Walter Afield

Citation
Walter Afield

Material Information

Title:
Walter Afield
Series Title:
USF 50th (2006) anniversary oral history project
Creator:
Afield, Walter
Riley, Danelle
University of South Florida Libraries -- Florida Studies Center. -- Oral History Program
University of South Florida -- Tampa Library
Place of Publication:
Tampa, Fla
Publisher:
University of South Florida Tampa Library
Publication Date:
Language:
English
Physical Description:
1 sound file (87 min.) : digital, MPEG4 file + ;

Subjects

Subjects / Keywords:
Hillsborough County (Fla.) ( lcsh )
Tampa (Fla.) ( lcsh )
Genre:
Oral history. ( local )
Online audio. ( local )
interview ( marcgt )
Oral history ( local )
Online audio ( local )

Notes

Summary:
During his time at USF, Dr. Walter Afield served as the first Chair of the Psychiatry Department in the beginning years of the USF School of Medicine. He was involved in the early development of the School, and worked to established positive affiliations with local health agencies while improving services to the community. Dr. Afield discusses the many challenges and successes of his experience at USF, from 1970 until he left to begin a private practice in 1976.
Venue:
Interview conducted February 24, 2004.
System Details:
Mode of access: World Wide Web.
Statement of Responsibility:
interviewed by Danielle Riley.

Record Information

Source Institution:
University of South Florida Library
Holding Location:
University of South Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
029070421 ( ALEPH )
250683340 ( OCLC )
U23-00001 ( USFLDC DOI )
u23.1 ( USFLDC Handle )

Postcard Information

Format:
Audio

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This item has the following downloads:


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text Danielle Riley (DR): You can just tell me a little bit about yourself, and make sure this camera is working.
1
00:00:3.9
Walter Afield (WA): Well, my name is Dr. Walter Afield, and I was the first chairman of the Department of Psychiatry at the University of South Florida medical school and the first full (inaudible) here. I originally was born in New York but grew up in St. Petersburg, moving here in 1953. I went to the University of Pennsylvania and then Johns Hopkins Medical School. And then I went on to Harvard for my residency, (inaudible) Boston Psychopathic Hospital, the Boston Childrens Hospital in child psychiatry and the Massachusettss General Hospital where I was also at Harvard.
2
00:00:35.8
I left Harvard to return to Johns Hopkins, where I was an assistant professor and did primarily child psychiatry from 67 to 70. I had no intention of coming back to Florida, the way academia was working then. I was going to move on elsewhere. I was very happy in Baltimore. Then I got a call from Don Smith, who was the dean of the medical school down here in the University of South Florida.
3
00:00:59.5
He had gotten my name from, interestingly, Jack Ewald, who was the chairman of the Department of Psychiatry at Harvard and had been my boss. Jack had been an instructor when Don was at the University of Colorado, and he called Jack Ewald up and said, you know, I need some youngster who is willing to come down here and build something out of nothing. And he mentioned my name.
4
00:01:22.2
So I came down. And I never expected to return back to Florida, and I really didnt want to. But I met Don Smith and was very impressed. He said, Theres a community mental health center that has gotten a grant over at St. Josephs Hospital. Id like you to go over, look at it, report to me, come back, and tell me what you found. I went over and reviewed.
5
00:01:44.2
Apparently, a Sister Loretta Mary [sic] at Josephs Hospital, who was a very impressive administrator, had filed one of the first community mental health center building grants in the country. And in 1968, she filed this and got money to build it, not knowing what she was building or doing, and she retired in a Sister Marie Sylvester program.
6
00:02:6.3
I came over and looked at it, and I said, Well, you have the plans. You have the building grant. This could be built. But there are a lot of political problems with community mental health centers, and they make people very angry. And they have all kinds of difficulties. Clearly, there were a lot of politicians in the school, and they were all in the community, and they were a little wondering what I was about. I went back to Don Smith, and I told him what the problems were.
7
00:02:32.8
He said, Put it in writing. So I wrote him a letter, and I said, These are the things that will be difficult for you. And then he called me about a week later, and he said, Will you fly down for lunch? Well, I had never flown anywhere for lunch. I was a 32-year-old whippersnapper, and I flew down for lunch, and he said, You know, Im prepared to make you chairman of the department of psychiatry. Do you want it? I said, Absolutely.
8
00:02:55.4
DR: What was the campus like at the time?
9
00:02:57.2
WA: Campus, I have some pictures of it, and you can see on some of the slides if you want to access them. When I came to campus, I had been visiting here periodically through the 60s whenever I would visit my mother, and in the 50s I saw the school go up out of nothing, really. The campus had a few, lovely, white brick buildings, small trees, very sunny and very hot, very small, very nice.
10
00:03:27.1
When you got off at Fowler Avenue, you drove through palmetto on all sides of the road. The only building was called the University Restaurant--which is where the current mall is at this point--in the middle of the wilderness. And then you would come upon this large tract of land. And so, when I came, the medical school was housed in the top floor of an engineering building, which is still here today, and I have it in one of the slides that I can present to you.
11
00:04:0.3
So it was a very new and barren but exciting-looking campus that had a lot of potential, not the typical thing that you see in some of the old schools. Don offered me the job, and I said, Well, Id like to. What are the things involved? And when do you need me? He said, I need you here no later than September. So I went back, obsessed and lost.
12
00:04:19.7
Im not sure I should come down here. I got everybodys advice, and they all said, You shouldnt do it, Are you sure? Its a new place, blah blah. And, of course, I finally went ahead and did speak to Jack Ewald again, from Harvard. And I said, Theres no tenure. This a school that doesnt even exist; its not even accredited; its not even built.
13
00:04:40.7
He said, What you need to do is get your behind burned a little bit. Theres lots of jobs out there. Youve got the right personality. Take it. Have you any questions? I said, No, sir. I took the job, came down in September of 70. First day I arrived, some very aggressive newspaper later came and took a picture of me and said, What are you going to do about the poor people?
14
00:05:1.8
And I said, Maam, I just got here. I dont even know where the poor people live. Im not sure what Im supposed to do. And lo and behold, I had a picture of me in the newspapers, and I had never been used to this kind of publicity situation. I came here, and we had a very small number of faculty members. Don Smith had just been appointed for about a year.
15
00:05:25.0
Before that, there was another dean by the name of Smith. I cannot remember his first name. He had been appointed by John Allen, the president, and apparently this dean didnt do much of anything, according to Don Smith. He said, Go up and down the state of Florida making affiliation agreements with hospitals. He spent four or five years doing nothing, so they fired him, brought in Don, and there was pressure to create a medical school.
16
00:05:48.8
The federal government had funded seven new medical schools at this time because there was a doctor shortage in 1970. And the seven were the Mayo Clinic, which didnt have a medical school; the University of California Davis; the University of Hawaii; the University of Arizona; the University of South Florida; the University of New York at Stoneybrook; and there was one in East Virginia also. And those were the seven schools that were supposedly to solve the doctor shortage.
17
00:06:21.8
When I got here, there was a dean, there was a business manager, John Mulholland. If you look at a picture of the founders, youre looking, if you go clockwise around--thats the picture thats in the library--youve got John Mulholland, the business officer; we have Keith Bowler [sic] who was a histology person from LSU; Andor Devry, who was the professor of pharmacology and had come from Nebraska.
18
00:06:50.8
He never liked to fly--Ill just give you some vignettes about their lives--so he would take the train. And he said the air conditioning went out, and he had a car for himself, so he took all his clothes off and sat naked driving home, coming all the way by car coming all the way from Nebraska to Tampa. Andor was Hungarian, a wonderful researcher and a very good choice for a professor of pharmacology.
19
00:07:15.3
You had Jim Ward, who was a retired anatomist, professor of anatomy that Don had known for 42 years in Mississippi and retired. Jim Ingram, who was a local practicing obstetrician and then became king of Gasparilla. That was to be a Gasparilla connection to try to get the community to accept us. Myself at the end of the table.
20
00:07:39.5
And then as you go around to Julian Dwornik, who was in anatomy and ran the admissions committee the first several years. And I think you had Gerald Cory, who was a biochemist on campus, and they chose to bring him in as the professor of biochemistry. Charlie Fishel, wonderful, nice, decent human being, a professor of microbiology. And then, of course, Don Smith. And that was it. We had a band of small people.
21
00:08:12.0
And we had several problems that we had to do all simultaneously and in a short period of time because Don was under pressure to build this within a year, or he would lose the federal funds. The previous Dean Smith had just gone around in circles and was doing nothing and had let time go. So Don did a major achievement, recruiting, getting it going, and we had the problems of starting in a community that did not want a medical school. That was a cardinal problem.
22
00:08:43.6
DR: Why was that?
23
00:08:44.6
WA: They were all afraid. They were scared. There were very few doctors here. There was one neurosurgeon. There was one neurologist. There were no cardiologists. The fear was that these doctors would be trained, they would bring in faculty, they would go out into practice, theyd compete with [them].
24
00:09:0.3
The doctor community was very hostile and did not want us. And youll hear more of that as I tell you, at least, my experience with it and, of course, everyone else experienced it too. Thats all since stopped, but that was the major resistance we had. And then when I got here, I found out that I had enemies that I had never even known.
25
00:09:25.2
I had never had enemies in my life because Id never run anything in my life. As I said, we were out in the woods. You had to drive through palmetto to get here. And Cecil Mackey had just come on as president of the university. When I came here, this was an exceptionally exciting place. There was a General Electric college quiz bowl that had been around where they would bring kids from all over the country and answer questions and compete with each other.
26
00:09:52.5
Well, there was a freshman team from the University of South Florida that had cleaned everybodys clock. They were just magnificent. An unknown school. There was a 168-foot Picasso that was supposed to be built here because Pablo Picasso, who liked the idea of the graphic arts studio and a new medical school being built, donated this 16-story statue designed on this little model, The Bust of a Woman.
27
00:10:22.2
I remember Don Smith saying, We dont want that ugly monstrosity here. But anyway, John Allen said, this isnt going to be a football school. Art is going to be our football theme, and medical school is going to be big-time. And so, into that environment, which was very exciting, came I. The tasks that we had were to work out affiliation agreements rather quickly with hospitals because we had no hospital of our own.
28
00:10:49.0
We had to recruit medical students. We had to design a curriculum. We had to recruit faculty. We had to start a nursing school, which we had a mandate to do, and Don Smith started that after we were all hired. He and I hired the director of nursing to start that. And even after we got going, we needed our own clinical facilities. We needed to relate with the community. Those were the tasks that had to be done simultaneously.
29
00:11:17.3
Unfortunately, I was the only one who was in the clinical world, so I had to go out and battle in the community because there were no surgeons or anyone else. In terms of the affiliations, what we did was we worked out an affiliation agreement with Tampa General and St. Josephs Hospital. St. Josephs was the best hospital in town at that time.
30
00:11:40.4
Tampa General [Hospital] was a very mediocre city hospital built in an isolated area where poor people couldnt get to it, on Davis Island. And it was run by this hospital and welfare authority, which was the county commissioners. I had never been to a meeting like the county commissioners. If someone wanted an X-Ray machine, they would go in and beg the county commissioners for an X-Ray machine.
31
00:12:4.1
And thats how things were done at this mediocre hospital, which things have reversed now, of course. Tampa General is the premier hospital in the area. But in that time, we worked out affiliation agreements with both of those hospitals. St. Josephs was to house psychiatry and pathology and was to be, basically, the major teaching hospital, which did not happen. Tampa General was also to be.
32
00:12:29.1
There was a VA Hospital under construction right across the street at the time, and, of course, we were to affiliate with that. And there had been a creation of what is called the Florida Mental Health Institute, and I will get back to that a little later, which was going to be constructed next to the medical school. Originally, the plan was that the medical school would run it; it would house the Department of Psychology.
33
00:12:52.7
The other affiliations we attempted to do, we got an affiliation with the All-Childrens Hospital, which was a little rocky because they were uncertain. We tried to get with the Hillsborough Community Mental Health Center, they were not the least bit interested because they were absolutely frightened. Memorial Hospital was a nursing home, so it didnt exist at that time. The VA, of course, we had.
34
00:13:15.7
And the University Community Hospital, which was right across the street, would not affiliate with the medical school. In fact, we could go and join the staff. I went to a meeting, and they said, Were not going to let any of these USF doctors have staff privileges here--keep them out, keep them out! That was crazy, I thought. We would not affiliate.
35
00:13:37.4
So we marched down with affiliation agreements, and there were a lot of people who wanted the medical school. Julian Rice ran Tampa General, and he was a very competent man. He runs the community mental health center now, but he wanted the medical school. Dr. Thomas McHeald, who was a good old boy, a very nice, Southern internist, ostensibly wanted a medical school.
36
00:14:6.6
But it did not appear by his actions that he did. And it was clear to Don Smith that Dr. McHeald was not a friend of the school. Again, because of this fear. And I didnt quite understand it, either, why people were so frightened. I had never been around an area where people were frightened with me or intimidated by me because I had been hanging around Harvard and Hopkins.
37
00:14:29.7
DR: Why do you think that was?
38
00:14:31.6
WA: Again, as I said, one, I was a little outspoken and inexperienced. But its rather scary with this new school coming to town, and theyre all going to lose their income. There were only 12 psychiatrists in this community at that point. The faculty, as I said, all had to do their thing. We had to begin recruiting a medical school class even though we did not have an accredited school, nor did we have a building.
39
00:15:5.2
So we started an admissions committee; we were all on it and got 32 brave souls to join the medical school charter class, which would be started in 71. That was a bit of a surprise. Surprisingly, we also had to build on the accreditation of the school. And we had to get accreditation and residencies.
40
00:15:35.9
The second clinical doctor to arrive was Dr. Louis Barnett [sic], a very first class pediatrician from the University of Pennsylvania, a major researcher with a major find. I remember when the AMA [American Medical Association] came down here to accredit the medical school, we were all involved, preparing documents. I wasnt even doing psychiatry. I was doing all these other things, preparing documents.
41
00:15:59.1
And the accreditor said, Well, youve got a very good psychiatrist and a very good pediatrician, but you dont build your medical school on those two. You better get some internists and surgeons. And, of course, were still in the process of trying to get them. And Dr. Bencke in internal medicine and Dr. Sherman came in surgery. They didnt come until 73. So from the 70 to 73 timeframe, I was kind of it.
42
00:16:23.9
And Dr. Smith also had hired a Dr. Rudolph Nore. And he had been a retired professor of surgery in Louisville. Don Smith was an interesting guy because he was a superb and consummate politician, very smooth, four letter words out the kazoo, tough character; you always knew where you stood with him; honest to a tee. But he knew how to survive, and he had already built two medical schools, so it was natural for him to go ahead and do this one.
43
00:16:58.6
So here we are, getting the accreditation of the school and trying to build the Department of Psychiatry, which was my additional job. The problem with the Florida Mental Health Institute, which very few people know about, was two state senators. Louis de la Parte and Richard Hodes were supposed to build a state hospital in Hernando County.
44
00:17:23.8
And everyone jokingly called it Hernandos Hideaway. And Louis de la Parte, who was an attorney, said, You know, I think this thing ought to be next to USF. It ought to be on the campus. And USF ought to have it as their Department of Psychiatry. Well, that was wonderful. There are models for that in the country; Columbia University, for example, has the New York State Psychiatric Institute.
45
00:17:44.9
Its a state hospital, but its their operation. Harvard has the Massachusetts Mental Health Center, a state hospital but controlled directly by Harvard. Those are the models of the best places in the country. Well, it turns out that the commissioner of mental health was a general practitioner by the name of Dr. Rodgers. I flew up to Tallahassee to see him. He said, Were not going to have anything to do with USF. Were going to build our own university there.
46
00:18:12.3
I said, Well, my understanding is Im supposed to start this. Well, no, Ive hired Dr. Ardel Larson, who was kind of a hippie in those days. I used that term back then. And he designed that hospital so that we couldnt take care of patients, and we couldnt have patients in it. And he said, Were not going to have anything to do with you. I came back to Don Smith; he couldnt believe it.
47
00:18:36.8
So finally, we got a meeting with the president, Cecil Mackey; with Carl Riggs, who was the Provost; Louis de la Parte; Dick Hodes; and Dr. Rodgers. And it turned out that nothing was in writing. They put this Florida Mental Health Institute there, spent 11 million dollars on it in 1970 dollars, and nothing was in writing. So there was no affiliation. And it took about 15 years to ultimately get involved with it.
48
00:19:9.2
They were going to be their own university and do mental health things that were wonderful to the state. So Don asked me to put a memo together why we should stay away from it, which I gave him, and he said, Well have nothing to do with them. Go build your thing at St. Josephs. This pulls us, then, into the--well, Florida Mental Health Institute just carried out.
49
00:19:32.2
They finally did build it, and they put in their first director, John Ainsley, who had nothing to do with the medical school. He lasted about six months, and one Christmas Eve, he was molesting some child, and he disappeared and went back to California. Then they brought in somebody else who was a minor player, and sort of leapt along.
50
00:19:51.8
The Department of Psychology wanted a piece of it at the university, the Department of Social Services wanted a piece of it. And it was floundering into absolute--it almost closed. They almost stopped funding it. When I came here, the governor was Askew and you had Lawton Chiles after that, they did--it was really a disaster and a waste of tax payers money, so we needed to go build a thing at St. Josephs Hospital.
51
00:20:24.3
And also, the VA Hospital was being constructed, and we had to be involved in that. There was a 200-guest psychiatric unit to be built there coupled with a day hospital and a research facility with full, unlimited funds. So I was supposed to run that from St. Joes and develop it. Well, the VA was under construction at the time, so I was involved in the plans and the drawings. Well, they had as a director a fellow by the name of George Fiskey and a medical director, Ross Corey.
52
00:20:57.5
As Don Smith said, they were VA hags who basically decided they were going to build an old fashioned VA with the grey, drab desks and so forth. He cautioned me, because Id never had any dealings with the VA, he said, Its a well ordered series of gears that move nicely. And if you put your finger in, youre going to get it cut off. So they only way to deal with the VA is to stand on the side and throw sand in it.
53
00:21:24.6
There was a deans committee that was supposed to be involved with the VA and get it going. But that had its own set of battles, and I can come back to that. But the interesting thing was, while it was being constructed, I would go over there and take pictures of where the medical school was supposed to be, which was an empty lot.
54
00:21:41.3
At 5:00 oclock, you had to be out of the building because they were letting German shepherds loose, who were guard dogs. They patrolled the halls of this construction and attacked anything that moved. In 1970, this school was on its way. The VA was on its way up. I had to, then, put most of my efforts into psychiatry as it was.
55
00:22:5.8
And, as I said, there were only 12 psychiatrists when I came to town. Sam Hibbs had been the second psychiatrist in this community, and hed built a private hospital called Hanfolk Manor, which was a long term, quasi-psychoanalytic institution that kept people forever and got into a lot of scandal later.
56
00:22:30.6
But Sam had hoped to be made chairman of the Department of Psychiatry, so I had an enemy in Sam before I even knew who he was. He had a group of psychiatrists, Arturo Gonzalez, Gil Web, Charlie Walker; Mike Gardner was the only psychiatrist who was really friendly to me when I came to town, interestingly. Dan Spray was here, Mauricio Rubio, Henry (inaudible), Bob Cauffer, Will Severis, and Wilson Rippey.
57
00:22:55.2
Some of them were very bad. Will Severis ultimately went to jail for having sex with and then killing one of his patients. He was a terrible psychopath. And then Dr. Rippey ultimately was caught molesting children, taking pictures of them and got arrested. But that didnt happen, really, until the mid to late 70s. But these were the local psychiatrists. Tampa General was the psychiatric unit. All patients were behind a steel door, closed, in pajamas, and in restraints.
58
00:23:31.7
They would restrain them to their beds at night. We had the highest commitment rate in Florida and the highest level of shock treatments. Thirteen hundred shock treatments in one month. The conclusion you draw from that is, either something is very crazy, or we have the craziest bunch of people in Florida. In this light, we were going to build this mental health center. Originally, my office was down in the basement next to the ward.
59
00:24:0.8
But we went ahead and designed it, and I decided we were going to bring 1940 psychiatry in Tampa up to the 1970s. So the doors were going to be open. We got fine art on the wall from the graphic studio here who was producing; first time fine art had ever been hung in a hospital. We put bright rugs. Everything was open. People would wear street clothes. This was supposedly innovative, and the local psychiatrists thought this was some kind of communist plot.
60
00:24:29.5
We had one come in and said, Patients will go into color shock here. You cant have this. This is unacceptable. And I remember one of the doctors was banging his fist, saying, Well boycott you. We wont admit any of our patients over there. And they all just formed a block and would not have anything to do with it. I was fortunate in--well, anyway, we went ahead and designed this thing.
61
00:24:55.9
We got some cats that strayed in. Those were our first patients. We got Busch Gardens to give us a big giant birdcage with birds. Everyone thought I was insane; the nuns thought I was insane in building this open hospital. They all thought people were going to be jumping out of windows and killing themselves, et cetera.
62
00:25:14.8
And the emergency--we created the first emergency service. I was fortunate that I was able to recruit the first masters degree psychiatric nurse in Florida from Denver, Pat Rhodes. And she was the only one that had any psychiatric training. None of our other staff did. They had no idea what to do.
63
00:25:33.9
We went ahead, finished the furnishing, and Ive got some slides of that that you can see; made it very colorful, very bright. And the only patients we had with this full staff were two cats and some birds. In a couple of months, we created an emergency service where, now its normal, but we would have a nurse go down in the emergency room, evaluate the patient and admit them. Well, hospitals had never heard of anything like that and neither had the community.
64
00:26:2.3
Only the doctor can handle this. We had battles with that to get it done. Finally, we got our first patient. We had all this staff. Patients began to come in. There was no commitment law in the state of Florida, so if someone came in and didnt want to say, they could leave. There was a senator, Maxine Baker, at the time, and she and I got involved in what is called the Baker Act.
65
00:26:26.5
Basically, it was a creation put out by Maxine Baker that copied an act of Massachusetts commitment law, where you could put somebody against their will in for three days, and then keep them for an additional 10 days if necessary and then go through the necessary commitment steps. This is in 1970s Tampa. This was present in 1945 in Boston and in New York and everyplace else in the country.
66
00:26:49.9
We were so far behind. And everyone was really frightened about this thing. And yet, all of these people had trained in good places. Dr. Rubio had been to the Institute of Living, and people had been trained from all over the country. But what we were doing was unacceptable, as they saw it. What did happen was we opened the place up. Three months later, presented statistics, we had no shock treatments, we had no commitments, and no suicides, fortunately.
67
00:27:22.3
And no problems and no injuries. But lo and behold, Tampa General had its 1,300 shock treatments and all the commitments. As a consequence, the community began to say, Maybe theres something here, begrudgingly so. And so, they started furnishing the places, taking people out of restraints. Memorial Hospital, at this time, had been created. It had been a nursing home, and they were going to build that into a psychiatric facility.
68
00:27:52.1
But Sam Gibbons and Sam Ward said that they would create it and copy what we had at St. Josephs. Anyway, we got St. Josephs going, we got the staff trained. Nobody died. We did some very decent treatment. And lo and behold, nobody went into color shock, and the new 1970s psychiatry had emerged.
69
00:28:17.3
Along about this time, I tried to do the same thing at the VA. And as I said, George Fiskey was convinced that he was going to have grey chairs and grey tables and everything drab and beds and people in pajamas. And I said, That isnt the way its going to be. Well, the battles were enormous with the VA. I had my hands full at St. Joes, and then here we have the VA wanting to do their thing.
70
00:28:42.3
We were able to get some things, though. We had a couple of rooms fixed up nicely. Interestingly, we got vindicated many years later when people came later and said to George Fiskey, You had a new VA; why did you turn this into an old VA when you had such wide opportunity? But nobody would listen at the time. This takes us, I guess, into 72.
71
00:29:5.2
The medical students were coming. Fortunately, I was able to get the accreditation approved for both child and adult psychiatry residencies, because Im board certified in both. And we managed, believe it or not, to get our first residents. Kailey Shaw, who is on the faculty now, was our first resident in adult psychiatry only because her husband had moved down from Baltimore.
72
00:29:31.8
I knew him at Hopkins, and we hired her as a resident. And we got our first child psychiatry resident, Raymond Slizinski, who had been running a child guidance clinic in St. Petersburg. And we had one faculty member who joined. A fellow named Richard Van Sickle who came from Ohio State [University]. And there we were. I have a picture of the four of us standing as the medical school was being constructed behind us.
73
00:29:57.1
All of this going on while were still going through an admissions committee, trying to recruit faculty, and me desperately trying to recruit faculty for the VA and everyplace else. Recruitment was very difficult here for some reason. We were bringing in a young Turkistan who was very talented and gifted. I remember one young man, Joe Digiacomo at the University of Pennsylvania was assistant professor.
74
00:30:21.7
I brought him down, and I said, Here, you can be a professor. You have a 200 bed psychiatric unit you can run. You have an unlimited budget. The dean told him this. All he could say was, Wow. Wow. And finally, I went up to Philadelphia and helped him push his car out of the snow, and I said, Joe, you belong in Florida. Finally, his chairman, Mickey Stafford, said, Oh, Joe, Im going to put you on the special residency selection committee.
75
00:30:48.0
You dont want to leave. Well, Joe is now an associate professor at the University of Pennsylvania. Never really made it and lost an opportunity. It was hard to recruit. We did recruit one doctor from South Africa. He was wonderful. The day he arrived, he had a heart attack and died. I recruited another doctor from McLean Hospital at Harvard, who had been assistant director of the day hospital for five years. Typical Harvard, they keep you going that way.
76
00:31:16.7
We got the day hospital going. The day before we were to open, he said, You know, I cant work here fulltime. I have to work one half time, instead. I said, David, come on. Were opening this center with or without you. Open it. And he didnt. But we opened it anyway. And we created a day hospital, had psychiatric units going.
77
00:31:37.5
The battles I was having with the VA had to do with psychology wanting to be separate and social work wanted to be separate. We had enormous battles over that, and I lost that battle, unfortunately. I kept fighting very tirelessly that it should be under psychiatry. No, no, no. We want our other psychology, and it went on and on and on to Washington, back and forth.
78
00:32:0.2
Still dealing with St. Josephs, I was fortunate enough to recruit another couple faculty. Marty Dinker came down from Johns Hopkins, and this is about 72. Along this, psychiatry was moving along. We had our residents; we had some faculty; we had a decent facility as St. Josephs, which some local psychiatrists still boycotted.
79
00:32:23.5
So we kept it a closed unit and had a very high-quality new treatment program going; a good media program which was therapeutic and was very vast and avant-garde. No one was allowed to shock people; no one was allowed to restrain people. I remember Dr. Rippey coming in and wanting to put people in restraints.
80
00:32:43.0
I said, You cant do that. He said, Well, I will. And I said, Well, then, get out of here. Needless to say, I made a lot of enemies. I had, I think, the whole 12 psychiatrists in this town wrote a letter to the governor saying what a terrible person Dr. Afield is. And it was this kind of battle. I just didnt understand this. I had never had people not like me or hate me, and lo and behold, there they were. The medical community didnt want us.
81
00:33:14.5
But the business community, the lawyers, wanted us badly. Dick Greco was mayor first time. He was mayor again many years later. But he was a very young man. And he and I became very close friends, and he was even my best man at my wedding. Dick and I would go everywhere, and that mad people very jealous. I was, again, this young kid who was a little too outspoken due to my inexperience, I suppose.
82
00:33:43.3
And we were going to go ahead and build this thing, and we did. Everyone in the community was very much in favor of it. But I also happened to be a bachelor, so I was very active with all of the young women in town and went everywhere and so I was avant-garde for the business community but not avant-garde for the medical community.
83
00:34:1.9
And the local medical society struggled very much to stop the medical school. To be able to join the medical society, you had to go down there and bring your degrees in their frames to show them. They wouldnt accept certification from the medical school. So you had to bring your 10 degrees down, pass them around the table so they could see them.
84
00:34:25.1
Very backward community, professionally. Just not enough people. There were a few good doctors, but not enough. And I think that was the big fear in the fight. We were with the former Tampa Psychiatric Society and then the Pinellas Psychiatric Society. I did everything I could to try to please these local psychiatrists, but it just couldnt be done.
85
00:34:53.3
Every time Id be on the radio or interviewed, they would sent letters of complaint to the medical society, How can you be interviewed on the radio? This is a terrible kind of thing. Again, 1970, 71. I had never joined a medical society in my life, but in those days, you had to be. I remember Don Smith said everybody joined because thats what weve got to do to make friends with these people although theyre not trustworthy.
86
00:35:24.9
And youre also going to join rotary because if I have to go, youre going. So he and I would go to rotary every week and mingle with the community. As I said, the nonprofessional community loved us. The professional community did not. I gave faculty appointments to everybody. The real anathema was I gave Ted Brown [sic], who was a very famous psychologist; I made him full clinical professor. And Syd Marin [sic], who was a psychologist.
87
00:35:53.6
Well, the psychiatrists went crazy that psychologists would have faculty privileges in a medical school. This was nothing new, but it was for them. The doctors were all given faculty appointments, but when we started--the medical students did start. We started the charter class. And the teaching program in psychiatry was basically teaching them basic psychiatry. They would come to St. Joes, learn about patients, see patients.
88
00:36:26.9
We also did a few things in the community, which angered the devil out of the local psychiatrists. Dick Greco, who was the mayor, took us down to Moses Whites, which was a very strong, powerful, black leader who had the best fried chicken in the world, and ribs, down in Central Avenue. And youd have to go--no white people would go there. And Dick would go, usually with his bodyguard.
89
00:36:54.0
And Moses White was adored in the community, and we brought the entire medical school class there. And I remember Don Smith saying, If you let anything happen to those kids, Im going to nail your behind to the wall. And I said, Don, thats not going to happen. Dont worry. We went down. And Moses was showing them about drugs, needles in the street, how their kids were falling apart.
90
00:37:14.1
We were looking at the issues of poverty while we ate fried chicken. It was one of the highlights of their class. They still talk about it. They even gave him a picture of the charter class, to Moses White. We took them to St. Josephs, and theres one slide where theyre all sitting and I said, I want you to go interview 10 patients at random who are having surgery tomorrow and talk to them and ask them what the surgery is and come back and meet me in an hour.
91
00:37:41.2
They all came back into the room. Nine out of the 10 said, We were shocked. These patients dont know what theyre being operated on for.  And I said, Well, this is typical. Doctors dont talk to patients. And we would try to teach them that this is how you learn to talk to patients, and this is what psychiatry is all about. We had a good time with the first year class. Got them through--I basically taught some of the anatomy classes, some of the physiology classes.
92
00:38:11.8
We had other faculty who began to join us. Im trying to remember some of their names. We had, oh, (inaudible). There were some other guys in physiology. We had Herschel Sidransky [sic] in pathology; Pete Dade [sic], he left; Bill Edwards came in ophthalmology, unfortunately, he immediately developed Amyotrophic Lateral Sclerosis and died, so then Bill Laden [sic] had to become professor in ophthalmology. We had (inaudible) in neurology.
93
00:38:58.2
Weve got Roy Benke, of course, and Rodger Sherman [sic]. I was so glad to see them come because all of the hatred that had been directed at me was then immediately turned to Roy Benke and Rodger Sherman [sic]. And they hated Rodger Sherman with a passion, did everything they could to screw him. When Roy got staff privileges, et cetera, et cetera. So this band of clinicians who were getting together saying, We just cant believe this. How do we do it? Jim Abram [sic] seemed to get along because he was a local doctor from the community who became king of Gasparilla. But, you know, none of the rest of us were kings of Gasparilla.
94
00:39:34.9
We werent evenwe were persona non grata essentially. Jack Hickman [sic] played an important role. He was an internist from Indiana who came down, became associate dean. I have particular fondness for him. For one, he was very gifted; very talented; did a lot of help with the picking the medical students and even teaching in the department of medicine. He also introduced me to my wife. I was a typical Irishman, New York street fighter; I had Irish and German descent, but I got married late. But anyway, Jack introduced me to my wife. So I was getting ready to get married at the age of 38. At the same time, I was also very involved in the arts and very intimately involved with Picassos statue that we were going to get.
95
00:40:25.6
And it ties in interestingly with the medical school. Because, here, Nesjar who was his engineer, was set to build this thing. And Cecil Mackey asked for donations. Everybody gave 2 and 3 thousand dollar donations. And he said, We want big donors. We dont want little donors. Well, everyone asked for their money back. It never got built. It could have been built up until the 70s. Nobody understood the significance of having the largest Picasso in the world right next to this medical school. A 16-story building out here on the campus, lost.
96
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DR: Why was it lost, do you think?
97
00:41:2.1
WA: It is now. Picasso died. The engineer is dead. Its back in the little models on the estate. Its not for us.
98
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DR: What happened, do you think, with that?
99
00:41:13.5
WA: We got very angry at it. Cecil Mackey was the wrong president. He was a politician who became--he was not John Allen. He was a politician from Tallahassee and was very cautious. He really didnt do much that was supportive, from what I could say. And then he left. And John Lott Brown came in. Then I left in 74 or 75, but I can get to that in a minute. And then after John Lott Brown, we had Borkowski, who was kind of a weak sister, didnt know what to do with the medical school.
100
00:41:48.7
Betty Castor did, but she wasnt here long. Then you had Dr. Genshaft, who I think probably knows what to do with it now. But from 70 to 74, we were having a real problem with leadership. We were fortunate to have Don Smith, but we were struggling very hard to build and build and build. Some thoughts about the mace that we got.
101
00:42:14.2
John Hickman was involved in that. Some guy by the name of Jimmy got the wood from the keel of some kind of boat in St. Augustine. And some fellow by the name of Estes from the art department came over with it all standing. Came over at night in his pajamas to leave some of us to show what he had stained and created.
102
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DR: And what was the mace, exactly?
103
00:42:35.8
WA: The mace that is in the library now basically is what they carry at the graduation for the medical students. Steve Estes was the artist in Deland who created this. And I believe it sits in the library at this moment, and they carry it at the graduation every year.
104
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DR: Only for the medical school?
105
00:42:57.9
WA: Only for the medical school. Its a traditional thing. After I left, what happened--I was, again, young, inexperienced, met my wife. I was really, very tired. I had a meeting with the local psychiatrists. They all came after they wrote to the governor and said, You know, we were going to do this. And I said, Well, Im going to build this medical school with or without you. And I developed some atrial fibrillation at the time, where your heart doesnt have normal rhythm. And since there were no cardiologists here, I went up to Johns Hopkins and had a cardio operation where they give electric shock and get it back to normal.
106
00:43:39.0
And they said, You know, you really ought to cut down on stress. And this was an enormously stressful job for me because, here you are, building two hospitals, dealing with all of the craziness of the community. And so, I basically said, I cant continue with it. Im going to stop. Im going to get married. And it was a big Irish-Catholic wedding at St. Bernard church that everybody came to. But I quit the chairmanship in 74 and stayed on.
107
00:44:12.5
I said, Look, Ill run the mental health center and finish it because, although the nun had gotten the building grant, there needed to be a staffing grant that was created. I spent the better part of the year writing this staffing grant for 1.9 million dollars. And Sister Marie Celeste, at the last minute, said, Im not going to submit it. I remember Don Smith saying, Why the hell didnt she tell you to do that from the beginning? You wasted all this time.
108
00:44:37.7
I said, You better believe it. She was afraid of it. They had federal money to build it; they were under an obligation to use it as a community mental health center for 20 years. She would not take the staffing grant because she thought that was going to control something. A community mental health center, at that time, required in-patient, outpatient facilities, partial hospitalization, consultation, liaison service and emergency services.
109
00:45:2.6
We created the first community mental health center in Florida at St. Josephs, and there were certain little tricks because, whoever designed it, Sister Loretta Mary, did the catchment area that we would serve all of Hillsborough County. Well, you cant do that. And we had to change the catchment area. The only way you could do it would be to negotiate with all of the various hospitals.
110
00:45:23.9
The only way to change the catchment area that would allow other places to develop community mental health centers, such as the Hillsborough Community Mental Health Center in Northside. Well, we would go down and negotiate. And I remember one person at Tampa General saying, Whatever is good for St. Joes cant be good for Tampa General! or Whatever is good for the university cant be good for Tampa General!
111
00:45:44.9
It was these kinds of battles, on and on and on and on. We did change the catchment area; we would allow a community mental health center to develop at Hillsborough and the Northside. Florida Mental Health Center, as I said, went on pace and did its own thing, and we stayed away from it. I quit, and I decided to stay running the mental health center to finish it.
112
00:46:7.5
The government was insisting that Sister Marie Celeste take the federal grant, and we were going to try to lift that up to the next step. They came down here, and she said, Put me in jail. Im not going to take your federal grant. Go to hell. And so, she kept the building money; the federal government didnt do a bloody thing about it, and 20 years later, she can use it wherever she wanted. So she carved it all up and turned into a radiology center. In the meantime, the VA opened, and that was successful, and I stayed on until about 76 in a clinical position then essentially went into private practice from then on.
113
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DR: Here in Tampa?
114
00:46:50.7
WA: Here in Tampa. Id been offered a variety of professorships. Interestingly, one at Stanford, one at Columbia, one at NYU, they were wide open. Nobody wanted the chairmanships at that point. And I said, Well, Im a good teacher. And people would say, Were not interested in your teaching abilities, we want you as a hatchet man. NYU was to clean out the tenured faculty they couldnt get rid of. The commissioner of mental health, which had a Harvard professorship, was to close out the state hospitals in Massachusetts.
115
00:47:22.2
And Stanford wanted a private entity to get more money. And so, they were interested in--Id learned, obviously, a tremendous amount here; Don Smith was a wonderful teacher and built and tried by fire and, what Jack Ewald said, I got my behind burned a lot, but I learned. And I had a lot of fun with it. But I didnt want to go on and keep doing this. And so, I got married. My wife was a bankers daughter; she said, Dont doctors take care of patients?
116
00:47:54.4
I said, Yeah, I think thats correct. And I gave that up. The romance of academia disappeared for me, and I left it. Everyone in academia was shocked because the logical steps for me to have taken at 38 was to go on and be a vice president at Cornell or one of these places; go be the provost and the president for a big university at 45. I remember Lou Barnes [sic] telling me, you should be in banking.
117
00:48:25.3
I said, You know, Ive got this cardiac thing, and it scared me. And Im getting married, and its time to have some kids and family and settle down. So I went into practice, and built a bunch of things, interestingly, in practice, which somewhat impacted upon the university; I still stayed active in the arts community and on the board of trustees and the presidents council, and I was very involved with Carl Riggs in the research council at the university. But not much with the medical school. Don left shortly afterwards, and they replaced him with Andor Szentivanyi, who had been a professor of pharmacology. Andor was a wonderful pharmacologist and researcher, but he really should not have been a dean.
118
00:49:10.4
DR: Why was that? Why shouldnt he have been a dean?
119
00:49:14.2
WA: He didnt have any administrative skills or political skills, so he said to the community, Come on in! He created a surgeon or--Rodger Sherman had quit. The man, Sidransky, the pathologist, he quit. I quit and went into town. Rodger Sherman went on to Grady Hospital. And they put in Dick Connor [sic], who was a very good surgeon but was not an academician, and it did not bring national recognition and repute to us as a medical school.
120
00:49:41.9
Andor just sort of fussed around. They subsequently had my replacement, Anthony Redding, came; he had been a student of mine at Hopkins, and he came in and they opened a psychiatric hospital, which failed for a variety of reasons. They finally brought Don Smith back in, and Don and I had a really strange relationship because he looked very much like my father; he was a real father figure, taught me an awful lot.
121
00:50:13.9
A crusty guy, he will tell you what you want to hear, but you could get to him occasionally. He swore like a sailor. He was absolutely wonderful. I remember when he came back, he said, You know, I feel like a caretaker for a multimillion dollar shit house, which sort typifies Don Smith. Not for public consumption, but anyone who knew him, thats what it was. He tried to salvage things.
122
00:50:43.2
He did a pretty decent job, but he was getting older, and they brought in a fellow by the name of Ron Kaufman. Don said as soon as Kaufman came in--hed come from George Washington [University], I think--he said, Well, who is your chief of staff? He said, I dont have a chief of staff. And thats all; he never consulted with Don Smith again. And shortly after that, all the orthopedic surgeons left. There were a lot of problems with that, which I only saw from the periphery and my lunches with Don Smith.
123
00:51:12.1
I had lunch with him the week before he died. I think he was a bit disappointed that we were never able to get the school where it should have been. He did design Moffitt [Cancer Center], interestingly, and gave me a tour of that. I remember his telling me, I designed this hospital as a general hospital because theres not going to be any cancer center here, so they cant even run it properly, so itll be our teaching hospital, which is what he was looking for all along. And the medical faculty all got together and created what was called UMSPPP, the University Medical Services Private Practice Plan.
124
00:51:51.5
That, indeed, was the death knell that everyone was afraid about. Here was this group of university people going to practice and take money away from their pockets. Well, it didnt. But they now have a very good practice program going that everybodys involved in. Thats one of the last things I really did, I guess, was to propose the UMSPPP situation but then left it and, as I said, did my own thing in private practice. In practice, as I said, some of the things impacted.
125
00:52:24.0
We started the first pain clinic in the southeast; started the first sexual dysfunction clinic; first interdisciplinary practice clinic; the first gambling addiction clinic; started one of the early managed care companies because of the horrendous abuses that were going on at Hanfolk Manor and at Fair Oaks Hospital in Boca Raton. It even made the New York Times that they were just ripping people off, keeping them in the hospital, sucking on the insurance. And what I had learned, very quickly, from this job is care is determined by who is paying the bill.
126
00:53:4.4
If youre a psychoanalyst, and theyre paying federal government pay, you have a large number of psychoanalysts in Washington. As soon as they stopped paying for it, they all disappeared. As soon as the Canadian government put it in, Toronto filled up with psychoanalysts, and then in stopped. In-patient psychiatric treatment was paid for. Once it got stopped, the hospitals started failing and getting closed down.
127
00:53:30.5
The people of Fair Oaks were the most aggressive in Florida, and it had a big expos, and I remember even being invited to Congress to testify in Congressman Schroders committee on this national epidemic. I had created a managed healthcare company, starting with Cigna and a few other insurance companies, and we would basically say, Why does this person need to be in the hospital for 28 days for his alcoholism or for three years or for five years?
128
00:54:1.6
And were not going to pay for it. That sort of spelled the death knell for all of the in-patient facilities, really. And then I sold it in 92, and I do mostly medical legal work now. I testify in courts, which is an interest Ive had since way back when I saw the Boston Strangler in 1961; Ive seen Ted Bundy; I just saw Aileen Wuornos before they executed her, our first female serial killer in this country.
129
00:54:32.7
DR: Did you speak with them?
130
00:54:35.7
WA: With great detail. Im an evaluator for the governor because there were some appeals about whether she should be executed or not. They made a movie out of her recently, and it looks like the lady, Charlize Theron, may get an academy award. I cant believe that theyve made a movie out of a prostitute who killed 10 men in cold blood. It made an opera, an HBO special, a book, a movie and a play. And Charlize Theron plays her with too much sympathy; this lady was not sympathetic. Very nasty kind of person.
131
00:55:9.4
Thats the thing that I do now, is primarily medical legal work and testifying. Ive gotten older. I did get married and had two kids. One of them went to Harvard and Columbia law school and came back to Tampa; the other one went to Duke and [University of Virginia] law school. Didnt become doctors. And I had a good time raising kids late in life.
132
00:55:27.5
But the medical school, as I look back on it, it had a lot of promise. USF had a lot of promise. In many ways, the promises were lost. Its like the Picasso that was lost. USF has a great medical--has a good medical school. Moffitt has helped it considerably. The Shriners Hospital has helped it considerably.
133
00:55:51.8
DR: Do you think it will ever be a great medical school?
134
00:55:55.0
WA: No, I dont think so because there are too many others. You know, if you look, for example, the history--I came down here because I thought we could build a Johns Hopkins. Johns Hopkins was built in 1893. From the day it opened its doors, it was the best medical school in the country, and it continued to boom. They didnt have the downtown battles. Again, times were different. But weve been at this 33 years.
135
00:56:19.6
We have a very good cancer center; we have a very good orthopedic center; there are a lot of good doctors. The dream did come true, or the fears came true, that doctors would come, high quality people, stay a while, and go into practice in the community. It enriched the community. We now have a very sophisticated medical community in Tampa, primarily out of the University of South Florida.
136
00:56:44.2
We train good doctors, students are good, high quality. I had a lot of fun, but we lost 33 years when--for example, Mayo Clinic is in the top ten ranking now. Duke was not in the top ten ranking; its now in the top six. It should have never been there, but because they got themselves a lot of young Turks--they went up to Johns Hopkins and got young Turks, built them up. The University of Miami, for example, when they opened, they went and got older men who were famous but retired; that was one way to get a good school.
137
00:57:19.0
Gainesville went off to Hopkins and hired them, got a bunch of these young kids, all of whom became very successful. Those schools have done well. We havent done as well nationally. Medical school is medical school, but we couldve been a lot better, but many opportunities were lost. There are still opportunities to grow and develop, but weve had a 33-year-old hiatus.
138
00:57:43.0
And you cant point the finger at any one thing. It was in Tampa; there were resistances; they had a good dean; they fooled around with a bad dean beforehand for five years; they got a good dean, and he did a wonderful job, got some good people in. Now, the community certainly did not do its part towards helping us. Now they love the medical school, which is fine, as it should be. But its been a long, hard haul.
139
00:58:14.7
We had a lot of fun, a lot of camaraderie, there were some awfully good people, most of whom are dead now. Don is dead, Charlie Fisher, Jim Ward, all the people I started with, Julian Dworniks still around. Roy Benke is still around and Lou Barnes. Everyone else is sort of scattered. I think Rodger Sherman is dead. But it was a nice band of people who worked hard to do something. It was very chaotic.
140
00:58:47.1
It was a great deal of fun, but it was bloody, really bloody. It shouldnt have been, and that held us back a lot. And then we did not get the support that we should have. Florida Mental Health Institute was a disaster, in my opinion. Only recently has it finally come around; this is 30 years later, after it was built. That makes no sense.
141
00:59:12.0
That should have been the New York State Psychiatric Institute or the Massachusetts Mental Health Center or something like that. It could have been and didnt. And its Florida. Part of it is Florida, part of it is relative. Im still here in Florida. I love it. Its a great place. I wouldnt live anywhere else. But those are the problems we had in the medical school; it was fun, but there are a lot of slides that I think you might find of interest.
142
00:59:42.5
As I look back on it now, nobody was malignant. They were just scared. From my standpoint, I was inexperienced, but even the experienced guys like Rodger Sherman got their behinds scraped, were out of battle and left. That happens in the beginning of a new medical school. Interestingly, it did not happen at Hawaii; it did not happen at Arizona; it did not happen at Stoneybrook, nor did it happen at Mayo Clinic. But it did happen here.
143
01:00:16.6
DR: How have you continued to be involved since?
144
01:00:20.1
WA: Not with the medical school anymore, you know. No mans a hero to his predecessor. I think Tony Reddings has since retired and theyve got some new men in now. I really dont have any involvement with the medical school, still with the university still. Im still in the arts department.
145
01:00:37.2
DR: How are you involved with the arts department?
146
01:00:39.3
WA: Well, I was very actively involved in the getting the Guarneri String Quartet to come here in residence for 15 years. In fact, they made a movie that had won an academy award, and theyre having dinner at my house with me cooking in the movie. So I played an active role in that. I played an active role in getting Joshua Logan to come down here. And the people in the graphic studio, very close with Will Rauschenberg, Rosenquist. A lot of the artists that weve got going. Im very active in the musical community. I created an opera company, Florida Lyric Opera, which unfortunately didnt last.
147
01:01:19.2
But part of that is Tampa too, I guess. Its basically kind of been--the school has changed. It has gotten bigger. Its more interesting. New things are happening. I think theres great opportunity and great potential, and as I said, weve turned out a bunch of good doctors, all of whom have stayed in Florida, or most of them.
148
01:01:45.7
We did manage to get one psychiatrist out of the charter class. I cant remember his name--thats terrible--Gary or something or other. But he was the first psychiatrist we managed to get out. But most of them have stayed and have enriched the community, from the charter class. Theyre still around. I look at them now, and theyre old men. And you know, I am--theyre not much younger than I am. I cant believe that, but I was the youngest chairman--
149
00:00:0.0
DR: Were back with part two with Dr. Afield, and were going to go over some photos that he has to share with us. And wed like to hear a little bit of advice for future students or staff or the medical community and for improvement.
150
00:00:17.6
WA: I think the future, the advice, really, is to get a good dean. Don Smith was a great dean. They have not had a great dean since. And this current dean, Dr. Daugherty, I mean, hes got tremendous financial resources, and for some reason they fired him over something. I look at it from the newspaper. With a year to go from retirement, thats kind of crazy. Particularly--that made no sense whatsoever.
151
00:00:48.4
DR: What were their reasons for firing him?
152
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WA: I dont know. I only know what, you know, you hear from the outside. Im not involved in it. I couldnt really say. You need a good dean who has foresight, not somebody from the community. And we have not had a great dean since Don Smith, in my opinion. And you need some, youve got good people here. There are good doctors. I think Moffitt is first class. Shriners is first class. Excellent, excellent, excellent stuff. The VA is a VA. Its not one of the top VAs in the country, but its still a major force.
153
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St. Josephs, interestingly, is no longer a teaching hospital. Psychiatry fell apart after Dr. Redding got in. They threw him out; the community took it over, and turned it to garbage. Tampa General is trying to reopen their psychiatry. Its very mediocre. Florida Mental Health Institute seems to be getting its act together, though they still have this, keep my distance, well take faculty appointments but we dont want anything to do with the medical school.
154
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And probably legitimately so, now, from their standpoint. But those things need to be merged. Psychiatry I can talk about. Psychiatry is in its death throes, quite frankly, primarily because now managed care has come in. I regret selling my company to the businessmen because they determine the care, and they take a percentage of the profit. So therefore, psychiatry is throwing drugs at everybody. They dont pay to do psychotherapy. They dont pay to hospitalize, and some people do need to be hospitalized. And I think psychiatry will disappear and go into the hands of internal medicine. Neurology probably will also, or they will merge in some way.
155
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With all the technology today, a chiropractor can diagnose a brain tumor with an MRI. So the role of neurology in psychiatry has changed. In terms of USF, good faculty, good grants, youve got some very good researchers there whove just got to keep pushing those grants, and they need to get some national recognition. Theyve already won the war with the community. And they need to, the name of the game here is money.
156
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It always shocks me when USF and St. Jude, we have $150 million dollars in grants this year, isnt that great? Well, yes, its great, but look at Johns Hopkins Medical School that has a billion dollars in grants, just the medical school last year. Those people are busy writing grants for them. The more grant writers you have, the more money you get. Feds have pulled out of healthcare. A lot of changes have occurred in healthcare.
157
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But I dont know, Im not sure that I can give much advice except that you have a nucleus of people now that have just leapt into the next level. Were in a great town, great area. Research is the name of the game and good patient care. A lot of things have changed drastically in 33 years. It seems it was only yesterday I was here in town for the first time, wondering what I was going to do for the poor.
158
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Well, there are awful services still. Services for children are as bad today as they were 33 years ago. They were nonexistent. Theyre throwing medicine at kids. USF has not taken a prominent role enough. They should be out talking about the things for the kids. The services for the mentally ill at the state hospital. When I was (inaudible), they warned us that its dark, which is death row.
159
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But the warden was telling me that they were operating a 100-bed unit for prisoners, a psychiatric unit. But whats happened, when they closed the state hospitals, these people who are on the streets all wind up in the jails. So weve just transferred the money from mental health system to the jail system. And now the prisons are going into the mental health business. Its kind of crazy. Now, this is not a local Florida phenomenon. Its all over. Psychiatry is in a lot of trouble. Medical schools are in a lot of trouble. The name of the game is money, money, money, and getting some control back and keeping the high quality doctors up.
160
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DR: What about the student population here? What is your impression of students?
161
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162
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I was very poor, I had no money. I would be coming to USF, or Id be going to Gainesville. Gainesville is a major university, which has risen dramatically through the ranks. USF will too. I have great respect for that. I kind of wish theyd called it the University of Florida at Tampa or at Lakeland or at Gainesville the way the California system has done. But we are what we are. Students are good. The top ten percent of the class anywhere in the country is the same. The middle third is not the same.
163
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The lower third is not the same. But your top ten percent is as good as anywhere around. Theyre as good as anyone at Harvard; theyre as good as anyone at Yale. Theyre good. It has nothing to do with where you went to school. And in medicine, people dont ask where you went to school. If you want to play an academic game, you kind of have to do what I did like going to Johns Hopkins, Harvard, Yale, or that sort of routine. Its hard to do it out of USF. You can do it out of Gainesville. So its hard to do it out of USF because we dont have that reputation.
164
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WA: And I think rightly so, is to create doctors who will stay in Florida, and they did that. They did succeed at that. There are a lot of good doctors now, who have studied here and have gone out and done a nice job, in spite of all the craziness.
165
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DR: Do you feel that counseling here for students is adequate?
166
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WA: No. Its terrible. I thought it was terrible in 1970.
167
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DR: Why is it terrible?
168
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169
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Hopefully, Judy Genshaft can change that. But that, to me, would be the high priority for the provost or some of the administration: to make it user friendly. Youre here. Youre a lot younger than I am. You know probably better than I know how difficult that is. Not Gainesville, Gainesville is user friendly. We need to be because we could be a superior school or a big 10.
170
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DR: Okay, so, on that note, lets go some of the information that youd like to show us with the pictures.
171
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WA: Theyve already scanned these pictures, and I have them, and I just thought I would go ahead and because--the man who scanned it wanted me to list the various things and what they meant so that he could edit them.
172
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DR: So the information youre giving us is going to go along with some--
173
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WA: It goes along with some--
174
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DR: The photos that we scanned.
175
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WA: So he can make some sense out of it. This slide 1 is the one that you have in the library, which is the only picture of the founders of the medical school. And if you go clockwise from left to right, left and around, John Melindi was the business manager; Keith Bower, histology from LSU; Andor Szentivanyi the pharmacologist; Jim Ward in the brown suit, hes the anatomist, Jim Ingraham is in the white coat; and behind some plants, (inaudible). Julian Dwornik, who did a wonderful job running the admissions committee for many years, and then Joe Corey, and Charlie Fisher and Don Smith. That was it.
176
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Slide 2 is a picture of me in September of 1970 standing next to a sign that says, Site of the University of South Florida Medical School, Thats all there was, an empty lot. Slide 3 and slide 4 are just maps on how you got here. It was a 10 minute drive from St. Josephs hospital to USF in those days because once you hit Fowler, it was all palmettos and a straight expressway in the middle of the wilderness.
177
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And now its bumper-to-bumper Steak n Shakes, and theyve got all those malls and so forth. The slide 4 is basically the university campus as it was then. It has enlarged a lot. Slide 5 and 6 are aerial shots. Slide 7 is a photograph of the student center. Slide 8 is a photograph of the building, I believe its engineering or science, which is where the medical school was housed until 1973. The top floor is where we were. I was looking, now there are six or seven buildings in front of it. Slide 9 is an aerial view of it. Slide 10 is a portion near the school, where the Picasso was to stand and is empty at this point.
178
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DR: Where was that?
179
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WA: Right next to the engineering building, near the College of Fine Arts. It was going to just rise right at the College of Fine Arts. But Ill feel better about that. Slides 11 and 12 and 13 and 14 are mockups or models of the medical school. They were handmade, and thats what we were supposed to see. Slide 15 is an empty lot, which is where the medical school stands. That was a picture taken across the street from the VA, which is on slide 16, which is under construction at this point.
180
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And we had to climb out through rafters and take the pictures, and thats where they had the dogs running around at night. It was a big building to control. Slide 17 is a picture of myself and Ross Cory and George Fiske looking over the plans. Fiske was the director of the VA, Cory was the medical director, and myself. We were looking over the plans of this 200-bed psychiatric unit that was supposed to be built. Slide 18 is, basically, they put the fence up to start digging.
181
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Slide 19 is a picture of four people; myself in a suit, to my right is Kailey Shaw, our first resident. Shes on the faculty now, but she was our first resident in adult psychiatry. To my left is Dr. Van Sickle, who unfortunately had a heart attack about ten years later, but he was the first faculty person. And to his left is Raymond Slazinski, who had been a psychiatrist, and he went on to do his child psychiatry residency. So there were the first two residents that we had on the faculty.
182
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And that would be in 1972. Slide 20 is 1973, the medical school was building behind us, and the faculty is larger. The only people that I can recognize here is the fellow next to me with the beard; thats Martin Denker that came down from Johns Hopkins. And we had a few residents (inaudible). Slide 21 is 1973, the school was higher, the faculty bigger. Slide 22 is, they hadnt put the grass in, the medical school was finished, and that was the department of psychiatrys faculty.
183
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Slide 23 is a shot of the completed medical school, which doesnt look like it does today because weve added more. Slide 24, 25, 26, 27, 28, 29, and 30 are the construction of the medical school. Basically, just putting up the girders at various times. They had some interesting signs outside telling how much was paid for by the federal government and how much was paid for by the state. But this was the reason Don Smith had to work so quickly to get this done, otherwise he wouldnt have gotten the grant money.
184
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Slide 31 is the slide of the opening of the VA and 32 is the VA completion without grass; 33, 34, 35, and 36 are the VA. Slide 37 is an aerial view of the university community hospital, which was built right next to the university. It was supposed to be part of the university. Havent gotten affiliated, still is not to this day affiliated with the University of South Florida. Slide 38 is St. Josephs hospital with the mental health center in the back; 39 is Tampa General Hospital. These were in 1972, 71, 72.
185
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And slide 40 is the All-Childrens Hospital, which has enlarged considerably since then. Those would be, that was the affiliated hospital, which has now become a major pediatric center, and pediatrics has done very well. Slide 41 is the Florida Mental Health Institute under construction; 42 and 43 are the St. Petersburg Child Guidance Clinic, which we had a loose affiliation with. The rest of the slides begin at St. Josephs Hospital, which, as I said, was to be a major teaching hospital; now it is not, primarily because the nuns didnt want it.
186
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They didnt understand it, and the practitioners didnt want it. But it shows a hole in the ground, which is where the mental health center was when I came down. That was it. It started its construction; in slide 45 you see it going up. In slide 46, you see it behind St. Josephs Hospital. Slide 47, you see it in some finality, in 48 the same. Slide 49, you see Pat Brooks is standing in the midst of trees.
187
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That was the first masters degree in psychiatric nursing in the state of Florida. The rest of the slides--slide 50, were sort of going over plans. As you look at these, they get a little repetitive. Fifty-one, were picking out bright colors for this drab place that was supposed to have bars and chains, but we got red rugs and orange rugs. Youll notice, in slide 53, theres a painting hanging on the wall. We managed to get a graphic studio that I was fairly involved with to hang their pictures at St. Joes Mental Health Center.
188
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Everyone thought, My God, these crazy people are going to destroy them and tear them apart. All the local psychiatrists said, You just cant do this. This is terrible stuff. Slide 54, were just going to a party. Fifty-five, 56 showing again the pretty girl who was the receptionist, in street clothes, surrounded by graphic studio prints, major prints.
189
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First time major art--in any place in the country, that I know of. Fifty-seven, occupational therapy. Fifty-eight, 59, 60 basically show the layout of the artwork that was all over. And people respected it. Sixty-one we were going to feed people; instead of bringing trays to them in their bed with plastic utensils that they couldnt hit themselves with, we put in a cafeteria for them to eat with knives and forks and not posed a great danger that everybody thought. Sixty-two, basically we had a little day hospital there.
190
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Sixty-three, 64 is myself and Pat Brooks moving up and down ladders. Sixty-five is the patient waiting room; we had Sister Karina (inaudible). At the other end of the room there was a pool table and a reception area. This was, for me, this was nothing new. But it was very new for down here and very avant-garde. Sixty-six is the bed the way they wanted it, the nuns and local doctors, which is a hospital bed, oxygen in the walls and something you could restrain people to.
191
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Sixty-seven is what they got: a sofa bed and a living room. It was pretty and attractive and colorful. Sixty-eight is laying out the grant, all the papers on the floor at that point. Sixty-nine is one of the first meetings of the charter medical school class at St. Josephs; thats where we were teaching psychiatry. Seventy, the main things I see there are some of the residents, Dr. Zago [sic] to the right and we had the nurses station specifically cut down as desks rather than glass and chains, which they had already designed them for the VA and we had to get them to knock out at great professional, personal cost because they just didnt want to do it.
192
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Seventy-one just the initial staff. Since the psychiatrists said they were going to boycott us, the only patients we had were two stray cats that came by. So slide 72 is our two patients, two cats. And it was like that for about a month after the psychiatrists said, Were going to boycott you were not putting anybody there. Seventy-three, Pat Brooks, and we created an emergency service where people would go down and non-physician would go to the emergency room, do the intakes and admit patients.
193
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That was unheard of, and now its the standard. Seventy-five is a picture of Phillip Quinn, a priest who was the first pastoral counselor. He was on the faculty of the school; he was brought in by the school to do pastoral counseling, had his PhD in psychology. Unfortunately, what he did was, after we got down and we were settling for a while, he started doing some private practice and pocketing money.
194
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I remember going to the nun about this and the bishop, and the nun was very angry at my doing this. And Sister Marie Celeste because she was very protective of Father Quinn. She goes in to see the bishop and immediately resigns from the church and goes out and gives and article about how wrong the Catholic Church is, and the bishop was pouting. He would say, Ive had enough of you damn psychiatrists! I never want to see any of you again!
195
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Interestingly, he did come around and marry us, but I thought he was non-forgiving at that point. Oh, 76 is just a cake when we were opening the place. Seventy-seven, Pat Brooks jokingly tried to pulls somebody in as a patient. She happened to be the first occupational therapist who had a degree. They had never heard of occupational therapy, and she had her masters. Uh, 78 and 79 are pictures of me with our two patients while we waited.
196
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One cat is sitting at the water fountain drinking, the other is sort of laying on my chair while we wait for patients and have this whole staff. The staff was playing ping pong with the cats in slide 80. Slide 81, the big adventure was the cats looking at a bird. Eighty-two, sleeping. Eighty-three, our staff and no patients. Eighty-four, somebody on the phone. Nancy Talley I believe, which we could never get--still no patients.
197
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Eighty-five, more jocular pictures of trying to drag patients in that didnt exist. Eighty-six, we do see residents for the first time. Steve Ziebel in the center, Kailey Shaw on the right, and I believe someone by the name of Gilbert Alasaya, who was a resident on the left. Slide 87, myself, Steven Ziebel and Kailey Shaw. Eighty-eight, Im not even sure what that is. Slide 89 is the meeting that I had talked about, where we were trying to have the students go and interview surgical patients and see how to talk to patients.
198
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Rudolph Nora had some advantage, he was in the background. Slide 90 and 91 are just 1970 and 1974, the mental health center, which was a success. I did fail to mention that there was a fellow by the name of Carl Schmidt that we brought in on our faculty. He was 94, he was a very famous professor from the college at University of Pennsylvania. When he retired, he was the first research director for the astronauts.
199
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He retired down here, and we brought him in. I dont think the students fully understood or appreciated him. But he always said, you know, he came from the nations oldest medical school to the nations newest medical school, and he was very proud about that. Slide 92 is my portrait that was left hanging in the medical school, and I think they disposed of all the portraits for some reason. Thats essentially the slides.
200
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DR: Thank you so much. Is there anything else?
201
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WA: Not really, no. That covers it. I hope it was productive and it made some sense.
202
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DR: It was.  Thank you very much.


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transcript timecoded false doi U23-00001 skipped 10 dategenerated 2015-06-10 19:30:20
segment idx 0time text length 100 Dr. Afield was the first member of the Clinical Department and founder of the psychiatry department.
1Background
3291 Dr. Afield was born in New York and grew up in St. Petersburg. He went to the University of Pennsylvania, Johns Hopkins University, and did his residency in psychiatry at Harvard. He taught at Harvard, then returned to Johns Hopkins and taught as an assistant professor there from 1967-70.
414 Arrival at USF
6457 Dr. Afield discusses the construction of a community Mental Health Center. The school got money to build the Health Center in 1968 and Dr. Afield looked at the plans and discussed possible problems and hurdles with Mental Health Centers. He put possible problems in writing and sent it to Dean Don Smith. Smith called him later and asked him to come down to Tampa for lunch and offered Dr. Afield the position of Chairman of the Department of Psychiatry.
718 Campus at the time
9374 Dr. Afield visited USF's campus periodically throughout the 1950s and 60s when he visited his mother. He saw the school come up from nothing. It had a few white brick buildings. The trees were small and everything was very sunny and hot. When you got off Fowler and drove through Palmetto the only building was the University Restaurant, which was where the mall is now.
1024 Deciding to take the job
12723 In 1970, the medical school was in the engineering building. The school was very "new and barren, but [an] exciting-looking campus with a lot of potential." This wasn't like older schools. Dr. Afield went back to Baltimore and got advice from lots of other people and many of them told him not to take the job. He took it anyway and arrived in September of 1970. On the first day he arrived, a very aggressive newspaper reporter interviewed him and asked him what he was going to do "about the poor people." He didn't even know where the poor people lived and was not sure how to respond to the question. There was a picture of him in the newspapers the next day. At the time, there were only a few faculty members.
1334 Challenges faced by medical school
15327 Don Smith, the Dean, had only been there for about a year. The previous dean did very little and was fired. Smith was hired and there was a lot of pressure to create a medical school. There was a national shortage of doctors, so seven universities, including USF, were given medical schools to help stop the doctor shortage.
16326 The people in the medical school had several problems to face. They had to build the school in a year to keep the federal funds and they had to start up in a community that didn't want a medical school. The local doctors were afraid that the students would be trained to compete with the very few doctors that were in Tampa.
1729 General Feeling around Campus
19445 Cecil Mackey had just come on as president and this was an "exceptionally exciting place." There was a College Quiz Bowl and they would get teams together from schools to compete with one another. A freshman team from USF had beaten everyone they faced, and this was exciting for the campus. The school's first president, John Allen, thought that this would not be a sports school, but a school that would focus on art and the medical school.
20Picasso statue
22819 A 168 ft. Picasso statue was supposed to be built here because Picasso liked the idea of the graphic arts studio and a new medical school. He donated a 16-story statue designed form a small model called "Bust of a Woman." While getting the medical school off the ground, Mr. Afield was very involved in trying to get the Picasso statue on campus. Cecil Mackey asked for donations and got some small donations, but the administration said "we want big donors, we don't want little donors" so people asked for their money back and the statue was never built. This means we could have had the largest Picasso in the world built right next to the medical school. Cecil Mackey was "a politician and he was very cautious and he didn't do much that was supportive." This was detrimental to getting the Picasso on campus.
2351 Affiliations with bay area hospitals and institutes
241265 They had to work out affiliation agreements with hospitals. They needed to recruit students and faculty and design a curriculum. They also had to start a nursing school and clinical facilities. All these things had to be done simultaneously. They worked out an affiliation agreement with Tampa General Hospital and St. Joseph's Hospital. St. Josephs was the best hospital in town. Tampa General was a "mediocre" hospital, which was difficult to get to and was run by county commissioners. Now Tampa General is the premier hospital in the area. There was also a VA Hospital under construction right across the street and USF worked to become affiliated with it. There was also the Florida Mental Health Institute, which was going to be constructed next to the Medical School. Dr. Afield hoped that this would house the department of psychiatry. They also successfully attempted to become affiliated with the All Children's Hospital. Unfortunately, their attempts to affiliate with the Hillsborough Community Mental Health Center were failures; the Health Center officials "were not the least bit interested, because they were frightened." The University Community Hospital, which was right across the street, would not affiliate with the Medical School.
2528 "Fear" of the medical school
27461 There was a lot of fear in regards to the medical school, which was difficult for Dr. Afield to get used to. Dr. Afield had never been in an area where people were "frightened of me, or intimidated by me because I'd been hanging around Harvard and Hopkins." He was "a little outspoken and inexperienced" and it was a little scary to people who might lose their income once the school opened. At the time there were only twelve psychiatrists in the community.
2831 Beginning of the medical school
301911 Thirty-two students joined the medical school's charter class that started in 1971. They also had to get the school and residencies accredited. The accreditors thought that USF had a very good psychiatrist and pediatrician but needed internists and surgeons, which they were trying to get. These people didn't come until 1973. Dr. Smith hired some very good people because he was a "superb and consummate politician." He was very honest and tough, plus he had already built two medical schools. They were getting accreditation and trying to build the department of psychiatry. There were two state senators who wanted to build a state hospital. Some thought it should be next to the USF campus, which would fit the model that Harvard and Columbia have, state hospitals affiliated with and run by a university. At the time, the Commissioner of Mental Health was a man named Dr. Rogers. He believed that they should not have anything to do with USF. They wanted to build a university at the new hospital. They called a meeting with USF President Cecil Mackey and Provost Carl Riggs and other administrators. It turned out that nothing was in writing. The Florida Mental Health Institute was going up and they had spent $11 million on it, but there was no official affiliation, so it took USF years to get involved with it. The FMHI was eventually understood to be a "disaster and a waste of taxpayer's money," but USF had to build something at St. Joseph's Hospital. The VA Hospital was under construction. They wanted to build a 200-bed psychiatric unit and a research facility at the VA. The people in charge of the VA wanted to build an old fashioned VA and Dr. Afield was warned that the VA system was "a well oiled series of gears that move nicely and if you put your finger in your going to get it cut off, so the only way to deal with the VA is to stand to the side and throw sand in it."
31Tampa's Psychiatrists in 1970
33591 When Dr. Afield arrived, the second psychiatrist ever in Tampa's community was still practicing. He had started a private "long term, quasi-psychoanalytic institution which kept people forever." He wanted to be the head of the psychiatry department at USF and held it against Dr. Afield that he was hired for the position. There was only one psychiatrist in town that was really friendly to Dr. Afield when he arrived. Some of the psychiatrists in town were very bad. One of them went to jail for sleeping with and killing one of his patients, and another was caught molesting children.
341241 Tampa General kept all patients in the psychiatric unit behind a steel door, in pajamas, and in restraints. Tampa had the highest commitment rate and the highest level of shock treatments in Florida. The conclusion to be drawn from this is that either something is being run poorly or Tampa has the craziest people in Florida. This was the backdrop for the Mental Health Center. Psychiatry in Tampa was still in the 1940s and Dr. Afield wanted to bring it to the 1970s. They put fine art on the walls, used bright rugs, and allowed the patients to wear street clothes. This was "supposedly innovative and the local psychiatrists thought this was some kind of communist plot." Many of the doctors refused to send their patients there. One doctor thought that the patients would go into color shock. They created the first emergency service, in which a nurse would go to the emergency room, evaluate the patient and admit them. Most hospitals didn't do this, believing that only a doctor could do this. There was no commitment law in Florida at the time. There was a commitment law in cities all over the country after 1945, but it didn't come to Tampa until the 1970s. Thus, everything in Tampa was behind the rest of the nation.
3538 Early days of the Psychiatric hospital
37537 They had no shock treatments, no commitments, no suicides, and no injuries after three months. Tampa General had 1,300 shock treatments and commitments and the community began to understand that this might be a good idea. He found that the VA Hospital wanted to do things more in the manner that they had been done in the past. They wanted to have drab grays as the colors and people walking around in their pajamas. This was not what they were doing in the early seventies, but a lot of people were resistant to change in the field.
3811 Residencies
40738 In about 1972 the medical students were coming to school and Dr. Afield was able to get approval of accreditation for both child and adult psychiatry. They got their first two residencies. One was Kailie Shaw, who is on the faculty now. Her husband had moved down form Baltimore and Dr. Afield had known them, so he hired her as an adult psychiatry resident. They also got their first child psychiatry resident, Raymond Sozlyzinski, who had been in charge of the Child Guidance Clinic in St. Petersburg. They had a faculty member named Richard Van Sickle who came here from Ohio State. The group of four was there while they were trying to go through the admissions committee and trying to recruit people for the faculty and the VA.
41Recruitment
43175 Recruitment was very hard at USF for some reason. They recruited one doctor from South Africa who was "wonderful," but the day that he arrived he had a heart attack and died.
4437 Tension among the local psychiatrists
46482 Psychiatry was "moving along" because they had residents, faculty and a decent facility at St. Josephs. The local psychiatrists were still boycotting them, so they had to keep it a closed program, but it was a good program. He made a lot of enemies because he was doing things differently. Dr. Afield would not allow his patients to be shocked or restrained. The local psychiatrists wrote a letter to the governor complaining about him, which was a different experience for him.
47653 The medical community did not want the medical school around, but the business community was very excited about it. Dick Greco, the mayor at the time, was very supportive and he and Dr. Afield became such good friends that Mayor Greco was best man at Dr. Afield's wedding. They spent a lot of time together and this made other people jealous. He was a bachelor when he arrived in Tampa, and spent a lot of time out on the town, which was "avant-garde for the business community, but not avant-garde for the medical community." Professionally, this was a "very backward community." There were very few doctors and there were even fewer good doctors.
48Every time he would do an interview, the local doctors would complain to the medical society. They would go and mingle with the community in rotary societies and medical societies to try and build businesses. The non-medical community liked them, but the medical community didn't. He gave faculty appointments to all the doctors on the faculty. Some people were amazed that he gave a psychologist full faculty privileges at a medical school.
49534 In psychiatry, the teaching program taught them the basics. They also tried to do things in the community. Dick Greco brought them to Moses White's restaurant. Moses White was a leader in the black community. There were very few white people there, but they brought the whole medical school class there. Moses showed the kids in the class about issues of drugs and poverty in low-income neighborhoods and they thought that it was a highlight of their learning experience. They even sent Moses White a photo of the charter class.
50424 They went to St. Joseph's and teachers instructed students to interview 10 patients who were going into surgery. Nine out of the ten patients did not know why they were being operated on. This was a lesson in that doctors should talk to their patients, which is what psychiatry is about. They had a good time with this first class. Dr. Afield taught anatomy and physiology. There were also more faculty members joining.
51128 There were more people arriving which helped redirect some of the hatred that the local community had pointed toward Dr. Afield.
5233 Presidents and the medical school
53265 Most of the presidents who followed Mackey "didn't know what to do with the medical school." Betty Castor wasn't here long enough to do much, but Dr. Genshaft "probably knows what to do with it now." From 1970-74 there was a real leadership problem on the campus.
5421 The stress of the job
56686 Mr. Afield was young and inexperienced at the time. He had just met his wife and was very tired. He had a meeting where local psychiatrists said what they were going to do, and Dr. Afield said he would build the school without them. He developed an abnormal rhythm in his heartbeat and had to go to John's Hopkins because there were no cardiologists here. He had a very stressful job and the doctors told him to cut down on his stress level. He decided to quit the job and get married. He quit the chairmanship in 1974, but stayed on to run the Community Mental Health Center until it was finished. The Florida Mental Health Center went its own way and USF "stayed away from it."
5716 Private practice
59592 Mr. Afield stayed here until about 1976 in a clinical position, but went into a private practice in Tampa after that. He had been offered professorships at Stanford, Columbia, and NYU. They wanted him to be a chair of departments and clean up their faculties, but he wanted to teach. He got married, left academia, and decided to go into private practice. Everyone was shocked because they thought he could go on to become the Vice-President or President of a major university, but he decided that he shouldn't do that because of his heart trouble and because he wanted to start a family.
60295 He built a lot of things that affected the university, even when in private practice. Once in private practice he still stayed active in the arts, the board of trustees and the president's council. He also worked with Carl Riggs on the Research Council, but did little with the medical school.
61Dean Don Smith
63They replaced Don Smith with a wonderful pharmacologist who should not have been a dean because he wasn't a good administrator and had no political skills. They put in a lot of good people, but they were not academics, which didn't bring much repute to the school.
64817 Don Smith came back to the school. Dr. Afield and Don Smith had a strange relationship because Don Smith was a father figure and taught Dr. Afield quite a bit. Don Smith "tried to salvage things, he did a pretty decent job but he was getting older" and they brought someone else in. Don Smith was probably "a bit disappointed that we were never able to get the school where it should have been." Don Smith was the person that designed Moffitt Cancer Research Center. One of the last things that Dr. Afield was heavily involved with was The University Medical Services Private Practice Plan. This was the thing that private doctors were worried about because all the university people were going into private practice. Now they have a very good practice program in which people from the university are involved.
65218 Dr. Afield learned very quickly that "care is determined by who's paying the bill." If psychoanalysts in Washington are funding, then psychoanalysts will get money, once they stop, the psychoanalysts will "disappear."
66Exposes injustices
68248 Dr. Afield noticed that there were a lot of places that were supposed to be treating patients well, but were treating them badly. He was part of a group that helped expose some injustices and Dr. Afield was even invited to testify before Congress.
6926 Different jobs Afield held
71549 He created and managed a health care company. They essentially wondered why a person needed to be hospitalized for a long time and got people to wonder why someone needed to be in for so long. This was the end of a lot of in-patient facilities. He sold the company in 1992 and does mostly medical legal work or court testimony now. This is something he has always been interested in. He was interested in the Boston Strangler Case and the Ted Bundy Case. He spoke with Aileen Wuornos and evaluated her for the governor before she was executed.
726 Family
73172 He also got married and had two kids. One attended Harvard and Columbia Law School and the other attended Duke and UVA Law School. He really enjoyed raising the children.
74USF and other medical schools
751730 The Medical School and the University both had a lot of promise and in many ways "the promises were lost, just like the Picasso was lost." Now USF is a good medical school, which has been helped by the Moffitt Cancer Research Center and the Shriner's Hospital. Dr. Afield doesn't think that USF will ever be a "great" medical school because there are too many others. John's Hopkins was built in 1893, and has always been the best medical school in the country. USF has a good cancer center and orthopedic center, which turns out a lot of good doctors that go into practice in the community and enrich the community. They train good students and doctors, but it took thirty-three years. Duke was not in the top ten before, now they are in the top six. Duke and the University of Florida had similar approaches to getting their medical schools respected. They went to Johns Hopkins and got some very successful people to work for them. Miami did it differently. They convinced some older, more established people to work there. USF hasn't done as well nationally. While there are still opportunities to grow, the thirty-three-year "hiatus" may have been too long. There were a lot of reasons, maybe it was the bad dean they had before the good dean, or because the community did not do its part to help the school at the time, but it "has been a long hard haul." There were fun times and good friendships and there were a lot of good people in the program. There were a lot of problems. The Florida Mental Health Center is finally starting to come around, but it has taken them thirty years to do so. "Nobody was malignant, they were just scared" and this caused trouble in allowing the program to grow and flourish.
76Involvement in Medical School now
78268 Dr. Afield is not involved in the medical school anymore because "no man's a hero to his predecessor." He has some involvement with the arts department. Dr. Afield played an active role in getting Joshua Logan and some people in the graphic studio to come down here.
79455 The Medical School has changed, it has potential and they have graduated a lot of good doctors who have stayed in Florida. They only graduated one psychiatrist from the original class. He still sees some members of the original class from time to time, which is amazing because they are all so much older now. They weren't much younger than he was at the time because he was the youngest department chair in the country when he began his career at USF.
8035 Advice for future students or staff
82660 His advice is "to get a good dean. Don Smith was a great dean and they haven't had a great dean since." They need a dean with foresight. There are some good doctors at USF, such as the ones at Shriners Hospital and Moffitt. St. Joseph's is no longer a teaching hospital. The Florida Mental Health Institute "seems" to be getting its act together. Dr. Afield believes that psychiatry is on a downward swing because managed care has come in and the businesses determine care. Psychiatry sells drugs to people and doesn't analyze, so Dr. Afield believes that psychiatry and neurology will disappear and go into internal medicine, or merge with one another.
83370 USF has a good faculty and good grants with good researchers. We need to get national recognition because the community recognition has come. Now they need to get more money to get more grants and be able to do more research and create a better national reputation. There is a great core of people and this is a great area for doing the research that they need to do.
84Services for children
85200 Unfortunately the services for children are just as bad now as they were thirty years ago. Rather than working with kids, they are "throwing medicine" at them. Services for the mentally ill are bad.
86Student population
88780 He can't forget the freshman team at USF that won the College Quiz Bowl over schools like Harvard and Yale. There are "very good students here." Dr. Afield remembers that during his youth there was just one high school in St. Petersburg: St. Petersburg High. There was no medical school at Gainesville at the time. Most people his age left the state and didn't imagine they would come back. Dr. Afield did and he is happy about that. These days he would have gone to USF or Gainesville, which is now a "major university." USF is also a very good school. Dr. Afield believes that the top 10% of a class anywhere in the country is the same; the middle third and the lower third are not the same. The school has done a good job of training doctors that will stay in Florida.
8936 Is counseling for students adequate?
91345 "No it's terrible." He feels that no one cares about it and it is terribly disorganized. He believes that it is challenging to get an education here because the "bureaucracy is difficult." It is tough to register for classes; essentially the school is "not user friendly." Dr. Afield feels that this should be the high priority of the school.
9225 Information on his slides
9444 Slide 1: The original medical school staff.
9555 2. Dr. Afield on the site of the future medical school.
963-4. Maps.
975-6. Aerial shots.
987. Student Center.
9948 8. Building where medical school was until 1973.
10015 9. Aerial view.
10110. Where Picasso was to go.
10240 11, 12, 13, 14 models of medical school.
10339 15. Empty lot where school stands now.
10416. The VA Hospital under construction.
10530 17. Looking over plans of VA.
10617 18. Building VA.
10750 19. The first two residents on the faculty, 1972.
10845 20. And 21. 1973 medical school and faculty.
10959 22. School finished with faculty department of psychiatry.
11023. Completed medical school.
11124-30. Construction of Medical School.
11219 31. Opening of VA.
11332-36. Completed VA.
11449 37. Ariel view of University Community Hospital.
11538. St. Josephs.
11639. Tampa General in early 1970s.
11740. All Children's Hospital.
11856 41. Florida Mental Health Institute Under Construction.
11942-43. St. Petersburg Child Guidance Clinic.
120130 44-48. The rest begin at St. Joseph's Hospital, which was supposed to be a major teaching hospital. It didn't work out this way.
12149. First Master's Degree psychiatric nurse in Florida.
12280 50-60. Going over plans and showing interiors of places, including the artwork.
12361. Cafeteria.
12462. Day Hospital.
12565. Waiting room.
12652 66. Beds as the nuns and local doctors wanted them.
12767. Beds they got.
12869. Meeting of charter school at St. Josephs
12920 70. Some residents.
13071. Initial Staff.
13141 72. First two patients: Two stray cats.
13242 75. Jesuit priest and pastoral counselor.
1339 76. Cake.
13454 77. Trying to pull someone in as a patient (jokingly).
13578-79. With the two patients.
13622 80. Playing ping-pong.
13781-85. No patients, just hanging about.
13886. Residents.
13989. Students meeting with surgical patients.
140325 Dr. Afield neglected to mention that there was a very famous professor of Pharmacology named Carl Schmidt who they hired. He was 94, had retired form the University of Pennsylvania and was the first research director for the astronauts. He was very proud that he came from the country's oldest medical school to the newest.
141End of Interview
unicode



PAGE 1

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