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Oral Histories

Radiologist Earl R. Miller, M.D.


Short Biography

Part I (August 9, 1994)

Wartime Work on Radiation Exposure

Remembrances of Joseph Hamilton

Neutron Therapy Research

Relations Between UC Berkeley and UC San Francisco

Working for the Manhattan Project and UC Medical Center

Process for Obtaining Radioactive Isotopes

Human Applications Committee and Informed Consent

Textbox: About Consent Forms (April 11, 1995)

Work With Soley to Diagnose and Treat Thyroid Disease With Iodine-131

Patient Consent; Contradicting Perceptions

Wartime Plutonium Injections

Hamilton's Research on Effects of Cyclotron-Produced Radioisotopes

Textbox: Dr. Joe Hamilton (April 21, 1995)

Research With Patients From Laguna Honda Home

Radioactive Iodine Uptake in Schizophrenia Patients

Recalling Dr. Joseph Hamilton

Invention of a Baby Holder (1951)

Technique to Produce Infinite Laminograms

Introduction of Stereoscopy to X-ray Film Making

Postwar Preference for Unclassified Research

Zirconium and Plutonium Injections

Research With Healthy Volunteers

Tracing the Records of Patient Consent

A Career in Research

Professional Contribution

Textbox: Recollections of Research Activities (April 11, 1995)

Remembrances of Personalities

Tension Between John Lawrence and Stone

Textbox: Robert Spencer Stone, M.D., L.L.D. (March 10, 1967)

Part II (August 17, 1994)

Use of Tomography to Diagnose Tuberculosis Patients

Textbox: History of Radiology, University of California at San Francisco, as Seen by Earl R. Miller, M.D. in the Mid 1980's

Working in the Radiological Research Laboratory

Investigating How Radiologists See Images

Establishment of the UCSF Radiation Laboratory

Remembrances of University Presidents Sproul and Kerr

Early Career

Work Through the AMA to Improve Radiology Training

Rise of Radiology Specialization

Study of Pediatric Patients With Congenital Heart Disease

Physiologic Studies


Brief History, Earl R. Miller, MD

E.R. Miller's Residency and Career at UC

Recollections of an Old Crock (March 16, 1978)

Activities of Earl R. Miller as Indicated by Published Material (April 22, 1995)

Chronological Bibliography

Remembrances of Personalities

HERKEN: When was the last time you saw Joe Hamilton?
MILLER: I have no idea. Actually if you know when he died, I can say that it was shortly before that. I went up to visit him one time. —Oh, I think that was when I saw Leah's work. I think that was it: I went to visit Joe.
BERGE:Was she still psychotic at that time?
MILLER: I don't know.
HERKEN: He was home. He wasn't in the hospital.
MILLER: He was at his home.
BERGE:What was he like in terms of personality?
MILLER: Good question. He was a nice guy. Number one. He was a dedicated scientist, dedicated scientist. He became sad when he was dying. I guess everybody would be. You don't fear death, you fear the dying. It was sad.
HERKEN: How would this manifest itself?
MILLER: Sad. I like the Spanish word tristé. That has the sound of sadness.
HERKEN: How would you characterize Stone when you talk about him?
MILLER: Stone was a Scotsman. That was part of his makeup. He was very chintzy about spending money on the department, for instance. He was an excellent clinician. He was an excellent radiologist. He was a dedicated and exciting research guy. Everybody recognized his work on patient analysis, and you have the best in the world.
HERKEN: He was somewhat of a prickly character, I had the impression, just in correspondence I've seen. He made some enemies.
MILLER: Yes, he could. It never came into my ken. Like Shimkin, for example, or even Bierman. He had a reason. He felt that those people were getting out of line. With John Lawrence, he thought he was getting out of line.
HERKEN: How so?

Tension Between John Lawrence and Stone

MILLER: I don't think I'm going to answer that. I don't know; he just disagreed with what [they were] trying to do.
HERKEN: With what Lawrence was going to do?
MILLER: Yes, trying to develop a medical school in competition, for example.
HERKEN: That would have been one cause of tension between Stone and Lawrence, certainly. John Lawrence was trying to create a medical school at Berkeley and Stone was at UC San Francisco. I can see how that could be a cause of tension.
MILLER: Stone felt strongly that there wasn't room for two medical schools twelve miles apart.
HERKEN: Although it seems somewhat curious that Stone would have been one of the liaison people between UC San Francisco and UC Berkeley.
MILLER: It was his work in both places.
HERKEN: I'm just thinking out loud here: I'm a little surprised that Stone wouldn't want to create his own center at San Francisco at the medical center and not have much to do with Berkeley.
MILLER: You see, timing is what this is all about. Early on, Stone did not have a bevatron, he didn't have a laboratory. The Berkeley thing had the big equipment for neutron therapy and the whole bit. That is why he would go to Berkeley. You understand?
HERKEN: Yes. Let me just mention a question Anna had asked earlier. Stone was one of the first to use neutron therapy. I think around 1947 he writes a paper and they abandoned this.
MILLER: He also was one of the first that did million-volt radiation therapy. He was the first one who ever used radioactive material in an attempt to treat a patient.
HERKEN: Sodium or phosphorus?
MILLER: Sodium, exactly. It's funny recalling this stuff out of thin air.
HERKEN: A couple of letters I've seen from Stone suggested that at one point there was a rivalry. I don't understand this, because I need a radiologist to enlighten me on this: a rivalry between Stone and his Sloan machine, the bevatron, and new cobalt machines were being developed and used on the east coast that used 360-degree rotation of the radiation beam. Is that correct?
MILLER: I have no idea.
HERKEN: The case I saw involved Loran Gatter (phonetic). Gatter was diagnosed as having a brain tumor, I believe, and he was initially treated by Stone in San Francisco, but then he went on to Mass[achusetts] General [Hospital to be treated] by one of the new machines.
MILLER: Normally, radiation therapy is given to the patient from two or more directions in order to give the tumor the most radiation with the least radiation to the normal tissue around it. With the 360-degree rotation the ratio of tumor to normal tissue dose is increased, and therefore there is less damage to the normal tissue.
HERKEN: This is actually a document that comes from the archive.

(Herken hands Miller a document)
MILLER: Is it in relation to large doses of radioiodine used for treatment of carcinoma or thyroid? A twelve-year-old boy was riddled with metastases from cancer of the thyroid. We treated him with 100 millicuries for five times. Today he is well. His father and I are dear friends, for good reason. This boy, now fifty years old or getting on to sixty, can break me in half. That was the one really shining example.
BERGE:Did you have any interactions with Dr. Paul Aebersold75 at all?
MILLER: I knew him. He was working with the Atomic Energy Commission and that was the relationship.
BERGE: Are you aware that, I believe, it was him that committed suicide later on? Do you know anything about that?
BERGE:You don't know anything about that.
MILLER: I know he was a magnificent dancer. All of the women loved him.
HERKEN: You didn't happen to know Shields Warren by any chance?
MILLER: I knew him, but I never really was close to him.
HERKEN: I was just wondering. From what we're seeing here, this sounds like research.

(Herken shows Dr. Miller a document.)
MILLER: This had to do, I'm sure because it was large doses of iodine, it was with carcinoma of the thyroid. It had to be, because we were attempting to get the tracer dose down farther, farther, and farther. Of course, when you're treating a carcinoma, you have to hit it hard; otherwise, forget it.
HERKEN: This is for the Project [(Contract)] 48, so that answers that question. So, this would have been AEC-funded at that point.
MILLER: '47, okay. I didn't know anything about that. You were asking before why I felt I didn't want to be conducting this, because you have to do this kind of thing all the time.
[Textbox: Robert Spencer Stone, M.D., L.L.D. (March 10, 1967)]

Part II: August 17, 1994

BERGE: This is an interview with Dr. Earl Miller by Anna Berge of the Lawrence Berkeley Laboratory Archives and Records Office on the 17th of August, 1994, at his residence in San Rafael, California.
MILLER: I haven't had this sense of paranoia about you, as I did about that guy.76
BERGE: The following interview is a continuation of an interview with Dr. Earl Miller on his work as a researcher and radiologist at the University of California in San Francisco.

Many of the following questions will be based on the history of radiology as seen by Dr. Earl Miller, which is a transcription of a recording on video of the history of the [UCSF] Department [of Radiology] as he lived it.

Dr. Miller, you made a number of references to different hospitals that you worked with. I was reading this [transcription of your video] and you mentioned, in the section on the growth of the department, a number of different other laboratories and hospitals. I was wondering if you could tell us a little bit about how your collaboration or the department's collaboration with other hospitals and other institutions worked—for example, San Francisco General Hospital, or any number of them.

Use of Tomography to Diagnose Tuberculosis Patients

MILLER: Let's stay with the San Francisco General to start with. The San Francisco General was a hospital for indigent people. It's still, I think, called San Francisco General. It's quite a different place now. At the time I was there, I was there as a [Radiology] resident from Stanford[University's medical school, 1937–39]. [The] San Francisco General Radiology setup was run by both Stanford and UC. I had nothing to do with UC at that time; in fact, I didn't know much about it. That's where I met Henry L. Garland.

Anything else you want to know about it?
BERGE:I guess I don't understand how you worked with them.
MILLER: I was a resident in training at Stanford, then at SF General, and then back at Stanford, in the old Stanford Hospital at Clay and Webster.
BERGE: Did you ever do any work after you were a resident there?
MILLER: There, no. Although, somehow I got interested in tomography.77 A Dr. Petrillo, I think—he was a radiologist—had one in San Francisco. Neither UC nor Stanford had one [(a tomograph)]. I went to the shop and built one. That was the time when tuberculosis78 was a rampant disease. A whole hospital wing was devoted to the care of these unfortunate patients. [To test the laminograph,] I asked the doctors on that ward to send me their six toughest patients, those in which there was persistent positive79 sputum80 and no demonstrable cavities. All six were shown to have cavities in the lungs with the new gadget.
BERGE:What's laminography?
MILLER: It's body-section radiography. By means of an arm, (pointing to different parts of his outstretched arm) here's the x-ray tube, here's the patient, and here's the film.81
BERGE:Any other hospitals you worked with?
MILLER: No. Then I went back to Stanford in San Francisco. There was a dual arrangement where both Stanford and UC sent residents to SF General Hospital for study.
BERGE:You mentioned, for example, Moffitt Hospital.
MILLER: That's UC. There's Moffitt and now there is another one on the UCSF campus called
[Textbox: History of Radiology, University of California at San Francisco, as Seen by Earl R. Miller, M.D. in the Mid 1980's]

Working in the Radiological Research Laboratory

BERGE: What kind of work did you do with the Radiological Research Lab?
MILLER: That was my life.
BERGE:It just had a fancy name.
MILLER: That's what I called it. The lab occupies 3,200 square feet, had a [machine] shop, electronics lab, x-ray room, dark room, conference room, and office space. In 1978, the regents renamed the lab the "Earl R. Miller Radiologic Imaging Laboratory."
BERGE: Are you feeling okay?
BERGE: Can you elaborate on what your research was like, in terms of how a general day was like?
MILLER: I did clinical work and teaching in the mornings, and I worked in the labs in the afternoons. There were two labs. The Radiological Research Lab was in the basement of the West Wing, [room] number 207. The Clinical Radiologic Research Lab was in the Cancer Research Institute on the13th floor of H.C. Moffitt. Two half-days a week I worked up in the Clinical Laboratory. The rest of the time I spent down in the other laboratory.

So, the work up on the 13th floor was primarily the study of physiology of the lower urinary tract and the study of speech. We examined patients who had lower-urinary-tract problems, patients who had swallowing problems, and who had abnormal speech, usually due to cleft palates. These patients required the use of the sophisticated equipment which presented anatomic and physiologic data simultaneously on each frame of an x-ray movie, and on each frame of a videotape.

The basement lab provided the instruments and the know-how to make and use such equipment. Data from the Clinical Lab was analyzed in the basement lab because it [(the Radiological Research Lab in the basement)] contained sophisticated TV and electronic equipment for the analysis and dissection of images. Data was usually presented on the face of the CRT82 tube of an oscilloscope.

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