Robert A. Garrett, MD
“Dr. Garrett was one of the world’s nicest people. A gentleman and scholar in the true sense of the word.” – J. Ludwig, resident ‘72-’75
Excerpts from Dr. Garrett’s “Urology at Indiana University”
In 1948 a fundamental change occurred in the dept. of urology. Commitment to enhancement of the full time clinical staff by Dean John D. VanNuys was initiated shortly after his appointment in 1946. At that time I was completing my prescribed residency period and was at the point of choosing between entering a private group practice or accepting the position of Instructor in Urology fulltime within the University. I chose the latter as the more challenging course. My original contract was a salaried one with no private fees accruing to the staff. My salary was $8,000 per year. In due course this arrangement was changed to a salary plus limited private fees. The limitation of fees was effectively achieved by the lack of hospital beds.
In the five-year period on the full-time staff prior to appointment to the chair in 1953, we had moved slowly toward a more functional service in a number of ways. Teaching at the resident level was strengthened by joint sessions with the radiology department in a weekly diagnostic “Pyelogram Conference”. Monthly “Black Book” consisted of a review of the month’s inpatient experience with emphasis on mortality and complications, attempting to establish cause and eliminate both. A monthly evening conference was devoted to a clinical research project undertaken by the residents. From these research projects came some major investigative efforts.
One matter persisting throughout my chairmanship was that of a dearth of adult hospital beds. While not a critical problem in the early years of my watch, it became an increasingly irritating one, affecting both service to referring physicians and recruiting efforts. Oft times admissions, both indigent and private were delayed up to a month. It was not until the Krannert Family made a generous grant to the University that the University Hospital, in planning stages since 1953, finally opened its first phase in 1972.
With the expansion of the residency an extraordinary group of residents served in succession. Dr. Edwin N. Kennedy, Dr. Robert K Rhamy, Dr. Don Yurdin and Dr. Paul C. Peters each adding a strength of his own to invigorate the program. Rhamy went on to join me on the staff at the University from which he was recruited to Vanderbilt where he was made Chief of the Division of Urology in 1964.
Dr. Paul Peters has had a distinguished career as Chairman of the Department of Urology at the Southwestern Medical School of Texas. He is a past president of the American Urological Association and has been a leader internationally in our specialty. In his early years in the department at Southwestern he took a very bold stand in renal transplant, pioneering that procedure and contributed significantly to its acceptance. While a resident Peters demonstrated an inquisitiveness that led me to regret that we had no research lab available to us. In 1990 he was awarded the Distinguished Alumnus Award by the Indiana University Medical School Alumni Association.
It may be well to mention my own somewhat anomalous position from the outset of my chairmanship. I was barely out of residency when much of the responsibility of leadership fell on my shoulders. Yet I was but a wee step ahead, if that, of some of my residents. A fellowship between us grew up that certainly defied the “Herr Professor” atmosphere. Indeed, when a Visiting Professor from New York was asked to comment on the residency program his remarks were to the effect that perhaps my relationship was a bit too low key. I am not certain that I ever corrected that aspect nor am I certain that I ever wanted to. In 1954 the residency term was increased from two to three years, and in 1959 we started to accept three applicants into the program.
In my own area of interest much progress was made. Bladder pathophysiology was given a boost by new radiologic methods of study working with Dr. J .A. Campbell a new cine ‘radiographic technique was used to evaluate voiding abnormalities in children. The phenomena of vesico-ureteral and bladder outlet obstruction were evaluated. A radiographic method of motion picture recording radiopaque media being voided from the bladder gave dynamic expressions of various clinical problems, some uninvestigated prior to this study. Manuscripts based on these studies were well received. During these studies we collaborated with the Liebel-Flarsheim people in developing the C-arm radiographic cystoscopic table, useful in fluoroscopic manipulations at cystoscopy.
As a part of these studies we initiated urodynamic recordings further elucidating bladder pathophysiology. Another area of investigation that pointed to the future was that of grey scale ultra-sound in evaluating renal mass lesions. Dr. David Schlueter, senior resident, collaborated with the ultra-sound physicists at the University of Illinois Champaign to record some of the first images of this nature in 1971.
In the early 1970s two facts became clearly evident to me. First, my hearing was fast approaching un-serviceability, making the duties of chairmanship extremely difficult. Second, Dr. Donohue’s reputation as an outstanding young urologist was becoming such that I feared we would lose him to one of several medical schools that were offering him their urologic chair. With these thoughts in mind, I approached the Dean, Dr. Glen Irwin, with the proposal that I step down from Chairmanship, and that Dr. Donohue be strongly considered as my successor. Donohue’s succession to the Chairmanship of the Department of Urology took place in September 1972, on my resignation, much to my own relief and gratification.
Notable Alumni during Dr. Garrett’s time as chair of the department:
Paul C. Peters completed his training in 1957 and went on to become chairman at the Southwestern MedicalSchool of Texas and helped to pioneer renal transplant being the first to successfully perform that procedure in Texas in 1964. He went on to become the AUA president in 1988 and was awarded the Ramon Guiteras award in 1993.
Dr. Robert K. Rhamy also completed his training in 1957 and after joining the faculty at Indiana Unviversity School of Medicine he went on to become chairman at Vanderbilt University’s Department of Urology.
Dr. William Bohnert completed his training in 1970 and served as the 2014 president of the AUA.
Dr. Anton J. Bueschen completed his training in 1972, was chief of urology at University of Alabama at Birmingham and served as president of the AUA in 2009.
Antireflux Surgery in Children (1966)
Use and Abuse of Antibiotics in UTI (1968)
Urology at Indiana University by Dr. Garrett