Speaking of Rochester; 108; Dr. Seymore Schwartz

How do you do ladies and gentlemen? I'm Barber Conable and the program is called, "Speaking of Rochester". In this program we explore with one of our distinguished citizens one of the Residents of the greater Rochester area. About the past and the present and possibly a little about the future of our community. We have as our guest today Dr. Seymour Schwartz. of the a of the a University of Rochester Medical School and and Strong Memorial Hospital one of the most distinguished surgeons in the country. Currently, the a the head of the National College of Surgeons. And, as such, a man known not just in this country, but in many countries for his services. He's an abdominal surgeon. And has been here since 1950 with a modest time out for a military service. Uh He and his wife who is also a doctor a are well-known in the community and a we're very pleased to have him as a guest today.

I'm going to call him, Sey if that's all right. His friends and admirers call him that and uh we'll have an informal discussion with him of of the role of medicine of a Medicine here in Rochester. And uh some of the very interesting hobbies he has a on the side. Sey, welcome to the program we're happy to have you with us. Um Doctor Schwartz came originally from the Bronx. He went to the University of Wisconsin because one of his teachers in the special course he was taking at the Bronx had the contacts to get him a full cost uh scholarship to the University of Wisconsin. He came here then in 1950. Which is a long time ago. Uh Had to take some time out for service during the Korean War. As in the medical corps. But has been here in Rochester ever since and is a, of course, has a

perspective on our community that we're very pleased about. Um Sey um. You've been working as a surgeon uh now for a long enough period of time so there's been tremendous evolution in in your work hasn't there? The technology of medicine is moving ahead of at a breathtaking pace. [Guest] Yeah - as I reflect on it in my own life in Rochester from '50 on there's been an entrance into the surgery in the field of transplantation was essentially nonexistent, cardiac surgery was a. non-existent as far as extra corporeal circulation. The pump oxygenated cardiac by-pass the most common operation the aeortial coronary bypass had never been performed. Uh - Peripheral vascular surgery was in in its infancy. There was little knowledge about

immunology or uh genetic aspects of surgery. There was essentially no minimally invasive surgery. And I've been privileged to live through a time of not only evolution but actually revolution. [Host] Well you must have had to study a great deal as you went along because of this dramatic change in surgery.[Guest] Yeah I think that's been part of the fun scenario that it's a constant study. The things that I learned often in medical school have proven to be wrong. And uh there have been changes in concepts. [Host] It is an empirical science, isn't it medicine. It it it involves finding out what works and [Guest] Right [Host] and improving the techniques for making it work [Guest] Right and much of it that we do is not based on a absolutely firm data base. A lot of it is anecdotal experience that evolves and somebody once told me that good judgment is based on a series of episodes of

bad judgment that you lived through and it's been an interesting uh development, actually. [Host] You're head of the American College of Surgeons now. How do you get involved in such a thing is it political or is it more a matter of a professional exchange of views. What what [Guest] Well, The American College of Surgeons which encompasses about 60,000 surgeons of all specialties evolved ah as an educational tool to educate surgeons. [Host] Exchange viewpoints. [Guest] Exactly, in fact it started with a Clinical Congress to disseminate information. It then became concerned with standards of surgical practice, standards of hospital practice, training the surgeons and a the level of competency of the residences. Ah, it has taken an additional role. Obviously, recently with concerns for socio-economic

events with the evolution of Medicare. It has been the spokesperson, if you will, for surgery with a capital S. [Host] Well, you travel all over the world in this capacity, don't you? [Guest] Yes. Yes, I do. [Host] And, I assume that you traveled a good deal before you became the head of the College of Surgeons ah. [Guest] Well, it was in a different role. Most of my travels were related to scientific issues issues, clinical concerns, but now my travels also encompass socio-economic issues. [Host] Is the University of Rochester Medical School a a that famous an institution that you're you're standing here has has brought you in contact with the whole world of surgery? [Guest] Well I think there's no question about the a history of the University of Rochester. The a being evolved and established by a Nobel Laureate. Ah ah, The people who he recruited individually were all a series of superstars. Ah and when I came to apply as an intern it certainly

stood out as one of the 10 major centers to learn surgery in. [Host] Well, now you've had a kind of a problem because your wife is a is a physician also; she's obstetrical and gynecological specialist, is she not? [Guest] Yes. [Host] And ah she works here in town too. [Guest] Yes. [Host] Does she work at the a at the Strong Memorial? [Guest] She has for the last 2 years prior to that [Host] Originally you couldn't do that, could you? [Guest] Right when we came there was an absolutely immutable rule that a couple could not work in the same hospital. [Host] Why is that? Were they afraid of nepotism or? [Guest] I have no idea what their reasons were. [Host] Mutual support to the detriment of the profession or something? [Guest] Well, they didn't want women working number 1 [Laughter] and they didn't want married couples working in any of the major institutions. In fact, we when we applied con-jointly we had to apply specifically at 2 different hospitals in a given community. [Host] So she during the early period of her service here she had to work in a

different hospital. [Guest] At the Genesee hospital, yes. [Host] Genesee Hospital. Um. Well imagine the 2 of you have some interchange because you're both interested in the field of medicine, so so generally ah it provides ah a certain degree of mutual support, doesn't it? [Guest] Oh, I think it does to a great extent. [Host] Yes. Well a Let's come to the future of of surgery. I have been told that that the minimally invasive techniques that is where you go in with smaller and smaller incisions and with more precise and a and smaller instruments. That that's the wave of the future, is it? [Guest] Well I think so. But I a just to make a confession and it's a confession on the part of most academic Surgeons which I classify myself as when this came to the fore, it came to the fore in the realm of laparoscopic coloestectomy

removing the gall bladder through the small ports almost universally the academic surgeons including myself said it wouldn't work. So it was not developed at a university center, but developed by people who established a dialogue with instrument makers to make better instruments and [Host] uh uh. [Guest]I think you're absolutely correct, it is the major change that has occurred in the surgery. [Host] But there is a problem you can't see what you're doing [Guest] No. [Host] to the same extent, can you? [Guest] No, I said [Host] Is it done with with instruments that provide a a screen a [Guest] Absolutely. [Host] vision so that you look at a screen and [Guest] That's exactly the way it works; you are operating on a television on the consequences of a television projection. But, interestingly enough many of the operations can be viewed a in an advantageous way by this technique and in fact I've seen much of the anatomy as my confreres do the laparoscopic work which I don't do as I watch

them work. It's extraordinary there's some anatomic features that I've never seen with the abdomen open as well as with the magnification of the laparoscope. [Host] But this means that people are don't require anywhere near as long a ah a. period of of of a a in the hospital ah. [Guest] That's correct. [Host] The the a after effects are nowhere near as severe as [Guest]Totally transform the health care system now. In the past a person would stay in the hospital after a gallbladder removal for perhaps 5, 6, 7 days. Now they go home the same day or the next day, [Host] But it goes beyond the gallbladder, now doesn't it? [Guest] Well, now they repair diaphramagic hernias laparoscopically, a some people do removal of the colon for tumors --laparoscopically, they can remove the spleen laparoscopically; you name the organ [Host] Laparoscopically means looking through an instrument to ta see what you're doing. [Guest] Exactly.

Rather than having the the body opened. [Guest] Exactly. [Host] Well, I assume that the University of Rochester now is is a pioneering in in this area to some extent? [Guest] Well, it is participating and in some extent pioneering a in laparoscopic work, but I do think that that's one of the the horizons that there has to be a greater emphasis on. [Host] Is this the major change that's happened in surgery since you started [Sneezes] working? [Guest] I think it's one of the major changes and certainly it's the most recent change of consequence, but other changes have been: the evolution of vascular surgery which Rochester's played a very major role in from the time [Host]Tell us what a vascular surgery is. [Guest] Well, that's improving the flow of blood to the extremities, [Host] The circulatory system [Guest] The circulatory system In the 1960s Charles Robb came as the chairman of the department of surgery and he came with a reputation from England and sort of ah

as a consequence the institution became identified with that skill in surgery. So that's a major change. Ah,The University has had every major leadership role in cardiac surgery from the days of Dr. Mahoney who was one of my mentors. Ah and now with the inception of transplantation surgery where we have evolved [Host] Transplanting organs.[Guest] Yes, and and now we're a major center for transplanting livers. Ah we the transplant surgeons performed the first transplantation of small intestine in New York State. Ah, so I think we're on the right track to having leadership in that role. [Host] How are we going to get enough donors for the transplantations [Indistinct][Guest] Well that's the major problem.You could have a program on that and everybody'd be appreciative, I'm sure. [Host laughs] [Host] Well, it's it must be fascinating work because it's so dynamic. Things change so rapidly. Technology is driving so many of our

our a various ah ah occupations nowadays, but none none more than med medicine. [Guest] Absolutely and actually that therein lies some of the problems when you consider the panoramic issue of the cost of health care. As ah the procedures become more refined; they become more expensive the instruments are more expensive. And ah when that's the case medical care becomes more expensive. [Host] Yes. But of course we do have many more a a people that have the benefit of of medical insurance of various sorts now than we used to have. [Guest] Absolutely. [Host] And. And that takes some of the curse off the increased expense. [Guest] Sure. [Host] Ah ha, but there's no question about it it's prolonging life and and a making the the whole business of surgery a good deal less unpleasant. Is that [Guest] We can speak for that from a database. Life has been prolonged and ah

surgical mortality and death rates and morbidity have decreased. [Host] Now Sey, I this is off the subject to some extent but I find that physicians because of the intensity of their work and and particularly people ah a who have a a very very tense specialty like surgery. Ah you have to a work I understand last night you were operating all night long. [Guest] Right. [Host] But I I find that physicians because they're bright people and because they're under such tension. Have have very interesting hobbies. And, a I know that you a became very interested in history over a period of time. Ah, how did you get into that was it a just a an escape for you? [Guest] Yes, actually that's true. I've always felt that that one of the problems with being as you point as so focused that you have a chance the circumstance that may evolve that you become, the word I use is

monolithic and not a complete individual and my escape was the romance of history. I look upon history as being romantic. And that's the reason I sought it out initially was medical history. And from that there was a short step to just American history and I then developed a focus on that. [Host] We have something in common [Guest]Yes, we do. [Host] When I was in Congress found that ah 1 of the most relaxing things I could do was to escape into another century. [Guest] I'm very comfortable in the 18th century.[Laughter] [Host] Well now you have a remarkable collection of pre-Revolutionary War maps American maps you specialized in. How did you get off into that? [Guest] Well, I bought a few maps I began to buy maps in 1963 a without much focus and then one of the map dealers who is actually a mentor, if you will, too said you're going to develop a

focus and I sat back and thought about it and I said, well I really enjoy American history, so I'll focus on American maps and with that he offered me the earliest printed map available of the North American continent which is a 1507 map, a I bought that map and a as a collector that sort of was a springboard for continuing the collection [Host] And 1 of the remarkable maps you got is 1 drawn by George Washington. [Guest] Yeah. Right. I look at that truly ah when I'm in at home. A it's a religious experience to have that map in my home. [Host] A map drawn by him after his trip up to tell the French to get out of the Ohio Valley [Indistinct][Guest] As a 21 year old a colonial militia major. Right.[Host] Yes, yes. Um. That you you're also are a an advisor to the Library of Congress on maps, are you not? [Guest] Yes, that's correct. [Host] And in 1980 you wrote a book on the mapping of America.

[Guest] Yes I did that because nobody had ever done that. And ah [Host] And because it was something you knew something about [Guest] I knew something about. But actually it's something I wanted to know more about and the discipline of writing the book a forced me to [indistinct] [Host] Do the research. [Guest]Exactly.[Host] Ah ha. And and then a couple of years ago in 1995 you you did a a book on the French and Indian War. [Guest] Well that had a couple of reasons behind it. Firstly, There had been no recent book on the battles. The last emphasis was Francis Bachmann's on Montcalm and Wolfe which was a very wonderful book, but focused on one battle extensively. [Host] Ah ha. [Guest]And the last book that had been written on the French and Indian War that incorporated all of its battles was published in 1772. [Host] You and I are speaking English today because of the French and Indian War, aren't we? [Guest] Exactly. [Host] That very easily could have gone the other way. [Guest] Right. [Host]And and

you're ah you have a particular emphasis on maps again in this book. A but a it shows a a a grasp of the overall ah military ah campaigns which were pretty fascinating. [Guest] Well actually it was a very well mapped war and as you know it was the first world war. [Host] Yeah. Yes. [Host] Yes.[Guest] [Indistinct.] [Host] The war going on in Europe between the same and the same [Guest]At the exact same time. [Host] Yes, and, of course, New York became pivotal in the French and Indian War, did it not? With the [Guest] So there was a sense of chauvinism about it too, you're right. [Host] Yes. Well what are you working on now in the way of history books? [Guest] Well, I'm now doing a book on the development of the boundaries of what we now call the United States and I've actually taken the skip and included Alaska and Hawaii and pointing out. I've gone afield of the-- I usually been in interested in before the 1800's so now this incorporates up to

modern times and how each territory evolved with the history of the territory was of the history of Statehood and the place naming of each of the major communities within the United States. [Host] Aah ha. You have other hobbies too, don't you? [Guest] Well a few, [Host] In this effort to become a whole human being and not just a specialist in an increasingly specialized field of surgery. [Guest] Well, I've been interested in the philosophy and history of surgery and doing [Host] And you have a good collection of art, as well. [Guest] Yes [Host] Ah ah and I think you like music as well. [Guest] Yes I do. [Host] Well it's an interesting thing to look at to see what people with your kind of tremendously focused and disciplined profession ah do to try to ah be sure they don't become too boring. [Guest] Well, the hobbies replaced the golf games which I've never had. [Host laughs] So ah

[Host] Well you probably don't have time for golf, but you can you can work on this other stuff. Ah the history and so forth. Whenever you have ah a time off. [Guest] It's as you suggest; it's a great psychologic release. [Host] You have a family, 3 boys who have been very successful. One of them is a doctor, 1 of them is an architect and what is the other? [Guest] One is the managing director of an the Executive Jet Corporation out of Hilton Head. [Host] Ah yes. That would be a very interesting job too. Well, that's a that's a remarkable that you and your wife busy as you are have had time to a focus on the family to the extent that you've got such successful children. Um as you look ahead, ah does the University of Rochester Medical School have pretty clear sailing? Do you think? [Guest] I think no school has clear sailing. [Host] Oh, because of finance and financial problems. [Guest] Yes, yes. [Host] It is a very expensive.

A very expensive incident to any college isn't it? To have a medical school. [Guest] Yes. And a and it's a fairly small school too. [Guest] Yeah compared to the state schools it is small and actually compared to many of the Ivy League Schools. [Host] I I'm I'm an attorney was originally and I liked smaller a legal schools because of the faculty student relationship which could be much more intense than it could in a factory like like a Harvard for instance. [Guest] So actually that's the essence as I see it of the University of Rochester and the Medical School. I've had the good fortune of visiting most of the schools in the United States and I know of no institution that is as student oriented as the University of Rochester Medical School, nor do I know of any institution that has the essence of collegiality that this school has.

[Host] Well, a certainly the if you have fewer students the faculty can focus on them to a much greater degree and that and that makes it a more human kind of place too doesn't it? [Guest] But I think historically the faculty from the days of Dr. Romano and Dr. Engle a had a sense of a . a major thrust of their work day and ethic was related to student education. [Host] hm hm. Um. [Host]The a so, the distinction of the school was is some guarantee of its future, I should think [Guest] Yes. [Host] I a it is a place where quality rather than quantity has been emphasized.[Guest] I think that's certainly true. [Host] And, of course, it is meant a quality of of medical service here in Rochester that goes beyond what you would get in a routine hospital, a doesn't it? [Guest] Yes, I think it is something I really do. I believe that the

populace doesn't appreciate it, a to the extent that they should. Rochester is very unique. I think the level of medical care is equal to any place in the United States and the ethical practice of medicine is really quite unique. [Host]There are other reasons for that of course including the homogenity of the medical financing. [Guest]Yes. [Host] The fact that a few big corporations like Eastman Kodak and Xerox have been able to pool their ah their medical benefits in such a way that that they can provide special a medical benefits. I know again when I was in Congress ah the Department of Health Education and Welfare used to use Rochester as something of a laboratory. [Guest] But it did stand out as a unique a circumstance in the practice of the community's practice of Medicine, the entire community. [Host] As you look ahead ah what do you hope for this area? What do. Is there anything you'd like to see that isn't here a a?

Anything you'd like to see evolve in some greater or some different way than [Guest] Well, I would like to see the school a raise its level as far as its academic imperative in excellence, I'd like, obviously, if you look at for an ultimate target, you would like that to be regarded as the best medical school in the country. [Host] Hm mm. [Guest] And a my focus has always been on the academic issues and ah I I'm optimistic that the school will improve in that in its stature. [Host] But your activities take you far beyond Rochester. You've ah been ah ah received awards from many foreign governments for services rendered. Ah [Guest] Well, in part that's been related to my own individual activities, but I like to feel that ah I play somewhat of an ambassadorial role as far as the community and certainly the medical community because it's been an interrelationship with that community that's allowed me to do what I've done.

[Host] Well, I hope you'll also keep your outside interests going I think that's [Guest] Have no fear. fear of that.[Laughter] [Host] I think that's a contribution to America's letters that are very much appreciated. A Ladies and gentlemen our guest today has been Dr. Seymour Schwartz of the University of Rochester and Strong Memorial Hospital. Ah a Nationally- Internationally known surgeon. A who a has been here since 1950 providing services to the people of Rochester and to the world. And a man whose many parts are expressed in his activities a beyond that of surgery. Ah, thank you for being with us, Sey. Ah, we've appreciate it.[Guest] Well, I thank you for having me. A pleasure. [Music]. If you'd like a copy of this program send $19.95 to WXXI. Post

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