Contributor: Andrew Wallace
In the spring of 1963, before I returned from NIH to be chief resident, Bess Cebe called to tell me Dr. Stead was ill with jaundice and that he was afraid he had carcinoma of the pancreas. Fortunately he was wrong (a rarity in my experience) and it turned out to be a gallstone.
His illness produced a brief period of anxiety on my part, matched only by the unjustified fear that I had to develop a housestaff schedule, including vacations. That fear was unfounded because Grace Kirby and Rebecca Clayton did all of that and so much more for us.
Title: Occasionally We Sat In Silence
The chief resident took morning report daily with Dr. Stead and with the two junior assistant residents from the private wards. About half the time was spent on patients admitted the previous day. Other times we talked about current events (it was November of that year that John Kennedy was assassinated). Sometimes we talked about our kids or anything else we wanted to talk about.
Most of the time Dr. Stead joined in and in typical Socratic style he turned our questions back on us. Occasionally we sat in silence while he turned pencils on his desk, either because he was not interested in the topic or simply felt the time was better spent thinking.
Title: A Chief Resident's Synopsis
It is hard to believe it has been 40 years since I was Gene Stead's chief resident at Duke. I have always felt I was extremely fortunate to come under his influence early in my career, and as what one might consider an experimental subject in medical education.
Dr. Stead was on the admissions committee that allowed me to enter Duke Medical School after only two years of college. He encouraged me to spend my first summer in research with Bill Knisely.
Dr. Stead was my physical diagnosis instructor in year two and arranged for my second summer with Harvey Estes. At the end of my junior year he told me I could skip my senior rotation in internal medicine and start the internship six months early. After the internship and junior assistant residency years he helped me get a two-year position with Stanley Samoff at the National Institute of Health. About midway through my time at NIH, he offered me the position as chief resident after I had completed my two years with the U.S. Public Health Service, allowing me to skip the senior assistant residency year. In short, no pun intended, he saved me nearly one-third of the normal time between starting medical school and joining the faculty. My reentry into clinical medicine after a foreshortened education and two years in a basic physiology laboratory was made a lot easier than it might otherwise have been by several factors. Bess Cebe was a friend and constant source of wise council as was Jim Mau, who was then in his first year as administrator of the medical clinic. Six months before I arrived, Bess had handpicked Doris Hawkins as secretary to the chief resident, who was then David Elder. Doris was the personification of quiet competence.
Like my predecessors and those who followed me, I had the benefit of twice weekly "therapy sessions' with Bingham Dai arranged for and paid for by the department of medicine. In my case, Dr. Dai helped a lot with the initial anxieties of being a chief resident. In the long term, what he gave other chief residents and me was a set of life-long skills for exercising what I call "self awareness." These sessions with Dr. Dai were one of the unique benefits of the year.
In those days all of Duke Hospital was available for learning and teaching. That included patients on the private as well as the public medical services, the clinics, surgery, pediatrics, ob-gyn, etc. I tapped as much of that as possible for my own learning and as material for weekly chief resident's rounds. Jim Morris was my counterpart at the VA Medical Center. We shared the joy of learning with 62 other medical house officers.
In reviewing that list today I see names of those who became leaders in clinical practice, education and research, including seven departmental chairs, two deans and several important entrepreneurs, either in their own right or in the pharmaceutical industry.
We had senior residents who not only had the normal prior experience, but also two years in the armed services as a result of the Berry Plan deferment. They brought maturity to the programs beyond their years. It was a remarkable pool of talent with an equally team spirit for learning that pervaded the entire atmosphere. I count at least half of those 62 house officers as either personal friends or professional relationships even today.
The year as chief resident was a defining one for me, my first real experience in a leadership position. Fortunately it was neither the beginning nor the end of a long and equally defining relationship with Gene Stead. I continue to see him once or twice a year.
If one wants to think about medical education, he is still the best mind to bounce ideas off of that I know.