History

PHYSICIANS AND SURGEONS

By Christopher Leggo, C.M., M.D.
The Father, Founder and First Secretary
Crockett, California

This account of the early history of the Western Industrial Medical Association is written as a personal document for those who may be interested and is not phrased for publication. Being informal, it may reveal personal events which would not be of interest to general readers, nor might the presentation of the material to them be in good taste. If it is filed away in the archives of the Association, some future scribe may draw on it for material, or some currently ambitious author may find as great judgment required in what he deletes as in what he includes.

It is inevitable that since I took the initiative in organizing the Association, there will be an egotistical flavor to this account. There will be either frank or implied claims of good foresight. There will be carefully rationed references to some blind spots in judgment.

One of the early, and viewed retrospectively, one of the most conspicuous blind spots was my stubborn insistence that the members should have a very close personalidentification with a particular industry, and particularly that theofficers be full-time industrial physicians when possible. This pointis emphasized now in an effort to partially correct an injustice to Dr.Solomon Weil of Rodeo. In 1932 he was employed half-time with the American Smelting and Refining Company at Selby, and he suggested that the very few of us who were engaged in industrial medicine in Contra Costa County form an association of industrial physicians. While I was then on fulltime with the C & H Sugar Company at Crockett, I had not been there sufficiently long to feel well enough oriented in either the communityor among the physicians to approve his suggestion and without me, Dr. Weil did not feel there would be sufficient support for him to proceed with the idea.

Some time in the fall of 1939, I decided to act on the suggestion Sol Weil had made, and invited about six industrial physicians to dinnerone evening at my home to form the Contra Costa Industrial Physicians Association. In the meantime, Dr. Weil had given up his Selby connection, although he was still practicing in an industrial community and was doing much industrial work. My then existing prejudice against allowing physicians not identified with a particular industry to take any active part inan industrial physicians' association operated to prevent my inviting the author of the original idea. Of those who were invited, the ones who accepted and attended were: U. S. Abbott and Harry G. Ford, of Richmond; M. L. Stauffer, of Pittsburg (Calif.); and J. M. MCCullough, of Crockett.There were omens at that time that the society would be a success, the outstanding one being that two physicians accepted the invitation and failed either to appear or to send regrets. The strategy planned at that meeting was to use the newly-formed" Contra Costa County Industrial Physicians' Association" asa name under which to invite industrial physicians in Alameda County to meetings and so expand to a Northern California group.

With this plan in mind, I went back to Chicago in January of 1940 to a meeting of the newly-formed AMA Council of Industrial Health and discussed the organization of a regional component society of the American Industrial Physicians with the then executive secretary of the association, Armour G. Park, who approved the idea. Consequently, I came back and laid plans which are described in a letter dated April 2, 1940, to Mr. Park, reading as follows:

 

"I was glad to get your letter and the list. There is not much time left to accomplish much this year, but there is my tentative proposal, all subject to your approval."

    • Call a meeting in approximately 2 weeks, of (a) those on your list in this neighborhood, of which there are ten; (b) inviting a selected number of others such as the Director of the Bureau of Occupational Hygiene and a few others who are wither full-time industrial physicians or who are prominent in this work.

 

    • At this meeting set up a skeleton organization for the 'Northern Section of the California Association of Industrial Physicians and Surgeons.'

 

    • Erect a temporary scaffolding for the 'California Association of Industrial Physicians and Surgeons.'

 

    • Ascertain by that time some live wire in Los Angeles who would call a meeting of a similar group for May 3, which is 3 days before the opening of the California State Medical Association convention in San Diego.

 

    • Attend this meeting with whoever else of our group is going South to the convention and encourage them to organize the 'Southern Section of the California Association of Industrial Physicians and Surgeons."

 

    • Plan then to formally apply for recognition by the American Association as a component society.

 

    • Lay plans for the annual meeting of the California Society for the 24 hours previous to the 1941 State Medical Society convention and use the coming year to increase the membership of the 2 sections, each having 2 or 3evening meetings during the year.

 

    • Again, through your lists or whatever other contacts we can make, attempt to have formed in Portland and Seattle, respectively, State organizations; namely, the Oregon and Washington Associations.

 

 

 

 

"If these plans materialize for them, group all of the Associations together into a 'West Coast Association' which would meet immediately preceding the State Medical Society convention of the State whose turn it was to have the meeting. In other words, if the 3 States were active, the West Coast convention would be held oneyear immediately preceding the California Medical Society convention;the following year immediately preceding the Oregon Medical Society annualmeeting; and the next year in Washington.

"I have talked to the President of the California Medical Society, who is Dr. C. A. Dukes who was at Detroit 25 years ago, but whose membership has at the present time lapsed. He sees no objection to the proposed program and will give us what help he can. By meeting immediately before state conventions, we should increase their attendance and not detract from it. On paper the plan looks perfect. What practical political difficulties we may encounter, I will learn. Do you see any objection? What is your criticism? What we do, of course, is not your responsibility until we are officially connected with you, but it is hard to stub one toe without hurting the whole foot.

"We must have a copy of your bylaws, explicit instructions as to what we can and cannot do, and preferably a copy of the constitution and bylaws of one of your present component societies for a pattern. I have talked to Legge who will not know until tonight whether or not he will be free to go South. I will make no further movement without your approval, but every day's delay will jeopardize any action possible this year. By proceeding as outlined, I believe we can have a good skeleton organization for California within a month and have a working organization here a year from now for the '41 State Society meeting. A successful meeting that year would clear the way for action in Oregon and/or Washington. What will bethe A.M.A. attitude? What are the red lanterns on the track? What mistakes can we make which will embarrass us and/or you? At what point should we ask formal recognition of you? I will supply the enthusiasm and the time to get it started. Can you supply the advice and the attention necessary because of my inexperience in the organization? If you would rather have us slowup, we can spread our efforts over the next year and build the organizationbefore applying as a component society."

The proposed meeting was held at the Hotel Oakland on April 26, 1940. Because so many of the proposals and so much of the philosophy developed at that meeting are still in force in the Western Industrial Medical Association in 1955, the minutes of this meeting follow in full.

"A dinner meeting was held at the Hotel Oakland on the evening of April 26for the purpose of discussing the advisability of organizing an associationof Industrial Physicians and Surgeons. Those present were:

    • Dr. Arthur L. Abbett - Fisher Body, Oakland

 

    • Dr. U. S. Abbott - Pullman Co.,Atlas Powder Co., A.T. & S.F. Railroad, A.R. & S.S.Manufacturing Co., Richmond

 

    • Dr. Gilbert M. Barrett - Bethlehem Steel Ship Bldg. Division, General Electric Co., San Francisco

 

    • Dr. Robert T. Legge - Prof. of Hygiene, Univ. of Calif., Past Chairman, section Preventive Medicine, A.M.A., Berkeley

 

    • Dr. J. M. McCullough - Union Oil Co. Oleum Refinery; American Smelting and Refining Corp., Selby Plant, Oleum and Selby

 

    • Dr. Lester Newman - State Compensation Insurance Fund, San Francisco

 

    • Dr. Henry Perlmutter - Paraffine Co.'s Incorporated, Emeryville

 

    • Dr. George Sanderson - Orthopedist and Chairman of the Industrial Medicine Section of the Calif. State Medical Association, Stockton

 

    • Dr. M. L. Stauffer - Columbia Steel Co., Pittsburg

 

    • Dr. C. A. Walker - Southern Pacific Co., Pacific Lines, San Francisco

 

    • Dr. Christopher Leggo - C & H Sugar Company, Crockett

 

The plan of organization as it was discussed and finally approved was:

The group to become organized as the California Association of Industrial Physicians and Surgeons.

Eligibility for membership to consist of the same requirements necessary for membership in the American Association of Industrial Physicians and Surgeons, which, briefly summarized, are:

 

    • Membership in County and State Medical Societies and a membershipor fellowship in the American Medical Association.

 

    • To be engaged in Industrial Medicine to the extent of at least 25% of thetime.

 

    • To have been so engaged for at least one year.

 

    • When the Association includes 25 or more members, application to be then made to become a component society of the American Association of Industrial Physicians and Surgeons

 

    • That eligible members be approached in Los Angeles in the hope that a parallel organization be formed there.

 

    • That the San Francisco bay area group meet two or three evenings each year.

 

    • That an annual meeting be held by all members throughout the State on the Sunday preceding the annual conventionof the California State Medical Society.

 

The various phases of Industrial Medicine which would become the basis for future discussions and would supply the common interest of the group were mentioned. These included:

Physical examination off employees.
Plant sanitation and preventive medicine in industry.
The problem of placement of partially disabled or aged employees.
The medical or surgical care of those disabled through occupational accidents or diseases.
The rehabilitation of employees not adequately adjusted following injuries or disease.
The status, interpretation and trends of compensation laws.

Also discussed were the various agencies which are active in Industrial Medicine, such as: State Bureau of Occupational Hygiene; The United States Public Health Service activities such as their Bureau of Dermatosis Investigation, their Venereal disease campaign; and the contributions by the American Industrial Hygiene Association; and numerous others with whose work an isolated individual cannot be familiar.

The annual dues for the California Association were set as five dollars ($5.00). This will include the annual dues for the American Association of Industrial Physicians and Surgeons and their journal and individual subscriptionsto their journal, "Industrial Medicine," if we become a component society as planned.

Considerable discussion was devoted to what effect, if any, the Association might have on the Industrial Medicine section of the State Society my meeting the day previous to the annual session. It was unanimously agreed that the program and spirit of the Industrial Physicians' Sunday session should be such that the interest in the State section meetings to follow should be heightened and not lessened. A requirement for membership in this Association is membership in the County and State Societies. As a consequence, no competitive spirit should exist to the detriment of the State Society. The attendance at the State section may not always have included an adequate representation fromthose whose great interest is Industrial Medicine. The fact that the two sessions will be held at the same place on successive days should stimulate an increasing number of Industrial physicians to attend both conventions at the expense of one trip.

Dr. Robert T. Legge was elected president of the organization and Dr. Christopher Leggo, secretary. They were authorized to appoint whatever other officers or committees prove desirable between now and the next meeting to be held in the fall.

"This arrangement was considered desirable as, by its elasticity, it would allow for Southern officers to be appointed should the hope materialize that a section in Los Angeles be organized.

"It was realized that the group invited to this meeting was necessarily limited because of inadequate information regarding the others in the district who might be eligible, available and interested. Each member was asked to submit the names of any men whom he felt would make desirable members.

We now had an interested nucleus and the problem was one of finding a sufficient number of interested industrial physicians in the southern part of the state to swell the total number to twenty-five, and to do this preferable with the blessing of the California Medical Association, or at least without arousing its opposition. Plans for the next steps are outlined in a letter to Mr. Park dated April 29, 1940. To the members who have joined recently and have observed the comfortable relations between the Western Association and the California Medical Association, the fears expressed in this letter that the CMA would be hostile to a new organization may seem to have been unrealistic. Be that as it may, they were anticipated and plans for surmounting them were described in this letter which follows:

"I am enclosing a copy of the minutes of the meeting held last Thursday night. I believe it was a good start. The situation was discussed considerably from the point of view of the Industrial Medicine Section of the State Society. Their chairman was present, and stated that he believed there would be a motion brought up this year to change the name of the Section. At the present time it is a hybrid organization including orthopedists and traumatic surgeons, and almost no interest shown by the plant physicians or full-time industrial men. Between the proposed State Council in Industrial Health, planned by the American Medical Association last January, and the stimulus of our organization, I believe the section will be transfused with new life. If, on the other hand, the name is changed and industrial medicine is not included, they will be committing suicide just in time to leave us their property. If we were to have already organized and be in the position of having killed the Section with our activity, we would be damned from Hell to breakfast.

"Yesterday I saw several of the officers of the State Medical Society. Their permanent secretary is quite in favor, and likes the idea of our Sunday meeting. Two of the councilors were in favor. The only 'fly in the ointment' was the present president, who does not feel that we should forma new association. We are forming it anyway, and do not feel that we will run into sufficient opposition to hamper us. If we meet at a different time entirely than the State meeting, I believe we will hurt both our own attendance and the State Society's attendance. I am going to have dinner tomorrow night with the president of the State Society, and we may have the opportunity of talking it out further. He was one of the originators of the American Association.

"As a matter of fact, I may have committed a tactical error in discussing this entire matter with the officers of the State Society - I do not think so. Sooner or later the groups will have to meet closer together, and harmony between the organizations should prevail. At least we will be doing nothing underhanded in advising them of our proposals. It would be impudent and ill-advised to take advantage of their meeting place, and steal the thunder of their convention without their cooperation. It may be that we are inviting criticism or opposition; if so, we would have incurred it sooner or later anyway. If they agree to it, we are away to a start which would have taken years to accomplish otherwise. These are my views, at any rate.

"The man to whom I wrote in Los Angeles, Dr. Phillip Stephens, was interested, but unwilling to do the spade work. I am going to the State Society Convention at Coronado the week after next, and will see if anyone will get it going there. If they do not, we shall have to wait until tour first annual meeting next year and draw them in then.

"Our next problem is the machinery for organization, and the finances. Could we not use your application forms and type our name at the top? If we do this, we would need about 100 forms to start with. We could extract our information and forward them to you. Your dues, I think, run from January first to January first, and we could make our membership for the same period. Would we be wiser to make it$2.50 for the rest of this year and collect the $5.00 on January first?

"Then there is a list of men who are already members of your Society, who live in California. I suppose their dues are all paid. Through what affiliations do they become members? Are they railroad surgeons, or are they just all industrial members? If they are the latter, could we not have you write them all, including a postcard for them to send me if they wish to accept membership in the California Society at no additional cost. We could frame a suitable card which would give us this information and stimulate their interest. One man has already paid his $5.00-Dr. Barrett-do you want his money now?

"I am sending a duplicate of this letter to you so that you can send it or take it to Dr. Cheney.

"Dr. Legge of Berkeley expects to go back to the American Association convention in New York. The time I am putting in on this affair makes it impractical for me to even attempt to arrange it this year. I am sorry, but believe that I can do more good by working at this end."

The California Medical Association met at Coronado early in May, 1940, and I spent the best part of time button-holding their officers and counselors and their prominent politicians, asking them to read the minutes of the April 26 meeting. What seemed to be success in the project was described by two paragraphs quoted from a reporting letter to A. G. Park, dated May 14, 1940:

"By a most fortunate accident I roomed, at the State Convention, with the councilor of the Association who became president-elect. As a result, I was in an advantageous position to explain our plans to many of the most prominent men of the State Medical Association. I met no objections-on the contrary, the typical remarks were 'it's a good thing,' 'this should have been done sooner,' etc.

"Our first annual meeting will be a year from now, approximately the first week of May at Del Monte, where the hotel accommodations and the setting were both beautiful. If possible, we should have some prominent figure from the American Association to be a guest speaker. All you have to do now is to find someone who will come out. We have no money, but we might be well able to pay his hotel expenses while here."

By November 20, 1940, we had apparently secured our twenty-five members willing to pay the annual five-dollar dues, which included the subscription to Industrial Medicine, and the first letter on the Western Association of Industrial Physicians and Surgeons stationery was dated Nov. 20, 1940, inviting the recipients to a dinner meeting at the Hotel Oakland on Dec. 2. The price of a dinner, $1.50, included a cocktail.

The interim officers, until the first annual meeting at Del Monte, California, May 4, 1941, were:

President, R. T. Legge
Secretary, Christopher Leggo
Treasurer, J. M. McCullough
Directors, C. A. Walker, Eric Liljenkrantz

Eric Liljenkrantz, the youngest of the group, was the first to die, being killed on duty with the Navy in a flight early in 1942.

At this first actual meeting of the Western Association of Industrial Physicians and Surgeons, on Dec. 2, 1940 at the Hotel Oakland, were the following, with their industrial identification:

    • Doctors

 

    • A. L. Abbett Fisher Body Oakland

 

    • Edwin Bartlwtt Bethlehem Shipbuilding

 

    • Armour & Co.

 

    • Dupont

 

    • W. P. & S. San Francisco

 

    • Martin Benzinger Owens Ill. Pac. Coast Co. Oakland

 

    • C. A. Dukes Standard Oil Co. Oakland

 

    • N. P. Dunne Westinghouse Elec. Co.

 

    • East Bay Transit Co.

 

    • Judson Steel

 

    • Merco Nordstrom Valve Co. Oakland

 

    • M. L. Fernandez Hercules Powder co. Pinole

 

    • O. R. Frasch Travelers Ins. Co. San Francisco

 

    • R. T. Legge Prof. Hygiene, U.C. Berkeley

 

    • R. C. Leggo C & H Sugar Refinery Crockett

 

    • J.M. McCullough Union Oil Co.

 

    • American Smelting Co. Crockett

 

    • C.R. McRae Southern Pacific Co.

 

    • Market Street Railway San Francisco

 

    • Henry Perlmutter Paraffine Companies, Inc. Emeryville

 

    • J. P. Russell State Dept. Public Health Berkeley

 

    • C. E. Smith Exec. Dept. Public Health and Prev. Medicine State Board Health San Francisco

 

    • J. L. Stauffer Columbia Steele Pittsburgh

 

    • C. A. Walker Southern Pac. Lines San Francisco

 

    • W. W. Washburn Southern Pac. Lines San Francisco

 

    • N. Weil Pac. Gas and Electric Rodeo

 

While we had apparently our required nucleus of twenty-five members, most of them were from the San Francisco Bay area and we were still groping in out efforts to recruit members from the southern part of the State. With this object in mind, I spoke to the Industrial Accident section of the Los Angeles County Medical Association on Feb. 13, 1941. The plans for the Association were discussed in this talk, and interest in the first annual meeting to be held May 4, 1941 in Del Monte was invited. In my discussion of the new association I note one sentence which read "An unwritten amendment is that we will welcome guests." That is still true.

The records available do not contain the names of those who became the original charter members. Neither does the correspondence show who was helpful in arranging for the Los Angeles meeting. Since all the names and faces were new to me, my memory will not do justice to the Los Angeles group. Certainly most helpful and interested was John Osborne who was of great assistance both to me personally and to the organization for several years. I have distinct recollections of Jerry Shilling and Packard Thurber. Joe Paluso spoke enthusiastically at the meeting in favor of the organization.

Neither do I have available at this writing a copy of the first program at Del Monte. I did receive aletter of one short paragraph from an internist in Los Angeles who expressedhis regrets that he could not attend. He signed himself Rutherford T. Johnstone.This short letter, however, showed so much spirit and enthusiasm that I importunedhim to attend if possible, particularly the "bull session" we would hold the evening before the meeting. He altered his plans and attended. Althoughhe was identified full time with a hospital group the entire practice of which was almost completely among industrial cases, I was very loathe to allow himmuch recognition in view of his lack of identification with a particular industry.Also there for the evening formal discussion were about a dozen others.

I recall distinctly only Bob Legge, Jim McCullough, John Russell and Red Johnstone. I was particularly anxious that there be no friction between out embryo group and the California Medical Association. When a misunderstanding arose about possession of one of the meeting rooms for the following day, and Bob Legge, our president, and Dr. George Kress, the secretary of the CMA, were arguing it out at the top of their voices in the lobby, I thought our new society was dead before it was born. The incident became a matter of amusement between them both before too many hours had gone by, and I found to my great relief that we were still in business.

As the "piece deresistance" for the program we had been able to obtain Dr. Louis Schwartz from the U.S. Public Health Service to give a paper on industrial dermatology. He was the last speaker of the day. He was also the longest. A cocktail at the expense of C & H Sugar was planned at the end of the meeting. After Dr. Schwartz talked on and on, and showed more and more slides, resentment, superimposed on boredom, took over, and we nearly lost some of our Los Angeles group as members thenand there. As I remember it, Osborne and Cheney were abetted in their incipient revolt by Ben Frees.

At the business meeting held at that session, Dick Scofield of Sacramento moved that the interim officers who had served during the past year be re-elected. John Ball of Santa Ana and Lou Cheney of Los Angeles were, I think, added to the board of directors. Dr. C. A. Walker was elected vice-president, I was secretary and Jim McCullough of Crockett was treasurer.

All the preliminary secretarial work was carried out by Miss Betty Caffrey, the industrial nurse at the C & H Sugar Refinery, who was eventually bestowed with thetitle Executive Secretary.

The records may reveal for those who are interested, accurate lists as to who were officers for this and succeeding years. The purpose of this account is served, I think, in describing some of the activities carried out in organizing the association, much of which would not be revealed by the records.

Actually, our records for several years following this are rather sketchy, and yet we felt that both our records and our correspondence were on a more businesslike basis than were those of the parent American Association of Industrial Physicians and Surgeons in Chicago. Since they were undergoing some organizational changes at that period of time, this belief may have been true. Much of our activity was of a frenzied last-minute type, in which enthusiasm was rather more conspicuous than was methodical attention to detail.

To maintain the interest of those who had been directors or officers, we established early in out history the practice of inviting all ex-officers to the annual meetings of the Board of Directors. That this practice has continued is due, we think, to the loyalty and the interest of the past officers; and the high percentage of attendance speaks for the enthusiasm the Association engenders in those who become active in its affairs.

What may not be realized by many who undertook responsibility when the Association was small is the volume of routine work which now must be performed by the secretary, the assistant secretary and the treasurer. Those of us who carried the responsibility in the pioneer days when enthusiasm was sufficient to launch the organization must admire and respect what seem to be the monumental efforts of the present executive staff and pay tribute to them.