Cardiology at the Los Angeles County + USC Medical Center: A Personalized History

By L. Julian Haywood MD

A history of events relative to the development of the medical sub-specialty of cardiology at the Los Angeles County + University of Southern California Medical Center, told from the personal perspective of a member of the Keck USC School of Medicine in the Division of Cardiovascular Medicine, who arrived there as an Internal Medicine resident in 1956 and has practiced academic medicine at the medical center continuously since that time.

• Language: English
• Publisher: BookBaby
• Release date: Jul 9, 2019
• ISBN: 9781543973174

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Chapter 1

The George C. Griffith Years

(1946–1956) and Interim (1956–1963)

Having completed a year of residency, split between the University of Virginia and Howard University, followed by a two-year stint as a medical officer in the US Navy, I arrived at L.A. County Hospital in September 1956 to begin the second year of residency training in internal medicine. I immediately inquired as to the ongoing teaching of cardiology, but the news was not good; there was no formal teaching in the form of special teaching rounds or conferences. This seemed to be directly related to the fact that Dr. George C. Griffith, the first head of cardiology at the University of Southern California (USC), was in the process of retiring—involuntarily—because he had reached the age of sixty-five, the mandatory retirement age at USC at that time.

Persistent inquiry, however, turned up the fact that there was an electrocardiography (ECG) conference that occurred regularly on Thursday mornings at 8:00 a.m. This appeared to be a step up from my intern year at St. Mary’s Hospital, in Rochester, New York, during which I had to track down the attending staff member who read ECGs regularly and agreed to let me join him for one-on-one sessions.

The Thursday morning ECG session—held in the main hospital auditorium—was presided over by Dr. William Paul Thompson and attended by several older attending physicians, who, I later learned, were all volunteer faculty for a different medical school. Some of them were pediatric attending.

In that manner, I learned that there were, in fact, three medical schools affiliated with the L.A. County Hospital: USC; the College of Medical Evangelists (CME); and the California College of Osteopathy (CCO).¹ USC supplied almost exclusively volunteer faculty, who were mainly in private practice and came to L.A. County one to three times each week to conduct teaching rounds. Among this group, Dr. Griffith had been an exception in that he maintained an office on the seventh floor of the hospital and had a secretary, who was situated next door to a largely inactive cardiac catheterization laboratory. Dr. Griffith also had a cadre of fellows who had trained under his tutelage, a few of whom were still around working on various projects while also engaged in some practice or other employment outside of the hospital. In addition, he maintained a large private practice at Good Samaritan Hospital near downtown Los Angeles, as well as an outpatient clinic of sorts next to the hospital, where patients were seen by his clinic associates and one or two fellows. Chief among Dr. Griffith’s clinic associates was Dr. Willard Zinn, who also was his private practice associate. ²

Although Dr. Griffith’s reputation was as a prominent cardiologist, he apparently came to Los Angeles to open a cardiology-specific practice without the benefit of formal cardiology subspecialty training. He is listed in the Directory of Medical Specialists as having been certified in internal medicine in 1941 and having served a rheumatic fever traineeship before arriving in Los Angeles in 1946.³ What I encountered in the way of cardiology infrastructure at L.A. County Hospital was the result of some years of on-site activity by Griffith.⁴

Dr. Thompson was the first formally trained cardiologist to arrive in Los Angeles, where, prior to 1942, he joined the CME faculty and the staff of Good Samaritan Hospital.⁵ He had trained at the Peter Brigham Hospital in Boston under Dr. Samuel Levine, to whom Dr. Thompson often referred with reverence. Less often, and less reverently, he referred to Dr. Paul Dudley White, the eminent cardiologist associated with the similarly Harvard-affiliated Massachusetts General Hospital, as P.D. Dr. Thompson joined the voluntary faculty of CME, which supplied approximately one-half of all of the teaching services at the L.A. County General Hospital across most of the medical, surgical, pediatric, and obstetrics and gynecology (OB-GYN) services.

During my two years of formal residency training from September 1956 to August 1958, I had regular contact with volunteer faculty from both CME and USC. Residents did rotations on medical services that alternated monthly between the sixth and seventh floors of the hospital, supported by staff affiliated with CME and USC, respectively. Years later, I learned that a separate hospital building provided patient care services under the auspices of L.A. County and CCO, but I had no contact with personnel in the osteopathic hospital or school and rarely heard them mentioned.

Through my first two residency years, the ECG conferences led by Dr. Thompson remained the only formal cardiology teaching activity. The most effective overall teaching activity, by far, was known as residents’ rounds, organized and carried out by the cooperating chief residents of the CME and USC training services and held at 5:00 p.m. several days per week in a sixth- or seventh-floor conference room.

Not long after my arrival at L.A. County, a surrogate of Dr. John Denny, assistant medical director of the hospital, approached me to work for two to three hours on Monday afternoons in a clinic devoted to hypertension patients, on the hospital’s second floor. Denny served under the medical director, Dr. William Evans, and both were CME faculty members. I agreed, since there were only two other regular clinics—one devoted to hematology patients and the other a hypertension clinic run by Dr. Robert Maronde of the USC faculty on Wednesday afternoons. After a few weeks, I became the senior resident and earned a small stipend for supervising the other residents and recruiting replacements. A major part of our responsibility was keeping good clinical records from which teaching and research material could be derived.

Later, Dr. Maronde of the Wednesday clinic asked me to collaborate on clinical trials of new anti-hypertension drugs. I readily agreed, beginning a long professional collaboration, mentorship, and friendship with Dr. Maronde. This experience fueled my determination to specialize in cardiology and pursue academic medicine, if possible.

Among the various attending physicians, some were strictly general internists, while some, by virtue of apprenticeship-like arrangements or personal election, devoted a major portion of their practices to individual specialties such as endocrinology, cardiology, hematology, and rheumatology. At the beginning of my residency, the only full-time attending physician at the hospital was Dr. Helen Eastman Martin. Dr. Martin was widely recognized as an expert in the management of diabetes and was the senior attending on a very busy ward devoted to the care of diabetic patients. She was later joined by Dr. Telfer B. Reynolds, who returned from a liver diseases fellowship under Dr. Sheila Sherlock in London, England, apparently after serving a previous year as a cardiology fellow at Brompton Hospital there.

During my second year of residency, a third-year resident, Dr. Shannon Brunjes, confirmed the diagnosis of pheochromocytoma in a young patient by using laboratory tests available at that time. Over the next several months, he surveyed the family and confirmed the diagnosis in several other family members. In the process, he set up his own laboratory and began screening hypertension patients. Supported by a part-time position, he stayed on after his residency to write up his experiences. A first-year resident, Dr. Vincent DeQuattro, whom I recruited to work in the hypertension clinic, became interested in this project and began to work with Dr. Brunjes. When Brunjes was recruited to join the staff at Yale’s New Haven Hospital as a medical statistician, Dr. DeQuattro was accepted for a fellowship at the National Institutes of Health (NIH) in a metabolic laboratory. He returned to USC a year later and accepted