New Beginnings for D.O.s in California

Dr. Viola Frymann, DO, interviewed by Dr. Michael Seffinger, DO

at the Osteopathic Center for Children, San Diego, CA
June 29, 2002

• Dr. Seffinger:  Thank you, Dr. Frymann, for spending the time in helping us understand the history of osteopathy in CA. I think you’ve carried a very integral role during the past half century in the history of osteopaths in CA. I would like you to help the students of today understand what that history has been and really how this has enabled them to become osteopathic students and joined a profession that is very unique. And, also give them some ideas of where they can go with this profession in the state of CA as well as nationally and perhaps worldwide because of the efforts of you and others have put forth and basically blazing a trail for them. We want them to be able to feel some pride and some understanding of their roots and hopefully not making the same mistakes as people before them have and perhaps capitalize on some of the successes and benefits that have been obtained for being part of this profession. So, what I would like to do is for you to first start with telling us who you are, how you got involved in this profession to begin with and what it was like if you can recall the days when you first became an osteopathic medical student and what was your impression of the profession here in CA at the time, what did you see, what did you learn, how did you feel and how was that as you were being developed into an osteopathic person. What was that like so that the students today can kind of get a sense of what it was like then compared to what they’re going through now?
• Dr. Frymann:  Well, maybe we should start at the beginning. My parents first met an osteopath when I was four years old. We were on holiday in southern England and we met this osteopath. I’ve never heard of such a being before. But my father had a long history of tuberculosis and so he undertook to treat not only my father but the whole family. We lived in Nottingham, the osteopath lived in Sheffield, and my father would drive the family there on a Sunday afternoon where he would treat us and he treated everybody including our dog when he was sick. As I look back, I don’t think he had a great diversity of techniques but he was such a dynamic, vital individual that everybody that went to him got well. And so I had a strong beginning in osteopathy but I had no intention of going into the profession. I was going to be a ballet dancer and all went well until the afternoon of the final exam I fell and injured my ankle so severely that I couldn’t dance anymore and that was devastating because that had been my only focus. Well I got osteopathic treatment for it but even so it was several years before I finally decided well that would be the career in osteopathy; but then we had a war that started and during the war the British school of osteopathy had to close because they couldn’t get deferment for their students.
• Dr. Seffinger:  You’re talking about WWII?
• Dr. Frymann:  Yes, don’t take me back to WWI, please. So it was a question then of what was I going to do in the interim until the war would end and osteopathy would be revived again. And so, I went to the University of London to study medicine but that was never a change of philosophy or concept, I was always looking towards osteopathy in fact from having had such an extensive personal experience I could look at the patient and think, “well, if that patient could just be manipulated they might not even have to have any surgery”. But any how, I graduated from the University of London and I still could not get the opportunity to study osteopathy. Then I got a residency job; the residency in England being comparable to what you call an internship here. The residency was at the Willedsterne (sp?) General Hospital and that was when we were suffering air raids. And so that was quite an experience because we would get an air raid locally, from the evening the patients would start coming in and we were required to do all of the initial care of the patients, write up the history and if necessary have them prepared for surgery first thing next morning. Sleep was an unknown commodity in those days. And then they would be shipped out of London the next day to somewhere in the country and so that this was quite a strenuous demanding experience of acute care. But then I remember celebrating the victory in London. I went down and stood outside Buckingham Palace and saw the royal family and then I had to walk back because there was so many people so it was a twelve mile walk back to the hospital. But at any rate, after that I finished at Willedsterne (sp?) Hospital and then the question was where to go next. I wanted to go into obstetrics. I wanted to be an obstetrician. But it wasn’t until after I’ve had a number of interviews that I discovered I was not eligible for that because they were giving the residency jobs to the men and women who had been in the service and needed to revise their obstetrics arts or experience in order to go back into practice and since I had not been in the service I didn’t qualify for those jobs. And so here I was wondering well what do I do next?
• Dr. Seffinger:  So, you mean you had a license to practice already having done something similar to an internship.
• Dr. Frymann:  Yes, that came after the graduation. So obviously obstetrics wasn’t the way that I could go at that time and I saw an advertisement in a British medical journal for a residency in a homeopathic hospital. I had been treated by an osteopath who used some homeopathy but I knew nothing about how to use it, what it was, or that sort of thing. But anyhow, I applied for the job and I was invited to come down for an interview. First question they asked me was, “well, what do you know about homeopathy?” So, obviously I had to say, “nothing”, but they accepted the fact that I was interested and so in due time I got the job there. That was challenging too because you learned on the first day that you can not prescribe anything but homeopathy for the patient and once you had that little discussion with the attending you discovered you better go and do your homework on homeopathy. So I was there for not quite a year because I finally succeeded in persuading Sir John William who was one of the principal physicians at the homeopathic hospital (he was also physician to the royal family) and he believed in osteopathy. He said, “I was treating a court judge a little while ago. This man had sciatica and I said I refuse to treat you homeopathically, you go down the street to that osteopath and get your back straightened out, because”, he said, “justice will not be done in that court until you do.” And so he provided the support and the documentation to enable me to get the money to come to the United States to study osteopathy because I had been told that that was the place to get the established osteopathic education.
• Dr. Seffinger:  The British school hadn’t come back?
• Dr. Frymann:  It had not opened at the time, no I’m not sure which year it reopened, but it had to get a lot of things in order before it could do so. So I didn’t know one school from the other at that time. The US government put out a little pamphlet which listed the school and how many hours of this subject and that subject and that was it. So I applied to Kirksville because it was the first school and I applied to Los Angeles because I thought I liked the climate. And Kirksville turned me down and I guess at this late date I can explain why which I learned when I went to Kirksville much later. Kirksville turned me down because in these immediate post war periods when paper was at a minimum the University of London had not put a big red seal on the bottom of the transcripts and Kirksville wouldn’t accept them without the big red seal on them. So I came to Los Angeles. Up to this point, my experience with osteopathy was people who used their hands to manipulate their patients. I didn’t have to be at COP&S (College of Osteopathic Physician and Surgeons) very long to find out nobody did that! Nobody! And I think if I hadn’t been too proud to admit to my father that I had made a terrible mistake, I would have packed up and gone home. But there was a man there who was getting his license in California from Hawaii and he had to put in a thousand hours there and so in the afternoons when students were in the clinic he and I would get in the treatment room and he would teach me manipulation. That was really the main source whereby I learned the use of my hands. However, during this time, what was then the Academy of Applied Osteopathy in those days, announced an essay contest for students which was the significance of osteopathy in heart disease. I didn’t know anything about it so I went to the library I searched the books what literature there was and I wrote the essay and surprising enough they awarded me the prize. Next year it was the same topic only it was kidney disease and so I searched kidney disease. So this was another way in which I got education about clinical application of osteopathy but it wasn’t through what they were teaching at school.
• Dr. Seffinger:  Now you came in as already being a physician, licensed physician basically in England, and so you came in as an advanced student?
• Dr. Frymann:  Yes, I had to do two years. I had to do all the osteopathic classes, whichever year it was and the fourth year.
• Dr. Seffinger:  You had to do some classroom stuff as well as the clinical stuff, there was an osteopathic course going on?
• Dr. Frymann:  There was osteopathic teaching but there was no mechanics. Mechanics didn’t exist then. Mechanics were not taught until the academy put out their first course in mechanics, I think it was probably about 1952 or 3. That was revolutionary. That upset everything we were doing because (the way) they taught manipulation (at COPS) (was such that) the instructor would show this is what you do, now go and do that. You imitated what the instructor did. That was how it was taught. And sometimes it was somewhat traumatic. In trying to imitate they didn’t give you a clue as to how much force you were supposed to put on. And so for years I had recurrent rib problems because of those courses on manipulation.
• Dr. Seffinger:  Was it primarily the high velocity low amplitude?
• Dr. Frymann:  That was all. There was nothing else. Nobody knew anything else. Well, the president of the school, Henley, he was troubled by the fact that these rumors kept coming back to him that his graduates couldn’t do osteopathic manipulation. And so in onset of this he decided every student would give him an osteopathic manipulation before they graduate. He started at the beginning of the alphabet. Before he got through B’s, he’s given up that one.
• Dr. Seffinger:  He was probably so sore.
• Dr. Frymann:  He didn’t think he was going to survive the core class. But that was his token effort to prove that his students could do manipulation. And so when I graduated, I again tried to go the same route. I tried to get a residency in obstetrics in California. But for various reasons that door didn’t open.
• Dr. Seffinger:  When did you graduate?
• Dr. Frymann:  1949. So, then I started to looking for somewhere to practice. Because the examining board accepted the hospital experience I had in England and did not require another internship and so I had...and interestingly enough, in this search for somewhere to practice, I went to Pomona, because the mother of the man who taught manipulation at college, she had a practice advertised and she lived in Pomona. We went out there in one of the hottest summer days, as you can imagine, in Pomona and as I sat down, she said to me, “do you like the desert?” “well”, I said, “what exactly do you mean by that?” “Well, have you ever lived in the desert?” I said “no”. (She said,) “well then, you don’t know what the desert’s like!” and that’s probably true but at any rate, she had a practice somewhere in the desert. She never did tell us where and she wanted somebody to go out there, run that practice, year round, do everything, deliver babies, whatever came up, regardless of the weather, regardless of the climate and then pay her half the income. Well, needless to say she had that practice being advertised for years.
• Dr. Seffinger:  Because nobody wanted it under those terms.
• Dr. Frymann:  But that was the only time I went to Pomona until we began starting the school so then I’m not quite sure how we got introduced to La Jolla. But if you once visit La Jolla you don’t go anywhere else. Well here there was an osteopath whose husband was in the Navy; he was getting out of the Navy and they wanted to retire to Texas; so she wanted to get rid of her practice and that was how I came to get started in California in La Jolla.
• Dr. Seffinger:  So you decided to stay here, you didn’t want to go back to England. Whereas they raised money for you to come here to begin with...
• Dr. Frymann:  No, they didn’t raise money; oh no they didn’t. I had to get permission from the Bank of England to bring money out of the country.
• Dr. Seffinger:  Oh, I see at that time it was very turbulent...
• Dr. Frymann:  I had to provide the money.
• Dr. Seffinger:  So then, when you left England you didn’t think about going back there?
• Dr. Frymann:  No, I took a one way ticket, and my father wasn’t happy with that.
• Dr. Seffinger:  Why was that?
• Dr. Frymann:  Because I always felt I belonged in the United States.
• Dr. Seffinger:  For what reason?
• Dr. Frymann:  I don’t know.
• Dr. Seffinger:  You just felt comfortable?
• Dr. Frymann:  Because that was where I knew I had to be, so I took a one way ticket.
• Dr. Seffinger:  And you felt comfortable here in Los Angeles?
• Dr. Frymann:  Well, I wasn’t happy with the school because it wasn’t teaching me what I thought I needed to know but it was the best we could get at that time and there was some good people for instance, there was Gordon Hatfield, the surgeon, who was a very osteopathically oriented surgeon, a person who really looked at the whole patient. Then there was the orthopedic surgeon whose name I forgotten, he was a relatively young man, he was probably in his forties, but his hobby was race cars and he crashed in a race car and was killed outright. That was a terrible loss to the profession. Oh yes, one of the requirements they had in the fourth year there was the obstetrical service and you spent two weeks at the Los Angeles County Osteopathic Hospital and you were on duty 24 hours a day. I think I had one night in bed in that two weeks. It was relentless and I don’t think they’re quite as mean on students today as they were then but I had an unfortunate habit of being able to function in my sleep without knowing about it and in fact I can remember one night I was called and I had got all the way to the labor room before I woke up and so that’s what extreme fatigue would do to me. I’d still operate but I’d have no recollection of it, which is not really very good. So then I started practice in La Jolla and that was what I was centered on, which was practicing osteopathy. And then the first hint that we got that something wasn’t quite right was when there was a report in the LA Times about the convention of the California osteopathic association stating that negotiations were in progress to bring about an amalgamation with the CMA.
• Dr. Seffinger:  When you say “we”, who are you talking about, when you received the information?
• Dr. Frymann:  That came out through the newspaper.
• Dr. Seffinger:  Meaning regular GP, osteopathic GP, regular doctors out in practice?
• Dr. Frymann:  Yes, and at that time there was a support through dues, you had to pay with your dues, a hundred dollars, I think it was a year to support the college and so I wrote to the college and I said I had no intention of paying to support the college if it was on the way to becoming a MD profession.
• Dr. Seffinger:  Was this in the early 1950s, middle or late. Had you been in the practice for some time or when you just started?
• Dr. Frymann:  Probably about, let’s see that came to a peak in 1959. It was probably about 1956. 1956 probably. And you can’t believe everything you read in the newspaper.
• Dr. Seffinger:  Did you believe that?
• Dr. Frymann:  Well, I was still uneasy about it. We had the San Diego County Osteopathic Association which was suddenly very pro-medical. They didn’t do manipulation, they didn’t believe in doing it. And so when I first became involved in doing cranial work, when I had been so inspired by Dr. Sutherland and his treatment of babies, that I went to the Hillside Hospital in San Diego and I asked for permission to treat their newborn babies. Well what they had to say to people who do cranial work was were that they were the “head shrinkers.” They had no use for these crazy people but there was a man there who was an anesthesiologist and he said well I was treated by one of those “head shrinkers” when I had a really bad headache, he said well, you give them permission. And that was how I got the opportunity to examine newborn babies over an eight year period and they didn’t have any use for it. Not once in all those years that I was doing it did the obstetrician ever come to see what I did to his babies. Not once. But anyhow that’s how I got started doing research. I was in Kansas City at the time the AOA forced the California delegation to explain what they were doing in California. They resisted, it was a very intensive battle on the floor and finally they were forced to come out and reveal that they already had a fully developed contract which they were prepared to sign with the California Medical Association. Nobody had any idea that these rumors were actual facts at that time. And the AOA gave them an ultimatum at that point, this probably was about July, July was when the House of Delegates met, that by the end of the year, the California Osteopathic Association must give a statement to the AOA that they were through with this that they had nothing more to do with this or they would lose their charter.
• Dr. Seffinger:  This was about 1960 or so?
• Dr. Frymann:  Yes, I think it was 1960.
• Dr. Seffinger:  It was just before OPSC was created in ’61 or just the year before.
• Dr. Frymann:  Well you see, then the California Osteopathic Association called a special meeting of their House of Delegates and the way this was arranged it was, you might say, a preplanned decision before it was ever done, each divisional society had one delegate to ten members. In San Diego here I think we had ten delegates and the delegates were either pro merger or opposed to merger but the voting was such that if a majority, majority might mean one, voted for merger then all five delegates were put in as pro merger. It was not proportionate to the vote and this was done in all the divisional societies and that’s how they got a 90% vote in favor of merging. So at this point, Dr. Eby realized that if there was not an organization in place by the end of that period that the AOA had stated that there would be no place for those who remained DOs in California to go and so he did whatever it took to form the Osteopathic Physicians and Surgeons of California so that when the COA was eliminated there was an organization to accept them. So that was how OPSC came to be formed. And there was then a tremendous effort being made to fight the battle because the law was such that it could not be totally changed until there was a referendum because it had been established by a vote of the people back in 1913.
• Dr. Seffinger:  1913 and 1922.
• Dr. Frymann:  And so that it had to ultimately go to a vote of the people. It was at this point in late 1960 that Gordon Hackfield telephoned me and he said you have to serve on the board of OPSC and I rejected this offer because I didn’t consider myself a politician and left that to the other folks and he said well, if you don’t get on the board and do your part, we’re not going to have an organization.
• Dr. Seffinger:  At that time you had your own practice, your own patients, you had a family?
• Dr. Frymann:  Yes, I had a child.
• Dr. Seffinger:  And you had a child you had to take care of and you were doing research at Hillside Hospital at the same time. So you had a full life otherwise. So what got into you to make you want to go into politics?
• Dr. Frymann:  I didn’t want to.
• Dr. Seffinger:  Of course.
• Dr. Frymann:  But there were so few people left you see. So few people who were not going out there taking their MD degree and so I was a little younger than most of the people who were available and so that was how I got swept into politics.
• Dr. Seffinger:  Were you a leader of any organization before?
• Dr. Frymann:  Not really, that wasn’t my bent at all to get into that area.
• Dr. Seffinger:  So, what happened then after you started to learn about all the different political problems that were happening at OPSC, you started to go to the meetings and eventually you were given the reins of that: you became the President of OPSC?
• Dr. Frymann:  Yes, and as Dr. Eby so often said, in most places you run for office, at OPSC you run from office. Because it was a go around: I was president twice, in fact I think most of us were president twice. And so that we had to try to devise ways in which we could combat which, you might say, “the juggernaut” of the CMA; they got the money, and they got radio, television, billboard advertisement for ‘improved healthcare’ that was always their favorite phrase you know and we were reduced to things like putting announcements on peoples cars in parking lots. We walked miles doing that and considering the fact that the COA spent about 3 million dollars, which in those days was a considerable amount of money, that we got as far as we did. We didn’t win the ballot in 1962 but we got about one third of the votes, which was quite significant considering the opposition that existed.
• Dr. Seffinger:  So, you mean the COA was really anxious to put this together so that they would become part of the CMA, they put money behind this, they wanted this, which is perplexing for the student of today to say why would you want to self annihilate, what makes people want to do that?
• Dr. Frymann:  Yes, but you see, there were other factors that were involved, during the war, the MDs were largely called up, they had to go and serve in the armed services. The DOs were not eligible to serve as physicians in the armed services, and so they were at home and they were treating a lot of the patients of the former MDs. But they were troubled because they could not get the social privileges, they couldn’t get membership into the country clubs and so on like an MD could and this had a lot to do with it; the social pressures that they felt people were prejudiced against them because they had a DO and not a MD after their name and because their conviction of osteopathy was very weak anyway, this just pushed them over the edge, so to speak. And so this was really what was behind it and the CMA made it look very attractive. They were going to give them privileges, they were going to accept the specialists into their midst, all this sort of thing. And one of the stipulations they made was that you would not be able to serve on the hospital staff if you didn’t get your MD degree. And they used T.J. Ruddy as their demonstration. T.J. Ruddy was on the staff of I believe seven different hospitals and he really adamantly refused to have anything to do with this business and so they fired him from all those hospitals but he was in his 80s. He was retired; it didn’t bother him, but they used this as a demonstration to all the other DOs that if you don’t get your MD degree, you won’t serve on the hospital staff. And unfortunately these young DOs weren’t smart enough to realize that if 50% of the hospital staff had refused to get their MD degree, the hospital couldn’t operate. And so they could have stopped it right there but they didn’t and so that was one of the major devices they used. So that for $65 without any additional education, you could have a MD degree and that was actually the error that the CMA made, that was how we succeeded in winning the war in 1974.
• Dr. Seffinger:  Okay we’ll get into that in a little bit. It sounds like your concept of osteopathy differed from the concept you found or practiced or used here about DOs in California.
• Dr. Frymann:  Yes.
• Dr. Seffinger:  Could you define what osteopathy was to you at that time or is to you today? You said manipulation was a major part of it in taking care of the whole person, you mentioned that as well, but could you define what that was for you then and what you decided to do about it,? I think when you started at COPS you had an idea in mind as to what osteopathy was that was clearer or stronger or different anyway than those people that were in California at that time.
• Dr. Frymann:  Well, there was the surviving group that was probably about 130 to 140 DOs actually in the state of CA there was probably another equal number that was scattered around the country somewhere. And at that time, it was the concept of the osteopathic general practice, I did minor surgery, the usual things that go along with general practice, manipulation was the central part of the treatment.
• Dr. Seffinger:  Was prescribing medicine part of that?
• Dr. Frymann:  Yes, but not a great deal because I had already spent a year at homeopathic hospitals.
• Dr. Seffinger:  What distinguishes your concept of osteopathy from the people that were primarily involved in COA that then changed?
• Dr. Frymann:  They didn’t treat patients.
• Dr. Seffinger:  So, you trained under people, in your clinical years, your attendings, did they treat people differently than you would have with the philosophy that you came with from England or how you’ve developed from your readings and what you’ve done with that?
• Dr. Frymann:  I knew that osteopathic manipulation worked. I did a very poor preparation for doing it when I graduated from COP&S but I knew it worked and so when then American Academy put on their first course, they invited me because they knew me from the essay contest so I went and took this course and came home utterly confused because we hadn’t been taught mechanics and hadn’t had any concept of mechanics and so it sort of revolutionized everything I was trying to do with the patient, to think differently, more specifically as to what was wrong with the patient.
• Dr. Seffinger:  So what was being taught at the Academy of Applied Osteopathy at the time nationally was something that you felt was real osteopathic teaching?
• Dr. Frymann:  I don’t know what they were doing, because I didn’t know anything of them until I got invited to this particular program.
• Dr. Seffinger:  In the 1950s?
• Dr. Frymann:  Yes. I think Harold Hoover’s father was one of the teachers at that time, he was one of them, there was another man, I can see him but I can’t really name him at the moment, and they’ve put on this course about spinal mechanics so I’d go home and try to integrate this which was really difficult. Well, then about 1953 I had a patient who came to see me who flew through Phoenix. She had been a patient with Thomas Schooley. She kept saying I wish you’d do for me what Thomas Schooley used to do, well, Thomas Schooley did something with his fingers about which I had heard nothing that was good up to this point but I got so tired of getting this statement from this patient that I finally decided to take the next course that came up which was November and so I met Dr. Sutherland and got introduced to the whole arena of cranial osteopathy. So this caused even greater turmoil in my practice. It took too long; patients didn’t think they were getting anywhere, so I struggled with this for a long time. Little by little the practice began to change in a very subtle manner. Well, then through another patient I got introduced Dr. Emory Traganza who was an optometrist in Lemon Grove. She was beginning to do work with children with learning difficulties and this patient who introduced me to her knew that I was treating children with problems of this nature, too, so we got together and began to integrate our practices. She would send me patients and I would send her patients and so we began to learn the interrelationship between osteopathy and the resolution of the learning problems through the visual perceptual problems of these children.
• Dr. Seffinger:  When you say osteopathy, could you define it for us, because you’re using a term that you have a definition for which is not necessary the same as the people who you’ve trained with at COP&S or your attendings?
• Dr. Frymann:  No it came from where I began, because in England, an osteopath is an osteopath.
• Dr. Seffinger:  So tell me what it is, for the students also, when you use the term osteopathy, what do you actually mean?
• Dr. Frymann:  Practice according to the principles of Still as it was at that time, and Sutherland a little later, so it was a manipulative approach to the problems not necessarily back problems or head problems, but to disease processes because remember Still emphasizes treating of diseases, not just back problems.
• Dr. Seffinger:  So to look at a patient mechanically, what can you do with your hands for this patient for this person?
• Dr. Frymann:  Yes.
• Dr. Seffinger:  So that theme that you felt was essential you didn’t see that happening at COP&S in terms of the education or curriculum.
• Dr. Frymann:  No.
• Dr. Seffinger:  When you started working with OPSC to try to come back toward change the event of the laws that transpired in 1962 was this the type of osteopathy that you wanted to promote within the OPSC group? Was that part of the founding concept or was that nothing to do with it? Was OPSC really for something that was just “let’s remain separate but equal profession” and not really have a philosophy? Or was it “that philosophy or principle”, was that part of OPSC’s beginning?
• Dr. Frymann:  Yes, because you see the people who were most likely to follow the CMA’s invitation were the people who were primarily oriented in general practice and who were disposed toward the medical model and so they were the people who went that way. Those of us who didn’t go that way were the people who were much more oriented towards the manipulative aspect. That’s why the great majority of those people who were the survivors were of an older age. They stated that the average age of those who initially formed OPSC were about 70 years, people who would have retired before the law was changed if they could have gotten somebody to come and practice with.
• Dr. Seffinger:  So, you were a rare bird really, you just gotten to practice and to join OPSC that time there were very few in your generation that were willing to go against the grain. Did you have support outside of California for these concepts or interests?
• Dr. Frymann:  Yes, in some areas, we had hoped to get some support from the AOA but that was tough going. We had to make a real plea every year to the House of Delegates for some support. Initially we got very little support, the AOA, they thought this was a problem way out west...you could do whatever you want to do with them. And so the AOA was not very supportive; they were passive, let’s put it that way.
• Dr. Seffinger:  And so here you are in 1962; I think that you have, I don’t know if you’ve met Dr. Lay or Dr. Allen at that time, Dr. Eby...
• Dr. Frymann:  No, Dr. Lay was not involved at that time. Dr. Lay could not get a license in CA. That was how she came into the picture, and because she couldn’t get a license then she started on the program of doing everything she could to see how this could get changed. Initially our focus was towards the legislature, and David, executive secretary or the COA, and when this all happened, he came and became the executive secretary of OPSC, well I’ll think of his name, anyhow he was a tremendous asset to us because he had been executive secretary of the COA, and he knew all the people involved. He knew the things they have been talking about and the plans that they have made and so when he came to us he was a tremendous asset to us.
• Dr. Seffinger:  I don’t have a file on him but there was a person who went with Dr. Eby to the convention in Florida to vouch for OPSC, started with a D...
• Dr. Frymann:  That was Dober. No, he was a MD, I mean he became a MD.
• Dr. Seffinger:  After he started OPSC with Dr. Eby he went ahead and ...
• Dr. Frymann:  But in going to Philadelphia, he prevented the same thing happening in Pennsylvania that happened in CA. A meeting in Pennsylvania was five days after the decision in CA.
• Dr. Seffinger:  So there were other states that tried to do the same thing as CA. I’ll try to find who that David is.
• Dr. Frymann:  He lived in Sacramento. He was an experience lobbyist, and he would commute, drive by car from Sacramento to LA for all the meetings we had here.
• Dr. Seffinger:  Did you know Steven Teale?
• Dr. Frymann:  Not personally, no. So, then the person that did come into the picture was Ruth Kelly. Ruth Kelly was one of five sisters, she was a teacher of physical medicine with handicaps, and her sister was a matron of the hospital, they all being in some way related to the health profession. Ruth Kelly was a dynamic individual. She was determined that she was going to recruit the patient world to bring about the change and so it was formed, “Californians for Osteopathy” and she worked so hard for this. She went to meetings of different organizations who might be interested in osteopathy and she was very supportive. OPSC put on a convention; it was always a little thing but it was always a very osteopathic meeting I can assure you and so she worked very hard to get public support for what was going on. Then in 1966 we had our hearing before the Business and Professions Committee of the Assembly and this was in Santa Barbara and the script for this had been very carefully prepared. Parents and children or patients who had benefited from osteopathy or people who had otherwise experienced what the DO could do for them had a script prepared and they were going to testify to the committee why it was important for osteopathy to return to CA. The objective of this committee was to prove to the committee that CA needed the osteopathic profession and the day before the meeting David was supposed to be there for the dress rehearsal but he wasn’t. Time was wasting. Finally, he comes in and he says, “I spent the day with a constitutional attorney”. And I said, “what do we want an attorney for, we’re not going to court?” And he said, “I think you’ll find this a value to us.” It was a rather cool response to this attorney idea, but the wife of this attorney worked for the surgeon I mentioned who practiced in Pomona who’s name I can’t remember, a sign of old age I guess.
• Dr. Seffinger:  I can’t remember some things from yesterday.
• Dr. Frymann:  Anyhow, because the wife of this attorney worked for this surgeon and knew all about what was going on and she talked to her husband. That was how he came into the picture. So, he had told me, “Well, I’ll come up and meet with the board at 7 o’clock in the morning.” The committee hearing was starting at 9 or 10am. He was coming at it from a totally different point of view from what is the usually idea of what an attorney does because he was so knowledgeable about the law of the state of California and he very quickly recognized that this was a matter of discrimination and so that the phrase that he coined so well was, that “This was not a matter of the color of the skin but it is a matter of the color of the degree!” And we said, “well, there’s nothing you could do; the record is already clear.” “Well,” he said, “just let me just sit in the back, maybe there might be a question I might counsel on.” He was, of course, Alex Tobin, and I was president (of OPSC) at that time. I had my script already made out and the chairman of the committee started asking questions and we followed the script. Then a committee member all of a sudden said it sounds to me as if this is a constitutional question and then he started asking questions which were not on my script at all that was about the past history about how we got to the situation, all the things that have happened and so on and so forth. So, finally when we’ve got as far as the lunch break, Mr. Tobin said, “let me talk to that gentleman” and said “I know him and I know him well”. And so he went and talked to him, explained a little bit more about the osteopathic situation and then the chairman gave him permission to speak for us. And so by the time lunch was over, he was now an employee of OPSC, so that he could in fact speak on our behalf. And so that was how we got involved with Mr. Tobin. And so he explored every possible way. We had a bill which was authored by about 20 senators and 15 assemblymen I think, and then these authors of the bill begin to get telephone calls from the chairmen of their respective parties: “If you support that bill, there’ll be no more from us!” And one by one they all dissolved and so that bill never came through.
• Dr. Seffinger:  That was the early 70’s or late 60’s?
• Dr. Frymann:  No that was...the committee meeting was ’66; this was probably about ’67 or maybe even earlier than that.
• Dr. Seffinger:  It was probably in the later 60’s.
• Dr. Frymann:  Finally it was recognized, the legislatures had told us so, that the only way you’re going to get this changed is to go to court, because the people have voted in favor of this, they passed the referendum, and so there’s nothing we could do.
• Dr. Seffinger:  We are talking basically about he licensure of new DOs in the state of CA. We are talking about the referendum and this is what really you were after was getting the licensing board back, the school itself had already given itself up to becoming a MD granting institution, that wasn’t allowed to be changed.
• Dr. Frymann:  The board had been taken over by the CMA. They hadn’t paid a dime for it; they had never paid anything for it and at that point when that bill was passed they could not mention the word osteopathy. Anybody who formerly had a DO degree could not mention the fact. They could not list in the telephone directory as an osteopathic physician. They could not in any way identify themselves as osteopathically related. The only thing that did identify it, and that was only to somebody who knew, was that their license had a 28 at the beginning of their medical license number. And so there was a need now to restore the profession because obviously it was going to disappear all together.
• Dr. Seffinger:  So, there was a referendum that took away the licensing board, there were bills that were passed as well that took away or defined what a DO was in the state, and what a MD was, how to use your degree ...
• Dr. Frymann:  No, they were all enabling bills, enabling bills had various objectives: Any licensed DO could get/buy a MD degree for $65; No DO could enter the state of CA because they could not be licensed by the MD board because there was no osteopathic school, it was accredited by the MD board; They could not be licensed by the DO board because they no longer could, it was forbidden; When the number of practicing DOs in the state fell to 40 or less, the board of osteopathic examiners would cease to exist. The reason for this was that there were 40 DOs practicing in California under the old drugless license and therefore it was assumed that they would not be covered by this and so that they would be the only people to be left practicing in the state of CA. That was the reasoning that was used. And so that it broke the plan by having more than 120 people still practicing, they didn’t anticipate that, so that those were the conditions that were established.
• Dr. Seffinger:  And also if they did get their MD degree, they could not display their DO degree.
• Dr. Frymann:  Yes, they could not display in any way that they were associated with osteopathy and the school was totally banished from osteopathy, didn’t have the name, didn’t teach osteopathy, it ceased to exist. And then at a later date, it was picked up by the university of CA. It was not by the university of CA originally. So then, the case was filed in 1967 with representatives of Each of the osteopathic schools; Those who were either born in CA; Raised in CA; Anyone who wanted to come back to CA to practice whether they were born here or not; Those in the armed services and could practice in Brandenburg or Camp Pendleton but couldn’t step outside to treat patients. So, those were the represented, all of the plaintiffs in this case, because, as I said, they couldn’t get a license through the MD board, and they couldn’t get a license through the osteopathic board. And the case was heard in the Appellate Court and the Appellate Court ruled in our favor. But they had some questions. Then it went to the Supreme Court. Then they had some questions. Then it went to the Superior Court. It went through the court system twice. And in 1974, we had the unanimous decision, all of the justices on the state’s supreme court, which is a very rare phenomenon to have a unanimous decision. And that was in ’74. So, then all of a sudden, all of the DOs in other parts of the country who had their CA licenses came to CA to give their support to the profession. All of a sudden, these people became members of OPSC. Which was overwhelming because OPSC had become a very tight entity. And so they reached a point were they had no money. We only had one person in the office, and by the end of 1974 we reached a point where there wasn’t even enough money in the treasury to pay the secretary’s salary. It was at this point that Dr. Eby suddenly said, “I make a motion that this organization should do everything possible to restore a college of osteopathy in CA”. Well, everybody laughed. After all, there wasn’t enough money for an office! And so that was the first words about establishing a college.
• Dr. Frymann:  David Rogers was, when we first became acquainted with him, had been the executive secretary of the California Osteopathic Association for a number of years. When the catastrophe happened and OPSC was formed, he left the COA and offered his services in the OPSC. And so he could bring us a great deal of inside information as to their activities that had gone on in the COA before it became open. And we knew what we were dealing with. He knew the personalities on their board. He knew what they were thinking and so on, so he was a most invaluable person. He was also an experienced lobbyist. He knew how to relate to conditions in Sacramento. He was very largely active in getting the legislature to support our efforts.
• Dr. Seffinger:  And who funded him? Was OPSC funding him, or did Ruth Kelly’s group?
• Dr. Frymann:  Well, the amount of funding was minimal. Nobody had very much money; but, certainly, yes, he was paid a salary by OPSC.
• Dr. Seffinger:  You know, looking back and reading these stories, it sounded like that a lot of you in OPSC who went to Sacramento like Dr. Lay, and your self, Dr. Allen and Dr. Eby, you put your time and efforts into this without any remuneration, you didn’t get paid for what you did, but it seemed like you believed in your profession, you believed in a cause, enough to put your extra time, your family time and effort into this and you were willing to stick it out until your goal was completed, regaining the licensing board for one and the status of your profession back. I’m not sure what your ultimate vision was?
• Dr. Frymann:  Rebuilding the profession.
• Dr. Seffinger:  In the state of CA, was it worth...was it the concept so important that you had to fight for that so badly?
• Dr. Frymann:  In order to do that you had to lie down and die. You either fight for it or give up everything. Dr. Lay had a few friends who wanted to have a license to practice, and they supplied some of their money to go to Sacramento. So, that there were people out there in the public...they wanted osteopaths. So, they did come forth with money. I can’t remember how much Ruth Kelly raised, but she certainly helped people to realize the need to support the action.
• Dr. Seffinger:  You in particular also had a strong desire to maintain the profession whereas most of the DOs in the state didn’t mind it going away.
• Dr. Frymann:  No, it was the older people who had the experience of osteopathy for treating the whole range of human ailments that just didn’t do a high velocity manipulation once in a while.
• Dr. Seffinger:  Oh I see, the younger ones who had come out of COP&S, they thought it was just a technique add on.
• Dr. Frymann:  Yes.
• Dr. Seffinger:  So they didn’t feel it was as much to give up, they can just do manipulation anyway, so they didn’t have a sense of what osteopathy really entailed.
• Dr. Frymann:  No, (they didn’t).
• Dr. Seffinger:  And you saw this having grown up and being raised and taken care of by an osteopathic doctor in England, knew what the potential was, and that was worth the fight and struggle?
• Dr. Frymann:  Yes.
• Dr. Seffinger:  So, you found yourself involved in OPSC, you found yourself promoting the profession and finally in 1974, the licensing board was reinstated and you had a lot of DOs outside of the state of CA wanted to come in now and support you and they wanted to retire here probably, too, I’m sure, and then Dr. Eby started with the idea of why not have a school again, and so what was your feeling about that at that time, do you remember when you heard that?
• Dr. Frymann:  It sounded utterly impossible! When Dr. Eby suggested it you know we had no money. But Dr. Eby was a man of faith and he knew that school would be built but even prior to that the first thing that we realized must be done, almost the day after the judgment was rendered, was that we must have a board of examiners that provided a practical exam so that we knew that we got people in who had hands that were of some value to them and that was how the practical exam came to be instituted.
• Dr. Seffinger:  Were other states using that as far as the licensing exam?
• Dr. Frymann:  I think some other states were, I’m not sure what, but Mr. Tobin was thoroughly in support of this and he worked through the legislative channels in order to get this established. And initially the results weren’t very good. About 30% of those who applied didn’t pass and so after about two years of this the governor complained. Too many people failed. And so they wanted to have the requirements modified somewhat. But it was a bad time. It was right in the beginning when Dr. Allen started having a course the day right before the exam to at least get those applying for the license some knowledge of manipulation so they could at least demonstrate a few simple things. But you could identify when the candidate came in the first few minutes whether they were experienced in what they were doing or they said what was Dr. Allen showing us to do, trying to remember what they heard the day before. For instance, Lee Rice, who at that time was in Camp Pendleton, those doctors who were under his care, they came in very accomplished. They knew what they were doing. They had their hands effectively doing. You could identify his students even though there was no identification other than who they were and what they did. You knew where they had been trained, and there were a few people who came in from somewhere back east who obviously were not very accomplished. And so, some of those people didn’t get a license. And so the governor required certain modifications; and they weren’t strict after a while. And then came a time when they said that all the members of the board should be removed and they should have a new roster of people. I was never an official member of the board. I was an assistant examiner of whom they used quite a number of to handle the practical exams. But I think the practical exam is extremely important because that’s the only way that you can judge whether the person is competent or not. They may be able to write the best written exam but that doesn’t tell you what they can do with their hands.
• Dr. Seffinger:  And what about these surgeons or people who don’t treat patients as much these days that come into CA, should they have to take the practical exam?
• Dr. Frymann:  Yes, because they should be treating patients before and after surgery and there are a growing number of surgeons, certainly in the east that are doing that.
• Dr. Seffinger:  What about radiologists or pathologists?
• Dr. Frymann:  Well radiologists have been trained in those manipulative skills and should have a rudimentary knowledge of them so that he knows he should use those concepts as he interprets an x-ray which is important. He should have certain basic skills. You’ll find that in most instances, the radiologists are the people who say, “oh, yes, I treat my family, my friends”. They’re not the ones who give me the most trouble. It’s the people who are the people out there doing it, family practice, that don’t treat their patients.
• Dr. Seffinger:  Most family practitioners, or lets put it this way, the people that do manipulation in the profession are mostly family practitioners or primary care doctors.
• Dr. Frymann:  Yes, but there are many in that department that do not do it.
• Dr. Seffinger:  Right, ok, let’s then talk a little bit about the school, and the school was begun...Dr. Eby was spearheading this but he asked you to also participate, you want to talk a little bit about that?
• Dr. Frymann:  Well, the board of OPSC was the board of the school at that time, there was nobody else you see, there weren’t many of us, and it was an action of the OPSC board that started the momentum. Yes, we had a number of interesting experiences because we got acquainted with Dr. Rust of the international university. He wanted to have the medical school as part of his campus.
• Dr. Seffinger:  That’s in San Diego right?
• Dr. Frymann:  Yes, it’s Miramar. Well, at that point we were totally green in as far as starting the university. None of us knew anything about what was involved, and although we never had an arrangement that was of value to us, we learned an awful lot through Dr. Rust. He taught us a great deal about what was involved in the process of starting a college. That education was invaluable to us. Well, then after that we, through Dr. Dilworth, who was another one of the staunch people in the early days, a patient of his was the president of the electronic college in LA and it seemed that we had to have somebody who was a president of something or other as the leader of this rule that we were making. And I shall never forget the terrible program that we had in 1976 in San Francisco when the AOA convention was there. We had probably been working on this college entity for probably about year and as I’ve said we learned from Rust and we were involved with this other man, this other man knew nothing about osteopathy, except about his electronic’s college, and so we thought naively enough that we were ready to make a presentation at the AOA convention. Telling them about what we were doing in CA, just about everything went wrong in that presentation. Somebody had put together a collection of slides, some of which we had gathered from the Texas college to show what an osteopathic manipulation department would look like, you know the tables and patients and so forth. And they had made some slides of Pomona on a beautiful sunny day. I had been given the placement of slides and I had been given a list of the slides. We hadn’t gotten very far when I discovered the list did not collaborate with the slides! So that was the first thing that went wrong. Well, after I managed to live through that, people began to ask questions. Well this person, as I’ve said did not know the answers and he wasn’t smart enough to call on somebody in the group who knew the answers. Well this man came to the back of the room, stood there and observed. I didn’t know who he was. It was only later that I discovered it was Dr. Pumerantz, who was at that time chairman of graduate education (for the AOA). And so that meeting was a total fiasco.
• Dr. Seffinger:  That was at the AOA level right?
• Dr. Frymann:  Yes. Well, then shortly after that I had talked to the AOA in Chicago and I was talking with Dr. Pumerantz and he told me very bluntly that that man we got working for us as president was useless. He wasn’t going to be of any help to us. So, after a while I said, “So, tell me what are the qualities we should be looking for in a president?” And so he listed them and I suddenly said to him, “Would you like the job?” He said, “no, no, we had basically established in Chicago; we had no desire to move.” And I said, “Alright.” But Dr. Allen got a call from Dr. Peterson who was president of Kirksville at that time and he said to him you know I think if you were to ask Dr. Pumerantz again he might be interested. So, I called Dr. Pumerantz and I asked him to come out and visit us, look over the situation. I wasn’t offering him a job in my way of thinking, this was just a get acquainted meeting, but he assumed this was the real thing. However, he came out and I remember we met him in Eby’s hospital up on Park Avenue. And it wasn’t very long before he said, “do we have $100,000 in the bank?” I didn’t believe we had $10,000 in the bank. He said, “Well you have to have that sort of money in the bank before you got started”. And so the conversation really went on like this...and finally when we took him to the airport and sent him home we all come to the conclusion that we just didn’t hit it off together. We weren’t operating on the same wave length you see. And I think this was in March, and I think he told us that if we were interested in him, we would have to have $100,000 in the bank by the very 1st of May, in two months! Well, it didn’t set very well with us...a naïve group of people. So then, we looked around to see if we could find somebody else, and an osteopathic physician up in Washington, somewhere up there, had a son who was dean of an university. Now his only experience with osteopathy was what he learned from his father. But anyhow, we talked with him, and was somewhat dismayed when the amount of money he’d thrown up was exactly the same as Dr. Pumerantz had said. So we thought after all, Dr. Pumerantz has got an osteopathic education, he was the founder of the Michigan school, he’s far more knowledgeable in the field we wanted than this other man is, so maybe that sort of money is what we needed to think about. And so that was how it came around to the fact that he was invited to take job if he was interested. And I’ll remember that day when the AOA was going to make their initial visit, we had this large painted building on the mall. We had not had any architectural plans made but Dr. Eby knew a student in the school of architecture and invited him to see it and put some plans together. Anyway, he was going to be there at 1 o’clock in the afternoon on a Saturday, in the morning. This architectural student showed us the plans as he worked out for this Penny building. When the AOA delegation came, they were most impressed. They complimented us on the way in which we had moved everything on to it, it was absolutely incredible, and so that was really how it began.
• Dr. Seffinger:  Things kind of fell into place kind of like providence is...
• Dr. Frymann:  Yes. And the real turn was in the negotiations for the Penny building. He said, “Well, I’ll let you have this little store on the opposite side of the street, and I’ll furnish it so the president will have somewhere to sit to begin.” And so he did. He put down a nice carpet, and he put down a nice big table and nice chairs and it looked like quite a professional office. And we were getting that I think for a dollar a month or something so that was how we began.
• Dr. Seffinger:  A lot of people wonder, how come Pomona? The previous school had relocated initially from Anaheim in the 1890s. It went to downtown LA area near Angel’s flight, which was where the LA College was, and then the next one was across from the LA county hospital. But all the center of activity with lots of doctors and where you had hospitals, and here in Pomona, this far out away from major hospitals?
• Dr. Frymann:  Yes, but one attraction was that it was a place of great need. There was a mixed population there, immigrants, and there was very little medical care. And it was felt this would be an ideal place for a clinic for service to these under-privileged people. That was one thing. Another thing was that Dr. Eby lived there and he had his hospital there. You see his hospital was still an osteopathic hospital, the only one in the state at that point I think. And so that was the other thing that attracted us there. And because this realtor was the father of Dr. Eby’s son-in-law, it was within the family and we got that Penny building for a ridiculous sum of money, ridiculous sum of money, so that was how it came to be there.
• Dr. Seffinger:  I think Dr. Eby later sold that hospital, there was never a hospital associated directly with the college.
• Dr. Frymann:  He tried to work out an arrangement but the college never worked out.
• Dr. Seffinger:  Okay, so once you had Dr. Pumerantz on board, you then had to develop a faculty, there were no real clinical faculty, all these people had left to become MDs, they pretty much left the AOA, how did you even conceive of a curriculum and a faculty to teach it, or was that not your job, was that Dr. Pumerantz’s job?
• Dr. Frymann:  Dr. Pumerantz, it was amazing, the second time we had a meeting with him, which must have been probably about three or four weeks after he arrived, all around this room he had got signs of what we were going to do this month, this month, this month; he had got the whole year worked out so that we were going to open next door in 1978 and there was so much to be done. It was an incredible amount of work that had to be done, and there had to be a feasibility study, and some other studies that had to be done. And a man came in from, he was the acting dean, he was never at the school when the school actually started but he was the acting dean, who did this work of doing this paper work, of putting this all together, and he worked tremendously hard. He was a urologist I remember. Very diligent, hard working person, and he put this together. He knew faculty people, he brought in some faculty people, and we had succeeded in enlisting Jerry Slattery, D.O. Jerry Slattery was going to be the anatomist and the teacher of OMM, very competent in both areas, excellent teacher, and then just about a week before school started, Jerry Slattery disappeared. Whether he got sick or exactly what happened, I don’t know, and nobody knows just where he is. He was just sort of taken out of the arena. And so between the starting of school, which I think was October, until January, there was no OMM taught at all. And the president would come to me from time to time and say, “you have to come here and teach it.” And I said, “Well, I have a practice here in La Jolla. I can’t just come up here and teach it.” So, in January, he finally put the pressure on and I said, “alright, I will come up here and teach all day Monday, I will work Saturdays at home and so I would drive up on Saturday evening to Pomona, I would spend all day Sunday preparing my schedule for Monday’s lesson, and teach on Monday.” And if we hadn’t had, I think, two public holidays in the course of those eight weeks, I don’t think I’d ever have survived, because, you see, I was it. I had no helpers, and at the end of the year they had to have final exams, practical exams. I had to do the whole thing and there were 36 students at that time.
• Dr. Seffinger:  And you didn’t have funds for somebody to hire to do this job?
• Dr. Frymann:  No, there were no funds. This was a voluntary service to the college. And so the 2nd year by this time they brought in 56 students for the 2nd year, so now the AOA required two full time people. Well, now what’s the definition of a full time person? That was somebody who put in 20 hours a week, and so I would drive up there on Saturday day, I would teach all day Monday and Tuesday morning, I’d drive back to be in the office by 2 o’clock on Tuesday, I would then drive up there on Wednesday evening after I’ve finished, I would teach on Thursday morning, and I’d drive back on Thursday night! And where was the 2nd full time person coming from? I couldn’t get anyone, so what I did was I called upon I think it was six of the best teachers in the country, Thomas Wolf, Thomas Schooley, Harold Magoun, Herb Miller. I think there were six people. Each one would come out for one week, twice in the year. And so that blend of all these people they got the other full time person. That was accepted (by the AOA). So that’s how we got through the second year.
• Dr. Seffinger:  The other faculty, however, were not necessarily DOs.
• Dr. Frymann:  No, the other faculty weren’t DOs because it was basic science primarily.
• Dr. Seffinger:  But when you went to the 3rd year or even had clinical courses in the 2nd year...
• Dr. Frymann:  No, and there was not much. No, but the osteopathic curriculum that I developed was not strictly based upon regions of manipulation. For instance, when we talked about motion, flexion, extension, rotation, etc, we put in the head on the top there so they had very early a recognition that there was a cranial mechanism that functioned in these various patterns of motion. When we talked about the thoracic area, we incorporated that with respiration and that was incorporated with cranial motion so that the teaching of the osteopathic manipulative skills were tied in, loosely, yes, but tied in with other clinical manifestations. The other thing we did was we had elective programs on Monday evening. We had half the group come at 6 to 8 pm, the other half would come from 8 to 10 pm and then we would cover all kinds of things, usually derived from the problems that the students themselves had and so that as they were diagnosed they were treated. And one little aside there, Pomona was not a particularly safe environment and opposite the area where we had the OMM department was a sporting good store and one night our first group left at 8 o’clock just in time to see a group of large men come out of the sporting good store, and the door was locked because the 2nd group had already come in and then we locked the door you see, all they could do was smash themselves against the wall and hope they could survive and they had the helicopter over and the search lights down there, it was quite an excitement that evening, and so we had a little excitement like that from time to time, and so my endeavor was to bring as much clinical relationship to what they were learning with their hands as possible.
• Dr. Seffinger:  So, the students, similar to what COP&S had before them, they had an OMM instructor who taught them osteopathic principles and how to use their hands, then they had a series of other instructors who were not related to that concept, teaching them whatever else...
• Dr. Frymann:  I think for most instance that was true. For instance, a fellow named Gabriel was teaching family medicine, and he of course was osteopathically oriented, I don’t remember all the other people that were teaching, and also Dr. Bales; Dr. Bales was dean at that time.
• Dr. Seffinger:  Gerald Bales?
• Dr. Frymann:  Yes, and he was thoroughly osteopathic in his thinking. He was a wonderful man and he was great, not only with what he taught them medically, but what he taught them about becoming a physician. What sort of a man or woman you should be, this sort of thing. He was a tremendous asset. We were all very disappointed when he left but it was because of illness and his wife’s family that he had to go back.
• Dr. Seffinger:  About when was that, mid 80’s or early 80’s....so it was about early 80’s? So, when the students went out to do clinical rotations, did they have...
• Dr. Frymann:  They went all over the place because there was very little available in CA. There were very few doctors in practice even at that time, and so they went to various parts of the country to get their rotations.
• Dr. Seffinger:  So, you really couldn’t control for that type of training, what type of training they could get, whatever they could get. The DOs that became MDs in CA, did some of them offer to teach?
• Dr. Frymann:  No, they virtually didn’t exist.
• Dr. Seffinger:  Because then you had Pacific Hospital started and Rio Hondo Hospital started accepting students in their rotations, and those were basically made up of DOs that became MDs.
• Dr. Frymann:  Ethan Allen was the one who probably organized the hospital opportunities. Gabriel did, he was another one, he was in charge of rotations at one time and so they were responsible in trying to build hospital opportunities.
• Dr. Seffinger:  Because I do know there were people that came out from the group that became MDs that did support the college, that did put some money into it, then they did have their hospital training sites open up and started internships and residencies as well here so...
• Dr. Frymann:  They were welcome; they were like crittlings to the profession.
• Dr. Seffinger:  It’s kind of hard because they weren’t supportive of OPSC, and they weren’t supportive of the DO profession or the AOA, yet now they say they’ll support the students coming out of the college. And the students who train at those sites sometimes get mixed response or treatment; they’re not sure if they’ll accept them as DOs or not, so it’s kind of an odd situation. But, you did the best you could, I understand, with the situation you had, so during the 1980s you had other people take over the department as you couldn’t do that forever, keep coming up...
• Dr. Frymann:  No, that was only one year we had that, then Morton was there for a while. Then he went to NJ, he was only there for about a year I think. So, little by little we endeavored to get it together, people on the outside who could serve as table trainers. And so, when we had put together the cranial course, we had to reach out far and wide to get the people we needed.
• Dr. Seffinger:  I think with the cranial course, this school was one of only a few schools that had a 40-hour cranial course as part of the curriculum.
• Dr. Frymann:  The only school!
• Dr. Seffinger:  Why was that so important? A lot of colleges of osteopathic medicine don’t have a 40-hour course in cranial osteopathy.
• Dr. Frymann:  At that time they didn’t even recognize that cranial even existed. In fact, CA was about the only school that did anything about cranial. But initially, the family whom I treated, the father was an attorney. He had a client who was able to make a donation from a foundation for $25,000 a year for the cranial course, which considered the size of the class at that time, that enabled the cranial course to go on. But then there came a time when the foundation wanted to put that money, not into various different entities, but into the building of a special school for children in Palm Springs. And so, all of a sudden, the money was withdraw from the college and that was when the battle for the cranial course began.
• Dr. Seffinger:  When was this about?
• Dr. Frymann:  I suppose about ’86 or ’87.
• Dr. Seffinger:  And so the battle you’re talking about has to do with whether the school will continue to have that 40-hour course?
• Dr. Frymann:  Yes, whether the school was willing to put some money into that course.
• Dr. Seffinger:  And what was the need for money? Why did the course demand money?
• Dr. Frymann:  Because of getting more instructors for the students.
• Dr. Seffinger:  Which is a requirement of the course?
• Dr. Frymann:  For the course to be approved.
• Dr. Seffinger:  By...?
• Dr. Frymann:  By the cranial academy. And also if you’re going to teach those sort of skills, you’re going to need that sort of supervision.
• Dr. Seffinger:  And that particular course, do you feel that it’s an important part of the curriculum; that it is an integral part to the osteopathic curriculum?
• Dr. Frymann:  Yes.
• Dr. Seffinger:  Why is that?
• Dr. Frymann:  Because you don’t cut off the patient here (pointing to her neck)! What is above has an awful lot to do with what’s below and many of the patients that you see have an important cranial dimension that they have problems with and they may not get over the problems in other parts of the body because their cranial problem hasn’t been solved. And certainly in resolving the problems of children you realize that so many of the problems our children have are the results of traumatic birth, cranial problems derived from the birth process; and therefore you’re only half an osteopathic physician if you don’t recognize those things and treat them. You know when we had the anniversary conference in February (2002) here, when they had the panel of researchers to answer questions, somebody asked the representative from France, how many hours of cranial do your students have. He said, “495 hours over six years”. Everybody up there was absolutely shocked. And when I had mentioned in other parts of the world our osteopaths have 40 hours, (they would say) “how much can you learn in 40 hours?” So, that in the rest of the world, the cranial concept is an integral concept of osteopathic teaching. It shouldn’t be something that’s over there and everything else is here.
• Dr. Seffinger:  I recall that there’s been a lot of controversy over adding cranial osteopathic concepts into the osteopathic curriculum nationwide back in 1940s, 50s, 60s, on and on, and that was finally accepted as being important enough to put on the boards. It was taught in every school to some extent, but in CA, it was an important concept, I guess people in the COA came out publicly against the cranial academy itself, against the concept of cranial osteopathic manipulation, and they were willing to give up the profession if the profession, AOA, was going to support the cranial concept. This was a statement that Dane Tasker made in 1960 to the COA delegates and I think it is a very integral part to the story of the history of osteopathy in CA actually. And I think it plays a very strong role in your involvement and also what you have been able to do at this center. So, I’d like you to talk a little bit about how you have developed an osteopathic center for children, how that relates to the education of students in osteopathic medicine here in the state, as well as what it provides for the patient, not only here but nationwide. And also what this means, too, historically in osteopathy in CA, to have a center for children here in the state and what it means for the future as well.
• Dr. Frymann:  Well, I didn’t start out to establish a center for children, it just grew. We had our little yellow house in La Jolla, which was certainly adequate for what we were doing. Little by little, the number of patients grew. Then, it was in 1982, when the college was desperately trying to find places to put it’s students, that I offered to make the practice available as a place for student rotations. And that was how the Osteopathic Center for Children came to be named. Then, I had an assistant to work with me and she was with me for about a year. And then when she left, somebody else came, and then this guy came for four years. And he was getting busy. It was getting crowded, and by this time we started looking for a larger place. We had explored just about every piece of real estate that was available in San Diego and couldn’t find one that seemed to be right. And then finally about ’85 or ’86 I think we did identify a piece of property in ??? that was about the right size. It was beautiful! It was a ??? nursery, it seemed to be appropriate. It seemed to be an ideal site for building a bigger building, if we wanted, which we estimated to about 10,000 square feet. The yellow house was less than 1,000 square feet. We had gone through all of the testing and processing that you had to go through when you try to purchase a piece of property. And then one day I got a call from Dr. Pumerantz asking me to come up for a conference with him and almost before I had sat down in his office he said to me I’m going to sell that piece of property that’s not in use, because at this time of course we were in deliberations, and they were involved in the purchase at this point, well it was just such a shock, he was going to sell it, he said I’ll give you 30 days to convince me why I shouldn’t. Well, by the time I left there I wonder what are we going to do? And it was at that point that ??? consulted with us and said, “you will have to form a not for profit corporation of laypeople who will own property so you will have a guaranteed place to continue to work.” And so, this organization “Osteopathy’s Promise to Children” was gathered together and negotiations of the not for profit ??? And we realized at that moment we had got to be independent from the college as far as the entity was concerned if we were going to continue at all. But we were focused on the property in ??? and we had reached a point where we had a final meeting with the architect on details of electricity, plumbing and that sort of thing when Sharon came to me on the phone Tuesday and said, “I want to show you something.” Now I was not very enthusiastic at all. We had seen enough. She said, “well, I insist you come and see this”. So, we came out here to this place, this enormous place, 29,000 square feet! What was I going to do with 29,000 square feet? Well, the first thing that impressed me was the fact that in our discussion with the architect on the previous Saturday, he said to me, “well, you won’t be able to have the demonstration kitchen any more.” I wanted this so that we could teach the parents how to feed their children wholesome food. He said, “you’ll just have to settle for a residential kitchen.” I said, “If that is all we could do, that’s all we could do.” We come in, just go through the entrance hall and there’s this fantastic kitchen on the right hand side, a commercial kitchen, and it looked even better then than it does now because it was fully equipped and operating at that time. So, when we got through with the tour, which was overwhelming: 50 rooms; each room had it’s own bathroom; and this circular conference area. Well, it was so big! What would we do? So any how, when we got through I said to the agent, “why do they want to sell it?” And he said, “Well, certain laws have changed regarding the Christian Scientists and if they have 50 people here, they have to put in certain medical facilities which they don’t want to, so the only way they can continue to operate is in a smaller facility. I asked, “well, where are they planning on doing that?” “Well,” he said, “well, they talked about ??? county.” I said, “where in ??? county?” He said, “probably in ?? I said, “well, maybe I’ve got just what you need.” And so the outcome of this was, that our property in ??? became the down payment on this property here. Well, I mean that was an incredible event right there because we had already had all the testing done, all of that sort of thing, which they would have had to do otherwise. Well, that was the first thing. Well, the amount of money that was involved was $2.25 million. Where are we going to find $2.25 million? Well, it was arranged that because they would have to have the time to build up there and because we had reached such a point in overcrowding in the little yellow cottage, it was agreed that we would take over the circular area, use that as our offices and reception room, they would still continue to operate out here and for as long as we were sharing the property, they would not pay us rent and we would not make payments on the principle. So we ultimately got two years without any payment either way.
• Dr. Seffinger:  You wouldn’t pay on the principle or wouldn’t pay interest?
• Dr. Frymann:  We wouldn’t pay anything; nothing. Well, it would have been 90% interest and a little bit of principle you know but we didn’t have to do that. Well, then we did have to, in the following January, make a substantial payment which I expected we would make out of the sale of the little yellow house January 31. Well, you know going through escrow takes time, and by the middle of December we had had nobody interested in buying. Well, a realtor in La Jolla who did work for charitable organizations said, “I think I can take a group of realtors there”. So, she took them through and the next day we got two offers. No question about the price, the only difference was that one man would have to go to the bank to get the money; the other man had the cash in his pocket. We paid off the payment fifteen days ahead of time. One of those absolute incredible events happening now. And so, it had always been like this: the money has always come in when it was needed, from all the way down to, I think it’s about $100,000.
• Dr. Seffinger:  How many years now?
• Dr. Frymann:  We started paying 1998.
• Dr. Seffinger:  In 4 years?
• Dr. Frymann:  Yes, money was received from donations prior to that time, but the actual payment didn’t start until 1998.
• Dr. Seffinger:  I see, in four years, $2.25 million, plus interest?
• Dr. Frymann:  And so, that it’s been incredible, all the money had always come. And when certain people get a little nervous and say, “How are we going to make the next payment?” I would say, “the money will be here. God doesn’t believe in interest you know, when you need money it’s there.” He doesn’t give it to you money to put in the bank. And so Dr. Morelli had joined us. She’s been with us 6 years now. Dr. Thomas came soon after. Dr. Thomas came just before we moved. Things were so tight in the small yellow house he didn’t even have an office. He just had one room that had a treatment table in it. One little desk in the corner. That’s where we squeezed him in the months he was there, until we moved here. Then, Dr. Centers joined us two years ago.
• Dr. Seffinger:  All the doctors are board certified?
• Dr. Frymann:  Dr. Thomas is in family practice, Dr. Centers and Morelli are pediatricians, and they’re all board certified.
• Dr. Seffinger:  Well, how does this play into the history of osteopathy of CA? What is the importance of this center to that process?
• Dr. Frymann:  This center is a demonstration of the vital importance of osteopathic principles and practice to the solution of so many of the health problems we encounter today.
• Dr. Seffinger:  Is it still a training institution?
• Dr. Frymann:  Yes. We have students who come here for rotations most of the time; the student who come here come from all over the world!
• Dr. Seffinger:  Now, in the last several years, there’s been another school in CA that’s also training students. Can you tell me about that a little bit, and your involvement with that school in training those students?
• Dr. Frymann:  Well, we’ve had one or two of their students because they were volunteers here before they even went into the osteopathic school. And so, as they have volunteered here, they said, “I want to come back here” and so, we’ve had very few students actually from there because my roster of students is built up way ahead of time. I’ve got a couple lined up in 2004. ... I’m not going to live forever. And so that we haven’t had many students from up north. We haven’t had as many students as from COMP, and this has just seemed to work that way, because we require the students to have had the cranial course, because if they haven’t had the cranial course, they can’t really relate to everything that goes on here. And the rotation to give the student the best possible value means he must have a certain amount of grounding in order to appreciate what goes on and so that requiring certain background training I don’t think is out of reason if they’re going to benefit from the opportunities that exist here.
• Dr. Seffinger:  Okay, so at this point you still have students coming from COMP, but you have students also from other states. Do you have international students coming?
• Dr. Frymann:  Yes, occasionally.
• Dr. Seffinger:  Occasionally from other places and you have been teaching in other states and other colleges as well as internationally through these years as well, correct?
• Dr. Frymann:  Yes.
• Dr. Seffinger:  Do you feel that what has gone on in CA has a story to tell to the people in other states of this country as well as people in other countries? That the story should be told and it should not be forgotten? Is there a storyline or important message that you think should be kept alive?
• Dr. Frymann:  Well, certainly as far as other countries are concerned, the message that has been conveyed to them is “well, unless you master pharmacology and you prescribe, and you understand surgery, and do that, you’re never going to be recognized by the AOA.” Their response is, “well, why should we? What does the AOA need of us? The AOA is not going to support what we believe is the true meaning of osteopathy.” And so, the professionals that are practicing osteopathy worldwide are not interested in the approval of the AOA. They’d like it but if the AOA is going to make demands that they can’t meet, then they’re not interested, and I think it’s very important to realize this, for students who come here from other states, come here because they know of the training that our students have had in the cranial course. Therefore, they come because they expect to get that sort of exposure here in the patient encounters. And here again, we do insist that they must have the cranial course first, maybe a Cranial Academy course, maybe a SCTF course. They may have come out and taken one of our courses here but they’re not going to get benefit out of the program if they don’t have the background in cranial.
• Dr. Seffinger:  What do you think the people at other colleges? There are 20 colleges now, I think, of osteopathic medicine in America. What should they know about the history of osteopathy in CA?
• Dr. Frymann:  I think they should know because is should be a warning, a warning of what happens when you default on the basic concepts and philosophy that Still and Sutherland taught. I don’t think osteopathy is ever going to die but I can see the day when it’s going to be re-imported from Canada or from Europe. But nevertheless, I think there is a growing movement towards more pure osteopathic teaching now than there has been. Ed Stiles’ program in Pikesville I think is excellent. But that’s one man in one place. But, I think that if his model could expand, it would be immensely valuable. But at the present moment it is very largely dependent upon him, and that’s not a very secure situation.
• Dr. Seffinger:  What about that model of his is unique?
• Dr. Frymann:  Because his emphasis from the first day in school is using your hands, palpating the body, feeling tissues and being exposed also to seeing patient encounters, so that initially the student maybe largely an observer, but they see these principles at work. That’s what builds the enthusiasm.
• Dr. Seffinger:  Is there anything that you would like to say about the importance of standing up for what you believe in, for a cause or taking opportunities when they come to you?
• Dr. Frymann:  Well, it has always been my belief that if the curriculum of a college is strong enough, you should be able to take the most medically oriented student and convince him of the validity and power of osteopathic medicine by the end of their training. That’s what I believe should be happening. That’s what I believe Ed Stiles is accomplishing in Kentucky. That’s what all of the schools should be doing. And if you could only do that, if you’ve got the conviction on the part of those who are teaching, so that individual gives them an exposure to things that will affect them, will impress them, and it’s the same thing here where a student will see a child changed in the space of 4 weeks, changed dramatically, I don’t have to preach to them about osteopathy, they can see it for themselves, they can sometimes see the difference between the child who comes into the treatment room and the child who goes out the treatment room. That’s how you teach students, not just by theory, not just to do this technique, and when you’ve seen that, when you’ve had the opportunity to experience that sort of change, you shouldn’t need somebody to get behind you and force you into it. You should have that conviction and that’s what we see coming out of students who are given that sort of opportunity.
• Dr. Seffinger:  Do you know that students at COMP now have a required rotation with a preceptor who uses osteopathic principles and practice including OMM?
• Dr. Frymann:  I think it’s wonderful, I think it’s excellent.
• Dr. Seffinger:  That’s part of their training. Now, most of the people listening to this, or reading about this, they maybe beginning their career, 1st or 2nd year osteopathic medical students, do you have anything to say to them about osteopathy in CA and where they should be thinking about their goal?
• Dr. Frymann:  Well, let’s say there’s never a dull moment in you life. I think that’s one of the characteristics about osteopathy practice because you’re looking at whole people, you’re not just looking at disease entities. And one thing which has struck me over the years is that I have met a number of MD graduates who have dropped out of the practice of medicine. They said it wasn’t bringing the benefit to patients which they have envisioned when they went into the profession. I have yet to see anybody who’s dropped out of the osteopathic profession for that reason. They may not be doing a very good job but there’s something about the osteopathic concept that looks at the total patient, this total individual, and sets their symptom picture into that total picture which is unique about osteopathy. And because you do that, because you’re looking at the whole patient, then you begin to realize that this patient, with this headache, may have had a fall on his back which has locked his sacrum and you’re never going to get rid of his headaches until you address the problem that he’s not telling you about but that you find; and the reverse is also true. When I first took a cranial course, the thing that impressed me most was that I have had patients who come in from time to time with their low back problems. When their heads got treated from previous traumas, they no longer had those recurrent low back problems! And I believe that the ability to look at the totality of the patient, is the most distinctive aspect of osteopathy. Structure and function, yes, that’s alright, MDs can relate to that, even recognizing the disease is an effect, is something they can reach somewhat, but the ability to actually look at that patient as a totality is the characteristic which most identifies an osteopathic physician, I believe.
• Dr. Seffinger:  So, with people who maintain that perspective and practice it, do you feel that the osteopathic profession in CA would survive?
• Dr. Frymann:  It will not only survive, it will grow, because there’s a tremendous demand out there. It’s very sad when we refer the patient to somebody in the distant area and they come back and they say, “well, he didn’t do anything, he didn’t touch me, he wanted to give me a shot and write a prescription”. That is so destructive to the reputation of the osteopathic profession that far too often we may refer to ???
• Dr. Seffinger:  I just wanted this final point about what the student of today needs to consider about their role in osteopathy in CA and what they need to pay attention to, and Dr. Frymann you were making a point about practicing osteopathy and making a difference in their patients as a primary way to express that but there are other things that I think people can do as well. I just met somebody who had tried to find an osteopathic doctor and was looking for a person who used their hands and the person did not and they were very frustrated and wondered what happened to the osteopathic profession. So, would you like to finish that concept and that tie to that statement you would like to make?
• Dr. Frymann:  Yes. I think our students need to know very early on that there’s a tremendous demand for pure osteopathic care. I mean, we have patients who come from all over the world seeking this particular type of care, and there’s a tremendous demand. These people have been everywhere. We have called this the end of the world clinic because these children have had everything in the book done to them. It’s incredible what they have come through, and finally they have come here, not because osteopathy is going to make them 100% perfect, but it is going to enable them to function at the optimum of their potential. That’s what it is all about. And, I believe this is what our students need to learn, is that they have got the opportunity to learn the skills that will meet the need of a vast number of people who can’t get help any other way, and there’s an increasing number of people who are turning to all sorts of modalities of alternative medicine because they have been unsuccessful with traditional medicine, and the students are failing their patients if they don’t acquire these skills so that they can render these services to their patients. And, I think this is extremely important, just because you’re listed in the yellow pages as a DO doesn’t mean to say that the patient can expect osteopathic care, and I think there’s some sort of false pretenses there if you’re not presenting yourself as a real osteopathic physician, and not just somebody with a degree after your name.
• Dr. Seffinger:  While you’re talking I recall that you not only have been demonstrating that to your patients and to your fellow colleagues but to students who come to train with you, you’ve also written about these concepts, you’ve lectured worldwide about them, but also you’ve decided to do some research in these concepts, can you mention a little bit about that?
• Dr. Frymann:  Well, let’s say I am not by nature a researcher. I wasn’t trained to be a researcher. That was never my intention, but research has always been thrust upon me. See, when I first met Dr. Sutherland, he talked about the treating the occiput of the newborn baby who had a vomiting problem. I had lost a baby who could not overcome the vomiting problem in spite of everything that we’ve been told to do at that time, so when I came back from Dr. Sutherland I was determined I was going to evaluate enough babies to demonstrate to me whether what he was true or not. So, that was how research project number one got started. Well, then I kept getting these questions: “well, you say you feel this motion, but you got to demonstrate scientifically that it exists”. And so, a connection with a scientist developed to create a machine whereby we could record the cranial rhythmic impulse. Again, that was something that was thrust upon us. Then, as we began to work with children with learning disabilities, the question was asked, “is there some specific lesion which is unique to the child with the learning disability?” And so, my impression was that you couldn’t say that there was, but in order to find this out I needed a retrospective study of 200 children, a hundred who had learning disability and a hundred who didn’t. And I came to the conclusion that what was unique was that the child with the learning disability had an injury during the birth process whereas injuries occurring after the age of two or three years of age did not affect the learning process. It might affect vision or some other aspect but it did not affect the ability to learn. It was the injury that occurred early in life that was significant. So, again, that was another thing that was thrust upon me. Then, we wanted to demonstrate that the osteopathic approach to a child with neurological dysfunction brought about significant change. That was how that particular topic got going which was spread over a three year period. Now, we were doing a retrospective study on children with seizure disorders, and we have had 85 children so far. Now these are the children that are in that group that are described in allopathic literature, of the 25% of children who do not respond to traditional treatment, which may be ACTH, it may be ketogenic diet, it may be anti-convulsant medications, it may be vagal nerve stimulators, it may even be surgery, so we get from that 25% of the leftover from those, and of those, we have shown, approximately a 30% change where they could be without medication, without seizures. Now that’s not a dramatic response, but we can say that probably 90% of the children we see have a markedly improved level of well being. Now, it’s very interesting that a study done in Australia on patients who have had surgery of temporal lobectomy which has gotten rid of their seizures but they are left with a phenomenon known as the burden of normality, which is very interesting. And these are psychological, psychosocial aspects which tend to increase over ten years after surgery. This illustrates rather dramatically the difference between the allopathic approach towards the symptom versus the osteopathic approach, towards the patient.
• Dr. Seffinger:  I believe you were working also with Dr. Moskalenko.
• Dr. Frymann:  Yes, on the nature of the primary respiratory mechanism.
• Dr. Seffinger:  And you just recently had an international research conference in February 2002 that was the first of its kind in this country?
• Dr. Frymann:  Yes.
• Dr. Seffinger:  Is this something that you foresee as a necessary component of the future of osteopathy in this state, to keep the students involved in research?
• Dr. Frymann:  I don’t think research should be generated, I think it should come with a drive behind it. I see too many problems with so called osteopathic research. When residents who are supposed to do a research project, they may not be sufficiently skilled in doing the treatment with the result they come out with a negative response, which is very unfortunate and they don’t have that drive, that motivation to find an answer to a question which they had inside and so research just for the sake of research doesn’t mean very much. I mean that’s the characteristic of Moskalenko which makes sometimes working with him a little difficult. He’s so enthusiastic about what he is doing, and if he sees something that causes him to go off in this direction, he’ll go off in this direction, even though that may not have been on his original protocol, but that’s how you get answers to things which maybe unexpected.
• Dr. Seffinger:  So research is really a search for questions, answers to specific question you have inside.
• Dr. Frymann:  Yes.
• Dr. Seffinger:  Is there anything else that you would like to share with the students before we close?
• Dr. Frymann:  Yes, I think first thing we should do is we should make it possible for them to get thorough osteopathic treatments themselves so that they have an experience within their own body or within their own family that proves to them beyond a shadow of a doubt the significance of osteopathic manipulative treatment. I think that’s number one. I think you’ll find that if you can arrange that so that these students are really treated by people who are knowledgeable, then they will experience something which they didn’t even dream could happen.
• Dr. Seffinger:  Thank you very much for your time, and for sharing with us, all of the osteopaths in CA, and the future students and the future osteopaths to come in CA. I think this is very valuable. I hope that everybody learns from it and if anything comes to you afterward that you would like to add, just let me know and I’ll put it into our conversation and to the historical document that we’re developing.
• Dr. Frymann:  Of course. I think another thing, I think we ought to take some of these students overseas. I think they ought to see the enthusiasm that exists in Europe, in Russia, in Japan, and Australia and see how important this is to the rest of this world. And the osteopathic world out there cannot understand the indifference of the so called DOs in this country.
• Dr. Seffinger:  Do you know how many osteopathic diplomats, or doctors of osteopathy, in other countries that practice manipulation?
• Dr. Frymann:  I don’t know. I know there are about 300 graduates from the school in Montreal. That was stated just recently, because they have now gotten their full accreditation from the university of Wales for their degree program, which is wonderful, really.
• Dr. Seffinger:  Excellent, thank you very much.