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GRETA CUNNINGHAM: Good afternoon. It's 12:04 with news from Minnesota Public Radio, I'm Greta Cunningham. The International Association of Machinists says its preliminary tally indicates 18,000 Northwest Airlines ground workers have ratified a contract agreement. Minnesota Public Radio's Mark Zdechlik reports.

MARK ZDECHLIK: If the ratification is finalized early next week when the ballots are officially recounted, a nearly two and a half-year long contract dispute between Northwest Airlines and its largest union will be over. IAM spokeswoman Mary Beth Christensen says although the contract is identical to what workers rejected last summer in the areas of wages, back pay, and pension benefits, the rank and file apparently favored several work rule changes.

MARY BETH CHRISTENSEN: We also brought back a lot of contract language changes that the first time around the membership had indicated to our negotiators that they wanted to have change.

MARK ZDECHLIK: Among the workers included in the contract are reservations agents, baggage handlers, and security personnel. This is Mark Zdechlik, Minnesota Public Radio.

GRETA CUNNINGHAM: Minnesota judicial leader said today the state needs 18 more district court judges to keep up with a booming caseload. The state has 254 district court judges. The last time the legislature added judges was in 1995 when five new positions were approved. But in the past decade, the caseload has increased 41%. Adding the judges would cost $12 billion over the next two year budget cycle, Governor Ventura has proposed total increased spending on the courts of $13 million.

The forecast for Minnesota today calls for sunshine statewide, with high temperatures from 18 in the North to 28 in the South. At this hour, Rochester reports clouds in 18 degrees, Saint Cloud flurries in 16, Duluth sunshine in 4 above, and in the Twin Cities, flurries are falling with a temperature of 17 degrees. That's the news update, I'm Greta Cunningham.

JOHN RABE: Thank you, Greta. Six minutes past noon. Programming on Minnesota Public Radio is supported by Anchor Concrete Pavers, bringing elegance to any path, courtyard, patio, or driveway. Now showing at the Spring Home & Garden Show.

[MUSIC PLAYING]

Welcome back to Midday on Minnesota Public Radio. I'm John Rabe, sitting in for Gary Eichten.

[MUSIC PLAYING]

War is often the mother of invention. Today, as part of our continuing Voices of Minnesota interviews series, medical doctor and inventor John Wild explains how he developed a life-saving device during World War II. Also this hour, we'll hear from two other pioneering Minnesota physicians, Dr. Arne Anderson, one of the founders of the Minneapolis Children's Medical Center, and Dr. Betty Jerome, the first director of the Teenage Medical Center, also in Minneapolis. Some of the language used in these interviews might be offensive to some listeners, by the way.

Dr. John Wild has lived in Minnesota longer than in his native, England. He's won the Japan and Columbus prize for developing ultrasound for detecting breast cancer. In World War II, Wild was a medical doctor in London. Germany's bombing of London killed thousands outright, thousands more died from blast injuries. John Wild told Minnesota Public Radio's Dan Olson about his discovery for saving some of the blast victims' lives, and how the discovery directed his attention to Minnesota.

DAN OLSON: The people who were injured in the bombing, I mean, they had to be treated, but then you were also living with the bombing. You were daily in danger of another bomb.

JOHN WILD: [INAUDIBLE] all the time. One incident I remember was very amusing. I was having a bath in the morning on the third floor. The nurses always looked after the doctors in England in those days, and you had to trust them to do things that you couldn't do. So anyhow, I was taking a bath on the fourth floor of this hospital, and it was blown up.

And I was on top of the pile of the hospital coming down with me in the bath. And the bath water was still in there. And so the nurse, apparently, she had gone somewhere, she said, Dr. Wild, are you are you all right? Are you still in the bath. So I said, yes, I'm still in the bath, nurse. So anyhow, I went down to several floors on top of the pile caused by the buzzbomb that had gone off you see. The hospital then disappeared, you see. So that was funny.

DAN OLSON: You're laughing about it now, but these are terrifying incidents to recall.

JOHN WILD: Well, at the time, you could stand it, providing you don't break and go back. You've got to be continuous. Then we have wonderful matrons, they're called in England. These were senior ladies who had a very Florence Nightingale tradition. She would watch the nurses until they cracked and send them away quick. So she couldn't afford to have hysteria amongst the nurses, so she would pick out the ones that were cracking and send them off somewhere for a rest.

DAN OLSON: Was the incident with the bath the buried alive incident?

JOHN WILD: No, no.

DAN OLSON: What's the buried alive incident?

JOHN WILD: Well, that came later in the army when-- oh, I had flu. When the second wave of bombing occurred in London, that was the V-2s. These were the long, cigar-shaped rockets that I admired tremendously. I thought they were awfully clever. And so anyhow, I had the flu. And the British army does not have influenza because it's a serious problem to let the enemy know that their friends across the way are all sick. So it's only a temporary febrile illness in the British Army. There's no such thing as flu.

So anyhow, I had this temporary febrile illness, and so I was isolated in a single complete fever unit at Greenwich at the Royal Woolwich Hospital. That was near the one where I'd been before and the other stuff. And I was still putting tubes down people. We haven't got to that yet. So anyhow, eventually as the evening went on, these bombs were getting closer and closer, and I thought, jeez, that's awfully clever. They've got them in a straight line from Dover up here.

And the damn thing was coming closer every 10 minutes. They were getting them off about every 10 minutes. Well, I went to sleep that night, and then I suddenly became aware of something funny. And the only explanation I can have for this is the pressure wave in front of this thing coming down at several thousand miles an hour, and I felt the pressure. And I was in bed horizontal, and I grabbed the pillow over my head. And the only thing I got out of it was some scratches on my hand.

In the meantime, there was a tremendous wallop. Then down came the beams, totally consumed, and this big beams were coming down on me, and the bed held them up. I was in the iron rails of the bed, you see, and the beam came down and pushed my body against the springs, you see.

And last thing I remember was seeing the fire flickering. I thought, oh shit, that's the end of it for me. I can't move. I can't get out. So I'd resign myself that was the end. The next I hear is there is a hole up here over my head, you see. Are you down there, Wild? I said, yes. All right. We'll have you out in no time, so--

DAN OLSON: These were the rescuers.

JOHN WILD: Yeah. And then the frames came in and took all these beams off me. And then they sent me on my feet and I couldn't stand up. He said, was anybody examined, Captain Wild, you see? So they looked at my-- no. So they said, well, why don't we see what his blood pressure is, you see? Sure enough, I didn't have any blood pressure. And that was a positive sign as to why I couldn't stand up.

So we now call this post-traumatic stress syndrome. Now, one of the most pernicious things there, while we're on the subject of the things that used to upset me, was seeing people die from blast on their bellies. Nothing wrong with them as you are now. But they would come in and slowly start to vomit. And their bellies would get bigger and bigger and bigger till you could play the drums on them. They were so tight, you see. And everybody, either they passed gas, as we say, politely--

[LAUGHS]

And then the gas went away. Or it didn't go away. In this instance, it would never go away and they ended up dead. So after about six of these, I got annoyed. And I thought, well, I'd like to see if I can't do something about this and get all this gas out. Otherwise, there's nothing wrong with them.

So I cut one open and found that his belly was full of blood. And that's what had caused the failure of the bowel. This was the one that died. And see, I had all sorts of nasty things I used to do. I wasn't held up by not being a pathologist, not being something else. I had a free rein to do what I wanted. And that's the nice thing about war. You get a chance to do whatever you want to do, you see.

DAN OLSON: And so upon seeing this swelling of the stomach, you figured there must be something you can do about this. This must be leading up to the tubes.

JOHN WILD: Yeah. Well, we had X-rays to see all the gas in the belly. That's the diagnosis. And the diaphragm or the department between the lungs and the belly would be up, pushed up, up, up and with the gas. And there's no way to break that except to try to suck the gas out of them. So I knew there was an American tube called the Miller-Abbott tube, which was a double-walled tube. One of these very smart American ideas which never work out once they get into the hands of the manufacturer.

Miller and Abbott, I'm sure, did very well with two separate tubes. But no, the manufacturer had to build one tube and two. So what happened was that the tube would not suck. It was a physiological tube supposed to collect a little sample of gastric juices and things in the body. But to suck out this gas and liquid in these people needed a really big tube. And the biggest you could get.

So I didn't have any tubes. War was on. And so I found the plastic tube around electrical cables. The outside insulation. And it was German stuff. Polyvinyl chloride, it's called. But there was one little problem, which I won't mention now. But it happened to have the wrong thing in for put on the nose. And the poor people's nose would run like hell with this oil, as it was called. Tricresyl phosphate, it was called. And that was irritating.

But I figured, well, the hell with their bloody noses. As long as we get them alive, their noses will get better later on. So I made it from condoms and made a hole right at the end, nowhere else, and attached a rubber glove, thumb, on the end as a weight and filled it half full of mercury to give me some weight to pull the tube down. Once I got it into the outer part of the stomach, I could then turn the patient on his side and the thing would roll over into the duodenum.

Sucking all the time, you see. Well, these tubes are long enough to go down 32 feet of bowel, which in these conditions was long enough, was about nine feet. Because as you decompress the bowel, it shortened up. It was only 32 feet while it was dead.

DAN OLSON: These people were dying because this gas was cutting off their vital function.

JOHN WILD: And giving them pneumonia. They were dying of chronic bronchial pneumonia, as it was called.

DAN OLSON: So they'd live with this condition for days, maybe even weeks.

JOHN WILD: Right.

DAN OLSON: But dying all the time.

JOHN WILD: And the nurses would be literally wondering why he was mucking around with them. They were so ill. And of course, you got to have the know-how to work with people that are seriously ill, so.

DAN OLSON: And apparently, it had the desirable effect.

JOHN WILD: And it worked. And I was able to save lots and lots of lives with that tube, making the tubes. And that's the connection with the Minnesota. Because we had here a wonderful man who had made a name for himself, Owen H. Wangensteen-- I always laugh with a name like that. But since I was reading books on the belly, at that time, I became interested in bowel failure. Surgeons never seemed to bother with it. And he used to say, bless you, my boy, and you either-- to use a crude word, you either farted and got better, or otherwise you didn't fart and you died, you see. It's that simple.

So anyhow, that meant we used to wait for the happiness. And the nurse would say, it happened today, sir. That meant the patient would pass gas in polite medical language, you see.

JOHN RABE: Medical doctor and inventor, Dr. John Wild. Wild lives in St. Louis Park. Came to Minnesota from England as a young doctor to take a job at the University of Minnesota. But he had a falling out with the medical school director. Influential friends helped him continue his research on ultrasound, though. He's the first to use ultrasound on humans for cancer detection. He's won the Japan and Columbus Prizes for his work. Let's return to his conversation with Dan Olson.

DAN OLSON: Let's catch up with ultrasound. Let's find out about ultrasound. You're interested in radar. Where did your interest in radar start?

JOHN WILD: During the war, as a medical student, I was concerned with the electronics of radar for spitfires. And I was in a shadow factory near my home as a medical student.

DAN OLSON: You call it a shadow factory.

JOHN WILD: Yeah. Shadow factories meant that Hitler wouldn't know where they were and specifically bomb them. And there were a lot of shadow factories all over London.

DAN OLSON: So you were working on development of radar for fighter planes.

JOHN WILD: Right.

DAN OLSON: Now we jump to the United States. You're here. You're affiliated with the medical school at the University of Minnesota. I wonder if you'd retell the story of the swimming pool and all of the things you had to pull together.

JOHN WILD: Oh, I see what you mean there, right.

DAN OLSON: To arrive at ultrasound.

JOHN WILD: We did get as far as that. I said, having looked over America, and I had to-- when Wangensteen said, look, I'm not going to support you anymore, too bad you won't be here next year or something like that. A real nice, tactful remark as concerning a patent argument that I had with him. So anyhow, I had to leave.

So I went off to get some help from the Board of Regents, including Charlie Mayer, who was a friend of mine, who knew about my Cambridge background, all that stuff. And said, you go on back to the university, John, and you'll get a call tomorrow from somebody. And the next morning, I get the call with an invitation to join electrical engineering, which is where I finally came through with the first pictures of cancer in the breast. And got the prize, incidentally, at the State Medical Society.

At the same time, a congratulations from Sir Alexander Fleming, the man who discovered penicillin, who was visiting. And he knew me, of course, from way back.

DAN OLSON: What a thrill.

JOHN WILD: Yeah. And-- for him.

[LAUGHS]

Excuse me. He said, what a thrill. I said, for him. I've got to keep up the ego, or I'm not--

And so I went to some friends of mine in St. Barnabas Hospital, which no longer exists, by the way. And Dr. Strickler and Rice were there at the time. And they very kindly gave me a place to work, no problem. And I was there for nearly six years, I think, developing ultrasound clinically. Till I had 117 cases done. I think we showed quite clearly that I was on the right track. And incidentally, I still am on that same track.

Namely, measuring the amount of sound coming out of tumors in the breast as opposed to that coming out of normal breast, which is not the same as trying to get a picture of a cancer in the breast with ultrasound. Entirely different thing. And unsuitable for the economics of finding cancer in women's breast. And it's vital now. The last thing we have on cancer, the first and the last, is to find it early. And they still haven't done it, even with X-ray mammography.

They no longer call it ultrasound mammography, which they should do. But they've now pushed out to sound right out the back door. Because you can have ultrasonic mammography as well as X-ray mammography. Thermal MAP-CAR, anything you like. But the radiologists are very skillfully removed or brought it to the idea of radiology and nothing else. Which is typical of America, the sloppy thinking.

DAN OLSON: Tell the story of where you took what we call the technology of radar and made it work for looking inside a human being.

JOHN WILD: Well, that's quite simple. I was looking to measure the thickness-- we're back again on intestine. And when I went to the Navy base, by some miracles we won't waste time on now, I was given access to this machine in the Navy base, which was used for training pilots in flying over enemy temperature. This is a big territory. They had this big swimming bath with about three or four inches of water in it. And in the swimming bath was a map of supposed territory. A scale map that these pilots would fly over.

And inside this was a little crystal, which was ultrasonic. Was flying as an aeroplane over this artificial map. And it would then show them what kind of signals they would see when they were up in the air, flying over whatever the map represented. And the point was that ultrasound was a perfect way to scale radar. One inch of ultrasound at 15 million cycles per second equal one mile on the ground. It was a convenient way to get the full scale radar into a laboratory. Small area.

And this marvelous machine was built during the war. And only in America. Nobody else would have bothered about it. But America will do these things. And of course, to be credited for them. Now, I wanted to use ultrasound from my experience with radar to measure the thickness of the intestinal wall, the wall of the intestine. By putting an instrument down the nose, as I already was an expert at, down into the intestine and measuring it.

And to my amazement, I found that I could do that very easily at 15 megacycles per second, using this same tank with the water in it and everything else, you see.

DAN OLSON: Why did you stick with ultrasound research? What is the promise you see in ultrasound research?

JOHN WILD: The reason was I saw immediately that we were going to find cancer early in the breast. And to this day, it hasn't been done. And that's beyond me. With a country like America, who likes to boast about the wonderful things they do.

DAN OLSON: You're saying that your ultrasound research has not been used to its fullest capability.

JOHN WILD: Absolutely. It can do. As I say, I got the prize in Minnesota for showing the first cancer in a woman's breast, declaring it as cancer. Then from then on, it's been nothing but misery. Because of the peer review group. Nobody here understands to this day what the hell I'm doing, except my assistant downstairs who does understand it.

JOHN RABE: Dr. John Wild. You're listening to our Voices of Minnesota interview series on midday. It's 25 minutes past noon. Time for us to check in with Greta Cunningham for a look at the day's news. Greta?

GRETA CUNNINGHAM: Good afternoon, John. A judge today ruled the Pilots' Union at American Airlines will get some additional time before they have to pay a fine. In a Dallas courtroom, the federal judge continued the contempt hearing until mid-April. The Allied Pilots Association said it needed more time to refute the carrier's statements of damages due to the 10-day sick-out. The judge had found the pilots in contempt over the weekend and said he'd issued his fine today.

The carrier has estimated its losses from all the flight cancellations to somewhere between $67 million and $90 million. Food giant HJ Heinz said today it will lay off up to 4,000 workers and close up to 20 factories over four years as part of a restructuring plan. A Heinz spokesman said the company plans to focus on its six core food products. In regional news, Northwest Airlines executives met with the Senate Transportation Committee this morning to report on the impact of a loan the state made to the airline in 1994. Loans and bonds by the state and local agencies to Northwest totaled $371 million.

Airline officials told legislators that by the end of the year, more than 1,000 employees will work at two Northwest Airlines facilities in Northeastern Minnesota. That exceeds the commitment Northwest made in 1994 to hire 854 people for the reservation center in Chisholm and the maintenance facility in Duluth by the year 2000.

A milk processing plant that recalled some of its products earlier this month will reopen today. State officials yesterday confirmed the presence of listeria bacteria at the Kohler Mix Specialties plant in White Bear Lake. But they still don't know how the bacteria got into some of the cartons. The company issued a nationwide recall February 6 of 55 kinds of dairy product sold under several brand names. There are still no confirmed cases of illnesses resulting from the recalled milk.

Looking at the forecast around the region, Rochester reports light snow and 20 degrees. It's sunny in Duluth and 10 above. St. Cloud reports cloudy skies and 17. And in the Twin Cities at this hour, some light flurries, a temperature of 19. And John, that's a look at the latest news headlines.

JOHN RABE: Thank you, Greta Cunningham. Welcome back to our Voices of Minnesota series on Midday. Today, featuring three pioneering and some may consider them renegade Minnesota doctors. Still coming up, Dr. Betty Jerome and Dr. Arne Anderson.

The Woodstock generation symbolizes an era when young people tuned out, dropped out, and hit the road for adventure. A side-effect was an explosive rise in sexually transmitted diseases. Dr. Betty Jerome was one of the medical doctors on the front lines treating teenagers' health problems. The Minneapolis pediatrician was the first director of the Teenage Medical Service, a South Minneapolis walk-in clinic created by Minneapolis Children's Medical Center.

Dr. Jerome is a native of West Virginia. She went to medical school in Chicago before moving to Minnesota to start her practice. She talked with Minnesota Public Radio's Dan Olson about how she became interested in medicine.

DAN OLSON: You went through childhood, apparently, among other things, with a fascination for medicine, or at least an interest.

BETTY JEROME: For medicine and anything that came up on the news or anything that came up that I could possibly understand, I was in there. I had trouble reading. I'm a right-left dyslexic. And I didn't know anything about that and the teachers didn't know anything about it. And my mother thought I was retarded for a long while, and then she realized I wasn't. But she didn't know what it was.

DAN OLSON: So in school, you had trouble.

BETTY JEROME: Oh boy, did I have trouble. I tell you, I'd count, if that kid reads and that kid reads and this one reads and reads, and then I'll have to read this. So I'd only study the one I was supposed to.

[LAUGHS]

DAN OLSON: You could get it eventually. You could get it. You could read.

BETTY JEROME: I got it eventually. When I went to a lecture in adolescent medicine and who was dyslexic, and it was mostly boys. It was surprising. And the other thing is they never know the right or left foot. I can remember dance class. They'd send me and say, now we're going to start on our right foot. Does everybody have their right foot? And everybody would say yes except me. I was standing around waiting to see what they were doing.

I used all these backup things to keep from making a fool of myself. And book reports. Oh god, you have to write a book report. So I never read a book. I got the encyclopedia and read the encyclopedia, and it told this life of this guy, and I'd write that up.

DAN OLSON: Eventually, how did you figure out a way to cope? You had to read, you had to write, you had to file reports.

BETTY JEROME: I had start at the beginning and read simple things and then read the complicated things. The complicated things, of course, were the pathology. And gosh, you could look in a microscope and see this stuff. I could not read when I graduated from high school. I never picked up a book. I could read a sentence. I could put the words together. But they didn't always say anything to me.

DAN OLSON: I think we are at a point in our history in this country where medical school enrollment is close to half and half men and women, if not at half and half. And what was it when you applied for medical school?

BETTY JEROME: They accepted 10 women out of 186. And they told us that they were going to flunk us out.

DAN OLSON: They told you they were going to flunk you out.

BETTY JEROME: Their intent was to get rid of us. And I talked to the guy at the registrar, and I looked at old Mr. Moon and I said, Mr. Moon, if you let me in, I will finish. I know I will finish. And he looked at me and said, how do you know that? I said, because I've made up my mind. That's what I'm going to do.

And when I got ready to graduate, I went in and I said to him, I said, you see, I did do it. He said, there was something in the way you said that that I believed you.

[LAUGHS]

DAN OLSON: They were not coy about it in the least. Women were not welcome in the medical establishment.

BETTY JEROME: Oh no. The boys would go to the bathroom and get an erection ejaculating and put their urine in our urine specimens all over the place. And we go, what are these things? We'd call a professor over. What is this little thing wiggling around in here? They just did all kinds of stuff.

DAN OLSON: You finished medical school. You became a pediatrician. What was your first job out of medical school?

BETTY JEROME: Well, I fell in love here. I was at a residency here at the old St. Barnabas Hospital. And they only had about 18 pediatric beds. And before I was through with them, they had 42.

DAN OLSON: As the parent of four children, I suppose the argument would be, you are and were uncommonly well qualified to be a medical doctor working with young people. And we'll skip over quite a lot of history to the point where you were-- was it 1968, the teenage medical center?

BETTY JEROME: Somewhere. Somewhere in there. I wasn't married, but I was interested in what happened. There was an accident of some kind. And some kid ended up over at general and shouldn't have been there. I mean, the family had money and was an unfortunate thing. And I kept saying, there should have been someplace for that youngster to go. But she didn't want to share with her folks what went on.

DAN OLSON: Really? So that was a red flag to you

BETTY JEROME: That was a red flag. And then I began to find out that there were a lot of kids. And the point was they were running loose at night. I mean, daytime, I had a practice. I didn't need to be a teens center. So I thought, well, gee, if we just opened at night and sat here We had kids that the police were after.

We had one boy with hepatitis. He sat there with yellow eyes and a big liver. He had run away from home, was living in an abandoned house with a whole bunch of other people. And he was the cook. The city health department and said, we've got an epidemic here. I need enough gamma globulin to inoculate everybody that lived in this house and this kid and everybody around.

And then I found out that everybody was having intercourse. And I thought, oh no, not that. And I said, but nobody's checking them to see if they have anything. And then I got interested in the sexually transmitted diseases. I mean, everybody knew about syphilis. They knew about gonorrhea. But they didn't know about chlamydia and they didn't know about a lot of other little side things that just caused trouble and yeast and things. And the girls were coming in with these symptoms, and I had to find out.

So I went down to Atlanta to a CDC meeting and learned all about sexually transmitted diseases. I tell you, I was down there. I studied my little ass off. And Children's didn't pay for it either. I did. And I got back and I decided that's what we ought to do. Well, after about, oh, six months or 10 months, we were doing all these cultures. And I found out that we couldn't get the cultures read by Children's Hospital. They didn't want to read any pap smears. Because they said these kids were having so much intercourse, their pap smears were terrible and they didn't want to do that. So the pathologist called me up and said, we're not going to read any more of your pap smears.

So I called Mount Sinai. And Mount Sinai read them. And they were a tremendous help. I sat on Children's board of directors, so I would talk about who had strep throats, and then I began to tell him about chlamydia and gonorrhea. And they didn't want to always hear it. But I must say, Children's finally came through beautifully.

And I finally said, we got to do some advertising. Well, how do you advertise for this? Well, how do you advertise? I got a slick trick.

[LAUGHS]

I was at Dayton's, and there was a-- I got the idea of putting a little sign on the inside of the toilet door and in the women's room. And, have problems? Think you're pregnant? Think you might have VD? See the Teenage Medical Service. And I didn't have to put very many of those up.

DAN OLSON: You were out there tacking these to doors.

BETTY JEROME: Yeah, I just tack it on the inside of the door. So we began to get patients, and we had to open during the day. We had patients flocked in there. And we had kids that were in desperate need of a place to hang a hat, go somewhere. They were runaways and they had no business being runaways.

DAN OLSON: These were young people from what kind of circumstances?

BETTY JEROME: Most of them were from middle class and upper class. The upper class kids didn't seem to know what the hell to do. The middle class knew. But--

DAN OLSON: Did you call the parents?

BETTY JEROME: No.

DAN OLSON: Why didn't you call the parents?

BETTY JEROME: Well, the kids weren't going to die. We were going to get them through this. We were going to get them hooked up back at home again. And I would get them over to walk-in counseling and let them sit behind the eight ball. I didn't want to sit behind the eight ball.

DAN OLSON: Did the law require you to call the parents at the time?

BETTY JEROME: I don't know what the law required. I don't think anybody else knew what the law required. I certainly had never seen a law that said that if somebody walks into your office, you're not allowed to treat them if you don't call their parents first.

DAN OLSON: These were young people about how old?

BETTY JEROME: Oh, these were anything from 15 to 18, 20. And you got them better. Oh, they get better and they fine. And they refer all their friends in and then--

[LAUGHS]

They were marvelous. It's just that some of them came from [INAUDIBLE]. One girl, I said, why don't you do something useful? I said, what do you like to do? She says, I love horses. I says, I would get a job carrying horses. I'd go down to some stable, and I'd keep myself busy. She looked at me and she said, why should I? I own two.

And I said, where are your parents? Well, she says they're traveling in Europe this summer. It was so blatant. I kept saying, good heavens. There were kids, though, that really needed a little help and backing. Their parents didn't know enough. One girl's mother literally locked her in the room. And she opened the window and voided outside the window.

DAN OLSON: Did any-- did many of the parents ever come to get their kids or track them down or make contact with you ever afterwards and say, Dr. Jerome, you saved my kids' life? Or Dr. Jerome, don't ever touch my kid again.

BETTY JEROME: No. Nobody ever said anything. And the kids knew enough not to say anything, too. They didn't even know. I said, don't tell them who we are. Just tell them that this is a clinic open for kids that are for runaways and need a little extra help while they're going through town. Because they all thought the town was theirs. They just loved the town.

[LAUGHS]

DAN OLSON: What about your kids? What did they think? What did they think of your work?

BETTY JEROME: I haven't any idea. I have no idea. But you are not a hero at home. I mean, nobody wants to talk to you at home.

DAN OLSON: What did religious leaders, what did lawmakers, what did public officials think of you and your work?

BETTY JEROME: Well, some of the people in some of these places got to know me pretty well. So that I was fairly reliable. And I hadn't done anything that was really against the law. And that when the kids would tell their parents that they were down to see Betty Jerome at the teens center, their parents knew I was on the board. And so they assumed this was going to be all right. It really was quite smooth.

DAN OLSON: I don't know the numbers. I don't know the currency of the numbers. Someone has suggested that we've crested the hill now on sexually transmitted diseases among young people and some other health problems. So we're over some of the worst of that. Is that right?

BETTY JEROME: Yes, except for the sterilizers. The sexually transmitted diseases that sterilize people and leave them so that they're not as fertile as they would have been. Well, we had condoms in the waiting room. And we sold it cheap.

DAN OLSON: You had condoms that you sold cheap in the waiting room.

BETTY JEROME: Yeah.

DAN OLSON: What was that for?

BETTY JEROME: Because if they'd all worn condoms, wouldn't have any trouble at all.

[LAUGHS]

But trying to get a 14, 15, 16-year-old to think that far is really terrible. And the nurses set the rules down there. I didn't set the rules. They did. They went as far as they could go and they felt was-- and they were pretty conservative.

DAN OLSON: The Teenage Medical Center is still open.

BETTY JEROME: It's still open. It's still--

DAN OLSON: Because there's still a need.

BETTY JEROME: Yeah. Yeah, they're still needed. They're still run by the hospital. They have good physician. He came and worked there and was trained there and then loved it and stayed. Once you fall in love with adolescents and you like them, you just never get enough of them. Because they're so bright and so alert and so into everything. And so intense. And you just don't want them to make a mistake. Suicides do occur. Yet today.

DAN OLSON: Are we, in your judgment, in a much better place now regarding teenage health in this country?

BETTY JEROME: Oh, yes. There was a big meeting in Washington, DC, and all of the people who worked in clinics and Detroit and Cleveland and Chicago all over. I went to that meeting. And I tell you, we were on the ball. The people that ran it were a whole adolescent section of the Academy of Pediatrics. And they set the rules. And they made sure that people were aware of what the needs were.

DAN OLSON: There's a big movement afoot, has been for years, to get more medical services in public schools. Is this is a good idea?

BETTY JEROME: Yes. There are kids in public schools that need more help than they're getting.

DAN OLSON: This, I gather, is very controversial from parents who say, wait a minute, I am the parent. I'm in charge of taking care of my kid. I don't want my child being seen by somebody I do not know and hearing and getting advice that I do not approve of.

BETTY JEROME: That's right. So the kids change their names. I mean, they're not so stupid. They don't come in and say, my name is so-and-so. You know my mother.

[LAUGHS]

And then it's amazing. The kids then see each other. Siblings that didn't know that they were independently coming in. And they get to talking and they get to laughing. And then they think it's funny that they both found the teen center. Same family. And it was just because their parents didn't pay that much attention.

DAN OLSON: Is it always the parents' fault when there isn't communication between the parent and the kid, or are adolescents just sometimes so stubborn and pig-headed?

BETTY JEROME: Oh, I think the adolescents set the barrier up first. They really do. They don't want to tell everything. And their parents are either overinterested or not interested at all. And they just are wild. Some adolescents are really very wild and very antisocial in their behaviors. And if you can hang on to them long enough, they get some sense.

DAN OLSON: It scares parents mightily, what you've described. Yeah.

BETTY JEROME: It scared me. Because I represented Children's Hospital, and I was in a tough spot. I didn't dare do something that was-- we did nothing illegal. But we did things that parents were afraid to do or were not going to get involved in.

DAN OLSON: Sale of condoms.

BETTY JEROME: Oh, yeah. Girls shouldn't have to go someplace else and get those, because they're not worth what they charge for.

DAN OLSON: Parents, of course, would probably pay you good money to hear some advice from Dr. Betty Jerome about raising kids. You're a pediatrician. You're not a--

BETTY JEROME: I'm rather reluctant--

[LAUGHS]

--to do that. I think that it's-- I don't know, it's like you're not really honest with the kids when you turn around and talk to everybody. And a lot of people come in. And you'd be surprised how many older women wanted information and help. And they'd call. And it was as though you were holding on to an awful lot of-- I felt like gee, maybe this is the way the priest feels when he comes out of confession.

But you just tuck it all away and then forget it and don't worry about it. You do the best you can with it.

DAN OLSON: Dr. Betty Jerome, a real pleasure talking to you. Thank you for your time.

BETTY JEROME: You're quite welcome.

JOHN RABE: Dr. Jerome is the first director of Teenage Medical Services, a South Minneapolis walk-in clinic affiliated with Children's Hospital. You're listening to our Voices of Minnesota interview series as part of Midday. Hospitals devoted exclusively to the care of children were well known on the East Coast, but none existed in Minnesota until the mid 1960s. Then, Dr. Arne Anderson and others led the movement in 1965 to create Minneapolis Children's Medical Center. Dr. Anderson talked with Minnesota Public Radio's Dan Olson.

DAN OLSON: Why did you and others decide to start a children's hospital?

ARNE ANDERSON: Care for children in the hospital. The hospitals of Minneapolis, including the university hospital, was not what it could be. Particularly the pediatricians who had trained in the east in children's hospitals had a very, very strong appreciation of that. And the rest of us sensed it. And the reason the care for children in the hospital wasn't as could be was that children mounted to less than 10% of the hospital's load.

And children are different. The way children are different is that they're very, very vulnerable to certain conditions and need special care. Now, this, of course, has manifest itself now 30 years later, in the intensity of these newborn care units. So that's one example that shows that. The second is that the children were in the formative stage of their life. This was emotionally as well as physically.

And you had had situations such as clubfeet, where most of the children had satisfactory surgery. But many children ended up social isolates and unemployable. Not because of their physical handicap, but because of their emotional handicap. And the third issue you had was that children health care is dependent on a community. They go to the hospital and get health care.

But how they're treated in school, how they're treated in the camps, whether they can go to camp or not go to camp, all of these things. So you needed a program, an institution which would go throughout the community and the places the children were and bring this message about child care to them. And lastly, children do not pay their own bills.

Well, the classic of this was the state of Minnesota was supporting the insurance companies who would write insurance policies to the employers that would not take care of the children in the first month of life. Employers and the labor people were sitting at the table trying to figure out things. And the easiest thing was to figure out was how to not take care of the children.

And so they would write these crazy insurance policies. When we went to the legislature with it, not one person stood up and talked against the bill that would make the insurance include life from birth on. And so that was why we organized to build a children's hospital.

DAN OLSON: I guess the impression a lot of us have is that health care for a great number of American children, indeed, perhaps the vast majority, is good, maybe excellent. But tens of millions of children, I suppose it's not an exaggeration to say, don't get good health care. What should be done?

ARNE ANDERSON: Well, I think we should have universal insurance. And the right to what we would consider an excellent quality of health care without them having to be concerned about whether or not their family can afford it.

DAN OLSON: I suppose the reason that's considered radical, controversial, is because it assumes that it would be a universal program health service. Like in some other countries, where people complain about not being able to get the service they want as quickly as they want.

ARNE ANDERSON: That is certainly one of the problems in other countries. But yet, if you look at the Scandinavian countries, they get the service in pretty quick order. And I would hope that the medical profession would have the commitment for universal access and excellent care. Timely care, et cetera. To overcome that kind of inertia.

DAN OLSON: You're a medical doctor, a pediatrician. I gather this is still a renegade view among your colleagues.

ARNE ANDERSON: Oh--

DAN OLSON: Universal health care.

ARNE ANDERSON: Oh, I don't think so. No, I think amongst pediatricians, which has been a very, very underfunded area of health care, I think the general belief is that the situation in Canada for the children and for the pediatricians is a lot better than it is here.

DAN OLSON: So should it just be a universal health care system for children up to a certain age and then private health care system for the rest of the adult population?

ARNE ANDERSON: Well, I'm not enough of a social planner to know exactly. But I think universal-- if we are going to make the assumption that health is the-- access to health care is a right. Then I think we have to make the assumption that it's a right for all.

DAN OLSON: Do you think that's an assumption we make in this country, is that everybody has a right to health care?

ARNE ANDERSON: Yes, I think we do make the assumption everybody has a right to health care. And we're making all kinds of schemes in order to make that possible. With the welfare system, the aid to dependent children, special aids for handicapped, social security supplements. On and on. I imagine if I thought about it, I could find out we have a dozen different programs trying to make that possible.

DAN OLSON: I suppose the objection I hear most often to some form of universal health care system is, as you've pointed out already, the bureaucracy. Who should run it? Should the government run it, or should some other kind of entity run it?

ARNE ANDERSON: Well, I think you have to tip this whole thing upside down. Health is a personal responsibility. And if you analyze the health care that children receive, it is more dependent on the child's immediate caretaker than anybody else. And we can't do the research in this country. But in other countries, the research has been done where it's correlated. The caretaker or the mother's intelligence is correlated with the state of health care of the child.

And that is notwithstanding the issues of poverty. When we start thinking about health care, we should tip the table of organization upside down. View over and over here the statement of who reports to whom. Or who do you report to? Or who reports to you? And you've got a better job if more people report to you, supposedly. That means you've got more power. Rather than, who do you support, and whom do you serve?

If you were to model yourself as a physician, after people that you had great respect for, you would find that these people have this concept of service. And one of the things, a man named C. Anderson Aldrich, who I had the privilege of being a student, talked about the flu epidemic of World War I. And what could doctors do during the flu epidemic?

And he made the point that probably the best thing you could do when you made a home call on a family had flu was to stoke the furnace. Now that scientifically has a very good basis, because if a person has a viral illness, one of the dangers of making that viral illness exacerbate and be very, very serious and severe is hard work. And it was found, for instance, in the polio epidemic that the people-- oftentimes the people that got bulbar polio were people that did extremely strenuous physical work just during the time they had the prodrome syndromes.

DAN OLSON: Because it plays their body out and their body can't fight off the--

ARNE ANDERSON: I suppose that could be a way of saying it. But at any rate, you see, what C. Anderson Aldrich was saying is that you do what is needed to have a better outcome. You don't do what is the prescribed formal idea of what a doctor does.

DAN OLSON: In this day and age, do you go along with the chorus of protest we're hearing from a fair number of physicians that they're being told what to do and that they can't really follow as closely as they'd like, apparently, the philosophy you've just described of trying to get a better outcome? Because they're being told what to do under managed care. Do you feel that's a just claim?

ARNE ANDERSON: Well, I think it's just claim. But I also think that the physicians-- well let me go back on this question you asked me before, where did I get this idea? When we were building Children's Hospital, a very talented businessman and I were trying to lay down the plans for it. And we were laying down the plans for governance. And I was on the school board of Edina. And I said, boy, I know one thing is we can't have a system like they have at that Edina school board, because it is so bureaucratic and so formal that we'll never get anything done. We have to have something that is more creative and more efficient.

And we were trying to figure out-- of course, you put the board on top and then the chief executive officer, et cetera, et cetera, et cetera. Everybody knows that table of organization. And we just couldn't make it work. And this was a man named Jim Miles. And Jim said, well, sometimes when you can't make something work, Arne, you tip the damn thing upside down.

So we tipped it upside down and we put the patient on top. And then we put the people that gave the patient direct service in the next line. Then we put the people that supported the people that gave the patient. We had the CEO on the bottom and the board of directors on the very bottom. It was an upside down triangle, as it were. But it changed two things.

One, it changed the relationship from a relationship of directing to a relationship of supporting. You can support a lot more people than you direct. In addition to the fact you get a lot more creativity from people you support than people you direct. Because you limit the creativity of the organization in the directive system to what the director can understand. In the supporting system situation, you have no limits to the creativity.

DAN OLSON: It's an interesting power arrangement, but I suppose it doesn't tantalize a lot of CEOs who imagine themselves as the source of all power and judgment.

ARNE ANDERSON: Well, I suppose it doesn't. But when we got larger and we then had to hire, train managers and such, of course, they couldn't understand it and they got rid of it. And about five years later, one of them went out to California. And I think they spent about $5,000 a week to go to some lectures out there from the fellow who wrote the Passion for Excellence. And suddenly I forget his name.

DAN OLSON: Was it Tom Peters? No, no, not Tom Peters.

ARNE ANDERSON: Tom Peters. And he said, you know what happened, Arne? Tom Peters got up. And then the blackboard, he put a diagram of your upside down table of organization. And he was amazed. But we believe it was as you analyze organizations, you find that those that have a lot of creativity are actually operating this way.

DAN OLSON: Dr. Arne Anderson, thanks a lot for your time.

ARNE ANDERSON: Good. Nice to have met you.

JOHN RABE: Dr. Arne Anderson, a founder of Minneapolis Children's Medical Center. He talked with Minnesota Public Radio's Dan Olson as part of our monthly Voices of Minnesota interview series. Tomorrow on Midday, at noon, we'll go live to the National Press Club. Programing on Minnesota Public Radio is supported by the Public Affairs Group of Tunheim Santrizos Company, bringing an understanding of business to the practice of public affairs.

Thanks very much for tuning in to Midday today. Talk of the Nation is on the way next. I'm John Rabe.