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Walter Afield

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Material Information

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

Subjects

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

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.
System Details:
Streaming audio.
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:
aleph - 029070421
oclc - 250683340
usfldc doi - U23-00001
usfldc handle - u23.1
System ID:
SFS0024311:00001


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Full Text

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COPYRIGHT NOTICE This Oral History is copyrighted by the University of South Florida Libraries Oral History Program on behalf of the Board of Trustees of the University of South Florida. Copyright, 200 8 University of South Florida. All rights, reserved. T his oral history may be used for research, instruction, and private study under the provisions of the Fair Use. Fair Use is a provision of the United States Copyright Law (United States Code, Title 17, section 107), which allows limited use of copyrighted materials under certain conditions. Fair Use limits the amount of material that may be used. For all other permissions and requests, contact the UNIVERSITY OF SOUTH FLORIDA LIBRARIES ORAL HISTORY PROGRAM at the University of South Florida, 4202 E. Fowler Avenue, LIB 122, Tampa, FL 33620.

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1 USF Florida Studies Center Oral History Program USF 50 th History Anniversary Project Narrator: Dr. Walter E. Afield Interviewer: Danielle Riley Current Position: Psychiatrist at the Location of Interview: Tampa Neurop sychiatric Institute Campus Library Date of Interview: Feb. 25, 2004 Abstractor: Daniel Bertwell Editor: Mary E. Yeary Abstract Completed: June 11, 2004 Edit Completed: June 18, 2004 Final Editor : Jared G. Toney TOPICS OF DISCUSSION Dr. Afield was the first member of the Clinical Department and founder of the psychiatry department. Background Dr. Afield was born in New York and grew up in St. Petersburg. He went to the University of Pennsylva nia, 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. Arrival at USF Dr. Afield discusses the construction of a commu nity 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 Smit h. 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. Campus at the time 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 Restaura nt, which was where the mall is now. Deciding to take the job 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 h im and asked him what he was going to do "about the poor people." He

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2 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. Challenges faced by medical school 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. The people in the medical school had several problems to face. They had to build the school in a year to keep the federa l 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. General Feeling around Campus 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 exc iting 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. Picasso statue 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. Affilia tions with bay area hospitals and institutes 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 thin gs 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 r un 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, w hich was going to be constructed next to the Medical School. Dr. Afield hoped that this would house the department of psychiatry. They also

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3 successfully attempted to become affiliated with the All Children's Hospital. Unfortunately, their attempts to af filiate 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 affi liate with the Medical School. "Fear" of the medical school 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 intimi dated 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 th e community. Beginning of the medical school 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 t he 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 bu ild 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 o f 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." Tampa's Psychiatrists in 1970 When Dr. Afield arrived, the second psychiatrist ever i n 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 ca ught molesting children.

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4 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. Early d ays of the Psychiatric hospital 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, b ut a lot of people were resistant to change in the field. Residencies 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 residen cies. 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. Recruitment 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. Tension among the local psychiatrists 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

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5 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. The m edical 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. Afiel d'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. Every time he would do an interview, the local doctors would complain to the medical society. They would go and min gle 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. 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. 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 kn ow 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 m embers joining. There were more people arriving which helped redirect some of the hatred that the local community had pointed toward Dr. Afield. Presidents and the medical school 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. The stress of the job Mr. Afield was young and inexperience d 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,

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6 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 th e Community Mental Health Center until it was finished. The Florida Mental Health Center went its own way and USF "stayed away from it." Private practice Mr. Afield stayed here until about 1976 in a clinical position, but went into a private practice i n 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 pract ice. 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. 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. Dean Don Smith They 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 aca demics, which didn't bring much repute to the school. 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, h e 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 R esearch 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 priva te practice. Now they have a very good practice program in which people from the university are involved. Dr. Afield learned very quickly that "care is determined by who's paying the bill." If psychoanalysts in Washington are funding, then psychoanalyst s will get money, once they stop, the psychoanalysts will "disappear." Exposes injustices 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 hel ped expose some injustices and Dr. Afield was even invited to testify before Congress.

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7 Different jobs Afield held He created and managed a health care company. They essentially wondered why a person needed to be hospitalized for a long time and got peop le 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. Family 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. USF and other medical schools 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." No w 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 doc tors, 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 succ essful 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 th ere 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 t rouble in allowing the program to grow and flourish. Involvement in Medical School now 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 pl ayed an active role in getting Joshua Logan and some people in the graphic studio to come down here. 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 psyc hiatrist 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

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8 was at the time because he was the youngest department chair in the country when he began his career at USF. Advice for future students or staff 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. USF has a good facu lty 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. Services for children Unfortunately the services for children are just as bad now as they were thirty years ago. Rather than working with kids, they are "th rowing medicine" at them. Services for the mentally ill are bad. Student population 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 t hat 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 happ y 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 thi rd are not the same. The school has done a good job of training doctors that will stay in Florida. Is counseling for students adequate? "No it's terrible." He feels that no one cares about it and it is terribly disorganized. He believes that it is cha llenging 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. Information on his slides Slide 1: The original medical school staff. 2. Dr. Afield on the site of the future medical school. 3 4. Maps. 5 6. Aerial shots.

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9 7. Student Center. 8. Building where medical school was until 1973. 9. Aerial view. 10. Where Picasso was to go. 11, 12, 13, 14 models of medical school. 15. Empty lot where school stands now. 16. The VA Hospital under construction. 17. Looking over plans of VA. 18. Building VA. 19. The first two residents on the faculty, 1972. 20. And 21. 1973 medical school and facul ty. 22. School finished with faculty department of psychiatry. 23. Completed medical school. 24 30. Construction of Medical School. 31. Opening of VA. 32 36. Completed VA. 37. Ariel view of University Community Hospital. 38. St. Josephs. 39. Tamp a General in early 1970s. 40. All Children's Hospital. 41. Florida Mental Health Institute Under Construction. 42 43. St. Petersburg Child Guidance Clinic. 44 48. The rest begin at St. Joseph's Hospital, which was supposed to be a major teaching hospit al. It didn't work out this way. 49. First Master's Degree psychiatric nurse in Florida. 50 60. Going over plans and showing interiors of places, including the artwork. 61. Cafeteria. 62. Day Hospital. 65. Waiting room. 66. Beds as the nuns and loca l doctors wanted them. 67. Beds they got. 69. Meeting of charter school at St. Josephs 70. Some residents. 71. Initial Staff. 72. First two patients: Two stray cats. 75. Jesuit priest and pastoral counselor. 76. Cake. 77. Trying to pull someone in a s a patient (jokingly). 78 79. With the two patients. 80. Playing ping pong. 81 85. No patients, just hanging about. 86. Residents. 89. Students meeting with surgical patients. 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

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10 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. En d of Interview


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