Fast Times

> Charlie Stevenson in his office in the 1970s. Charles S. Stevenson, M.D., now 97 and living in a retirement community in Laconia, N.H., served for 25 years as professor and chairman of Ob/Gyn at Detroit's Wayne State University School of Medicine. In 1972 he moved to Center Sandwich, N.H., to practice as a country doctor. He wrote this memoir for family members more than a decade ago. When it appeared for the first time in this magazine, 11 years ago, it became one of the most requested Annals Of Hopkins articles ever.

A physician recalls his days as a medical student during the Depression, when a Hopkins founder helped him pay his tuition—and then extracted a promise.

In 1932, when I was in the spring of my second year at The Johns Hopkins University School of Medicine, I found myself owing $365 to Mr. Burgan, bursar of the Medical School, but I had no money with which to pay him. Since our country was in a deep depression, however, it was generally understood that quite a few students in the school were not able to keep their tuition payments up to date. Many were going around in threadbare clothes and had holes in the soles of their shoes. Some were getting only two meals a day. But we were all in this boat together, and it bred a real camaraderie among us. I don’t recall hearing any words of complaint.

For myself, I wasn’t any more uncomfortable with my debt than were the other students. Still,  I felt sorry for Mr. Burgan, who, despite the responsibility of his job, was the soul of generosity and kindliness. He never put any pressure on the debtor students to hurry and “pay up.” But at the same time, by subtle innuendo, he let us know that our debt was real and that we should pay it as soon as we could. We students did not talk among ourselves about our financial obligations but it was understood that repayment was our No. 1 priority.

I had been born and raised in Baltimore and knew that I must scratch around and see if I could raise some money from my relatives and old family acquaintances. My aunts Margaret and Mary Stevenson at once suggested their lifelong friend, Miss Alice Owens, who had been private secretary to Dr. Howard A. Kelly for some years and worked every day with him in his private radium therapy hospital on Eutaw Place. My aunts knew from Miss Owens how generous Dr. Kelly was in helping young people who needed money for their education. After speaking with my aunts, Alice wrote me a note offering to talk to Dr. Kelly on my behalf. She said she would try to arrange an appointment for me to meet him and advised me to “come right out” with my story as he did not like “to beat around the bush” in such matters.

>The Hospital as it looked during Charlie Stevenson’s med school days.

I wrote back and thanked her and said I’d come see Dr. Kelly any day. I could get out of class by 3 p.m. and would go over by streetcar, which would take about 45 minutes. (All of this seems like yesterday.) In a few days, a note arrived from Alice saying that my appointment was at 4:30 p.m. the next Friday. I was really excited about the prospects of this meeting and was well aware of the importance it might play in my life career. As a young man growing up in Baltimore, I had read in the Sunpapers about how Dr. Kelly had traveled to Europe to bring back radium for research at The Johns Hopkins Hospital. I had also read in a medical history text of his bringing modern gynecology and obstetrics to Baltimore when, as a young man, he came from Philadelphia in 1889 to become one of the first three clinical professors in the new medical school.

On the appointed Friday, I rode across the city on the streetcars, walked south for some blocks and finally came to the large, three-story building that was his home, office and hospital. I went up several stone steps and rang the bell next to the brass plate, “Howard A. Kelly, M.D.” The maid who opened the door directed me up the stairs to the second floor, ushered me into Dr. Kelly’s office and told me that he would be in when he had finished examining a patient.

The room was cozy, with a dark rug on the floor and light-colored walls. There was a large, stained oak, roll-top desk with a swivel oak chair in front of it. Several framed diplomas and awards were on the wall, and I noted that one of them was from the medical faculty of a German university. I was greatly excited that I was momentarily to meet so great a specialist in gynecology and cancer.

Then another door opened, and he came in. He had on a long white physician’s coat, stiffly starched and spotless, and was about medium height and build, with a round face and fair skin, sparkling eyes and a genial smile that made him appear younger than his years. Radiating good will and a “can-do” youthful enthusiasm, he stepped up to me briskly and put out his hand for me to shake, which I did warmly. Exchanging his white coat for his regular suit jacket, he motioned me to sit down. He then sat down in his desk chair, swiveled around and faced me directly.

> Howard Kelly, one of Hopkins’ “Founding Four” original physicians, brought modern gynecology and obstetrics to the new hospital in 1889.

“According to what Miss Owens told me, we have some personal business to attend to,” he said right away. “I understand that you are trying to work your way through Hopkins medical school the way you worked your way through Princeton, with the help of a scholarship. I regret to say that we never had any regular scholarships at the medical school. I’m sure that you, like so many, are having a difficult time of it, but don’t ever give up!”

Without further ado, he reached for his checkbook and turned to me again. “Exactly how much do you need to pay up your medical school bill for this year?”

“Three hundred and sixty-five dollars,” I answered quickly.
He proceeded to write out a check for that amount. “Now you go and hand this check to Mr. Burgan tomorrow,” he said. “He will have a rubber stamp with which he will endorse it over to the medical school. I’m counting on you to study hard to get good grades and to become a truly good physician. You might even want to become a woman’s specialist! We have a fine woman’s clinic here at the Hopkins, and I can’t think of a program anywhere in which you could get a better training.” I took the check from him, folded it and put it in my shirt pocket.

It all happened so quickly I was practically dumbfounded and deeply moved. Miss Owens had been incredibly effective in laying out the scenario for me. I had not had to ask him for the money, nor even speak one word about it!  Finally I found my tongue and spoke up, “Thank you very much, Dr. Kelly.”

He replied at once: “Don’t thank me. Thank the Lord above.” He smiled at me in a happy way.

I said, “Sir, I want to discuss with you how and when I can repay this loan. I doubt I will be earning any money for the next six to seven years.”

He interrupted me. “You are not to repay the money to me. When you start earning and get ahead enough, you must search for another needy and worthy medical student—another Charlie Stevenson—and pass it on to him. In years to come, I am sure that you will do many gentle and kindly things in helping your patients. These will be more than adequate recompense for me.”

On hearing this expression of faith from such a great man, I resolved to carry out his instructions as best I could. He gave me a fatherly pat on the shoulder and said, “Now you get back to the medical school. You no longer have to carry the worry of that unpaid bill. Let me hear from you every June at the end of examinations as to how you made out. I will follow your career with great interest, and I want you to consider yourself my protege.” With that, he ushered me out of his office.
I went on through graduation from the medical school in 1934, was granted a gynecology internship and then was selected as the one to go on through the full five-year residency training [at Hopkins]. I was fully aware that I was being given this great opportunity in Dr. Kelly’s department, the one he founded in 1889.

> Charlie Stevenson in 1934 and Victor McKusick in 1946, in their School of Medicine photos. > The operating room in the women’s clinic, where Howard Kelly performed surgery.

Late in my residency, in the middle of February 1938, Dr. Cullen told me that Dr. Kelly was coming over to do a laparotomy for the residents and students and had requested that I serve as his first assistant. I had seen him perform surgery briefly once before and knew that he made quick decisions and was a rapid operator, and so it was not without some temerity that I met him as he got off the elevator. I presented a brief history of the case while he was dressing and later as we were scrubbing.

The operation went very well. Dr. Kelly was amazingly spry and dexterous for someone 77 years of age, and his hand motions and use of the instruments were perfectly controlled and accurate. He did a rapid supracervical hysteromyomectomy and, stepping away from the table, directed me to draw the bladder fold of peritoneum posteriorly over the cervix stump, suture it there, then close the abdomen. He at once began to quiz the residents in the stand and gave some explanations of how to avoid pitfalls in difficult cases. He enjoyed the occasion immensely, as did we.

Later, when we were alone in the dressing room, he asked me, “Stevenson, what are you going to do with your fine training when you finish here at Hopkins?”  I told him that I wanted to become a teacher and researcher. “Don’t stay in Baltimore,” he said, “Here you would just be another good Hopkins-trained gynecologist.”

At the end of August 1939, I started a residency in straight obstetrics at the Boston Lying-in Hospital of Harvard. But in June 1940, I still had so many debts from my medical school and my gynecology residency that I had to temporarily cease training and go into private practice in Pittsfield, Mass. My wife, Betsy, and our little son, Charlie Jr., soon joined me there, and we had a happy 32 months together before I left to go on active duty in the Navy in April 1943.

During the last week before I boarded my ship, I was busy paying off my debts and saying goodbye to my family. I called Hopkins and explained the instructions Dr. Kelly had given me 11 years before and asked them to line up a “needy and worthy” medical student for me to come to meet. On the agreed day, I traveled to Baltimore to pass on Dr. Kelly’s $365 with the same instructions he had given me.

Thus it was that on the last Thursday of the month, I went to the bursar’s office and there met Victor A. McKusick. I liked him at once, wrote him a check (at his request made payable directly to the medical school) and explained to him, word for word, as best I could recall, what Dr. Kelly had instructed me to say.

Sadly, I was in a great rush to get to my ship in Norfolk and just could not work in a call to Dr. Kelly. Ten months later, when I got home from the invasions of Sicily and Salerno Bay in Italy, I learned of his death.