Recollections of Dr. Joseph A. Resch; member of the first-class of neurology residents at the University of Minnesota (1946-1948) in a letter to Dr. William R. Kennedy

Prior to 1946 Neurology was part of the Department of Nervous and Mental Disease. The Department head was Dr. J. C. McKinley, Dr. A.B. Baker was responsible for neurology and Neuropathology and Dr. Burtrum Schiele was responsible for Psychiatry. A Dr. Reynold Jensen was in Child Psychiatry. Dr. Starke Hathaway was a Clinical Psychologist. Of interest is the fact that the widely recognized Minnesota Multiphase Personality Inventory (MMPI) was provided by Dr. McKinley and Hathaway.

In 1946 the Department of Nervous and Mental Disease was changed in name to the Department of Psychiatry and Neurology. Within this department was the division of Neurology and the division of psychiatry. Clinical Psychology was also in this arrangement. Dr. McKinley was disabled at this time and Dr. Donald Hastings was brought in as Head of the Psychiatry and Neurology Department.

Dr. Baker became the head of The Division of Neurology. Dr. Joe R. Brown joined the Division of Neurology. He served half time at the Minneapolis Veterans Hospital and half time in the University based division of neurology. Dr. Harold H. Noran had a two-thirds time appointment in Neurology. He was primarily involved in the teaching of neuropathology and was in charge of the Neuropathology Laboratory. There was no EEG or EMG laboratory. The Fellowship Program (residency program) had two locations. At the V.A. Hospital the following fellows; Dr. Andrew Leemhuis, Dr. Zondal Miller, Dr. Milton Baumanand Dr. V. Richard Zarling. At the University Hospital were based Dr. David Daly, Dr. Joseph A. Resch, Dr. George Holt, and Dr. Fay Tichy. An Internal Medicine Fellow was assigned for three months as a rule, as part of the Internal Medicine Fellowship program. At times there would also be a Neurosurgery Fellow for a period of a quarter or sometimes longer on the Neurology Service. Similarly there could be a Pediatric Fellow at times. On a regular basis Psychiatry fellows served six months of their three-year program on Neurology. A similar requirement was that all Neurology fellows were to serve six months of their three-year program on the Psychiatry Service.

The Department Head of Psychiatry and Neurology, Dr. Hastings also headed the Psychiatry Division. The Neurology Program was largely a clinical and didactic affair. There were two lecture courses in Neuropathology (General Neuropathology and Brain Tumors). Weekly Brain cutting sessions took place at the Neurology Laboratory. After the cutting sessions, slides of the previous week’s case would be reviewed. At the time of brain cutting a brief case summary preceded the procedure.

Ward rounds under Dr. Baker or Brown were a daily affair on weekdays (not Sat. or Sun). On Saturday there was also a case conference at the University Hospital and at times the V.A. Hospital. In the first year of the New Program I seem to recall that these could be Neurology or Psychiatric. In the first year of the new program there were also weekly lectures in Psychiatry and Clinical Psychology attended by both Neurology and Psychiatry fellows. Clinical teaching was primarily by Dr. Baker and Dr. Brown. The training program in these early years did not involve Hennepin County or St. Paul Ramsey Hospitals.

Neurology Clinics took place in the afternoons. The patients were largely non-private coming in from all over the state. The neurology Service had twenty beds. It was adjacent to the Neurosurgery Station. The Head of Neurosurgery was Dr. W.M. Peyton, Dr. Lyle French was associated with him. (In later years Dr, French became head of Neurosurgery.) There was a close and rewarding cooperative effort between Neurology and Neurosurgery.

Some exposure occurred with town Neurologists who in actuality had practices involving Psychiatry as well as neurology. These clinical faculty members sometimes came to listen to clinical Neurology sessions. I recall Dr. Gordon Kamman, Philip Arzt, Ernest Hammes’s Jr. and one or two other whose names I can’t recall.

Clinical Sessions, aside from general Neurology cases, also had special clinics on two afternoons. One was the convulsive Disorder (Epilepsy Clinic) and the other was the Parkinsonism Clinic. Neuro-Radiology sessions took place on Friday afternoons. Dr. Harold O. Peterson presided. Neurosurgery and Neurology staff, fellows and students attended. A brief clinical summary was presented by the relevant neurologic or neurosurgical fellow. A review of the x-rays by Dr. Peterson and discussion by the staff would follow.

In so far as neurosurgery is concerned I would be remiss if I did not mention Dr. Harold Buchstein, a private practitioner. He ran the Neurosurgical program at the V.A. hospital as far as training activities. We had weekly rounds on Pediatric Neurology Cases. Dr. Reynold Jensen the Child Psychiatrist would see the cases and they were seen by Dr. Baker or Brown and the neurology fellows at these rounds.

On an approximately annual basis Neurology fellows had to present a formal discussion or actually review a group of papers of classical nature on some subject e.g. Temporal Lobe Seizures. We could use slides or posters to aid in the presentation. Every few months Neurology fellows singly or possibly with another fellow would see either a full time faculty member or downtown clinical faculty, at the home of the faculty person, for an informal evening conference on general aspects of the program - presumably for an informal evaluation of the fellow’s progress and possibly some input from the fellows on whatever concerns they might have. As already alluded to this was a largely clinical training program. We certainly were trained in the history and examination aspects of Clinical Neurology. The procedures we preformed were Spinal Puncture, Pneumoencephlography, Myelography and visual fields. EEG, EMG, and Angiography were not yet available. Neuroanatomy, at least for the University fellows, was learned by attending Dr. Rasmussen’s lectures to the medical students and then serving as teaching assistants in the student’s Neuroanatomy Laboratory. I recall seeing some Mayo Clinic Neurosurgery fellows at these sessions.

Of note in the 1947/48 era the residency was skewed somewhat into the Poliomyelitis area in that during the Minnesota epidemic of that time many complicated cases came to the University Hospital. That meant a lot of Iron Lung experience and also tracheotomy maintenance in bulbar polio cases. In regard to conference attendance we on occasion were taken as guests to the Minnesota Neurological Society Meetings at the Town and Country Club (The minutes of the MNS (1909-1948) are preserved at the MN Historical museum. Copy made for Dr. Kennedy will be scanned and added to this History).

The American Academy of Neurology was founded in 1948. Dr. Baker was the first president and Dr. Brown was the first secretary. The Academy office was located in the Neuropathology Laboratory.

Concerning Neuropathology. Dr. Fay Tichy took over the laboratory from Dr. Noran. In later years, I don’t recall the exact date, Neurology became a separate department.

N.B. the Department has an album of Pictures of all the Residents and this may be helpful in filling in some of the blank spaces of my report.

Joseph A. Resch M.D.

June 2004

This letter was sent by Dr. JosephResch, former Head of Neurology, University of Minnesota, to Dr. William R.Kennedy. Received January 24, 2005.

Dear Bill This is the additional info Ithought about –RE: The early residents.

Dr. George W. Holt was there when I arrived. I had met him in the service. He left the University and went to Hastings State hospital. Ralph Rossen, the Supt. At Hastings had an interest in Neurology but had no connection to the University program. Another early resident was Bill Chalgren. Dr. Baker gave him an instructorship when he got out of the service, which completed his training. Asyou know he went to practice in Mankato.

Now as toclinical faculty; aside from Ernie Hammes Jr. from the St. Paul side there was Paul Arzt, a nice chap. At the senior level there was Gordon Kamman, who was quite knowledgeable. He had studied in a lab in Switzerland (I think) possibly in Germany. He was really good, but busy in his Psychiatry practice. For a time he was Commissioner of Mental Health. Incidentally Ralph Rossen had the Commissioner job for a time. Another clinical faculty member of Minneapolis was Robert Meller. He had a busy Psychiatry practice and didn’t participate very much.

At Minneapolis general (now Hennepin county hospital) an old timer with good training was Dr. Joseph Michael. He also had a big Psychiatry practice. He was the

Psychiatry /Neurology consultant. He stepped down, at least where neurology was concerned, and Harold Noran took over. Dr. Baker started sending residents on rotation to the General Hospital. The next Neurologist was John Logothetis for about two years, then Milt Ettinger, who remained there for many years.

I should mention Dr. Russ Anthony again. He came on board as faculty about 1947 with a VA/University set up like Joe Brown. He was trained by a well known lady neurologist out east and was skilled in EEG as well as EMG. In the service he followed a group of peripheral nerve injuries prior to Bill Kennedy’s suggestion that I develop some interest in EMG- was Russ Anthony. However we had no EMG and only a half interest in EEG so Russ went back east and joined a well known psychiatrist. He was a good teacher and friend and there was some thought about my joining him if things turned up there. He was interested in using EMG diagnostically in cases of Lumbo-sacral disk disease. He helped me in a project in which I had a patient rigged up in the EEG set up and whom Ithen gave an electroshock treatment (It was one of my psychiatry patients) Quite an EEG. I did have approval from Dr. Schiele (Psychiatry Professor) Idon’t recall if I did more then one of these procedures and have lost ormislaid the records. I do recall the EEG pattern.

The residency program was quite informal then, as to neurophysiology, there was a nationally known physiologist whose lectures to students I audited. I think Dave Daly and Fay Tichy may also have done so. I can’t remember his name. He had an EEG and with a lot of arranging he would do a patient. I think his name was Gelhorn. He was famous but aloof and rigid and the Chief and he didn’t interact positively.

Sorry about the wandering about so much but after almost sixty years that’s the way things get.

Sincerely,

Joe Resch M.D.