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subfield code a C53-000062 USFLDC DOI0 245 Patricia Cowdery oral history interviewh [electronic resource] /c interviewed by E. Charlton Prather.500 Full cataloging of this resource is underway and will replace this temporary record when complete.7 655 Oral history.localOnline audio.local710 University of South Florida.b Library.Special & Digital Collections.Oral History Program.1 773 t USF College of Public Health oral history project4 856 u http://digital.lib.usf.edu/?c53.6
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text E. Charles Prather: Were privileged to have with us this afternoon Dr. Patricia Cowdery; an M.D. whos, far as Im concerned, has spent her entire career in public health; and shes almost unique in that she started in public health before she went to medical school, and I really think she had some public health experience even before she went to college within the Board of Health laboratory system. So, she waskind of had a career set, whether she knew it or not. Im aware that she spent some time in private practice, but a short period of time between stints in matters of the publics health. Shes a long time health officer for the city of Jacksonville; she is an employee of the State Board of Health, in a number of capacities, over a number of years; and spent themore years than she will let me remember, formally in public health programming with the Florida State Board of Health; and I dont want to mention either, but her history and her knowledge of the action of the Board of Health goes back a long time, and because of that, its a particular privilege to have Dr. Cowdery to be willing to come and just kind of reminisce with us about public health in Florida. Dr. Cowdery, thank you so much for coming out
Patricia Cowdery: Oh, you know, you remind me of theI grew up in public health, absolutely
CP: (laughs) I knew that.
PC: My first memories were working in the old laboratory with Mildred Galton and Mun Kwan.
PC: And I cant remember what year it was, but it was before med school.
CP: Yes. Can I ask when you entered medical school? Thatd give us a handle
PC: I entered med school in 44.
CP: In 44, and that was at thein Philadelphia Womens Medical Complex?
PC: No, there was Temple University.
CP: Temple. Im sorry, Im sorry; I got you confused with another lady physician of our mutual acquaintance. All right, and you went there in 44, so it was 42 or maybe even 40?
PC: Probably 42 or 43, and
CP: Whatd you do?
PC: Worked in the old enteric bacteriology lab.
CP: Oh, you did?
PC: And learned the mysteries of typing salmonella.
CP: Oh, you did?
CP: This was as a college student or high school student?
PC: AsasI think it was in the time between I gradgraduation from college and entering med school. I, you know
CP: Okay, 44
PC: In those early days, women didnt go into med school very much, and I wanted to make sure I didnt outgrow the idea, cause it was a pretty expensive proposition to get started on, if you werent sure you were going to do it.
CP: Yeah, and at Temple too, and this was war years. World War II
PC: This was war years.
CP: War years, too. Hm. But what brought you to board of health laboratories, though? It just was
PC: I majored in bacteriology at college.
CP: Oh? Oh, you had? And where was college?
CP: Vassar College. Ooh, thats one of those ladies colleges?
PC: Yes, yes. A Seven Sister The Seven Sisters is a loose association of liberal arts colleges in the Northeastern U.S. that are historically womens colleges. They are Barnard College, Bryn Mawr College, Mount Holyoke College, Radcliffe College, Smith College, Vassar College, and Wellesley College.. (CP laughs)
CP: Yeah, yeah. And so, you had a bacteriology degree?
PC: I had a bacteriology background.
CP: And you came here, and they let you practice it.
PC: Yeah, I thought it was very interesting, and this was a place I could do it and get paid.
CP: You got paid.
PC: Not a lot, but got paid.
CP: Yeah, but you were a Jacksonville girl.
PC: I grew up here.
CP: Youyou enjoyedyeah, you grew up in Jacksonville; as Im recalling, you didnt graduate from high school here. Did you go to a private high school?
PC: Yes, I went to a private high school, but here in Jacksonville.
CP: Oh, okay, okay. I dont want to interrupt and talk.
PC: No, I just remember the lab. I remember Mun Kwan saying, Draw the stool. (PC laughs) (CP and PC laugh) Wed be opening all these damned samples.
CP: That was a goodyou need to tell the audience that Mun Kwan is Chinese by birth and background, and a very accomplished parasitologist, and was
PC: And artist.
CP: And artist. A very accomplished artist, as well.
PC: Yes, he was great. A parasitologist beyond belief, and thats how I knew him; and I was so amazed when he ended up a professor of art at thewhere? Jacksonville University.
CP: Jacksonville University. After he retired from here.
PC: And has all kinds of one man shows, and
CP: Worldwide. Worldwide.
PC: Tremendous, tremendous respect.
CP: As a playwright.
PC: But I knew him when. (PC laughs)
CP: I have to tell you a quick story about him. He, once upon a time, as a Christmas present, gave me a watercolorpersonally gave me, as a gift, a watercolor; and he just presented himself to my office; and laid this wrapped up something flat on my desk, which I immediately recognized, even wrapped up, as a painting; and I opened it up very quickly, cause he had flipped on his heels, and was started out; and I says, Oh, my gracious! An original Kwan! Was my first remark to him; and he turned around and said, Yes, done by hand. And out he went. (PC laughs)
PC: Well, his early paintings you could recognizeif you lookedthe parasites that inspired them
CP: Yes, yes, you could
PC: It was very interesting. He got more abstract after that.
CP: In his early days.
PC: Â But you couldyou could see, in his early paintings, these little old parasites that he was used to.
CP: Yeah, and for our audience, hes stillI think hes professor emeritus of art at the Jacksonville University.
PC: Yeah, yeah, yeah. Hes older than I am, so he would be emeritus.
CP: No, now, that the emeritus be
PC: But anyway, I wouldanyway, hes no longerhes not active; but I just loved being with him.
CP: How long did you work here, with the labs? And you were a formal employee, you were not a student? An intern?
PC: I was an employee. Each time I came.
CP: Yes, yes. Formal employee.
PC: A formal employee, and sort of bounced in and out as I went to med school; and then we had a hiatus, because of the war, where, originally, we were supposed to go three years straight, with no summers; and the H-bombor the A-bomb was dropped; and so, theythe war ended, so they didnt want us to finish in a crazy schedule; so they took us out of work for six months, so that wed start back in September, instead of June. And so, I had six months, and I came back here; and I cant remember which one of my adventures here, with that oneI think it was the Earnest Hines Rapid Treatment Center.
CP: Oh, really?
PC: You know, thethe ship, I guess it was some of kind of ship transporttroop transport ship.
CP: Troop transport, and it was
PC: They had that anchored at the foot of the
CP: Alsop Bridge [in Jacksonville].
PC: The Alsop Bridge. Youd get it past the old six-sixty-six building
PC: And there was a gangplank that went up and down, so that people would not go on and off that ship without permission. And so, I would report there in the morning to do dark fields and run the lab; and it was in the very early days of penicillin.
PC: And people were getting, I think it was something like ten thousand units every four hours.
CP: Maybe that much. It really started off with six thousand units.
PC: Well, I cant remember exactly.
CP: That was the first
PC: But they went through, and the patients were brought from all over
CP: All over Florida?
PC: All over Florida; and they were berthed in all of these places and fed well; and the gals that gave the shots would go walking up and down the aislesthey werent aisles. What do you call them? But anyway, calling people in every four hours, and theyd go, Â Shot time! Shot time! Up and down the aisle. (PC laughs)
CP: And then the patients would drop their pants, and go
PC: And theyd go in, and get their shot, and go back to playing cards.
CP: We need to tell our audience that this was for syphilis.
PC: Oh, this was for syphilis. Yes, this was the rapid treatment center for syphilis. And I guess it was the firstin the wave of the first being able to treat syphilis rather than rub in mercury and all that those drag things.
CP: It was a real treatmentcure for syphilis.
PC: Yes. It was amazing.
CP: And you was on the ground floor of that.
PC: Well, I was onat least, on boat.
CP: Yeah. This, let me remind youno, not remind you to tell our audience that this grew out of the war effort for doing something about syphilis, because a positive syphilis test was reason for deferment from the draft; and we had a lot of people, particularly in the south, who were drafted and found to have syphilis.
PC: Thats right.
CP: And so these rapid treatment centers grew out of that need to do something about it, and there were a number in the US, and it just thrills me that you were on the ship. Im very familiar with that history, but I didnt participate.
PC: Well, it was a very interesting thing. I think, in the beginning, the thing that impressed me, was you had get permission to go on up and down that gangplank.
CP: Even you, as the laboratorian?
PC: Well, it was up, you see, and you had to get somebody to let it down, so you could get off.
CP: Oh, and someone there was controlling it. Now, going out of that, and beginning in about mid 45, 46, permanent sites were established as rapid treatment centers; and the one for our area was in Brevard County in Cocoa, an old military base there. Did you get involved with that, as a (inaudible) site?
PC: No, we hadno, we had an extremely active V.D. clinic here in Jacksonville.
PC: But I guess that was after the technique and the art was all put down in stone.
CP: Fair enough. And the penicillin flowed like wine. Ive also readparticipated in your Jacksonvilleyou had a semi-rapid treatment center, but it was a daypatients came in by the day, and we had twenty-four hour penicillin, and two that was in peanut oil.
PC: Oh, yes. People bitched about that.
CP: Man, it hurt. But it wouldI had some of my earliest days there, in the Jacksonville V.D. clinic; but patients being treated to high doses, high doses: six thousand units per day. I was the one that had to collect their urine, and they would bring in their gallon jugs every morning, when they came to get their next dose, there were given another sterile, clean gallon jug to collect their urine; and the penicillin was reciprocated back out of the urine. You know, thats my beginning.
PC: Its fascinating that the amount of penicillin we pour into people
PC: I.V. Intravenously and otherwise, just compared to the tiny bits that we used
CP: Yeah, just amazing. Just amazing. Well, that was a fascinating beginning, and this was in your medical school years, but you ultimately graduated from medical school, which you did in 44
CP: Forty-eight. Yeah, you told me you entered medical school in 44. Graduated inthen what happened? You were nowlet me ask you first, what got you excited about medicine? Why did you want to go into medicine? What stimulated you?
PC: I hated playing dolls.
CP: You were a girl, too, and you hated playing dolls.
PC: I didnt like the things that little girls did. They bored me to tears. So, I justI remember trading a doll Id gotten for Christmas, in a very circuitous way, with the neighbors little boy who had gotten a microscope for Christmas, and he didnt want it. Â So, I traded the doll for, I dont know, some comic books, and traded this for that, and ended up getting the microscope from Dave. So, it started early.
CP: Marvelous! Do you remember an age when you was doing this undercover bartering?
PC: I dont remember when II just gave
CP: Thats all right. And then you to Temple, how many girls were in your class?
PC: Six, I believe.
CP: Out of a class of what?
PC: A hundred.
CP: A hundred; thats a pretty large medical school class.
PC: Maybe it was ninety, but it was
CP: Thats still large.
PC: Maybe they beefed em up because of the war, also.
CP: They did, they did. Yeah, they did, all of them, on that jacked up program. All right. Did you have any interest in public health because of your two experiences before you got there, before you graduated, were you stimulated into community health in any way?
PC: I was interested in public health, but med school and internship over at thewhat was the Duval Medical Center, which became University Hospital, which is now Shands Jax; Shands Jacksonville Medical Center but I got fascinated with clinical medicine, as well.
CP: Yes, yas, yes?
PC: The Saturday Night Knife and Gun Club in the emergency room, and all the babies being born in
CP: In the emergency room.
PC: As you were moving from one place to another, and it was a challenging and fun thing, so I enjoyed clinical medicine, but Iyou know, my roots were in public health, really.
CP: Yeah. Did you go into private practice immediately after your internship? You got married somewhere along here, and starting having babies.
PC: Yeah, I did, I got married just before I graduated from med school; and, gosh, its hard to piece together, but I ended up with children, and [its] very difficult to piece together a career in clinical medicine when youve got three kids.
CP: And young, and not too far apart.
PC: That are fairly close together, that always seem to get sick the same time my patients got sick.
CP: Oh, boy.
PC: And I just couldnt juggle all the balls of keeping a family and a practice both doing well.
CP: And both of them are first priority demands.
PC: Thats right. So, thats what really put me back into public health on a full-time basis.
CP: And you could have some regular hours here, and predict your hours.
PC: I thought I could schedule things, and I could, to a certain extent.
CP: Okay. Well, what brought you in? What did you comewhere did you start?
PC: Actually, I guess, while I was in med school, I started doing laboratory work with Dr. Hardy.
CP: Oh, you did?
PC: Wonderful experience. That wouldmust have been while I was in med school, because he had brought back from the Korean War stacks and stacks and stacks of charts of material having to do with cholera and diarrheal disease.
CP: Shigellosis, actually, I remember a lot of antibiosis.
PC: He needed the material in them collated in a way that it could be usable for publication and so forth.
CP: Yes, yes.
PC: And so, I would go through these charts, and record the number of stools and the temperatures, and how long they were sick, and thisjust great reams of material about these diarrheal diseases and these messy, messy charts that he brought back with him.
CP: Yeah, as I recall, through the Armed Forces Epidemiological Board
PC: I mustI know it must have been med school, because I was impressed that, when I got back, and we were in our G.I. series
PC: In med school.
PC: They mentioned the simplicity of the Hardy swab, which waspeople had been having a much more difficult time getting
CP: Rectal swabs.
PC: A rectal swab, and his neat little
CP: Tell us.
PC: Q-tip in a tube
CP: In a rubber tube.
PC: In a rubber tube that had a bias tip.
CP: Yeah, and then you could lubricate that.
PC: And youd lubricate it, it slipped right in, stuck your swab out, pulled the swab back into the rubber tube, label it, and send it on to the lab.
CP: A Hardy-Watt swab. Yep, Hardy-Watt swab.
PC: And there I was, in med school, and the physicianbig professor was talking about the big improvement, now we had Hardy swabs.
CP: And so, you had to say
PC: Id just say, I know him.
CP: Ive worked for him.
PC: Ive worked for him, yeah. (CP laughs)
CP: Thats fun. Tell yourtell our audience that Dr. Hardy was Director of Laboratories.
PC: He was Director of Labs, and he was
CP: For the State Board of HealthFlorida State Board of Health.
PC: Yeah. Oh, a real gentleman.
CP: Super, first class gentleman.
PC: A very first class gentleman.
CP: And all the specimens that he had. He had been sent to Korea by the Armed Forces Epidemiological Board for the purpose of investigating the diarrheal disease among prisoners.
PC: Yeah, thats whatprisoners of war.
CP: And he carried a team, he carried a team of laboratorians and pathologists from here, from the state laboratory in Florida, there to do all of that. And they
PC: Well, we had a good lab.
CP: Yeah, we did, and we had Dr. Hardy.
PC: We had Dr. Hardy, and I think we had recognition as an enteric lab.
CP: Yeah, he brought back millions of laboratory specimens, besides those billions of charts, too. And I personally got involved with all those millions of laboratory specimens of isolates of salmonella, and shigella, and multitudes of other things, and the classification of those; and this lab spent years classifying those. You mentioned with Doctorwith Mildred Galton, that you got involved with the typing of salmonella.
PC: Yes, indeed.
CP: Im gonna bet those were Korean War specimens.
PC: They could well have been. Thats good. A very intricate process, in those days; I guess they do it P.C.R. Polymerase Chain Reaction. A biomedical technology used to focus on a segment of DNA and copy it billions of times. now, but anyways, ours was
CP: Theyve changed all the names since I was there. I dont know, they even changed the name of the bacteria, so I cant even talk to them anymore, no. But you came back; now, you were involved with that, and after your internship
PC: After, Ill tell you when it became apparent I had to close my office.
PC: And I wanted to go back to public health on a half time basis.
CP: Ah, yes.
PC: And I came back, and I talked to Dr. Sauder.
CP: And he was director of the Board of Health.
PC: He was the head of the Board of Health, and the big guy.
CP: He was the big boss.
PC: He sure was big boss; and he found things for me to do, working, gosh, with Sidoff over in
CP: Chronic disease.
PC: Chronic disease. And then, they decided they needed to get more data about nursing home patients, and the medications they were getting, and the care they were getting, and just general information about who was in nursing homes. And so, I went to work on a, sort of, an individual basis getting information about nursing homes; I learned a lot about nursing homes since before they were licensed.
CP: Ill bet you did.
PC: And it was
CP: Heck, your work probably wasit was kind of the precursor for licensure, wasnt it?
PC: It was, it was; because there was no licensure, and because of my data, we had, in Florida, particularly in Duval County, set up standards, and sort of graded people, and required inspections, and so forth. And whenI had a sanitarian, and a nurse, and weand me; and we visited each nursing home at a regular interval, and filled out forms, and made them fill out forms; then, when Medicare came along, I looked at those, and I thought, Gosh, were better than that. We did more than they did when they started out.
CP: Yes, yes, yes. That was your first job, on a part time basis?
PC: That was my first after, you know, when I was fully out of med school, out of practice, that.
PC: And it sort of grew from a half time, to a three-quarter time, you know.
CP: As your children aged.
PC: As my kids aged, Iand there was a little, you know, arrangement for their caregot little less complicated. But Im not quite sure how I ended up out of chronic disease and into other areas of public health. I just sort of slid from one thing to another; got a tremendous experience with epidemiology, with chronic disease, with
CP: Nursing homes.
PC: Nursing homes, maternal and child health, you know, health clinics, and how to gather data, which is an art that you dont learn in med school
CP: No, you dont.
PC: Or learn, you know, whats valuable and whats not valuable.
CP: And how do statisticians lie.
PC: Yeah. And we didnt, of course, have computers, and so, very complicated cards that you stuck pins through to
CP: Those are called McB?
CP: Marginal punch cards
PC: Thats right, the McB cards.
CP: Yeah, they were a godsend, as far as Im concerned.
PC: Well, they were a lot better than one, two, three, four, five.
CP: They sure were. They were.
PC: Yeah, it was
CP: I suspect you slipped from a place of need to a place of need.
PC: I think I did.
CP: But in the process
PC: I was fairly adaptable.
CP: You got some tremendous experience, though.
PC: That is true. When I wentdecided if I was going to be in public health, I wanted to be a real pro.
CP: Yes, good.
PC: So I went back to Johns Hopkins to get my masters in public health.
CP: Oh, you did? When did you do this?
CP: Okay. Oh, youve been in public health for years!
PC: I went to Dr. Sauder andto see whether the state would sponsor me, and I was fifty years old. I said, I dont know whether youll get that many good years out of me.
CP: They will.
PC: But I was sponsored, and I went up to Hopkins, and discovered how much I knew already.
CP: Yes, yes, through your day-to-day experience.
PC: I had just discovered a lot of stuff, just on my own.
CP: Great, great, great.
PC: But II hadNow, Ive had my union card, I can tell politicians and people who wereby that time, I was a health officer of one sort or another; I could put my foot down and say, This is it, you know? This is the truth.
CP: This is my union card; I know what Im talking about.
PC: This is the truth, I know what I am saying.
CP: Yeah. Where were you? What was your job at the time you took a break to go to Johns Hopkins?
PC: Uh, I was, I guess, the Duval County Health Officer, prior to consolidation.
CP: (Affirmative murmur)
PC: Yeah, thats what happened: I waswhen the State Board of Health was, you know, sort of shoving me around from here to there
PC: They needed somebody in Duval County because Dr. Morgan was about to retire.
CP: Yes, he had been the long time Health Officer for Duval County.
PC: And so, I went over as a sort of second backup person; and then he retired, and I had never met the county commissioners, I didnt know a soul over there; and I was on my way to MacClenny to do some public health something or other, and I was on the road; and I heard a news break saying that Dr. Patricia Cowdery had been appointed by the county commission to be the Health Officer for Duval County.
PC: And I turned around and went back to the courthouse where our offices were, at that point, and said, Whats this all about?
CP: Whats this I hear on the radio?
PC: They said, Well, there wasnt anybody else. (CP and PC laugh) Not that you were so good or anything, (CP laughs) just there wasnt anybody else. I said, Gee, thanks.
CP: You remember the year?
CP: You dont have to.
PC: I dont. It was probably 62 or something like that.
CP: Okay. I remember your days as the County Health Officer, though.
PC: Yeah, it was before consolidation; and so, the city and the county, we each had our own little departments.
CP: Yeah, the city of Jacksonville and Dr. Ed Smith was
PC: (Affirmative murmur) And certain things, the city politicians would notI dont know if they wouldnt acknowledge they existed or what, but the county took care of those. We took care of all venereal disease, whether it was central city or not. We took care of all tuberculosis.
PC: And we did a lot of the child health stuff, because the argument was the kids move back and forth across thethey do, the city limits, and its better to have them all in one system.
PC: So, wedeven though there was separate departments, there was a lot of crossovers.
CP: Did your relationships with the cityas Health Officers, yours and Dr. Ed Smiths
PC: I remember him well.
CP: Yeah, it was cordial, was it not?
PC: It was cordial
CP: Yall worked together okay.
PC: We had interned together.
CP: Oh, you were over at Duval?
PC: Over at Duval medical.
CP: Oh, you had?
PC: So, we knew each other well. There was a certain amount of defensiveness because the citythe county was part of the State Health system.
PC: And was there for professionalI mean, we had standards you had toin order to be a sanitarian, you had to meet certain standards; in order to be a nurse, you had to have so many years, and all of this; and the appointments in the city were political, to a large extent. And so, we did notit was very difficult to compare one to the other; and I think the city got a little bit defensive that we were just too hoity-toity with our requirements; that people, you know, have a college degree, stuff like that.
CP: And that the Health Officer be an MD.
PC: Yes, the Health Officer would be an MD.
PC: But it was, all in all, it was a cordial relationship.
CP: I always felt that it was. From my vantage point, it seemed like yall worked together very well.
PC: Yeah, I think the both of us had the well being of the community at heart, and he had to work with those politicians. I discovered after consolidation endedI mean, started after the two departments merged, and I became the head. After Tom McGibbony did it first, for a year or so, and then I did it. That you have to work to work with those politicians.
CP: Yes, you do.
PC: I mean, the art of making them think it was their idea in the first place.
CP: Good, good call for the audience on how to cause programs to progress in the political environment.
PC: And when to give and when to not give.
PC: And so, I got more sympathy for him in that he had tohe had some very difficult politicians
CP: Yes, yes.
PC: Some of them ended up going to jail, and they were not of the highest character.
CP: You served the city atfor our audiences sake, the65 or 66, that city inthe city of Jacksonville, and the county of Duval through a referendum of the registered voters decided to combine their governments; and you became Floridas second charter government. County government, it is called; and you only have one government, and that governs all city and all county stuff, and all the functions came under consolidation; and we stopped having two health departments, we now have one, but we are called the city of Jacksonville; and in all circles, except for the state legislative elections, you are the city of Jacksonville; but when you have a Florida legislative election, you are the county of Duval.
PC: Well, we had two communities, Baldwin and the Beaches, that did not join; and so, they were part of the county, and therefore, they were our responsibility as the county health office, even though we city.
CP: Yes, yes, yes.
PC: So, it was very complicated; and when the law was driven updrawn up, they didnt know, you know, the unintended consequences that they abolished all districts. Among the things they abolished, because it was all going to be one, were the mosquito control districts.
CP: Oh, yes. You
PC: And the mosquito control districts had their ownoh, lord, what are they?
CP: Funding source. They have a funding
PC: Their electI dont know theyre elected people or appointed people who run
CP: Mosquito control districts?
PC: Mosquito control, and so, all of a sudden, there wasnt any, and there was no way written down in the law of how to reconstitute it.
PC: Whoops, yes.
PC: But itthere were a lot little baubles like that.
CP: I recall, not vividly, but there was a lot of outcry about that mosquito control thing. Cause I think Duval, what is Duval County really, was covered by two mosquito control districts.
PC: (Affirmative murmur)
CP: Didnt you have two?
PC: There was a city and a county.
CP: Thats right, thats right. There was a city and a county mosquito control district.
PC: And the citys was a primarily spray and catch basin, you know, they were the inner city.
PC: And so, there, they took care of catch basins, which was their primary source of larval; and the county, of course, was this huge area of woods, and swamps, and villages, and everything else; and so, the county had dredge, you know, ditch, and drain, and
PC: Fill, and spraying, and all sorts of things on a grand basis; and I dont know whether we had helicopters that early or not, but we got helicopters along in the process, that we got secondhand from someplace; and I was taken up a couple of times in a helicopter, to make quick inspections of, not mosquito control, but landfills, cause we couldthey could pick me up and take me out to a landfill, boom boom, without having to traipse through all the back roads to get there. Except, I think they probably were called dumps, then.
CP: I think they were called dumps.
PC: Yeah, but I did not like that helicopter; you sort of slurped round to the side when you turn. I was chewing my nails.
CP: So, youwhat diddid you continue as the County Health Officer while McGibbonya General, Dr. McGibbony.
PC: McGibbony was brought inyeah, he was a Major General, and was to be the head of the health and hospital accrediting system of the United States. You know, its based in Chicago.
CP: Oh, oh, yeah, the Joint Commission hospital
PC: The Joint Commission The Joint Commission is an independent, not-for-profit organization. Approximately 82 percent of the nation's hospitals are currently accredited by The Joint Commission.yes, thats right, he was; and somehow or other, they lured him down here; maybe because there was good weather, and a good naval hospital and so forth. So, they brought him down here, and he headed up the initial
CP: Combined health departments.
PC: Combined health department.
CP: But he didnt do that long.
PC: He stayed with it nearly a year, I think, and then went on to a big federal project that was based here, in Jacksonville, but also involved, I think, thirteen other counties.
CP: Yeah, where did you fit in all
PC: Oh, at that point, I was the Mental Health Officer, in that after the war, lots of money became available for drug treatment.
CP: Up in Mental Health?
PC: And that was scheduled as Mental Health.
PC: And so, I was detailed to write some grants and make some money, so that all of these soldier boys coming back addicted to heroin and other stuff could get treatment; and so, weI wrote grants and, theoretically, this was to be a private, non-profit institution; the state didnt want it, and the city didnt want it; but it ended up a private, non-profit thing that I wrote up.
CP: And whose auspices were you doing this writing under?
PC: Under Dr. McGibbony, somehow.
CP: Oh, okay.
PC: Oh, you know, Im not sure it was legal, but he told me to doanything he told you to do, you did.
CP: But you was getting paid, though.
PC: He was a general.
PC: And so, I did it because he told me to do it; and so, we got this huge grant, which the city sort of bobbled and gulped, and said, You know, all these millions, what are we going to do with this? And so, the mental health clinic, which was supposed to run it, didnt have the expertise, which is not surprising. They dealt with a hundred thousand dollars is a lot of money, and this was big thing; and so, I just, somehow or other, pulled in lots of different groups and peoples, and ended up, eventually, it being a being a governmental operation.
CP: Under the auspices of city, county, or state?
PC: Under the auspices of the city.
CP: Okay, and McGibbony kind of sittin on the top of the totem pole.
PC: In the city, Dr. McGibbony sitting up there, and when Id say, God, I cant do that, hed say, Yes, you can, and hed walk out. You know, I would say, Is that legal? Hed say, I dont know.
CP: Doesnt make any difference.
PC: Doesnt make any difference. You get it done; weve got to get it done. Weve got all these boys coming home; weve got to treat them.
CP: We got to do something.
PC: Got to do something, thats right.
CP: Yeah, and if we need forgiveness, well get it later.
CP: Yep. All right, but did you find yourself as the head of this activity?
PC: I was the head of the mental health sectionMental Health Division, and thats when I went off to Johns Hopkins, thats right.
CP: Was this an escape, to go to John[s] Hopkins?
PC: In a way. In a way. And when I got back, Dr. McGibbony was ready to quit; to join thethis big federal health planning business.
CP: Thats right, thats right, comprehensive health planning.
PC: And so
CP: Or hospital consultant.
PC: Ithe head of thewell, it was not the mayor, but the mayors guide, called me over and said, Would you be interested in being the Health Officer? And I looked at him, and saidYou know, I wasntmaybe this was ultimately practical, I dont knowI said, Uh, Ive got so many years vested in the state system, and the city does not, you know, recognize that, but Id have to switch my retirement system, and Ive got three kids to support, and I dont want to take a chance. And I said, Ive got to stay on the state retirement system. And he said, Is there a law? And I said, Well, Ive been told that you cant. He said, Well, well see. And so, he got some legislators to waive the
CP: Pass the cute little old law.
PC: Waive the requirement so that I could work for the city, and be under the state system.
CP: That was a useful precedent, though. You remember when the City Health Department was required to come under the Division of Healthof the latter days of the Board of Health, your precedent on that established a rather relatively easy transition for the city employees to become state employees.
CP: You remember? And vice versa. Cause they had the same problem; they couldnt transfer our retirement system.
PC: Yeah, Ithereswhen you reach a certain age, you need that security feeling.
CP: Yes, yes, you do. Yes, you do.
PC: Im glad Ive got it.
CP: Im glad youve got it, too. Yeah. All right, you wannacan you tell me the year?
PC: I took over the health department in 71, 72, I guess.
PC: I graduated from Hopkins in 71, so it would have been probably 71.
CP: And you continued, for the rest of your career, as the City Health Officer.
PC: I stayed there
CP: Till you [retired].
PC: Through four administrations, I was the only department head who did that; and I dont know whether it was they couldnt find somebody else or whether
CP: They were satisfied with your work.
PC: I just kept themyou know, kept stroking them, and telling they were doing good things, and lets keep on doing it.
CP: How to get along with politicians.
PC: Thats howI learned a lot.
CP: Did you learn that in the school of public health or did you learn that through the school of hard knocks?
PC: I learned that just from seeing what worked and what didnt.
CP: Thats the school of hard knocks.
PC: Thats the school of hard knocks.
CP: Because you were eminently successful as the Health Officer. I want you to recall a little bit of HRS [ Health and Rehabilitative Services]. The infamous term HRS came into being in 69, and you became Health Officer not long after that, and part of the HRS transition was the demand, the command that the City Health Department come under the umbrella of HRS/the division of health/a new Health Officer. Can you remember back and just talk about that transition a little bit? As I remember, you werent a friend of HRS, nor, rather, outspokendiplomatically outspoken adversary.
PC: Oh. Of HRS. Not of state of public health.
CP: Not of public health. Oh, no. No, no, no.
CP: And Im not trying to put you on the spot, and Im notI dont mean that in a bad way.
PC: I can remember going over to testify before the legislature on several occasions, where I could do it because, by that time, I was a city employee, and I could notthey couldnt get back at me.
CP: Thats right; you were not a state employee.
PC: I was not
CP: And you was a public health spokesperson.
PC: And so, I would go over there and put the points of public health across, and
CP: Yeah, I remember that some smoke filled
PC: I remember, once, one of the heads of HRS, in its middle days, I guess, called this district administrator over here, who was Lucy Haydee, and said Who is that doctor that came over here as a Health Officer? Shes got to be fired! And Lucy just started to laugh; she said, We cant. She doesnt work for us.
CP: That was the beginningthat may have been the stimulus. Now, there were several of those episodes.
PC: Oh, there were.
CP: But I participated in some of the smoke filled, darkened rooms, working up an agenda to put the words in your mouth to come over there and speak.
PC: Oh, I can remember that, and also
CP: And you did it. You did it so well.
PC: We used the Florida Medical Association as a cover.
CP: Right. There was a lot of that.
PC: To do a lot of publicI would be requested to testify by the Florida Medical Association, so they would bring me over for that.
CP: Yeah. It was so valuable, so valuable to the big scheme of things.
PC: I dont know howit certainly kept them from riding too roughshod.
CP: Yes, they did.
PC: It kept throwing bumps in the road for em, which is what we needed to do. (CP laughs)
CP: Yep. You got any particular highlights you want to remember about that? About those days? A particular legislative meeting?
PC: Not really. I remember one where I was testifying, saying that the state health officer, the head of HRS, should be a physician. I mean, this business of having a social worker head up an agency which was primarily health did notthat does not compute; and so, I went over there and the head, I cant remember which was, at that point
CP: Well, they had a bunch of them.
PC: There were a bunch of them, wasand he was a social worker, was arguing that social workershe testified before I did, the social workers had
CP: the broad
PC: the experience in administration they had degrees that were not medical, but they had degrees that
CP: They were good doctors.
PC: Theywell, they were able to run big systems, and they had administrative experience and degrees; and I countered with the fact that I had a degree in public health administration from Johns Hopkins, and that I had been administering a multimillion dollar budget for about ten years, and we were doing very well; and so, doctors could be administrators. And that was the one that wanted me fired. Wanted me fired.
CP: That probably was Ingry. Probably was Ingry.
PC: That was, thats right. (CP laughs)
CP: Sounds like him.
PC: Yep. He did not like that. Course, he didnt change either.
CP: No, no, he didnt change an iota; but hed be the one to holler Fire! Fire! Fire! Get rid of them! And he could it. Oh man.
CP: During those transition days, ultimately you becomeyou became HRS.
CP: In, I dont remember the year, but you didthe City Health Department became a part of HRSbecame a part of the public health system of Florida. Now, istalk about those transitions, those transition years. You were the Health Officer while all that was going on.
PC: There wastheythe primary problem, during the transition, was personnel. The very different levels of expertise of the city and the state professionals; in that the county had been part of the state system, which like all state systems, is beaurcratized, and you have to be able to do this and you have to pass an exam to do that, and so, the people that were employed by the old county health department, you could look at their job title and you would know what their training was, and youd know what theyre able to do.
CP: Yes, you could.
PC: And then you looked at the city, and you had a lot of, sort of catch-as-catch-can titles, there was a whole group of people, who were employed for the specific purpose of going out into the polling districts, when an election was coming up, and getting out the vote for the politicians that they represented, and whatever method they had to use, and in between times, so that theyd get paychecks, they worked for the Health Department in some unnamed way.
CP: Oh, boy. Oh boy.
PC: And so, we had to, because part of the law integrating us, was toeverybody was to have a job, nobody was to lose a job, nobody was to get a decrease in pay.
CP: Thats right. You should have had a whole
PC: And so, we were stuck with these fifteen or twenty ward healers. Who had worked for the health department, and you know, those were the kindand also, for diplomatic reasons, you had to have some of the city people in supervisory positions.
PC: Working over some of the people in the county who were more skilled than they were, and so, there was a lot, a whole lot of friction and hard knocks, during that time, whenbefore we finally got everybody straightened out in a system where, at least, not that many people were angry.
CP: Yeah. Good. How many years do you think that
PC: Its enough to make you feel like youve have your bath in administration doing that, I can tell you.
CP: Ill bet you had did. Ill bet you had did. How long did it take you tothis transition, from the beginning to you feel like youre on an even keel?
PC: Probably four, maybe five years.
PC: Because you had to let attrition take care of certain things.
PC: And you were absolutely stuck with the law.
PC: You couldnt fire anybody, and you couldnt have your good people be supervisors, because you had to have some of the other system people be supervisors.
CP: You had to play the politics and the diplomacy.
PC: And it took a long time to get it all smoothed out.
CP: Im remembering your Environmental Health Director, who was one of those, and not remembering his name, and Im glad I dont, but that was a problem of major proportions.
PC: It was.
CP: It was supervising some trains out of turn, and apparently, that guy was totally incompetent.
CP: But he was the boss.
CP: You know? You and I had conversations about that, and you explained to me how come they aint nothing we gonna do about that.
PC: That was one of thoseone of those things you couldnt do anything about; because in the law, we werent allowed to do anything about that.
CP: Oh, me. From your long experience, now, I want you to speak further to your relationship with HRS, as you grew up into it. Just talk aboutcause youd had a very good, seems to me, position as the County Health Officer; and then, you slid in, accidentally, as the City Health Officer, and you kind of slid into that, as it seems to me.
PC: I think I did.
CP: Yeah. So, youve been graced along, no problems, everythings working good, then suddenly, bap! Heres HRS. Now, talk about that.
CP: You suddenly had problems on your hand.
PC: Well, Ithe problems that were most difficult was when the City Health Department had to combine with the State Health Department, which, you know, had thehad good standards, and high expectations, and so forth; when we hit the HRS, that was just a state-wide mess of notpoliticians not paying any attention to the way needs had to be met. They gave all these diagrams of silos side-by-side (CP laughs), and how you provided service from here to here; and I remember one time, we had, at that point, sentinel chickens for our
CP: Encephalitis surveillance.
PC: Encephalitis program, and they were, you know, scattered all around, and we had a real expert, old Mr. Milton.
CP: Oh, I know him. I remember him, yes.
PC: Who could bleed a chicken just like chopping a pill.
CP: He could bleed a chicken.
PC: He could bleed a chicken, thats right. And so, we would go out to these various flocks, and draw blood on the chickens to see whether they had any encephalitis bugs; and those reports would be sent, in the old days, directly to the Health Officer, if there was a problem. And so, one time, I got a call from Minnie Schreiber, on a Friday, in the lab. And she said, Pat, Im not talking to you right now, youre not supposedyou know, were not supposed to be talking. But
CP: I aint called you, but.
PC: But five of your chickens are positive, and its Friday, and Im supposed to send this information to Tallahassee, and then Tallahassee will send it back to you, probably Monday or Tuesday; and its a weekend, and the mosquitoes are out; and so, Ill let you act accordingly. So, I called Paul in mosquito control, and said, Old Plank Road is a hot spot. Weve got to do something about it this weekend, because weve got a bunch of positive chickens, and weve got a bunch a mosquitoes, and so, he said, Thank you very much, and so, they sprayed, by a helicopter, out Old Plank Road Way; and on Monday afternoon, I got this frantic telegram from Tallahassee, telling me positive chickens on Old Plank Road.
CP: Oh, man; oh, man.
PC: It was a messed up system
CP: Thats terrible.
PC: Where communication, medical or health related communication, had to go through this gosh-awful system of, I dont know, filters over in Tallahassee that everybody had to know what everybody was doing, and the two people who needed to know what was going on, in order to take action
CP: The last to learn.
PC: Were the last to learn. I mean it was aIll use a polite word, it was a messed up system.
CP: Oh, man; oh, man.
PC: And so Iit was just the politics ofI dont know whether he was a dreamer or what, thinking he would improve the healthcare system by having health and welfare and all of these things in one business, but it was too big.
CP: Im convinced that he was misguided, except there was two of them, they were misguided and were sincerely believed that they had the solution to the problem.
PC: They surely did. I mean, they were not evil or not thinking they were, it was nothing Machiavellian about it, but they sure did mess it up; and it never has straightened out, I mean, they pulled health out onto its own, now.
CP: The total of HRS, as we know it, has been dissolved. Everything has gone its own, individual ways. Not even the name remains. Did you know?
PC: Hooray. Well, you know Im out of the loop so much that I dont know whats going on too much.
CP: The new department of health two years now. A new departmentFlorida Department of Health.
PC: I knew it was a department of health, for sure.
CP: Secretary. Headed by a secretary.
PC: But I thought that they still had childrens services, and mental health services, and
CP: They do. Theres
PC: AFDC, you know, all of that was still combined, I guess its not
CP: It is. No, no, childrens medical services was department of health.
CP: But AFDCwelfare, the old welfare department, is back; its called the Department of Children and Families, and its anomaly is mental health. Mental health belongs to it, but there is a movement afoot to bring mental health into the proper family.
PC: Isince my retirement, Ive been involved with several programs; and one of them is the drug and alcohol system at Duval.
CP: Yes, yes.
PC: And they would like very much to have their state contacts be under health, rather than under children-families.
CP: Its a philosophic guidance, even though the philosophy that guides that department is appropriate; but its an inappropriate administrative philosophy for mental health services. That was the problem with HRS. For your general interest, Ive been in touch with one of the twobeen in touch with both sponsors of that infamous bill of 1969, and of 1974, that we called HRS; and they will be sitting in this chair, in due courseone will; the other one isAlzheimers has caught up with him real badly.
PC: Well now, Sandy D'alemberte was
CP: He was partial. He was not the brain back up at
PC: He wasnt the main one.
PC: Well heso, hethey seemed to genuinely think, well, its like people think that all of these HMOs and complicated systems to provide healthcare are the answer.
CP: Thats right; but were learning, arent we?
PC: Theyre not quite the answer.
CP: No, theyre not quite the answer. From all your years now, in being the Health Officer, and being very, very much a part of the Public Health System; and for the audience, I want you to know shes quite humble, this Dr. Cowdery is, but she was a very prominent player in public health policy and public health action in this state for many years, and you cant tell that from her humidity, right nownot her humidity, her humility right now. Let me ask youIm telling them that you were this player; pinpoint some highlights of your total career.
PC: I think that some of the early ones, of going on the ship, you know, the rapid treatment center?
PC: That was, you know, that stands out as something that was very different. I think that the first mayors staff meeting that I went to after I was appointed the department chairman for the citys department; which was health, welfare, mental health
CP: Oh, thats right.
PC: And bioenvironmental services, which had all of pollution control, toxicology, toxic spills, EPA, all of that was under it, too.
CP: Thank you for saying that. I was aware of that, and weve been talking local health officer, but you were unique in all of Florida, cause you were head of that department that had everything under the sun in it.
PC: Headed by a doctor.
CP: Headed by a doctor, too.
PC: Thats right. It made a big difference.
PC: It made a big difference.
CP: Now, you went to your first council meeting.
PC: I went after theyI was appointed in 7271,72, as the director of that department, and they had never had a woman. You know, I was the first woman department chair. So, I walked in, and all of the guys didnt know where I was supposed to sit. Im supposed to sit at the big table, with all the department directors.
PC: And that was a funny, you know, a funny little episode. Just like when I was lucky enough to be able to choose my own division chiefs, because most of them retired with Dr. McGibbony, the older ones.
PC: And so, the head of bioenvironmental services; which was pollution control, in a large sense, dealing with EPA, dealing with water, dealing with everything. The best candidates were retired military engineer types. So, I had some very good ones, but they werent accustomed to working for a woman.
PC: And it was so funny (CP laughs) to get theyou know, the staff meetings, they would almost say Yes, sir. (CP and PC laugh) You know, a question of whether they were supposed to stand up or not stand up, and so, it was a very interesting time.
CP: That was fun.
CP: But your background in training and experience taught you well how to manage that.
PC: Oh, yeah, it was a sense of humor. (CP laughs) A sense of humor.
CP: Thats cute. That would be a highlight, and that would go over a period of time, as every time you brought in a new one, you went through the same thing.
PC: I think that after I broke the ice, they gottwo or three years later, they began to bring in other women as department chairs, and
CP: Oh, good.
PC: People were used to it, by that time. (CP laughs)
CP: What were some of your lowlights, in contrast to highlights?
PC: That god-awful mess of trying to merge two sets of personnel with totally different training, and a law that didnt let you do it the way it needed to be done. That was really the absolutethat was the pits.
CP: Yeah, and you already told us, it took four years to get through that.
PC: Yeah, and it had to be done, and nobody else was gonna be able to do it any better.
CP: Thats correct.
PC: And so, it had to be done.
CP: And it was accomplished very successfully.
PC: It, we got through it. We got through it.
CP: Yeah, you did.
PC: We, you know, sponsored for those who would get caught into it; training to upgrade people, so that they could supervise, do things like that. So, we got over it, but that was aI didnt enjoy that one.
CP: Now, I want our audience to know that your long experience in Duval, part of this, youre now a member of a committee thats charged for operationalizing a state museum of public health in medicine, located here in Jacksonville, are you not?
PC: I just got a letter recently.
CP: Yeah, that youre appointed to that committee, and the experience that yourethe experience that youve had here, to bring to that committee function, I think, is just astronomical; and it pleases me, when I read you were a member of that committee. To have spentfor the audiences sake, it is the original state board of health building, built in 1911.
PC: That was a beautiful old building.
CP: It surely was a buildingold building, and it still stands; it is not occupied, its been condemned; but through federal and state money sources, the building is being refurbished to its 1911 appearance, and the legislature has spoken that it shall be used as a museum of Florida public health and medicine [The Wilson T. Sowder Florida Museum of Medicine and Public Health]. When it is refurbished, for our audience, Dr. Cowdery, I want them to be aware that youve been appointed as a member of a committee to operationalize, if thats a good word, a museum for Floridaa Florida museum for public health and medicine located in the original building of the Florida State Board of Health. A building thats referred to as the Julia street building, which is presently condemned, but the more and more public health action in Florida, in essence, began in that building; but through the wisdom of legislature, and funds from the legislature and federal sources, that building is being refurbished; its not been in use now for many years, its been a condemned building in bad physical shape; but
PC: It was a beautiful old building.
CP: Yes, it was, and you got your start in public health at that building.
PC: I did indeed.
CP: And I want to report that I got my start in public health in that building, but its been refurbished to its 1911 appearance, and will be a Florida museum for public health and medicine.
PC: I hope thats true.
CP: And I hope you have some artifacts thatd be from your experiences here.
PC: Im not a packrat. I really am not.
CP: Oh, youve got something.
PC: Ill try to find something. But Iat this point, at my age, Im trying to clear stuff out instead ofinstead of collecting.
CP: I understand, yes; but it pleases me that youre a member of that committee.
PC: I am delighted to be
CP: Cause I think you have a lot to bring to the deliberations of that committee.
PC: Well, you know, after I was in different places; visiting in Iowa, visiting in New Jersey, visiting friends in Connecticut, visiting various places; I would look at their public systems, and they couldnt hold a candle.
CP: They dont have a public health system, compared to your
PC: They had littlea nurse in this county would be visiting schools, and a nurse in that county would be doing something else; and Id say, Well, how about the restaurants? How about the landfills? How about, you know, when a disaster happens, who responds?
CP: Theyd never thought of it.
PC: Dont know.
CP: Never thought about that.
PC: I just dont know.
CP: Yeah, and in New Jersey, their state health department pure latency. Yeah.
PC: There wasI kept thinking everybody had one, but no.
PC: No, they didnt have doodily-squat.
CP: No, its only in recent years that every state has had an operating state health department. Two thereswhere theres some, and Its since manning your professional career, started as thatas that so. Hm. What have we left out?
PC: You know, I think maybe some of the big toxic spills that we had that
CP: Yes, oh, boy.
PC: That, where, we had a big pesticide plant, over on the west side, and itsomething happened over a weekend, and it blew up; it messed everything up; and the stuff was potentially very toxic, and so, I called the emergency response teams in Atlanta, with EPA, and was discussing the material with them; and the woman who was the head of that particular section, she said, Thank God Im talking to a doctor. She said, Im usually talking to the sheriff or the fire department, And she said, Trying to line up somebody from your community, who would know what was what, would be impossible. She said, Oh, it is so good that Im talking to a doctor. And I thought, Thats the organization that we have.
CP: Yes, yes, yes.
PC: Usually, Im talking to the sheriff or the fire department. (CP laughs)
CP: Thats great. Did- If you were ever to give advice to a graduate public health students, what would it be?
PC: Well, I would tell them it is one of the most exciting and challenging careers; that Ive sorted of backed into it because I could schedule time with my children.
CP: Thats an advantage, though. Thats an advantage.
PC: And would notit wouldnt interfere with family life so much. I had no idea that it was so much fun
CP: At that time.
PC: That it was so challenging, and that you make an impact.
CP: You cause a difference. Yes, you do.
PC: When I was practicing private practice, my patients loved me; and, you know, I would treat a sore throat, I would diagnose appendicitis, I would take care of somebodys foot fungus; you know, I would do this, and they would all think it was fine; and, at the end of the day, I had treated all these little people; and it didnt make any difference.
CP: Not really.
PC: And when you are in public health, you make a difference. You really can make a difference.
CP: Yes, you can.
PC: The community is your patient, and you treat your patient; and its an exciting career; I would not tell anybody that, you know, its meant for
PC: Dummies that cant make it or women or anything. Its a great career.
CP: Yeah, it is not for wimps. Thats good. Well, what else have we left out?
PC: I dont think theres anything else; youve sucked me dry.
CP: No, I dont think so; but let me do tell you, Dr. Cowdery, on behalf of the College of Public Health, especially at the University of South Florida, and the universitys library system, I just thank you sincerely; and for myself
PC: I enjoyed it.
CP: I thank you sincerely; and its been so much fun reminiscing, because a lot of this I had not preliminarily thought of; Im fairly familiar with the larger picture of your career, but not the details of your career, cause you and I have kind of been in this together, in the same city, for a long time, soand you was one of my favorite people
PC: Well, thank you.
CP: In spite of the fact that youre a woman health officer.
PC: And, you know, I remembered things today that I hadnt thought of in years.
PC: Its been fun.
CP: And its fun, the free association.
PC: (Affirmative murmur)
CP: The free association, and remembering; and youve painted, and in a number of ways, what, to me, is a very, very significant chapter in the history of Floridas public health. Youre not the first woman health officer
CP: You know, weve had many, and they have all been outstanding. I thought of that when you said earlier that youre the first woman in the department had ever had. I immediately had flashbacks to the woman Health Officers that weve had, and they have all been outstanding. Every one of them. Theres many of those who are still in public health; theres a number of those who left public health, though; who, and I think of three immediately, that went on from Florida positions of local health officers to make very, very important contributions in larger ways. One, coolly enough, became the head of the Department of Pediatrics at one of our major medical schools; another one continues to be the chair and professor of obstetrics and genecology at a major US medical school. Those two, and a third is somehow associated, but I dont know exactly her title, at the moment. I think of three of names, immediately very reminiscent of yours. You started, you got, thats now exactly Im gonna do, is a convenient sort of job, but you got hooked.
PC: Well, you walk down the hall, and you see a door open, you got to go through it.
CP: Thats right. So, let me thank you, Dr. Cowdery, truly, for taking the time to come and share with us; for students of history today, and students of history tomorrow, will watch this tape with great fascination.
PC: Oh, my.
CP: And Im sure; and let me tell you that today is February 22 of the year 2000, and I am Skeeter Prather.
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