Birth of UCI College of Medicine

Dr. Thomas L. Nelson, MD, interviewed by by Dr. Michael Seffinger, DO

at his home in Davis, California
May 24, 2005

This is Michael Seffinger, DO. I am at the home of Thomas L. Nelson, MD where this interview occurs. It is about 3:00 p.m., May 24, 2005, in Davis, California. This is an accounting of Dr. Nelson’s involvement with the California College of Medicine (CCM) soon after its conversion to a regular medical school. He also talks about his interest in the history of pediatric osteopathy in the Los Angeles area and within the predecessor school, The College of Osteopathic Physicians & Surgeons (COP&S).

  • Dr. Seffinger:  Give us a short history of your life.
  • Dr. Nelson:  I am Thomas L. Nelson. I usually go by the name Tom Nelson. I am Professor of Pediatrics, Emeritus at Univ. of California, Irvine (UCI-CCM). I was born in Barranquilla, Colombia, South America where my parents were missionaries. I was raised in the United States from about two years of age. I went through the public school system in California. I graduated from Bakersfield High School and then went to the University of California in Berkeley. I started in electrical engineering, but transferred to pre-med and graduated with an A.B. in medical sciences and a minor in mathematics. I first became involved with the osteopathic profession when I came to the CCM. This was in 1964 and shortly after the College had become affiliated with the University of California. Prior to this move, I was Professor and Chairman of Pediatrics at the University Of Kentucky College Of Medicine in Lexington. Prior to being recruited to U. of Kentucky, I was Assistant Professor of Pediatrics and Lecturer in Psychiatry at the University of California at San Francisco (UCSF). At the same time, I was Superintendent and Medical Director of the then Sonoma State Hospital (SSH), which was affiliated with UCSF for residency training in several specialties. My laboratory and clinical research during this time was being conducted at SSH. This was a very large hospital with about 3500 beds for developmentally disabled persons of which about half were children. Also I am Board certified in both Pediatrics and Allergy and Clinical Immunology.
  • Dr. Seffinger:  What brought you to the California College of Medicine?
  • Dr. Nelson:  I was recruited to CCM by Warren Bostick, who was then the Dean of the College. Dr. Bostick and I had known each other for many years. I was one of his students when he was a very young Assistant Professor in Pathology at UCSF. Later I became a faculty and Academic Senate member at UCSF; and so, Dr. Bostick and I were fellow faculty members. He knew about my teaching ability at the UCSF Medical School and the research that I was doing at that time in Parasitology. Dr. Bostick became very involved in the political process as he rose in the California Medical Association. He eventually became President of the Association. During this time, he became aware that I was involved with the State government both with the Department of Mental Hygiene as well as with the State Legislature. Thus he knew that I had experience preparing, presenting and defending large budgets to the State. In the position I held at SSH, I reported directly to the Director of the State Department of Mental Hygiene and thus was only once removed from the Governor. I believe Dr. Bostick was pleased that I had had experience in administering a large institution and knew my way around State government.
  • Dr. Seffinger:  The next question is what events were you personally responsible for that had an impact on the history of the profession?
  • Dr. Nelson:  I came to CCM at a very significant time in its history. The College was still in the midst of its transition from being a private, independent professional school to one affiliated with the University of California. The College was receiving State money through the University’s budget while at the same time it still had a Board of Trustees which was a “hold-over” from its private days. The Provost had previously been the President of the private school. At the time, there was many of the previous faculty still at the school. For instance, my predecessor as Pediatric Department Chair, Dr. Jane Hamilton, was still there as were three others of the Department's full-time faculty. So, in essence, when I came as the first chair of pediatrics in 1964, I inherited four faculty members who had previously been osteopathic Pediatricians. This retention was true of other departments at the time. In fact, the previous chairmen of the Departments of Psychiatry and Physical Medicine and Rehabilitation remained in their positions for some period of time after the conversion. In that way, I became very familiar with the College and how it had been in the past (or at least in the recent past) and how it was at the beginning of the transition to a college granting the M.D. degree. Furthermore, students that I had (senior students), who had started thinking they were going to receive a DO degree suddenly found they were going to get an MD degree. They had a lot of anxiety, a lot of questions particularly about residencies, and how it was going to work out for them. I became quite involved in the process of helping some of these students, particularly the ones who were interested in pediatrics, in getting adjusted into the medical profession in which they now suddenly and unexpectedly found themselves. I say that was probably my main involvement with osteopathy at that time. Subsequently many of the alumni of the prior school stayed involved with CCM. I became quite active in the Alumni Association in those early years and thus I knew many of the graduates of the College going back a number of years.
  • Dr. Seffinger:  How were you able to accomplish...
  • Dr. Nelson:  My responsibilities were pretty much those of a traditional department chair. I remember that Dr. Bostick told me, “Make this into a good department of pediatrics, one that would be nationally recognized, get a research program going that will be competitive with what’s going on in other schools in the country” and I think also implied was “get the students to like you and like pediatrics and like what they are doing and be happy with themselves as medical students in this school which is now the California College of Medicine.”
  • Dr. Seffinger:  Who were your mentors?
  • Dr. Nelson:  The most influential people in determining my career after medical school primarily go back to my time at UCSF. William C. Deamer, M.D. was chairman of the Pediatric Dept. at UCSF when I was a medical student, resident and young faculty member. I was his first fellow in Pediatric Allergy. Dr Deamer probably had the major influence in my decision to enter academic medicine. Marshall Porter, M.D. was my predecessor as Superintendent and Medical Director at the SSH. He introduced me to administration of a large institution and also taught me much about the political process, personnel management, and fiscal plans and budgets. Dr.Hamilton Anderson who was chairman of the Dept. of Pharmacology at UCSF had much to do with my interest in research.
  • Dr. Nelson:  I am going to leave your questions for awhile and talk about some of my interests in the old school and the Pediatric Department and the College during the transition period. I believe this may give more insight into my early experiences at CCM than this question and answer format. My predecessor, Dr. Jane Hamilton was someone whom I consider to be a very remarkable person. She was very positive about the changes occurring around the time of my coming. Obviously she was doing everything she could to make the transition easy for the students and for me. To come as the first traditional MD into a department with all previous DOs was obviously a bit of a strain for the remaining faculty, the students and for me. Dr. Hamilton did not seem to feel very much of this and she did the best she could to ease the strain felt by the other three faculty members who were there. Remember we had students in process; we couldn’t stop the process of teaching; students were in their pediatric clerkships; teaching had to go on. We had Unit #2 of the Los Angeles General Hospital with its pediatric ward, with its pediatric clinics which were very busy, and with its neonatal nursery including a neonatal intensive care unit that had to be staffed. So, I was in the process of recruiting new faculty while at the same time keeping a department in operation. Dr. Hamilton was very, very helpful to me in keeping these functions going. I think that she did this with a great deal of sacrifice to herself. After I had been at CCM for about a year, she came in one day and said "Tom, I think now the time has come for me to leave. I’m doing this because I want to make it easier for you. I know that you have asked me to stay on, but I just think it would be best for this transition if I moved on. I’ll stay in the vicinity. I will be helpful to you and be an advisor if you need one. I’m going to stay here and take a position with Los Angeles County Government. I will be available and I will stay on the volunteer faculty." She became the Director of Communicable Diseases in the Los Angeles County Department of Public Health, an important position to say the least. The other three faculty members’ situation was different. Remember I had been charged with developing a department that would be comparable with other traditional medical schools. With this requirement, I did not believe two of the remaining faculty would be able to meet expected standards in teaching ability nor to develop a research program. I think they realized that themselves. So it was a process that I would bring in new faculty and they gradually phased themselves out. I don’t remember the exact dates but I’d say within a year and half or two years those two faculty members had left for other positions. The third one was a young lady who obviously had much talent. She was a good pediatrician, she had studied pediatrics under Dr Hamilton as a resident and she had learned a lot. I felt she had potential but I felt to make it into a traditional medical school, she was going to need to develop a subspecialty and obtain research training. Therefore, I asked her what she was interested in. She was interested in pediatric hematology, so through connections, I arranged for her to have a fellowship position with the University of Southern California at the Childrens Hospital in Los Angeles. She left the Department with the understanding she could come back after completing her fellowship. She did come back for a short period of time, but I believe that she still remained uncomfortable. She eventually, probably within six months after her return, moved to the Pacific Hospital in Los Angeles where I think that she was comfortable. I saw her a little bit, but as time went on, unlike Jane Hamilton, she pretty much broke her ties with the school and I didn’t see more of her. Another interesting person was Dr. Lawrence Cosgrove, who was the one resident who was a carry over from the COP&S and Unit II of the County Hospital. He remained as a resident in pediatrics, finished the residency and then went into pediatric practice in the southern part of Los Angeles County. I had occasional contact with him for a few years and the last I knew, he was still practicing pediatrics in Los Angles County. Dr. Seffinger, he might be someone you would find of interest to interview as he might give you some insights into the transition from the perspective of a resident. During the first several years following my arrival, we recruited faculty from all over the country. Quite a few mid-westerners and easterners came. I recruited another pediatric hematologist who had trained at UCSF, Dr. Susie Wong Fong. Dr. David Mosier was an important recruit because he came as a full professor. He came from the University of Illinois where he was the Director of a research institute. He was a pediatric endocrinologist who was nationally and internationally known. Previous to Illinois, he had been on the faculty of UCLA, so he knew the UC system well. He was a big help to say the least. Dr. Donald Sperling came as young pediatric cardiologist out of a fellowship at USC and Los Angeles Childrens Hospital. He had administrative talent and soon became the vice-chairman of the Department. Dr. Kenneth Dumars, with whom I had been a fellow faculty member at the University of Kentucky and who then had moved to the University of Colorado, came to cover the area of Genetics. He also was appointed at the full Professor level. Dr. Bruce Ackerman, who had just completed a fellowship in Neonatology at the Geisinger Medical Center in Pennsylvania, started the Division of Neonatology and covered the newborn service and the Neonatal Intensive Care Unit in the hospital. I won’t go through the other entire early faculty but they came from scattered schools throughout the country. I brought out as the chief resident, a resident that I had had at the University of Kentucky. He was also a big help as we needed an experienced, mature resident since we were recruiting new residents who were new graduates of CCM and other schools. We had a very successful first year. Almost 25 percent of the graduating class went into pediatrics that year. So I considered that a success and I know that Dr. Bostick was pretty happy with it also. Now to go on more about my interest in the College, I became quite interested because I realized not too long after I was at CCM that there was a small close knit group of pediatricians in Southern California, primarily in Los Angeles County, who had been osteopathic pediatricians; most of them had been certified under the osteopathic board. I became interested in how they had trained, how they became pediatricians and in the history of this group. Some of them I came to know well. One of them, of course, was Dr. Jane Hamilton. Another important name in the history of pediatrics at the College was Evangeline Percival. Although she was dead at the time of my arrival, it was apparent to me that Dr. Percival was a very beloved figure in the College and among recent alumni. There had been a pediatric award named after her for the outstanding student in pediatrics and I continued that award up until the time I left UCI. I hope the Evangeline Percival Award for the outstanding student in pediatrics will continue. It is a monetary award and is considered quite an honor to receive at Honors Day. I soon learned that Evangeline Percival and Jane Hamilton had been very good personal friends as well as being in a mentor/student relationship and that after Dr. Percival's death, Jane Hamilton received all of her papers. I understood them to be quite extensive having to do with events during her time as department chair, but Dr. Hamilton never offered to let me see them. Another previous department chair, Dr. Betsy McCracken was also interesting because her father was an early graduate of the College. She also was a graduate of COP&S and in many ways she had grown up, if you will, in COP&S with her father being a faculty member. As I became more interested in the school, I received a great deal of information about the history of the pediatric department from Betsy McCracken. She was not at all defensive as I found some of the other people that had previously been osteopathic physicians. I think one of the reasons for this was she had gone to the University of California Berkeley some years after receiving the D.O. There she graduated with a Master’s degree in Public Health and had specialized as a public health pediatrician. She was very involved with the Los Angeles County Public Health Department both in relation to the College and not in relation to it. She became the district health officer for the Public Health District of Los Angeles which surrounded the College and the County Hospital. She stayed on as an important volunteer faculty member in that aspect of pediatrics. I was very happy to have her. I found her in many ways a person who was very much like academic pediatricians that I had known in M.D. granting schools. She was an especially important person as far as I was concerned in being a very good source for the history of the College and the Department. From this nucleus of previously osteopathic pediatricians, there were many others who stayed on our volunteer faculty and who were practicing in various parts of Los Angeles. Some of them were involved with Pacific Hospital and the Glendale Adventist Hospital, some of them were on the faculty and on the staff at the White Memorial Hospital, so that many of them had achieved considerable recognition within pediatrics in Los Angeles County, but they remained in this close knit group They stayed with the College as long as we stayed in Los Angeles, but when we moved to Orange County, they did not stay on the faculty and I lost track of most of them except for Jane Hamilton with whom I maintained a considerable contact up until very recently. As I became increasingly interested in this group of pediatricians in Los Angeles, I decided that I might eventually write a paper about their history. I thought it would be of interest to pediatricians generally how these people maintained and trained themselves when they were not accepted into traditional training in this country. I never did write the paper, but I still have a great deal of information and data about osteopathic pediatrics within the old College in a box in my attic. I traced it all back to a woman who went to Europe to receive the training she could not obtain in the U.S. at the time. She went to Europe in the early 1910’s. She was at the Children’s Hospital on Great Ormond Street in London which was probably the greatest pediatric institution of that time. Following London, she went to the Vienna Polyclinic where she studied with one of the great pediatricians of that day. On her return to Los Angeles, she limited her practice to infants and children and most importantly established a Division of Infants and Children within the Department of Medicine and an infant feeding clinic. There were other early graduates and faculty members who, wanting post-graduate training in Pediatrics, had gone to Europe. Some had even received an MD degree there. This original osteopathic pediatrician of which I speak selected a small group of osteopaths who were interested in pediatrics, mostly women but not entirely, taught them and they became the origin of this small nucleus group. They trained others that followed them so that what I saw when I arrived was the end of this process. Jane Hamilton was moderately accepted in the other part of the County Hospital. She attended grand rounds there and was on speaking terms with the Chairman of the Department of Pediatrics of the University of Southern California who was also the head of pediatrics in Unit #1 of Los Angeles County. Some cross patient consultations were taking place so she wasn’t entirely cut off from M.D. pediatrics. It appeared to me that her pediatric education came through self learning, reading the important pediatric literature, sharing with the pediatric osteopaths in Los Angeles, contacts with faculty in Unit I of Los Angeles County Hospital and the teaching from Betsy McCracken and Evangeline Percival. I must say that I considered her an excellent pediatrician. I had no fault in any way with the care she was giving the children or the infants. She was at home moderately in the newborn nursery and the intensive care unit but she was very, very at home on the wards and in the clinic. We made rounds together, so I had much opportunity to observe her on the in-patient service. As I said before, I wanted to and was willing to keep her on the faculty. She felt it was best for me and probably felt it was best for her, if she moved on into government service although she remained as a volunteer until the move to Orange County. I stayed in contact with her up until 2003. Last contact I had with her was when we exchanged Christmas cards in 2003 and she had written a note to me at that time on how she was. I sent her a Christmas card in 2004 with a note. It did not return so I think she probably was receiving mail or somebody was receiving mail for her. She lived in Alhambra, California, and this morning I looked her up on the medical board roster on the internet and according to the roster she still has a valid license in retired status. She has been disabled for many years; she had a spinal cord problem and had neurosurgery for it with poor result. She had chronic pain. Even when she was still full-time on the faculty, she had great difficulty with chronic pain but kept up a brave front although it was obvious many times that she was in pain. She never married. I’ve been to her house in Alhambra. She eventually retired from the Public Health Department of Los Angeles County and was living a retired life in Alhambra. One other interesting experience I had in seeking the history of the Department in the old school was finding and interviewing the Department’s first pediatric resident. Before me, the succession of Pediatric Department Chairs had been first a man whose name I cannot now remember, Drs. Betsy McCracken, Evangeline Percival and Jane Hamilton. I discovered that the first Pediatric Resident at Unit II was appointed during the tenure of the first Department Chair mentioned above (they had the title of Department Executive in the old school.) who was in place in the 1940s. I traced this ex-resident and found he had become the Public Health Officer for Placer County. I went to Auburn, CA. and interviewed him there. We were about the same age and had been residents at about the same time in the 1940s. One of the fascinating things I learned in the interview was that his Department Chair at the time was in contact with the Pediatric Chairman at UCSF at the time I was a resident there. These two men were meeting with each other fairly regularly discussing mutual problems. Although the UCSF chair was in place during the time I was a resident, and I was his first fellow, and a faculty member and I used to cover his practice when out-of-town, I never heard about these contacts from him. I found this a very interesting story.
  • Dr. Nelson:  I think this in enough for now unless you have any specific questions.
  • Dr. Seffinger:  What did you notice the difference was between DOs or osteopathically trained physicians at COP&S compared to those trained elsewhere? Did you notice a difference in their style of medicine or their attitudes, their philosophy, their practice? Maybe you can touch on that.
  • Dr. Nelson:  Okay, I noticed less difference among the pediatricians than those in other specialties of medicine. First is that I think that those in the College as full-time faculty members were probably reading more non-DO literature in favor of traditional medical books and journals. Certainly that was true of my predecessor. With the full-time faculty, I saw little difference in philosophy or style of practice. It was with the volunteer faculty, the people that were out in the community that I would say that I saw some differences. They seemed less based in the basic sciences and were more interested in psychology, sociology, and what was going on in the community and family environment of their patients. However, I really did not have enough contact with the outside activities of the voluntary faculty to make many observations.
  • Dr. Seffinger:  Yes, I was wondering if they were practicing more the art of medicine than the science of medicine type of a doctor.
  • Dr. Nelson:  Well, I think that in essence, I was saying is that appeared more patient oriented, not in the physiology or in the chemistry of what’s going on, but more what was going on with the patient as a person and more what was going on with the patient in relation to the community and his family. But as I said, I really did not have enough opportunity to observe their practices to make definitive statements in these matters. One very obvious difference between the clinical faculty in COP&S and the academic pediatricians elsewhere and the faculty whom I had known at the University of Kentucky and UCSF was their lack of research activity. Dr. Jane Hamilton and Dr. McCracken had a few publications but they were all in the nature of case reports and non-controlled clinical observations. Among the very earliest new faculty appointed during the transition, Dr. Mosier, Dr. Fong and Dr. Dumars had training, experience in research and publications to meet the standard of the University of California. However, due to very little and mostly unsuitable space for laboratory research, and inadequate venture funds for research, the charge of being competitive with other pediatric departments around the country was not met in research during the transition period. It is only after the move to Orange County with more available space that research began to take its proper place in the Department’s activities and it is still developing.