Midwest's Mayos

The late Drs. William and Charles Mayo, of Rochester, Minn., who hated publicity so much that they once wanted to sue for "libel" a newspaper which praised them, this week are the subject of an authorized biography. Five years ago, three years before they died, the Mayo brothers gave the University of Minnesota permission to publish a biography of themselves and their pioneer father, Dr. William Worrall Mayo, who died in 1911, at 91. The Doctors Mayo, published this week by the University of Minnesota Press ($3.75), is authored by a onetime Minnesota librarian, Helen Berniece Clapesattle. Written with Victorian reverence, the book is a jumbled mass of facts and recollections about the growth of a great medical institution, a dull book full of interesting facts.

Ferryman on the Minnesota. William Worrall Mayo came to the U.S. from Britain in 1845. He became a pharmacist in Manhattan's old Bellevue Hospital, later studied medicine at Indiana Medical College, moved, after several stops, to the little town of Rochester, Minn., 75 miles from Minneapolis. To eke out his meager earnings as a physician, the lively young man worked at various times as druggist, tailor, horse doctor, ferryman on the Minnesota River.

During the Civil War, 39 leaders of the hostile Minnesota Sioux were hanged. Dr. Mayo carted off the body of an ugly brave named Cut Nose, and after dissecting him, he strung together his skeleton, used it to teach his young sons anatomy. About this time, he mortgaged his house to buy a microscope.

As his practice grew with the population of the wheat belt, Dr. Mayo went back to Manhattan, studied surgery and gynecology. After he returned he began removing ovarian tumors, soon became so successful in the specialty that doctors came from all over the State to watch his work. He did not believe in antisepsis, always wore tails and top hat, and carried his instruments loose in his pockets.

In 1861 his son William James was born; four years later came Charles Horace. The boys went everywhere with their father. When he performed operations, they were his assistants: Will acted as first assistant while Charlie stood by with needles and thread stuck in his lapels; before he was twelve, Charlie became his father's anesthetist. "We were reared in medicine," Dr. Will once said, "as a farmer boy is reared in farming."

Will and Charlie. In 1880, at the age of 19, Will Mayo went to the University of Michigan Medical School. Three years later, a serious, dignified young M.D., he returned to practice with his father. Although he assured people he was going to be "the greatest surgeon in the world," the farmers mistrusted him because of his youth and even his father kept tight rein on him. But when he was 27, Dr. Will asserted himself.

One day he examined a woman with an enormous ovarian tumor. His father made plans for an operation the following Sunday, invited doctors from near & far to watch the performance. Then he went off to St. Paul for a consultation. On Sunday, a crowd of doctors gathered around the woman's bedside, but Dr. Mayo did not show up. Taking his courage in his hands, Dr. Will performed the operation himself. When his father came in, he was "speechless."

Dr. Charlie, who went to Northwestern in 1885, was "only average." But after his return, three years later, he blossomed out into a brilliant surgeon. He did the operations on the head, left most of the abdominal work to his brother. While Dr. Will was stern, autocratic, self-possessed, Dr. Charlie was warm, friendly, unpretentious. He often wore rumpled old clothes, even fell into a mud puddle on the way to his wedding. Dr. Will always tried to slick him up, rarely succeeded.

Mecca of the West. In August 1883, a great tornado struck Rochester. Since there was no hospital, scores of victims were bedded in a local dance hall, were nursed by sisters of St. Francis. After the catastrophe, the nuns pinched and scraped for four years, saved several thousand dollars for a three-story brick building. Although old Dr. Mayo had been against the plan, he took charge of the hospital, ran it with his sons. Thus, unwittingly, the Mayos started one of the greatest revolutions of modern medicine: clinical group practice.

The equipment was crude (the nuns carried all the water up from the basement), but the skill of the Mayos soon jammed St. Mary's with patients from all parts of the expanding West. The hospital gave the young brothers their big chance --a large testing ground for new surgical techniques. Where other surgeons, for example, could speak of their success in a score of goiter operations, the Mayos could cite hundreds, later thousands of cases. Gradually they hired assistants who were specialists in fields like pathology, laboratory diagnosis, biochemistry, set them to work on practical research problems.

Although the brothers devised only a few original operations, they had a talent for improving on other men's ideas, the opportunity to give them mass application. They are given credit by surgeons today for perfecting or popularizing certain types of surgery for stomach ulcers, various operations for hernias, breast amputation for cancer, excision of goiters, etc.

By 1914, a large new hospital had been built. When the brothers' savings piled up to several million dollars, they donated a million and a half to create the Mayo Foundation for Medical Education and Research, thus established a connection with the University of Minnesota Medical School.

Today the Mayo Clinic is housed in a skyscraper building; connected with it are six hospitals and several hotels. On the staff are 200 doctors, 300 medical associates, 1,000 nurses, technicians and non-professional workers. To Rochester every year travel 100,000 patients from all over the world. Patients pay according to their means: 25%, says Miss Clapesattle, pay nothing; 30% pay bare costs of treatment; the other 45% "defray the expenses of the institution and its program." Some fees, she admits, are high, "and Dr. Will was sometimes disturbed to learn just how high."

The Mayo Clinic, like its founders, cannot boast of a great deal of original work, but serves as a testing field and improving plant for new theories. It is remarkable for its quick application of new discoveries to bedside practice. Some of its outstanding contributions to medicine: isolation of thyroid hormone (Dr. Edward Calvin Kendall); perfection of oxygen masks for aviators (Drs. Walter Meredith Boothby, William Randolph Lovelace II & Arthur Bulbulian); cutting fibers of the sympathetic nervous system to treat circulatory disturbances of hands and feet (Dr. Alfred Washington Adson); use of iodine in certain thyroid diseases (Dr. Henry Plummer).

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