BURNS:
What has changed about medical care today, compared to the days when you first started practicing?

MURRAY:
The biggest change is the tremendous number of people now employed to take care of an office load.   When I started out, we only had, besides me, a receptionist, a nurse, and a bookkeeper in the back, and that was it. 

One reason for the difference is that, back then, I wrote out my own notes.  Now the doctors dictate everything.  So they have to have a transcriptionist.  Then they need a file clerk.  Then maybe they have to have two file clerks.  Then you have an appointment clerk.  First thing you know, you have eight or ten people working in the office.  And all these people get social security and hospitalization benefits.  And you wonder why the cost of medicine is so high!

BURNS:
A lot of the ancillary services are also more sophisticated now.  You did your own lab tests.  You  used to have an X-ray machine out there, too.  You don't see that any more.  Now you send the patient to a radiologist directly, to the hospital.   As far as laboratory work goes, you guys probably had a hemocytometer there, and did your own CVCs and such?

MURRAY:
Yes, and after awhile we purloined Paul Shinn and his wife.  They'd come in after hours.  During the day, we'd draw blood samples, stick them in the fridge and they'd come in there at night and handle them.

I used to kid Paul and make him mad and  say, "Here's Paul Shin.  He used to work for me. Now I work for him."

And he'd say, "Oh, Doctor, don't say that!"

BURNS:
How did you have the courage to lay out the capital for that X-ray machine?

MURRAY:
We bought it used, from a veterinary.  It was an old Picker, and the head on it was a stationary anode -- we didn't have a rotating anode.

That was the same head that I used in our mobile machines during the War, the Pickers.

Our machine was just used for taking chest X-rays, and of extremities, and occasionally the lower abdomen, and so forth.

BURNS:
Did you ever set fractures in the office?

MURRAY:
A few, where you didn't have to do any manipulation.  Otherwise they'd have to go to the emergency room, or you'd get an orthodopod for them to see.  A lot of people had insurance and they wanted an orthopod to take care of them.  That was OK with me.

BURNS:
How did you decide to give up X-raying there?

MURRAY:
When we built the office, I had my dad lead-line that little closet, which was my darkroom.  But then regulations started coming down about radiation exposure, the number of people who were being exposed, and whether you had registered technicians taking the pictures.  If I took the pictures, it was OK.  But if I taught Alone or somebody else how to do it, it got to be more of a pain than it was worth.  And Don English the radiologist, was on Blue Cross and Blue shield but  they would not pay for X-rays done in a doctor's office unless it was a radiologist's office.

BURNS:
When did you stop doing the X-rays?

MURRAY:
I suppose it was some time in the late 50s.

We took one of Scott when Polly was pregnant, but that was at Mount Carmel. 

You guys always liked that orange X-ray paper I would bring home.

BURNS:
How long did it take to develop your average X-ray?

MURRAY:
We had developer's tanks and a floating thermometer.  At first, our building wasn't air-conditioned.  So sometimes we had problems with hot developer.  Sometimes you'd just wave your picture over the top of the developer solution, and it was instantly ready to put into the hypo.

But we stumbled through; we had readable X-rays.

BURNS:
Did you ever have to send the X-rays elsewhere, where patients would want them sent?

MURRAY:
Not so much then.   That wasn't true then as much as it would be today

Bu, even so, we didn't have an X-amat, like a hospital might.   Those machines are great!  You slide that sucker in there and, in sixty seconds, you've got a finished product.

Before that, we'd have to wait three to five minutes, depending on the temperature of the water, to see the X-ray; then you had to dowse it down and rinse it well.  Then you had to put it over into the hypo, into the fixing solution.

Then we'd go, "Well, now we've got to dry these things" and it would take ten or twelve hours for them to dry.   Now and then we would sell our waste to processors who would recycle the silver.

BURNS:
Now it is so dramatically different.  Just yesterday I was looking at a brain with the residents.  It had a very interesting malformation and I called the lady who was head of radiology at the children's hospital.  She had done a scan on this and she said, "Let me show you what I'm doing using the fiber tracking system we've got." 

They can go in there down and give you a colorized version of the brain.  You can pick a track of the brain and it will have its own unique color.  I was blown away!

I felt like I was just on the caboose of using this.  Medicine is full of promise, no illusion about that.  But I've never been so dazzled as when I have seen what the radiologists have done.  It's going to revolutionize the way we teach microanatomy!  It's amazing technology.

MURRAY:
We had the head of radiology from the University of Florida at Gainesville down here last week talking to us retired doctors about the science of nanography   The things he told us we couldn't believe!  It's amazing what they're going to be able to do!

BURNS:
What treatment for illness changed the most during your doctoring years from 1951 to 1993 -- and what never changed at all?

MURRAY:
The best thing that happened was the polio vaccine.  We used to be scared to death during polio season.

For a long time, we really didn't have a lot of things to use to fight it -- mainly mercury hydrochloride injections as a diuretic.  They  worked somewhat. 

Wolffia serpentina for hypertension was a big breakout thing when I started in practice.  Now I take a small tablet of that stuff refined, twice a day.  It used to cost a terrible lot -- now it's about five cents or somethuing a tablet.

BURNS:
Do you think medicine has moved too much from a "prevention" point of view to a "treat with expensive patented medications" point of view? 

MURRAY:
Sometimes it seems that doctors don't say "lose 20 pounds" or "quit smoking or it's liable to kill you."   Somebody'd sue you for saying those things now.

Doctors don't spend time with patients enough now.  That's why they get sued more often, because they don't talk to people.

DENNIS:
I think there's a recognition of that in the medical curriculum -- a recognition that we need to bring back some of the human aspects of medicine.  The approach can be cumbersome when you try to standardize things --  it's like trying to "standardize" how to be a human being.  But I think people are paying attention to prevention.

MURRAY:
Yes, more so.  When I was in practice and somebody would tell me something of an extremely sensitive nature, I never ever wrote it down.  If my records were ever subpoenaed, there wouldn't be anything in there. 

[Cases were recalled but, in keeping with the Doctor's policies, not recorded in these records!]