First-Class Teachers

In the University’s sesquicentennial year, we remember three noted faculty members who inspired students with unforgettable lessons about medicine—and humanity.

BY CANDACE O’CONNOR

Ernest Sachs in the lab

Setting an example for compassionate patient care: Carl V. Moore

His father was a St. Louis police officer, his mother a northside confectionery owner, and Carl V. Moore, AB 28, MD 32, took a series of menial jobs to pay for his education. Through-out his life, he held strong, basic values: hard work, frugality, honesty, kindness. He always made time to talk to students, and “he never forgot that a patient was a human being and not just an interesting case,” said molecular biologist Oliver H. Lowry after Moore’s death in 1972, days before his 64th birthday.

Moore joined the medical school faculty in 1938 and stayed for his entire career, serving as dean, 1953 to 1955; vice chancellor for medical affairs, 1964 to 1965; and head of his beloved Department of Medicine, 1955 to 1972. A pioneer in the young field of hematology, conducting classic studies of iron metabolism, he was elected to the National Academy of Sciences in 1970.

Yet teaching was his greatest pleasure. In class, he stressed the importance of observation, recalls Virgil Loeb, MD 44. “I’ll never forget it. He would insist on his students looking at the patient’s blood and urine in the laboratory microscope. It wasn’t enough to get a report that told you what the problem was; you had to see for yourself.”

Carl Moore—teaching was his greatest pleasure—preferred the personal approach.

His Saturday noon clinics were models of clarity and compassion. He would emerge from the wings, pushing the wheelchair of the patient whose case he planned to discuss that day. Unlike other faculty, who relied on a house officer to describe the history and physical findings, Moore did it all himself—never ignoring the patient in the process. “He would stand behind the chair, holding the handles, and present the case, flawlessly,” says M. Kenton King, MD, dean of the medical school from 1964 to 1989.

No setting was off limits for learning. As a young house officer, King was admitted to the hospital with a terrible sore throat. Moore stopped by, shone a flashlight down his throat and couldn’t resist another lesson. Excusing himself, “he went into the bathroom, literally tore the mirror off the wall, and put it down in front of me so I could see it too,” King recalled.

Day in and day out, he taught by example. Once Moore came to the hospital in the middle of the night to tell a terrified medical student that he did not, after all, have a fatal form of leukemia. Another time Loeb and a lab mate were eager to test whether a blood transfusion from a patient with low platelets would reduce the recipient’s count, too. Moore insisted upon being the subject —and wound up seriously ill for a day, though the research was a success.

One morning, Moore visited City Hospital, where a difficult case was being presented by a house officer who confessed he did not know what was wrong with the patient, though she had a blood disease. During his talk, Moore’s mind wandered, and by the time the young man finished, Moore realized with a start that he had heard little. Now it was his turn to speak, so he gently approached the patient, asking her questions no one had thought to ask before over the many years she had been ill. Eagerly she described previous bouts, then Moore turned to the crowd and announced quietly, “She has pernicious anemia.”

Perhaps Moore did not have the star quality of his predecessor in internal medicine, W. Barry Wood Jr., another superlative teacher. “Barry Wood dazzled people, he was so good at everything he did,” says King. “Carl Moore didn’t dazzle people—he just made you realize he was a good doctor.”

Endowing students with a love of science: Mildred Trotter

A new medical student,” says Loeb, “is a frightened animal. They have seen the movie version of the dissection of bodies and are expecting all kinds of macabre things. But there, in the gross anatomy lab, we found Mildred Trotter. Here finally was a teacher you could become closer to than some of the tough, steely guys on the faculty; here was a breath of loveliness in an environment of dead bodies.”

To generations of students, Mildred Trotter (“Trot” or “Millie,” to grateful alumni) was a mother figure, warmly interested in their welfare. Not that she was a pushover in class: She was tough, meticulous, exacting. Hands on her hips, she barked at students when she thought they needed a dressing down.

On one never-to-be-forgotten quiz, she asked for the names of nerves supplying the muscles of the leg. In his answer, William Landau, MD 47, exuberantly included the nerves that supply the thigh muscles—and got a “zero” for his effort. The leg, Trotter wanted to make clear, only covered the distance between the knee and the ankle.

Trot came to the University in 1920, a Mount Holyoke graduate who earned a 1924 PhD in anatomy, then joined that department as instructor. Named assistant professor in 1926 and associate in 1930, she finally became a full professor in 1946—the first medical school woman to achieve the rank—after demanding to receive the promotion or know in what way she was deficient. Twelve years later, she won another hard-fought battle when her title was changed from professor of “gross anatomy” to the broader, more accurate professor of “anatomy.”

Mildred Trotter, MD, working with her much-beloved bones.

Her lifelong interest was bones—her office was littered with ribs, femurs and tibia that she had studied and measured. Through her research, she built a national reputation in physical anthropology. After World War II, she was called to Hawaii to identify the remains of those killed in action; her formulas for estimating human height from bone evidence are still used by the FBI today.

In class, her enthusiasm kindled students’ interest in this often-dry material that required pure rote memorization. “I read Morris’ Anatomy and if it wasn’t quite clear …I read Gray’s Anatomy, and I knew all the nerves and muscles and God knows what all,” said Daniel Nathans, MD 54, in a 1979 reminiscence. “But that is the kind of atmosphere there was in that course.”

At alumni reunions, Trot—who died in 1991 at age 92—received standing ovations. “It was an honor to have her come sit at your table,” says Loeb. Adds King: “If you took 1,000 School of Medicine alumni and asked them to name the teachers they remember, I think 999 would mention Mildred Trotter.”

Training young doctors by insisting on excellence: Ernest Sachs

In 1954, neurosurgeon Ernest Sachs published a small book, Prerequisites of Good Teaching & Other Essays, which offered hints on how to teach. “Be enthusiastic,” he wrote, “be sincerely interested in your students.” All but the last—“dramatize whenever possible, making use of suspense and surprise”—made him sound like a gentle academic, in the mode of Carl Moore.

In fact, Sachs was gruff, domineering —a tyrant in the classroom. He held Thursday noon clinics on the third floor of Barnes Hospital in the now-defunct surgical amphitheater widely known as “the pit.” That nickname inspired a few for the combative Sachs, who became the “bulldog” or “lion” in the pit. A short, stocky man, he had a large belly that he used as a tool, butting students to underline his displeasure.

In the pit, he taught physical diagnosis, summoning a nervous student to detect the problem of that day’s patient. “You would sit there in abject fear that this was your day,” recalls Loeb. One patient had a metal ring taped to his navel — a device to help target X-ray images — but the hapless student guessed it held in a hernia, and Sachs roundly berated him for missing key clues. “When it was over you could sit down and take a deep breath,” adds Loeb, “since you only had to do it once a semester.”

Later, students realized they had actually learned a great deal. “He taught them basic principles never to be forgotten,” said Edmund A. Smolik, MD, in a 1958 obituary for Sachs, who had died at 79. “Generations of students …continue to hail him as their greatest and most inspiring teacher—the fear replaced by affection, the tension by myriads of delightful anecdotes.”

Sachs, who earned a 1904 medical degree from Johns Hopkins, served on Washington University’s faculty from 1910 to 1949, becoming the nation’s first professor of neurosurgery in 1919. A founder of the Society of Neurological Surgeons, he helped shape the field, training 30 fellows who went on to major positions.

Behind his fierce exterior was kindness, intensified by personal sorrow. He had a young daughter who contracted meningococcal meningitis; in that pre-antibiotic era, the only hope seemed an unproven surgical procedure, performed for Sachs by a younger colleague. The child died anyway, and afterwards Sachs was more protective than ever of his patients and of families who suffered loss. Secretly, he also paid the tuition of several medical students—perhaps some of those he had so sharply berated.