I Never Imagined

By Henry Seidel

Henry Seidel looks back on the pleasures and the pathos of shepherding a generation of medical students toward their M.D.'s

April 1968 was a fractious time for me and for the nation. I had just left the private practice of pediatrics to take a faculty position at the Johns Hopkins Children’s Medical and Surgical Center. President Lyndon Johnson, responding to student unrest and national ambivalence with the war in Vietnam, announced his decision not to run for another term. Four days later Martin Luther King was assassinated. Baltimore was gray, the sky was gray, and the National Guard patrolled the streets close by the Hospital. Then, an unexpected phone call gave a nudge to my professional life.

A representative for David Rogers, the newly appointed dean of the medical faculty, asked if I might be interested in working with Rogers as assistant dean for student affairs. I didn’t even know such a position existed. It certainly hadn’t when I was a student at the School of Medicine in the mid ’40s. Julie Krevans, about to become the senior associate dean, had recommended me on the basis, I thought with a smile, of my many years as pediatrician for his children.

I decided to do it. "It," I learned, would mean writing the dean’s letters that each fourth-year student needs to apply for residencies, taking responsibility for financial aid, participating in several academic committees, and being available to students who encountered personal or professional obstacles. All this was to be done part time without interfering with my clinical responsibilities. I began on July 1.

On my first day in my new office I made a remarkable discovery. I had access to the past. My inherited desk was empty save for a notebook detailing the class ranks of School of Medicine graduates from the mid-’20s until the present day. The School of Medicine always has given grades, but until sometime in the ’60s they hadn’t been passed on to students. My medical school class of 1946 coped quite nicely without knowing where we stood academically. Grades weren’t a compelling concern for us. Unless we received a letter from the dean with the unfortunate instruction not to return, we knew we should show up next year. Now, I had the power to view my own record. Only a few seconds of "should I?" nagged at me. Then, I found the record labeled "Seidel" and satisfied my curiosity. It was probably good, I discovered, that I hadn’t chosen a career in basic science.

In working with students, the habits of patient care quickly took over. I wanted to get to know them. The method I knew best was to take a history of each. I had their records, but I needed one-on-one meetings where I could lean back comfortably and suggest, "Tell me about you." I began that exercise with the 90 men and women in the senior class of 1969.

Three years later, Dave Rogers left Hopkins and I moved into another medical center administrative post in nearby Columbia, Md. That ended my role with students, forever I thought. Then in 1977, Richard Ross was named dean of the medical faculty and asked me to move back into my old post—full time. This time, there was no question that I would accept. I’d grown enormously fond of the job. I served as student dean for the next 13 years as part of the Ross administration, but never stopped teaching and seeing patients.

I learned a lot. Students are not monolithic. What a student said was not necessarily what the student thought. What students said also needed to be considered in the context of their own experience and not mine. They came to me with expressions of uncertainty, fear and inadequacy. I needed to approach these potential problems with deliberate speed. The discipline essential to the clinician came in handy.

Some students wanted money for inspired schemes. I realized early on that I could not abuse the budget but I could find legitimate ways to manipulate it. A long-ago graduate named Sellards, for instance, had provided money to fund student experiences in underserved areas of the world and also in California, Florida and Louisiana. I defined those states as no longer "underserved" and shifted those funds to students with other grand ideas. I also discovered wonderful School of Medicine friends, like Ralph and Ellen Anthony, who were constantly coming forth with discretionary funds for student needs. Here are some examples of projects we funded:

• Cecelia lost her books in a basement flood. With a bit of manipulation and discretionary money, we replaced them.
• A very ill and very courageous Denise, whose lungs had been scarred by radiation after treatment for Hodgkin’s disease, wanted to go to Guy’s Hospital in London, but needed portable oxygen and someone to meet her at Heathrow Airport with a fresh supply of oxygen. The Anthonys’ gift allowed it to happen.
• A group of medical students dreamed up the idea of starting a spring-weekend "camp" to teach athletic skills to East Baltimore children. The students did the work and scrounged the necessities, but we came up with the money to make the project work. And it’s still going on today.

A MEMORY: The death of Alan Trimakas of the Class of 1979 during a street mugging was my most painful experience. Alan, a senior just a few months from graduation, was intent on a residency in internal medicine. Dean Ross ordered Alan’s degree to be conferred posthumously. I spoke at this young man’s funeral in Cleveland and in a sense conferred that degree. A copy of Harrison was placed in his coffin. Since then, I have talked often with Alan’s mother and father. Their hurt stays. The tree at the corner of Monument and Wolfe was planted by Alan’s classmates in his memory.

IMPRESSIONS: Students aren’t bashful about evaluating the curriculum and the faculty. They offered critiques year after year along with "plans" for change. And faculty listened. I remember once when the first-year class felt considerable dissatisfaction with a major course that was overwhelming them with material. A group of students met with the director. He sat with them and listened, even fed them doughnuts, and within a year, he had revamped the course.

Match Day is the emotional peak of the fourth year. It defines tomorrow. My part in that day lay in the writing of the School of Medicine’s "official" dean’s letters representing our students. It had always been the practice on Match Day to read out fourth-year students’ names in an orderly sequence, and hand them, one by one, an envelope containing their residency appointments. With that kind of organized approach, though, the few disappointed students couldn’t help but stand out. And so, we chose chaos. The envelopes were divided into four or five packets and given to several of us from the dean’s office to disperse to the senior medical students. We stood in a row at the foot of Tilghman Auditorium and, precisely at noon, yelled, "Come and get it!" Most students were elated with their assignments. In the midst of their resounding yips and yaps, those who didn’t receive a match with a hospital they’d hoped for were protected. Still, I knew, and their sadness dampened my pleasure.

Students customarily recite the Oath of Hippocrates at our graduation exercises as each enters medicine’s eternal road. The moment is inspiring. Yet, I found that for the overwhelming number of them their grasp of the human condition didn’t stem from Hippocrates. It was in them. That realization affected me more than anything. There was much in my time that was discouraging, much that might have taken the edge off my hope for the future. It didn’t happen. Our students took care of that.

The years with the students changed me. Since my own graduation, pediatrics had been my professional culture. It was good, but there was more. The students lived in a different culture in which all of medicine beckoned: patient care, teaching and research. As they felt their way, most shared their groping with me. Today, I have a far better understanding of the panoply of medicine.

It is a joy each year to touch base with many of our graduates at holiday time. Their families grow. Their addresses change. Their careers evolve. Marschall not so long ago became a chief of medicine in North Carolina. Joel became the director of an internal medicine residency program in Boston. Their successes are too numerous to count, but my wife and I note their progress in an expanding album highlighted by the pictures that come with the cards and letters. There is grief, too. We have learned of illness and early death.

Retirement came at midnight on June 30, 1990. The transition was bittersweet—me loath to go, but pleased that Frank Herlong would succeed me in the Office of Student Affairs. The students overwhelmed me, decreeing that a scholarship and the annual student show would carry my name. My wife, May Ruth, and I talk about our years: Johns Hopkins. . .being a physician. . .the students. . . profound awe. I was 16 when first I came to Baltimore for my college interview at Homewood—I never imagined.

Left, with class of 1986 graduates and right, with Meredith Renzenbach in 1990 at the first annual Henry Seidel student show.

The Class of 1980 with Seidel front and center.

Scenes from Seidel shows. Note the program designed to match the New England Journal of Medicine.