LETTER TO THE HONORABLE ALLEN W. DULLES FROM I. RIDGEWAY TRIMBLE, M.D.

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80R01731R000300090002-2
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 22
• Document Creation Date: December 14, 2016
• Document Release Date: March 31, 2003
• Sequence Number: 2
• Publication Date: November 30, 1959
• Content Type: LETTER

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THE JOHNS HOPKINS HOSPITAL
BALTIMORE 5. MARYLAND
IVAN L. SENNETT. JR., M. D.
PATHOLOGIST-IN-CHIEF
ALFRED BLALOCK, M. D.
BURGEON-IN-CHIEF
ROBERT E. COOKE, M. D.
PEDIATRICIAN-IN-CHIEF
NICHOLSON J. EASTMAN, M.D.
OBBTETRICIAN-IN?CHIEF
A. MCOEHEE HARVEY, M. D.
PHYSICIAN-IN-C H IEP
A. EDWARD MAUMENEE, M. D.
OPHTHALMOLOGIST-IN-CHIEF
November 30, 1959
The Honorable Allen W. Dulles,
Director of Central Intelligence,
Washington-25,
D.C.
Dear Mr. Dullesr
RUSSELL H. MORGAN, M. D.
RADIOLOGIST-IN-CHIMP
RICHARD W. TE LINDE, M. D.
OYN ECOLOOIST?IN?C HIE P
JOHN C. WHITEHORN. M. D.
PBYCHIATRI.T-IN-CH IMF
As President of the Society of Medical Consultants to the
Armed Forces, I wish to thank you for your extremely interesting
talk to us last Sunday evening. Having attended all of these
meetings since the Society was founded in 19146, I can truthfully
say that your presence as well as your remarks meant more to us
than those of any previous speaker.
I am taking the liberty of attaching a reprint of mine
relative to the subject which you and I were discussing the other
night, in which I quote your illustrious and revered brother.:-.I
am also attaching a copy of a letter written to the Baltimore Sun-
papers relative to the conquest of polio which we also discussed
at that time.
With warm personal regards.,
Sincerely,
I. Ridgeway Trimble, M.D.
I RT/mlh
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ER 11-9544/a
1. Ridgeway Trimble} M. D.
The Johns Hopkins Hospital
Baltimore 5, Maryland
Dear Dr. Trimble:
Thank you for your very kind letter of November 30th regard-
ing my talk to the Society of Medical Consultants. I appreciate your
sending me a copy of your letter to Mr. Philip Potter concerning the
United States exhibit at the Fair in India, and was pleased to receive
a copy of your address on the opportunities and responsibilities of the
physician in world affairs. I found this most interesting.
It was a pleasure to meet with you and discuss matters of
mutual interest.
Sincerely,
Allen W. Dulles
Director
IG/LBK/drm (18 December 1959)
Distribution:
Original - Addressee
1-DCI
1 - ERv`
1 - IG chrono
DOGItF'YE~11'
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Reprinted from The Journal of the American Medical Association
November 28, 1953, Vol. 153, pp. 1143-1149
Copyright, 1953, by American Medical Association
OPPORTUNITIES AND RESPONSIBILITIES OF
THE PHYSICIAN IN WORLD AFFAIRS
CHAIRMAN'S ADDRESS
I. Ridgeway Trimble, M.D., Baltimore
One of the prerogatives of the chairman of any organ-
ization seems to be that in his farewell address it is
permissible for him to stray from the narrow confines of
a strictly scientific path to the broader avenue of philos-
ophy. My subject concerns the opportunities and respon-
sibilities given to the physician and the surgeon to aid in
the prevention of the war that seems to be daily drawing
closer and to make obsolete the recourse to war as the
attempted settlement of political and ideological differ-
ences. This is a big order, a difficult assignment, but at
the,beginning I should like the purport of these remarks
to be clear.
I do not want to be in the category of the politician who
had been addressing a large crowd of people at some
political gathering in North Carolina for a considerable
time. A man attracted to the scene asked one of the lis-
teners on the fringe of the crowd, an interested farmer,
"Is he making a good speech?" The farmer replied, "He's
making a powerful speech." "What's he talking about?"
asked the visitor. "He ain't said," replied the farmer.
For a few moments, therefore, I would like to develop
the following related thoughts: that only international
understanding will prevent war; that physicians have a
common language and enjoy the confidence of the people
more than any other profession; that physicians know
the true meaning of war better than anyone else; that
politicians and statesmen and soldiers have thus far failed
to prevent wars; and that physicians have a great oppor-
tunity and obligation that they must seize and fulfill
without further delay.
Read before the Section on Surgery, General and Abdominal at the
102nd Annual Meeting of the American Medical Association, New York,
June 3, 1953.
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Furthermore, I feel impelled to bring these thoughts
to your attention for your critical evaluation and to
stimulate your interest in this whole subject, because they
represent an effort to'ease the fearful burden that we are
passing on to our children. From our fathers we inherited
a world that was bright and full of promise. To our chil-
dren we leave a world over which hovers the ever darken-
ing cloud of a warfare so dreadful as to surpass the
imagination, so dreadful that we seek to ignore it by forc-
ing all thought of it into the background of our con-
sciousness. We cannot sit by complacently; we must think
of and plan constantly for ways and means to protect in
the future those lives for which we are responsible.
THE FUTILITY OF WAR
"Important as preparedness for war may be, evidence
is increasing that military success alone is no guarantee
of peace. On the contrary, history would suggest that
civilizations ultimately face extinction if war is their sole
method for achieving international accord. Perhaps more
important for our own security than perpetual mobiliza-
tion is the assurance that the opposite shores of the
Pacific, as well as the Atlantic, are in friendly hands. One
of the most important instruments, properly used, in the
cultivation of such friendly understanding is the role of
medical education."
To every thinking man the futility and absurdity of
war is so manifest that it is difficult to realize that this
is not universally appreciated. Leonardo da Vinci dis-
posed of war in two words, "Pazzia bestialissima" (the
most bestial madness).
We have the very recent lesson of the inability of war
to settle world problems when we reflect that, after vic-
tory in World War I, we fought our former allies in that
war, the Italians and the Japanese, in World War II; and
when we reflect that, after victory in World War II, we
are fighting in the Korean War against China and Rus-
sia, two of our great allies in World War II.
The farmers in North Dakota, in North Borneo, and
in North Korea have the same basic desires: to have
1. Smyth, F. S.: Our International Responsibility in Medical Educa-
tion, J. M. Educ. 26: 360, 1951.
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enough to eat, to have enough to wear, to have shelter
over their heads, and to live in peace. The little Chinese
peasant family, in that country that has always been
until very recently our traditional friend, does not want
to see its only son or any other member of his family go
off to war any more than does the little American family.
But none of these little families, whose sons do the fight-
ing or who may themselves be blown to bits in this total
warfare, seem to have any voice in the decision to pro-
voke or to commence a war in the present state of organ-
ization of civilization.
The late eminent biologist and philosopher, Dr. Edwin
G. Conklin,2 maintained that intolerance, bigotry, and
prejudices were man-made and urged their elimination
through the application of the true scientific spirit. The
resemblances of all men, he believed, whether the Aus-
tralian bushman or the philosophers of the most civilized
countries, are greater than their differences. "Heredity
is not responsible for social behavior, racial antagonisms
are not born, but these antagonisms are carefully culti-
vated and developed."
"We may be reasonably sure, from the history of
evolution, that the societies which survive will be the ones
that can change to meet new conditions; and that those
which crystallize their philosophies and their societies in
any fixed, dogmatic form are eventually doomed. The
dinosaurs were large and powerful; but the dinosaurs are
dead." 3
Mind you, I believe in arming strongly against threat-
ened aggression and in fighting when you are attacked and
your family, your home, and your country must be de-
fended. In World War I, at the age of 17, I volunteered
for the Army in 1918 and attained the proud rank of
corporal in the infantry. In World II, I served as an Army
medical officer four years overseas in Australia, New
Guinea, the Philippines and Japan, the last one and one-
half years on the staff of General MacArthur. I am still
a member of the active Army reserve. As an aside, I
2. Conklin, E. G.: Freedom and Responsibility: Biological View of
Some Problems of Democracy, Boston, Houghton Mifflin Company, 1935.
3. Winslow, C. E. A.: Economic Values of Preventive Medicine, Chron-
icle of World Health Organization 6: 191, 1952.
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might add that I agree with my former commander that
once war is joined there is no substitute for victory.
But all this talk of war and chivalry does not preclude
my thesis that by intelligent, coordinated, ceaseless effort,
war as the settlement of political affairs can be made ob-
solete. As Nicholas Murray Butler said, "To reject eter-
nal peace as an absurdity and as something foreign to the
creed or to the temperament of any people is to proclaim
oneself a barbarian and an enemy to all mankind... .
Physical force, terrorism, despotism cannot accomplish
the high ends at which civilization aims. Intelligence,
sound moral standards and the spirit of service can do
sb, always have done so, and will continue to do so."
PEACE THROUGH INTERNATIONAL UNDERSTANDING
Shyness and unfamiliarity lead to misunderstanding,
suspicion, and fear, which are largely responsible for the
enmity that exists among individuals, communities, and
nations today. If a driver blows his automobile horn at
a motorist, he turns and scowls and looks upon the inci-
dent more or less as a personal insult. However, if he
recognizes the driver as a familiar face when he turns,
his irritation and suspicion vanish and he waves gaily. So
often the rather fierce, forbidding look on the face of a
stranger is put there by shyness and as a protective re-
action. A quiet word, a casual comment, and the for-
bidding stranger becomes a genial companion.
Lasting peace can be possible only when people under-
stand each other; understanding can come only when
people can be given the opportunity to meet each other
frequently, to listen, to talk, to discuss. The American
people are great joiners and have a great affinity for
traveling all over the country to meetings and confer-
ences. Sometimes foreigners speak derogatively of this
American characteristic, but it is a healthy custom. In
Nashville, Tenn., I recently attended a meeting of the
Society of Clinical Surgery, where members came from
all over the country. In the same hotel was a national
meeting of the African Violet Growers Association. They
seemed to be having just as profitable a time and seemed
to be spreading just as much understanding among them-
selves as we in our society.
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Mr. Malenkov and almost all the high ranking mem-
bers of the Soviet high command have never left Russia.
No wonder they become introspective, ruminative, sus-
picious, and fearful. Think how much good it would do
Mr. Malenkov to travel around a bit and attend meetings
such as we do, especially such a one as the African Violet
Growers Association.
Surgeons seem to travel more frequently and further
to conferences than anyone else. I venture to say that had
physicians and surgeons in 1861 been given the oppor-
tunity to travel and to meet and discuss their problems
and to know and understand each other as we do today,
they alone could have prevented the incredible catas-
trophy of our Civil War, rightly called by Adams the
American Tragedy.
Science and learning are truly international and there-
fore should lead in creating international amity, so that
scientific societies must take the lead in establishing co-
operation and friendship among all nations. As an ex-
ample of understanding resulting from free exchange of
medical concepts, from frequent visiting in our medical
circles, made easier of course by a common ancestry and
a common language, is the close relationship between
physicians and surgeons in the United States, Canada,
Great Britain, Australia and New Zealand, and South
Africa. I believe that our profession has played no small
part in cementing the ties that exist between these coun-
tries, so close that even the wild statements released by
the irresponsible pseudostatesmen of both countries
cause little more than a trickle of annoyance and amuse-
ment over the calm surface of fundamental understand-
ing that exists between us. We know and understand each
other so well that we shall never fight a war on opposite
sides.
UNIQUE POSITION OF THE PHYSICIAN
The trust and the confidence and the respect shown
to the physician by his patients brings about a relation-
ship that is unique. Even priests of the church cannot
come so close to the man who is ill or whose family is
ill as can the physician, who alone is familiar with the
physical and mental requirements of his patients. He
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stands for hope and strength and is looked to for guid-
ance and help.
As physicians, then, we have deservedly or undeserv-
edly won the confidence of the common man more than
have any other professional workers. The common man
believes that we understand his problems and that we
earnestly want to help him. We seem to him like a father
in the presence of his children. Our counsel is sought for
all sorts of perplexing problems' in addition to those of
illness. Such a relationship brings infinite power and
infinite responsibilities.
As physicians we have been educated and trained to
prevent disease and epidemics, to cure and comfort the
sick, to heal wounds, and to straighten the body. We,
therefore, understand the dreadful ravages of war better
than any other class of men. As physicians we have a com-
mon understanding in our profession throughout the
world. We speak the same language.
Physicians' regard for human welfare transcends their
nationalistic feeling. In 1882, cholera, always lurking
in India, sneaked across Egypt to Alexandria, and all
Europe was alarmed.3& From France, Pasteur sent his as-
sistants Roux and Thullier; from Germany went Koch
and Gaffsky. The rivalry was keen between the two com-
missions just as hatred was keen between Germany and
France and just as bitterness was present between Pasteur
and Koch. Each strove to beat the other in finding the
cause of cholera.
Then one day a telegram came to the Germans, "Thul-
lier of the French commission is dead-dead of cholera."
Koch and Gaffsky immediately went over to their rivals
and Koch was one of those who bore Thullier, the young-
est of the investigators, to his last home. As he put wreaths
over the wooden coffin, he said, "They are very simple
but they are of laurel, such as are given to the brave."
Dr. Paul Hawley wrote me of another instance of this
sort only last week. He stated that, when the Germans
were driven out of Paris by our Army in World War II,
the commanders of German military hospitals were
3a. de Kruif, P.: Microbe Hunters, New York, Harcourt, Brace and
Company, Inc., 1926.
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ii .
ordered to sabotage their hospitals so that they would
be unusable by the American and British forces. The
German medical officers disregarded this order. In only
one hospital was there any sabotage. In Hospital Beau-
jon, a hand grenade had been exploded in the telephone
switchboard. All the rest of the hospital was ready for
immediate occupancy and use, with x-ray apparatus in
perfect working order, instruments in order in their
cabinets, etc.
A PROUD RECORD
Our inheritance as physicians is a proud one, and our
accomplishments, attained under a free system of indi-
vidual enterprise, in the fight against disease stand out
as the bright hopes of developmental science as opposed
to the questionable advantage of other scientific accom-
plishments, such as the development of increasing speed,
increasing explosive force, and increasing toxicity of
chemical agents. As an evidence of their high regard for
physicians, the general population has voted our profes-
sion the only one subject to draft in the armed forces.
The medical profession in countries throughout the
world where adequate educational facilities are available
has waged war successfully against such epidemic dis-
eases and other human scourges as the plague, smallpox,
cholera, rabies, malaria, typhoid, yellow fever, diph-
theria, hookworm, pernicious anemia, diabetes, syphilis,
tuberculosis, pneumonia, and local and general bacterial
infection, to cite only a partial list of achievements. The
conquests of surgery over pathological lesions and con-
genital abnormalities of the abdomen, chest, brain, heart,
and great vessels are well known to all of you. Time does
not permit the mention of victories over disease in the
domestic animal and the plant domains.
There are new frontiers for medicine, particularly for
American medicine, because our country has assumed
the leadership of all free nations. These are the oppor-
tunities for medicine and physicians to become leaders
in the field of medical statesmanship. Political statesman-
ship and armed might alone have not proved equal to the
task. The physician, because of his prolonged and con-
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tinued life of study, is trained to. command. He seeks no
political office and, because of that fact, his position for
influence is greatly strengthened.
THE PHYSICIAN IN WORLD AFFAIRS
The influence of physicians in,public affairs has waned
greatly in the past hundred years. There was a time
when they were civic leaders as well as professional men.
To that position they must return. But they cannot re-
turn if they remain within the confines of their medical
duties, pursuing blindly and furiously their limited objec-
tives. First of all they must fulfil their primary function
of healing the sick, of course, but they must raise their
sights. They must use their intellect and their energy
ceaselessly to plan and to act in this great struggle to pre-
vent the destruction of civilization as we know it today.
For the physician to remain strong and to increase his
influence in medical and world affairs he must remain
free and independent. Commenting on the triumphs of
the medical profession over disease, Dr. W. Edward
Gallie of Montreal stated, "And as I think of this glorious
era, I cannot help wondering if it could have happened
under state medicine. Would the fires of research have
glowed as brilliantly under bureaucrat direction and
political control as they have in the immediate past?
Could management by the civil service have been as suc-
cessful in attracting these bright young minds to the study
and solution of the problems of health and disease? My
experience with politics and the civil service makes me
doubt it and makes me think that we should avoid at all
cost the introduction of socialistic changes. . . . The
spectacle of what is going on in England and New Zea-
land with their schemes of state medicine, is quite enough
to drive bright and clever young men into other fields
of endeavour. At any rate there will be no sons of doctors
entering medical school if state medicine comes. I would
venture to predict that with the advent of socialized med-
icine, as it is advocated by the socialist and communist
parties, this golden age of medical discovery will come to
a close and we shall enter a period when progress in the
study of health and disease will bog down to the speed of
the civil service. The idea that medical research can be
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kept alive by government grants is just silly if it turns out,
as I think it will, that the bright boys no longer want to
be doctors and will no longer enter the schools."
PRESENT TRENDS TOWARD HELP
There exists a wide and ever-increasing groping to-
ward effective means to promote international under-
standing. We in America have such a strong belief that
our way of life and our system of government offers the
best opportunity for a free, happy, and peaceful existence
that we are almost childlike in our enthusiasm to convey
our concepts to others. Certainly, we have no imperialis-
tic motives. In my early memory, such organizations as
foreign missions of our churches, the Rhodes scholar-
ships, and the Rockefeller Foundation were associated
with schemes to promote international good will, but only
recently have I appreciated the full significance of this
principle.
Whatever may be said, by the critics of the outpouring
of dollars, materiel, and personal effort from many indi-
viduals and agencies from the United States to the
peoples of the world since World War II, it cannot be
denied that all of this represents a spontaneous gener-
osity from millions of Americans heretofore unheard of
in the history of the world. Now, however, the time has
come, in fact is long overdue, when we should insist that
our donations be distributed in a business-like manner,
fairly but economically. The supply of the old milch cow
is not inexhaustible. Since the end of World War II, our
government has spent 40 billion dollars through various
kinds of official aid to help other countries. But along
with some gratitude, we have won large measures of dis-
trust and ill will. In many parts of the world never has
our prestige been lower. This is not a dollar problem. It
is a human problem. People in other countries want a
helping hand, not a handout; they want dedicated help,
not money bag help.
They are not won over by the mere mention of dollars,
or by the gesture of throwing largesse to beggars. Our
purpose should be to assist less fortunate nations to stand
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on their own feet. It is not the responsibility of the United
States to supply enough chlorophenothane (DDT)
powder to eliminate malaria in India, but to instruct the
Indians, as is now being done at Delhi, how to make
factories to manufacture their own chlorophenothane.
"It is just this difference between doing the job for them
and helping them do it themselves that will make or
break our entire foreign policy. To do the job for other
nations is nothing more than a continuation of the hated
colonial imperialism. To help other nations become self-
sufficient is the true spirit of the commonwealth of free
nations, which is our objec`ive." 6
ADVANTAGES TO OUR OWN NATION ,
This whole program of help to other nations holds very
definite advantages to our own nation. We cannot afford
to contemplate visions from an ivory tower. We are
working day by day in a tough and practical world. In
the first place, the commonwealth of free nations is wag-
ing a campaign against a disease that threatens to become
pandemic and destroy life as we know it today. I speak
not of a biological disease but of the political disease of
communism. Communism thrives on ignorance, hunger,
and disease.
The life-span in northwestern Europe, North America,
Australia, and New Zealand (the so-called developed
areas, where one-fifth of the population of the globe lives)
is an average life expectancy of 63 years. In another
group of "undeveloped areas," including the homes of
nearly two-thirds of the world population, the life ex-
pectancy is only 30 years. This simple fact emphasizes
in dramatic terms the major problems of the human race
today. Morbidity takes an even greater toll of our eco-
nomic resources than does premature mortality. In the
case of the mosquito-borne diseases, the malaria control
in the Philippines reduced school absenteeism from 50%
daily to 3% and industrial absenteeism from 3510 to
4%. In Liberia, there is only one physician to every
63,000 inhabitants. In India, mothers who know that
7 out of every 10 babies bom to them will die in infancy
5. Moore, R. A.: New Frontiers of American Medicine, North Carolina
M. J. 13: 457, 1952.
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 or childhood are easily persuaded by the propaganda of
the Communists.
One of the most important tasks we have today is to
win the people of Southeast Asia into the commonwealth
of free nations. Indeed, the peace of the world could well
depend on it. Southeast Asia (Indochina, Thailand,
Burma, and Malaya) in other hands, as it was in 1942,
opens the great plains of India and Pakistan, the islands
of Indonesia and the Philippines, and the continent of
Australia to conquest. We recently lost the Chinese ball-
game 400 million to nothing; we cannot afford to lose
these other peoples as well.
It appears that by strange coincidence, our two for-
mer principal enemies, recently defeated in World War
II, must in the future form our principal outposts of
defense against the Communists. If these two nations
can be won over to embrace the principles of democratic
government, rearming them gives the free. nations im-
measurable strength; but if, when armed, they return to
their totalitarian background, rearming them may prove
disastrous. There is no surer way to win them over than
to have their physicians brought into our medical orbit.
FELLOWSHIPS AND FUNDS
To promote the advancement of science throughout
the world, there are an increasing number of fellowships,
funds, and prizes available for graduate study and re-
search in medicine and allied sciences, through associa-
tions, foundation funds, institutions, and others. A list
of over 200 such donating agencies in Canada and the
United States is kept on file by the Association of Ameri-
can Medical Colleges, whose headquarters is in Chicago.
There are the private funds, such as the Rockefeller
Foundation and the Ford Foundation, and in recent years
very valuable help has been given through two sources.
One is the Fulbright Fund, which is derived from the sur-
plus war material in foreign countries belonging to the
United States and sold into commercial channels, the
proceeds being made available for scholarships to and
from these countries. Such scholarships are awarded on
a competitive basis. The other source is through the
Smith-Mundt Act. This fund provides a sum of money
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 for leaders from other countries to come to the United
States.
The World Health Organization (WHO) is a special-
ized agency of the United Nations. As such, it inherits
the functions of the Office International d'Hygiene
Publique, the Health Organization of the League of
Nations, and the Health Division of UNRRA. In its seven
years of existence WHO has proved that nations can
work together on common problems without losing any
of their national sovereignty. Its budget for 1954 is
$8,487,700. The United States' share of this budget will
be about one-third of the total, or $2,800,000. Assess-
ments are made against 70 member states and three asso-
ciate members.
Recently, the Point-4 Program has been transferred
from the State Department to Mr. Harold E. Stassen, the
Mutual Security Director. Point 4 was so named because
it was the fourth point in Mr. Truman's 1948 inaugural
address and proposed technical aid to underdeveloped
countries. It was administered under an agency organized
for this purpose, the TCA (Technical Administration
Cooperation). Under Mr. Stassen also falls the agency
that was set up to administer the Marshall Aid Plan for
Western Europe. It was originally called the ECA (Eco-
nomic Cooperative Administration) and was subse-
quently renamed the MSA (Mutual Security Agency).
Under a new plan these agencies have been taken over
by the new Foreign Operations Administration. There is
the United Nations International Children's Emergency
Fund (UNICEF), which has been doing work of the
greatest importance.
The United States Public Health Service for this past
year has participated in health programs of 20 countries
of the Near East, Far East, and Southern Europe, as well
as in 18 countries of Central and South America.
In this connection, mention should be made of the
value of visiting medical teams such as those organized
by the Unitarian Service Committee, working in con-
junction with our State Department. These teams in
Poland, Germany, Japan, South America, and other
countries have demonstrated beyond all doubt that
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American, British, and Scandanavian medical educa-
tional methods and techniques are received with the
greatest enthusiasm by these countries. The descriptions
of the impression made by the first operation in Berlin
for congenital heart defect by Dr. William P. Longmire,
and the first pneumonectomy in Bogota, Colombia, per-
formed by Dr. George Humphreys, are heartening to
read.
As one studies this subject, one becomes encouraged
by the ever-increasing number of people donating their
time and their money to such organizations as Agricul-
tural Missions, American International Association for
Economic and Social Development, Band of Christo-
phers, CARE, English Speaking Union, Experiment in
International Living, Friendship Stations, Interdepend-
ence Council, National Committee for a Free Europe,
and World Neighbors, to mention only a few. Some of
the individual physicians who have been keenly inter-
ested in this problem of the promotion of international
understanding through medical exchanges are Dr. M. H.
Clifford of Boston; Dr. Edward L. Young of Brookline,
Mass.; Dr. Thomas Greenaway of Sydney, Australia;
Dr. Frances Scott Smyth of San Francisco; Dr. Robert A.
Moore of St. Louis; and Dr. Eldridge Campbell of
Albany, N. Y.
Such facilities as have been mentioned offer great
opportunities to promote science and world peace. Per-
haps the most important part of this work to physicians
is the training program for foreign postgraduate students.
Indisputable as the advantages of such a program may
be and useful as it may be to our hospitals needing house
officers, nevertheless, along with many others in this
country, I have been disturbed by the procedures and
methods used or followed in the training of the young
men in medicine from foreign countries. I use the term
postgraduate student advisably, because it is through this
group that our efforts can be made most effective. It is
not my idea to recommend the addition of more foreign
physicians and more foreign medical students for prac-
tice in our own country. Every medical school here has
more applicants from our native population than can
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possibly be admitted. Also, once a foreign student is here
in medical school for four years and then several years
more in training, he is likely to remain in this country and
not to return home, where he is really needed.
First of all, in many instances, there has been insuffi-
cient screening of these young people in their own coun-
try to give assurance that those who come will greatly
benefit by the experience or be of real help to the institu-
tions in this country. Too many people with inadequate
training have come to the United States, have taken the
first job that was offered to them that paid any money,
and have been at times exploited by the hospital that
took them on. The continuation of practices of this type
will injure international relations rather than improve
them.
The language barrier is a serious one. It is irritating
to the nurses, physicians, and patients in the hospitals
involved, and puts the foreign house officers in a bad
and unfair light. Too often the reaction is, "He seems to
be pretty stupid; he can't even speak English."
A second complaint of hospitals in which the foreign
house officer works is that many of these men have had
poor or insufficient fundamental training at home. A
third objection to this whole plan is that many have come
from abroad who have never had any intention or return-
ing to their own country after finishing their training. A
fourth disadvantage lies in the unwillingness of some
chiefs of service in our hospitals to put out a little extra
effort to train these physicians on their staffs. These diffi-
culties are all aggravated when a resident house staff has
a number of foreigners to assimilate, each from a differ-
ent country.
My belief is that the most efficient way to accomplish
the desired result is by a plan that would give a continuing
year by year liaison for unilateral or bilateral exchange
of personnel between, one hospital in this country and a
sister hospital in a foreign country. There should, of
course, be sufficient flexibility in. the plan to permit the
unusual person an opportunity to visit another institu-
tion, if.there are sufficient reasons to recommend such a
variation.
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n ?
This arrangement would carry one step further the
plan of our State Department for the past two or three
years, which has been to try to develop a certain geo-
graphical zone of interest by each of our medical schools.
For example, Washington University in St. Louis was
asked to undertake this reciprocal arrangement with the
University of Bangkok in Thailand; Harvard with the
University of Calcutta in India; Columbia with the Na-
tional Taiwan University in Formosa; and Johns Hopkins
with the University of the Philippines. There have been
similar requests to other universities in this country.
So far as I know, only the arrangement between Wash-
ington University and Thailand has been agreed on and
given trial. This has met with great success. Dr. R. A.
Moore, the dean' of the School of Medicine at Washing-
ton University, has been a leader in this whole program.
His school was the first in this country to establish a co-
operative teaching program under the Marshall Aid Plan,
and in 1951 received a two-year grant-in-aid from the
Economic Cooperation Administration, the administra-
tive unit for the Marshall Plan, for this purpose. The
results of this have been highly successful. Groups of
outstanding Siamese have come to Washington Univer-
sity for postgraduate work, and during this past year
seven faculty members from that school of Medicine
have been sent to Bangkok as part of the teaching assist-
ance program. These seven were associate professors in
biochemistry, anesthesiology, obstetrics and gynecology,
pathology, physiology, and surgery.
The Johns Hopkins Medical School has not yet entered
into a formal arrangement with the University of the.
Philippines. Such a suggestion was made by the United
States Department of State two years ago, and Hopkins
indicated its willingness to participate, but nothing bind-
ing has yet been arranged. Three members of our school
of hygiene are leaving this month for a year's residence
in the Philippines.
An independent plan of great promise has been started
with reference to Japan by Dr. Eldridge Campbell," pro-
fessor of surgery at the Albany Medical College. This is
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still in the stage of unilateral exchange, but it is this uni-
lateral approach that is the most important one, and plans
should not be held up for establishment of a feasible
bilateral exchange.
Eighteen months ago Dr. Campbell visited Japan and
Korea as surgical consultant for the Surgeon General of
the Army. Before leaving the United States he asked the
surgeon of the Far Eastern Command to have a number
of well recommended Japanese medical graduates avail-
able for interview, saying that he could offer them a
limited number of internships and assistant residencies,
and that they must pay for their own transportation. To
his surprise, 42 Japanese were on hand for the interview
from all over Japan. He brought four to his school, four
to Chicago, and one to Cincinnati. In Albany the two
Japanese assigned to anesthesiology, the one in ortho-
pedics, and the one in neurosurgery have done such good
work that there is much enthusiasm for continuing this
program with Japan. They have been elevated to the resi-
dent status for the coming year. The one assigned to
neurosurgery in Cincinnati has turned out to be an un-
usually good student, a hard worker, and very popular
with the staff; he has improved a deficient surgical tech-
nique with great rapidity, and has rapidly overcome
initial difficulties in language. One of the Japanese in
Chicago assigned to orthopedics has done so well that
he will stay on as an assistant resident. The three others
have done very good work on the pathological service.
The American Army pathologists in Japan have or-
ganized a pathological society with the Japanese. This
society is concerning itself with opportunities for post-
graduate study in the United States to promising young
Japanese. The College of American Pathologists in this
country will place the men in positions where they will
gain the experience that will fit them for their job in
Japan when they return home.
Approximately 40 Japanese graduates are now on the
intern staff of American hospitals in Japan. Japanese
medicine was based on German medicine. Their hospital
histories and their scientific papers and most of their
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present text books were written in German. The dis-
integration of German medicine has left a void in Japan
that this country could readily fill.
In Germany, the University of California in Los An-
geles has recently entered into a reciprocal arrangement
in a limited way between its surgical service and that of
the Free University of Berlin. Professor Linder of Berlin
has been offered an exchange professorship in California.
Recently the College of Physicians and Surgeons of
Columbia University has been working on an affiliation
with the Free University of Berlin at staff levels and at
residency training levels. In this past year Dr. and Mrs.
Hilton Read, physicians of Atlantic City, N. J., independ-
ently arranged for 27 interns to come from Germany to
some of the hospitals in New Jersey.
The chair of surgery at the Peter Bent Brigham Hos-
pital in Boston has for a long time invited a distinguished
British surgeon as temporary occupant. St. Mary's Hos-
pital (London) is about to begin an exchange of a junior
staff member with the Children's Hospital of Boston.
Since the end of World War II there has been an active
and mutually stimulating exchange of senior staff surgical
personnel between Guy's Hospital in London and the
Johns Hopkins Hospital in Baltimore.
A training program of continuing reciprocal relation-
ship between individual hospitals in this country and
individual hospitals abroad is one that might be followed
by other free countries where well-established medical
schools have the same thing to offer as we do, such as
those in Canada, Western Europe, Australia, New Zea-
land, South Africa, South America, and elsewhere.
The plan for this country would include the medical
school hospitals, the independent hospitals associated
with medical schools, the private clinic hospitals, and
independent hospitals of other categories. All of these
hospitals must meet certain teaching and training stand-
ards if first class training is to be offered the candidates
selected from foreign countries.
These candidates must be carefully screened by such
responsible agents as committees from their medical
schools and hospitals. They must come over here with
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the understanding that they are to return to their own
countries after completion of their training. Here, the
coordination might be supervised by such permanent
associations as the Association of American Medical
Schools or the Institute of International Education.
Language difficulties present a barrier for successful
training. The ability not only to read and write English
but to understand and speak it are essential for success
in this program. The foreign governments concerned, if
such a program is approved, should initiate courses of
study in English that would prepare the candidates for
the assumption of their duties in American hospitals.
Even in the various branches of medicine in this country,
medicine has become so specialized that it seems that
each group "can communicate only with those immured
in the same mausoleum." A happy and unusual feature
of the plan is that much of it could be carried out without
subsidy from the government, but should have the ap-
proval of the State Department.
In all this effort, Americans should approach the prob-
lem vigorously but with humility, remembering the words
of our own Secretary of State, John Foster Dulles :
"Among other peoples, the Japanese, the Indians, the
Mexicans, to name only a few, there are many who pos-
sess a love and appreciation of beauty, a capacity for
human understanding and a richness of sympathy which
we might well covet for ourselves. If we apply a true
measuring rod, we will approach them humbly and not
in a mood of lofty superiority."
CONCLUSION
In conclusion, I wish to restate that the physicians,
who enjoy the real confidence of their people more than
any other profession, who know the true meaning of war
better than anyone else, and who have been given superior
education, have a great opportunity and a great responsi-
bility for world peace. They must assume leadership,
they must not rest, they cannot die until they have by
ceaseless application of their trained minds worked out
and put into practice plans that will bring to their own
children and to the world the one opportunity they may
have to escape the disaster that daily appears more
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threatening. We must remember: "There are times
when the future of this world of ours seems rather grim;
and voices of discouragement and dispair are heard in
many quarters of the globe. Since the days of the cave-
man, however, this earth has never been a Garden of
Eden, but rather a Valley of Decision, which calls for
all the toughness and the resilience which the human race
has at its disposal."
8 W. Madison St. (1).
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November 9, 1959
Mr. Philip Potters
The Sunpapera,
Baltimore-1,
Maryland.
Dear Mr. Potter:
I enjoyed very much your article on the United States
exhibit at the Fair in India, which was published in the
Baltimore Sun of 8 November, 1959.
There is one area of achievement by the United States
which in the past has been overlooked in these exhibits and
which might prove of great interest and might also have tre-
mendous phychological value. I am appealing to you to bring
it to the attention of the proper authorities*
I am referring to the accomplishment of the medical
scientists in the United States in their conquest of polio-
myelitis. Heretofore, the dread of this great killer and
crippler of our children and young people in general either
hovered over all parents day and night or struck relentlessly
with its fearful power year after year.
If the Indian people or the Russian people, or the Chinese
people or any other people were polled as to which they con-
sidered the greater scientific achievement, the Sputnik and
the Lunik on the one hand and the Salk vaccine; or the even more
promising and more recent Sabin vaccine, on the other, there
is little doubt that the overwhelming vote would be for the
accomplishments against polio.
Large charts to show the incidence of the disease before
and after vaccination, models of the manufacturing process of
the vaccine, photographs of victims of the disease - all could
be formed into a powerful exhibit.
I am a surgeon, and in no way connected with this triumph
of medical science except as an observer, but I thought the
whole idea of sufficient importance to call to your attention.
Sincerely,
IRT/mlh
I. Ridgeway Trimble, M.D.
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