Some things that VUMC people should know

Compiled (and mostly written)
By Wayne Wood

Sometimes it’s called “institutional memory.” It’s that set of facts, tales and beliefs that define any collection of people. The collective memory that holds a group of people together, that encapsulates a core of knowledge that members of the group have. Lore: Families have it, sports teams have it, companies have it, and universities and medical centers have it. So, of course, Vanderbilt University Medical Center has its lore; its facts, its institutional tales, its weird stuff that people who have been around a long time just know. But unless you are the kind of person who spends lunch hour in the library looking up exactly who Commodore Vanderbilt was or what chicken embryos and milk shakes have to do with the history of Vanderbilt, this information has existed mainly as oral history, passed from older employees to newer employees over lunch or on slow afternoons when there’s a little time to talk. Until now. “VUMC 101: Some Things VUMC People Should Know” won’t tell you everything you need to know about the lore of the Medical Center, but it’s a good start, and it’s the first time all this stuff has been collected in one place. Some of the items in this conceptual attic are good and some are bad, but, taken together, they paint a picture of who we, the staff, faculty, students and volunteers of VUMC are, where we came from and maybe give a road sign or two about where we’re going. Some of it is historical. Some of it is hysterical. Some of it is just plain weird. And it all happened here. And remember: those who do not know history are destined to look like saps when everybody else is slinging around references to “The Flexner Report.”

The Commodore made his money in shipping and railroads. A LOT of money. Cornelius Vanderbilt (1794-1877) was born to a poor family on Staten Island, N.Y. When he died, he was worth about $100 million and was the richest man in the country. He made his money through, first, shipping (which is where he got the nickname “Commodore”), and then railroads. He wasn’t much known for giving his money away, but he did pony up a gift of $1 million to help found what became Vanderbilt University. Before his gift, it was to be known as Central University. There had been plans in place to found a Methodist-affiliated college in Nashville since the 1850s, but those plans were postponed by the Civil War. Following the war, the effort was led by Methodist Bishop H. N. McTyeire. Pity the development officer (or whatever the money-raisers were called then) venturing forth in the devastated postwar Southern economy trying to raise funds for a school. Family connections came to the rescue. Early in 1873, Bishop McTyeire visited Cornelius Vanderbilt and his wife in New York. Mrs. Vanderbilt was a second cousin to the bishop’s wife. As a result of this visit, and following prolonged discussions, Commodore Vanderbilt offered a half million dollars (followed soon by a second payment of a similar amount) with stipulations that the new university be located in or near Nashville, and that the Bishop be president of the Board of Trust. Vanderbilt said he had a vision of a place that would “contribute to strengthening the ties that should exist between all sections of our common country” when he gave a million dollars to create a university in 1873. He didn’t need to point out to people of that time that the ties that “should exist” had been pretty hard to come by in recent years, what with that succession thing and all. Still, his wish that the university help pull all sections of the country together has lately been much more in evidence, with a substantial part of Vanderbilt’s student body originating from other regions of the U.S. Cornelius Vanderbilt never visited the university that bears his name.

The football field is named after a medical dean. Medical education in the late 19th Century was a considerably less formal enterprise than today. In fact, raising the professionalism of the graduates of the School of Medicine was a major goal of a reorganization begun in 1895. William L. Dudley (of Dudley Field fame), professor of Chemistry in the college of Arts and Science, was appointed medical dean; admission requirements were raised to require a high school diploma; the course was lengthened to three years of six months each; and laboratory work in the basic sciences was added to the curriculum. Three years later, in 1898, the quality of education was again upgraded; the course requirement for graduation increased from three years to four years; and the number of months of instruction each year increased from six to seven.

The anesthesiologist circus acrobat James Tayloe Gwathmey, M.D., was a leading anesthesiologist in the U.S. in the early 20th Century, and was arguably the first shining light on the national stage who graduated from the Vanderbilt School of Medicine. In his spare time, he was a circus acrobat. Gwathmey—that’s him in the center, in the white shirt—earned his medical degree in 1899, and in 1914, after practicing medicine for years in New York City, wrote Anesthesia, the first complete text on the subject to be published in the U.S., and for years the standard work in the specialty. But it’s worth noting that Gwathmey was also the author of a standard work on acrobatics called Tumbling for Amateurs, and, before attending medical school, had actually dropped out of Virginia Military Institute to join a circus as part of a traveling acrobatic troupe. It would be a pleasure to report at this point that some current medical faculty are also circus performers, but we appear to have no acrobats, freaks, bearded ladies or trapeze artists among us—which is too bad, because that would make a GREAT “Asking is the Answer” commercial.

Neonatal Intensive Care started here Patient care of newborns was revolutionized in 1961 at VUMC as Mildred T. Stahlman, M.D., founded the Division of Neonatology and began the Vanderbilt NICU, the first in the nation to make use of respiratory therapy for infants with damaged lungs. “It was an exciting time for everybody,” Stahlman remembered, “but it was also very hazardous; nobody knew what the outcome would be.”

The partnership: Alfred Blalock and Vivien Thomas Alfred Blalock, M.D., was a surgeon, and Vivien Thomas was a research assistant in surgery. Thomas was African-American, and due to the racism of the time, was ineligible to be a student or faculty member at Vanderbilt in the 1930s. Despite these barriers, Blalock and Thomas worked as partners in conducting pioneering research leading to the first cardiothoracic surgery for infants born with “blue baby syndrome.” The work was essential to the development of open heart surgery. Blalock and Thomas later jointly moved to Johns Hopkins. Their story was turned into the movie “Something the Lord Made.”

Here’s what the hell they were thinking when they built Medical Center North They were thinking: Now this is a snappy building. Around 1920, the idea surfaced that rather than renovate the medical school on the south campus, perhaps it would be wiser to build a new facility on the west campus. Chancellor Kirkland agreed and selected G. Canby Robinson, M.D., a graduate of Johns Hopkins, to be dean and professor of Medicine. Robinson’s plan, innovative for the time, included construction of a single structure, which would house the Medical School, the hospital, and research laboratories all under one roof. That building, which opened in 1925, and its additions, is what we now call Medical Center North. (Of course, for most of its existence, for all practical purposes it was the Medical Center). Medical Center North was built with a tic-tac-toe board design that had two north-south hallways and two east-west hallways, and open courtyards in between to provide all rooms with light and ventilation. The simple design of the building was modified over the years, with additional construction adding new corridors or wings every 10 years or so, through 1972, when the Joe and Howard Werthan Building was added on the front. After the opening of the new hospital in 1980, no new construction was added to Medical Center North until recently, when an animal care facility and the Imaging Center were added to the building. Also, Medical Research Building III, which opened in 2002, is connected to Medical Center North, but is considered a building in its own right.

Chick-a-boom The method of culturing vaccines against viruses in chick embryos was developed at VUMC in the 1940s by Ernest Goodpasture, M.D., who became dean of the School of Medicine in 1944. Goodpasture’s method allowed the mass production of vaccines for smallpox, typhus and yellow fever, and therefore saved lives all over the world.

Earl Sutherland’s Nobel Prize Vanderbilt’s first Nobel Prize for Medicine or Physiology came in 1971 when Earl W. Sutherland Jr., M.D., received the prize for his discovery of cyclic adenosine monophosphate (cyclic AMP). Cyclic AMP is important because it occurs as an intermediate in the process of converting glycogen to glucose in the liver, and when he discovered it, Sutherland theorized that it acts as what he called a “second messenger,” carrying instructions from the first messenger, a hormone, into the cells. That insight still forms the basis of the way scientists describe how hormones work in the body.

Children’s Hospital Vanderbilt Children’s Hospital was founded in 1970 under the leadership of David Karzon, M.D., known as “The Father of Children’s Hospital.” It was housed on the third floor of Medical Center North, then moved to the “new” Vanderbilt University Hospital when that facility opened in 1980, occupying the fourth, fifth and part of the sixth floor. The Monroe Carell Jr. Children’s Hospital at Vanderbilt opened in 2004, and is ranked one of the best in the nation by Child Magazine.

“The Cradle Will Fall” In the winter of 1983, VUMC was stalked by a killer. Luckily, this particular killer was fictitious, as Medical Center North was used as a shooting location for the TV movie “The Cradle Will Fall,” which starred Lauren Hutton, right, Ben Murphy, James Farentino and William H. Macy. The plot revolved around Hutton’s character, who is an assistant district attorney investigating the apparent suicide of a woman. It turns out that the death was not a suicide, but…MUUUUUUURDER. And, wouldn’t you know it, the chief suspect is the physician (Farentino) who is treating Hutton when she is hospitalized after a car accident. Medical Center North was under process of renovation, but parts of the building still pretty much looked like an old hospital, which is what it had been until three years before. So it was a perfect set for this spooky movie, based on the novel by Mary Higgins Clark. The movie first aired on CBS the night of May 24, 1983, and is still available on video and occasionally airs on extremely late night TV. Voters at the Internet Movie Database give “The Cradle Will Fall” six stars out of a possible 10.

Babies who Can’t Wait # 1: Elevator Music The elevator designated MCN 1, now primarily used as the quickest way to get to and from the Post Office in the basement of Medical Center North was the site of one of the most unusual births ever recorded at Vanderbilt Hospital. When Medical Center North was the home of Vanderbilt Hospital, the current location of the Post Office was the Emergency Room, and elevator MCN 1 was the connector to the upper patient wards and rooms, including Labor and Delivery, on the fourth floor. The date was Sept. 17, 1971, and Barbara Viner and her husband, Vanderbilt medical graduate and resident Nick Viner, M.D., had rushed to the hospital because Barbara was in labor. The young couple hurried into the ER and Barbara was immediately helped onto a gurney and wheeled to the elevator for the ride to the fourth floor. Then things started happening fast. Too fast. “All I remember is, they said, ‘He’s coming’ and ‘There he is’—and I was still on the elevator,” Barbara remembered later. Their baby boy was born in the elevator. Barbara and Nick named their newborn son, Dan (it’s not recorded whether they considered Otis). Twenty-three years later, in 1994, Dan Viner followed in the footsteps of his father and came to medical school at Vanderbilt. Before he came for his interview, his mom had some advice for him: “When you get on the elevator, look up—you may recognize it.”

The Strange Events in the Parking Garage
On the hot afternoon of Aug. 22, 1995, what happened in the parking garage across from VUH ignited a bizarre series of events that wound through federal courts for more than seven years.
On that day, a nurse phoned Vanderbilt Police and reported a man in a strange disguise was lurking around the garage. When an officer responded, he immediately spotted the man, who was decked out in an obvious wig, an Abe Lincoln-style fake beard, and, most ridiculously out of place on a Nashville August afternoon, a large trenchcoat. He also wore padding around his waist, to make himself appear heftier.
The officer detained the man on trespassing charges, and asked for some ID. He was given a British West Indies drivers license issued in the name of Steven Maupin.
But the man was not named Steven Maupin. His real name turned out to be Ray Mettetal Jr., M.D., and he was a former resident at VUMC. In his possession was an enormous, veterinary-style syringe with a four-inch needle filled with a boric acid solution, as well as a map of the Vanderbilt campus, diagrams of the garage, notes on garbage pickup schedules in Belle Meade, and a photograph of a Belle Meade house that had, until just a few months before Mettetal’s arrest, belonged to George Allen, M.D., chair of Neurosurgery at VUMC and Mettetal’s former boss.
As police developed their case, they discovered from interviews with both Vanderbilt sources and Mettetal’s family and friends that the former resident had an apparent grudge against Allen. The theory that Mettetal was stalking his former boss with intent to do him harm was strengthened by searches of his house and a storage locker in his new home of Harrisonburg, Va., where he had vials of poisons and reading material such as “The Complete How-to-Kill Book” and “Silent Death.”
The irony is that Mettetal would likely have been completely inconspicuous in scrubs or street clothes had he not ineptly tried to fool everybody with his clownish getup.
The case was transferred to Virginia for trial, since federal charges of possessing poison for use as a weapon were considered a stronger case by prosecutors and Mettetal’s attorney desired that his client be tried in a federal court rather than a state court, as he would have been if charged in Nashville.
He was convicted in 1998, but the case was overturned on appeal. Mettetal was retried in 2001, and again convicted. But for a second time, the conviction was overturned. In October 2002, the federal appeal judges ruled that the arrest of Mettetal for trespassing—which led to the discovery of the syringe and fake ID, which led to the search warrants for his Virginia property where the poison was stored—was improper, and therefore the evidence couldn’t be used.
Mettetal, who served more than five years in prison on these charges that were later overturned, is a free man.

Babies who Can’t Wait # 2: Oh, What a Feeling Mary and Steven Faber of Molecular Physiology and Biophysics were married to each other and worked in adjacent labs in Light Hall. Mary was set to have a baby at any time, and when she went into labor, Steven went to get their car to rush Mary to the hospital. But young Daniel Steven Faber had other plans. He was born at 10:58 a.m. Friday, Feb. 26, 1993, in the back seat of his parents’ 1988 Toyota Corolla wagon, which was in the loading dock area behind the building then known as Medical Research Building I, now the Robinson Research Building.	Riding the Shuttle. The ONLY Shuttle. VUMC began running a shuttle between the parking lot off Natchez Trace and Medical Center North in 1984. In contrast to the numerous buses and routes today, things were a little more bootstrap in those early days. There was only one bus, so a rider who wanted to catch it at MCN sometimes needed to page the driver, who would be waiting for riders at the parking lot. There was one memorable winter morning when it was so cold the shuttle wouldn’t start. Longtime driver John Alexander, above improvised by loading people in his car and driving back and forth until a mechanic could get the bus started.	The TB Porch In the original Medical Center North, a porch for tuberculosis patients ran between the B and C corridors on the second floor. Before the invention of antibiotics, there was no cure for TB, but fresh air was thought to be beneficial to the patients, so the original building had a porch adjacent to the TB ward. Above the porch, on the third floor, was a narrow walkway between the B corridor and C corridors. The second floor porch and third floor outdoor walkway were bricked-in in the 1950s, when antibiotics had TB on the wane, but are still visible above the awning of MCN that faces Medical Center Drive. The rows of windows that are the remnants of the old porch are on the second and third floors that cross between corridors above the awning and back about 50 feet.

The Chapman Quadrangle The quadrangle was named in 2001 in honor of John E. Chapman, M.D., who retired that year as Dean of the School of Medicine, and his wife Judy Jean, who taught for many years in the School of Nursing and School of Medicine. This arched gothic doorway is the traditional entrance to the School of Medicine, and there are photographs of the faculty dating back to the 1920s taken in front of this door. This quadrangle was also the site of medical school commencement ceremonies until about 25 years ago. This area was not always a closed courtyard. The wing of the building opposite the archway, the A.B. Learned Laboratory (now incorporated into Medical Research Building III), was built in 1960, closing off the courtyard. The street grid of Nashville once continued through this part of campus and just beyond the door on the far side of the Quadrangle was a busy street. The photograph at left from the 1940s shows this area basically being used as a parking lot.

The Voice The person you hear giving voice mail prompts on the VUMC phone system is named Marsha Graham. She lives in California. She has recorded voice mail messages for phone systems all over the world. The next time you hear “At the tone, please record your message,” think about what she looks like.

The Presidents and Vice Presidents Come Calling The first sitting president to visit VUMC was Bill Clinton, who, along with Vice President Al Gore, was here in 1995 to visit Gore’s mother, Pauline, who was hospitalized at the time. Clinton and Gore arrived outside Langford Auditorium and made their way through throngs of well-wishers including Drew Gaffney, M.D. and Anderson Spickard III, M.D., on their way to Mrs. Gore’s room in Vanderbilt Hospital. The visits from presidents to VUMC have come pretty regularly since. Clinton returned in 1996 for one of his last stops at that year’s election campaign. He spoke to a packed house in Langford Auditorium. Clinton and Gore, along with first lady Hillary Clinton and Tipper Gore, were in Langford Auditorium again in 1998 to participate in Gore’s then-annual Family Re-Union conference. And President George W. Bush visited Monroe Carell Jr. Children’s Hospital at Vanderbilt in 2004 to discuss technology in health care. And yes, as part of the event he, too, took to the stage in Langford Auditorium. And while he didn’t specifically visit the Medical Center, President John F. Kennedy spoke at Dudley Field in May 1963. Langford Auditorium hadn’t been built yet.

Building Boom
In 1974 Vernon E. Wilson, M.D., became vice chancellor for Medical Affairs, and the next year John E. Chapman, M.D., became Dean, a position he would hold until stepping down in 2001. The two men began an impressive program of construction of new facilities that continues to the present. The first of the new series of buildings was Rudolph A. Light Hall. The building, which opened in 1977, contained School of Medicine classrooms and laboratories, and was the first major freestanding addition since the opening of the new Medical Center building in 1925. Langford Auditorium was soon added onto Light Hall, and was followed by Vanderbilt University Hospital in 1980.
Roscoe R. “Ike” Robinson, M.D., became vice chancellor for Health Affairs in 1981, and the building boom continued: the Child and Adolescent Psychiatric Hospital in 1985; The Vanderbilt Clinic in 1988; Medical Research Building I (below, now named the Ann and Roscoe R. Robinson Medical Research Building) in 1989; the Kim Dayani Human Performance Center in 1989; Stallworth Rehabilitation Hospital and the Medical Center East outpatient building in 1992; Medical Research Building II (now the Frances Williams Preston Building) in 1993; and the Annette and Irwin Eskind Biomedical Library in 1994.
In 1997 Harry R. Jacobson, M.D., became vice chancellor and oversaw more building projects, beginning in 1999 when the School of Nursing dedicated Patricia Champion Frist Hall, above, a new classroom and office building adjacent to Godchaux Hall, the 1925 School of Nursing building, which opened following its second major renovation in 2006. Medical Research Building III opened in 2002, the addition to Medical Center East housing the new Bill Wilkerson Center and the Musculoskeletal Institute in 2003; The Monroe Carell Jr. Children’s Hospital at Vanderbilt opened in 2004; and the Imaging Center, another addition to Medical Center North, opened in 2006.

The Fence Post Kid The Vanderbilt ER, like any urban Level 1 trauma center, sees its share of noteworthy events, tragedies and sometimes even comedies. But there was a case that came through the ER in the early summer of 1986 that people still talk about. The patient’s name was Mike Harper, a 15-year-old from Mt. Juliet, Tenn., but, in telling the story, he’s usually just known as the Fence Post Kid. On that just-out-of-school summer night, Mike was riding around with his friend, Chad, who was 16 and had been given the keys to his family’s Audi 5000. On a deserted two-lane country road, the boys got an idea: let’s see if we can get this car to 100 miles per hour. Bad idea. Even worse execution. Chad lost control of the car and it spun into a row of fenceposts, backward. One of the fence posts came through the floor of the car, through the back of the passenger side car seat, and…through Mike. All the way through. He was impaled on a six-inch thick fencepost. Amazingly, he was conscious and in no pain. But he was scared. He had lifted up his T-shirt and had seen his skin folded under where the post came through, and he had also heard the concerned tones of the paramedics who came to the wreck site. The paramedics called LifeFlight and Mike was loaded into the helicopter with the post still protruding from his body. His parents were told that Mike likely has massive internal injuries and that he might not survive the necessary surgery to remove the post. But there were virtually no internal injuries. As the post penetrated his body at an estimated 60 miles per hour, the organs simply rolled aside and made room. Had the post been slightly to the left, Mike would have had a gaping wound to his side and bled to death. Slightly to the right would have meant likely fatal internal injuries. Mike went home one week later, and before the summer was over was playing baseball, leaving the tale of the Fence Post Kid behind as the trump card on quiet nights when ER people play “can you top this?”

Quintuplets On Jan. 20, 1987, the only set of quintuplets in the history of VUMC were born. Within a little more than a day, four of the babies—two girls and two boys—died. The surviving baby, Stephen Hawkins, struggled to live as his parents, James and Darlene Hawkins, (left, with tiny Stephen) dealt with the births of five children, deaths of four children, and the critical condition of their surviving son. Stephen did indeed survive, and is almost 20 years old.

Nutrition Study
In the 1940s the study of human nutrition was one of the strongest areas of research at VUMC, and with nutrition in pregnant women especially a problem in the rural South, Vanderbilt nutrition researchers, with funding from, among others, the Rockefeller Foundation, the Nutrition Foundation, the state of Tennessee, and others, designed a study to examine how much iron pregnant women need by tracing the absorption of the mineral with an isotope. Other similar nutrition research was being done at the same time.
The study was completed, published in a medical journal, and the University sent out a press release about it which was published in Nashville newspapers.
In 1969, researchers from Vanderbilt went back and did a retrospective on the original studies, and this study was also published in the medical literature.
In 1993, the U.S. Department of Energy began releasing records of various studies performed during the same era as the Vanderbilt nutrition studies. Some of the studies were ethically dubious, and the nutrition studies were lumped in the public mind with some of these other studies.
The Vanderbilt studies were called “secret Cold War” studies even though they had been covered in the professional and lay press and had nothing to do with Communists and everything to do with anemia among pregnant women.
While the studies from the 1940s and 1950s were certainly not conducted by the standards of the present day, the work was valuable science seeking to improve people’s lives. After the release of records in 1993, some people claimed harm from the studies and sued the University, some resulting in settlements.

VICC Among the Best
The Vanderbilt-Ingram Cancer Center is the only National Cancer Institute Comprehensive Cancer Center in Tennessee, and is consistently among the best in the annual survey by U.S. News and World Report.