your experience there, your impressions of, of Nashville and--and all of that-- YOUNG: Well, Vanderbilt was a different school, uh, than it is--the--the medical school is much better than ours. The class was only fifty or sixty and uh, they attracted a medical student from a different social level and actually, a different intellectual level. I uh, I think the students in the upper uh, third of our class or so-- UNIDENTIFIED FEMALE: Excuse me-- [Pause in recording.] YOUNG: --I think the students in the top third of our class are as good as the ones at Vanderbilt. Not getting anything? I had the impression that the uh, uh, top third of our class or top half would of been competitive at Vanderbilt, but their class--I think our class was weak at the lower levels, but I think--theirs all throughout, was strong. And they had a much more sophisticated group of people there; they were more of a national class. The uh--and it was a good change for me because we--we mostly treated indigent patients here, and there they had more private patients with the uh, faculty being more directly involved in the patient--patient care. Uh, but I think our--their- -their medical school back then was--was--the student body was better than ours, as--as a group. SMOOT: Um-hm. Okay. You went there in 1966? YOUNG: No. Yes, in sixty--'65. SMOOT: Okay. Was-- YOUNG: I graduated here in '65 and then I was there from '65 through '71. SMOOT: Okay, and went there as a resident in general surgery? YOUNG: Intern in general surgery. Spent two years in general surgery and then four in neurosurgery. SMOOT: Okay. Now who did you work directly under there? YOUNG: Dr. Meachem, who was the--uh, when I live--was--he was the chief of neurosurgery. SMOOT: Okay, and a good one. Did he influence you in a number of ways? Uh, surely he did. YOUNG: Well, they, uh--the, uh, program--I only ap--uh, applied to uh, here in neurosurgery and Vanderbilt. I didn't go to look at a bunch--a lot of programs; but there the clinical program is very good. And uh, Dr. Meachem made rounds and saw he--every--his patients, uh, every day and uh, did the operations on his patients; and was a, uh, superb uh, clinician, and had uh, great uh, rapport with his patients, and so he influenced me on uh, how the physician really should interact with his patients, both on a professional level, in how he should take care of them, but also, on getting along with them and liking them and getting them to respect him, and all those other aspects. SMOOT: How does he spell his name? YOUNG: M-E-A-C-H-E-M. SMOOT: Okay. First name is? YOUNG: William. SMOOT: William, okay. Well, tell me, what makes a good surgeon? Good neurosurgeon? What--what sort of skills, talents, abilities, uh-- YOUNG: Uh, surgeons have different personalities. When you were mentioning that uh, surgeons and medicine people being different- -surgeons had different personalities. The uh--uh, probably uh, neurosurgeons and cardiac surgeons are the most demanding and insist on things being perfect. Probably their personalities are that way when they come in to the field, and maybe that's what attracts them, but if they're not, you soon learn--because their--not everybody is that way. But you soon learn you have to be that way to get the results that you want to get. SMOOT: Um-hm. YOUNG: And uh, I think the field you're in probably helps develop your personality, because you have to--to be successful in your field you have to change your personality some. But uh, being a successful surgeon, a lot--uh, you have to be intelligent, but uh, hard work and being willing to spend the hours, and being dedicated to uh--being willing to do what's best for your patients. You do whatever is necessary to accomplish that. SMOOT: Um-hm. Okay. I've heard some talk in recent years about uh, changing the outlook uh, that doctors have, uh--or the relationship that doctors have, with their patients. Uh, now I'm referring somewhat specifically to the fact that some doctors have been, supposedly, uh, characterized as having a kind--a God complex. Uh, surgeons in particular, within the profession, uh, often described as having this sort of mentality. Uh, some people seem to think that's good, some people think that's bad. I don't know, but I--I would like for you to tell me a little bit about that. Was there anything, first of all, that directed you in those--along those lines, uh, to develop any certain kind of--of attitude or mentality in dealing with people, uh, that might have been described as I just, suggested? YOUNG: Uh, you know I think that-- [Pause in recording.] YOUNG: Um, I think that's a false impression. Uh, a neurosurgeon and cardiac surgeon probably suffer from that more than anyone. But I think that's a, uh, false impression. Uh, we do things to people that can truly cause them a lot of harm. And you quickly learn that you want uh, the person and their family to be in agreement with what you are doing, and to understand it. Because when you get a bad result you want everyone to--to be as accepting as possible. I think where that impression of uh, some surgeons and cardiac surgeons and neurosurgeons start is that we sometimes act that way toward other physicians, who we feel don't know as much as we do about how to manage the problems. And I'm afraid sometimes we treat the other physicians that way. But most, uh, cardiac surgeons and neurosurgeons treat their patients just the opposite way. So I think what those--when people say that is, they're probably describing how we treat them, rather than the patients. And most patients probably develop better rapport with their heart surgeon- -cardiac surgeon often--than they do--now that may not be true at the Cleveland Clinic or Mayo Clinic where people kind of--what I think of is coming to a factory-- SMOOT: Um-hm. YOUNG: --and don't know their surgeon. But I--I don't think that's true, generally. In areas particular like this, it is just the opposite. SMOOT: Um-hm. Well, you studied under Dr. Eiseman. YOUNG: Um-hm. SMOOT: I've heard uh, a variety of views expressed uh, regarding Dr. Eiseman. What was your impression of him? Uh, was he a role model as a surgeon? YOUNG: Uh, not as a surgeon. I think Dr. Eiseman, uh, his big--his biggest strength was his leadership and as a--and as his personal characteristics. Attracting--uh, he was a--uh, I remember when he re--uh, uh, recruited Charlie Wilson; he was the first neurosurgeon and he had uh, only finished his residence a year or two before, but Dr. Eiseman was able to see in him that uh, he act--truly was going to be one of the--one--in the world one of the three or four best neurosurgeons in the world; and Frank Spencer and that the group of people--so he--his--he had a strong personality. Uh, he had good vision and could judge peoples' character. And was a charismatic person as far as being decisive and forceful. I think that's--was his strongest trait. Uh, he was a uh, superb teacher and set very high standards for all the house staff. And I mean he--but he--everybody was afraid of him and expected to--and they knew that they should accomplish what he said that he wanted done. But, uh, I think those probably outweigh his surgical skills. SMOOT: Okay. Well after you had finished your residency at uh, Vanderbilt, what did you do? YOUNG: I went in the Army for two years. SMOOT: Now why did you do that? YOUNG: I was in the uh--see that was uh, during the Vietnam War. And so I signed up as--in the Berry plan, because your choice at that time, was either be drafted after your internship and go into the Army as a general medical officer or try to get deferred and finish your specialty. So, uh, I got--I was the--one of the people that got deferred to finish my residency. SMOOT: Okay. YOUNG: And then went to uh, Korea for uh, a year, which--instead of Vietnam--the Vietnam War was in '71 was just winding down, and actually that was, uh, a--for me--my wife went and our youngest son--and that was a, uh, great experience. Uh, I wasn't very busy in the Army and we visited every Buddhist, uh, temple. Went to every uh, mound of the dynasties there. I read all about Korean history and visited every art museum and uh, collected uh, or bought furniture and got to go to Japan several times. And uh, that's--when I became chief of neurosurgery here. I then started, uh, encouraging our residents to go someplace, for at least six months, to live in another country and get part of their education; because uh I thi--it was such a broadening experience for me to live in some other country and spend the time to read about their culture and get to know them. SMOOT: We have a lot more to talk about, but I suppose we should--we should stop here. YOUNG: I better. SMOOT: So let me-- YOUNG: Do you want to do it some other time, and finish? SMOOT: If we may. YOUNG: Would be fine. SMOOT: I'll thank you for-- YOUNG: Do--does this seem too egotistical (laughs) the things I'm telling you, or too personal? I-- SMOOT: No--No, not at all. [End of interview.] Dr. Byron Young (Chief of Neurosurgery, Director of Kentucky Neuroscience and Orthopedics Institute, and Johnston-Wright Endowed Chair of Surgery), grew up in Somerset, Kentucky, attended Transylvania University, then enrolled in the second class of the University of Kentucky College of Medicine. In this interview, Young discusses his first years at medical school and the prejudices concerning Kentuckians. He describes the surgery department and his decision to pursue neurosurgery. Young also discusses his time after his internship, including serving in the Army in Korea. insert here