HARALAMBIE GEORGE CICMA: AN AUTOBIOGRAPHY A Vlach’s Life in His Time Part IX

Harvard Medical School

I, full of zest and ambition, was the first to register when Harvard opened in October. I went immediately to the bookstore next to the school and purchased the required textbooks— all second, third or even fourth hand—even these used books were very expensive.

Our class was very large, over two hundred students, the majority of them were doctors’ sons and/or wealthy; all had been friends for years and formed tight cliques which I could never hope to enter. We were instructed to assemble in the amphitheater at eleven in the morning and you may be certain that we gathered there promptly. Dean Edson spoke briefly, “You are here to undertake a very serious, difficult but necessary, task; to acquire the knowledge and skills of your chosen profession—to help the sick and the dying! To be a doctor, to assist your fellow man. You will have to utilize all your time, energy and dedication to achieve this goal. Our professors will supply you with the necessary fundamentals of a medical education but you have to master these principles. You will succeed or fail strictly on your own. It is up to you to develop a satisfactory study routine, keep to it and work really hard; those who survive this first semester will be fairly certain that they can make it all the way.”

Our arduous adventure had begun! During this first semester we had a one hour lecture each morning with our Anatomy Professor, Dr. Warren, he was a magnificent lecturer. The rest of the morning was spent in the dissecting room. This enormous room was filled with tables, each with a cadaver; these were assigned one to each two students. My partner was Robert N. Ganz, a very nice young man (perhaps ten years my junior). He is now a prominent pediatrician in Boston four of my grandchildren are currently under his care!

Anatomy was not an expensive subject, it required only the books, a dissecting kit and locker charge. It was a very interesting undertaking to trace the pathways and distribution of blood vessels and nerves through the body; to study the relationship of the muscles and their conjunction with the bone structure. It was- a revolution to find how nature has housed all the vital organs in protective custody; rib cage guarding heart and lungs, brain being protected by an egg-shaped skull—the toughest of all possible covering; all the things which I had taken for granted were now portrayed in a new and animated way and I again thanked God for all His wonders.

We were continually under examination, an instructor would pass our cadaver, pick up a blood vessel or nerve and request that we name it and explain all about it. My special instructor was Dr. Alexander S. Begg who, in 1921, became Dean of Boston University School of Medicine; it was he who reorganized the entire medical department and was influential in helping Boston University achieve international recognition.

Histology, under Dr. Louis Braman, occupied our afternoons; we had many lectures but the largest part of our work was using the microscope to study the cellular structure of various tissues and organs. Harvard, unlike Boston University, did not have microscopes available to rent or use—Harvard expected the students to purchase their own!

I took this new problem to Lester Whitaker, hoping that he would let me use his. He, however, needed it for his own work in the second year medical studies. He said that he had a friend who had just graduated from Boston University and was now doing an internship; it was just possible that I could use this microscope, perhaps even free of charge, he would let me know the following day. I met him in the amphitheater and he stated, with a big grin, “Well, cheer up, Harry, I’ve found a microscope for you and it won’t cost you a penny—just take good care of it and you can use it for all your work in Medical School. You go to the main entrance of Boston University School of Medicine tomorrow at four-thirty and they’ll have it for you.”

I was there on the dot and I waited and waited, looking around for a man with a microscope; at about four-fifty a very attractive young lady rushed up and asked, “Are you Harry Cicma?” I admitted that I was and she went on to explain that she was Lester’s friend and was going to lend me her microscope.

“But he said a medical student, a graduate, had the microscope,” I stammered.

“That’s true. I graduated last June and I’m working now at the Homeopathic Hospital, doing my internship.”

“But Lester didn’t tell me you were a girl.”

“Oh, never mind, he likes his little jokes. He was just teasing you. Do you want my microscope or don’t you?”

“Sure. O. K. Of course I do, only he surprised me. I’ll take good care of it, if you will let me use it,” I finally managed to say.

“Well, all right then. Good luck to you.” She left immediately, a very busy young lady.

One more problem had been surmounted. Working with the microscope absolutely fascinated me, another whole new world was opened up. Unlike the dissecting room, everyone worked independently in this course. My old bug-a-boo came up again but our very wonderful Professor Braman was most helpful, always willing to explain a difficult point, to repeat anything requested and, most marvelously of all, he tolerated my lousy drawings! Histology was an extremely interesting subject and was made easier for us as it was presented in such an excellent manner.

We were seated at tables, each with his own microscope; of my companions, I remember Fuller Albright, James Faulkner and Edwin Cave—of all my classmates they were the only ones who were anywhere nearly friendly to me. They accepted me for what I was, a hard worker who had no money but plenty of guts and ambition! Faulkner, especially, was kind to me, inviting me to be his guest at the “Y” where he had a membership, for swimming and showers, trying to assure my having some relaxation in my rigid schedule. I was surprised and delighted to be given, by Albright, a Christmas present of a Medical Dictionary—something I needed desperately and could not afford to buy; even today, I have this in my office; it has, of course, been supplemented by numerous later editions for efficiency’s sake but the original gift still holds a most treasured place in my store of very pleasant memories.

I was happy, even with this small circle of friends, I also had Lester but he was a year ahead of me and busily engaged in his own studies. In my class there was a young Greek, Aristides Dukakis, and we walked to school together every day, going from Pembroke Street to Longwood Avenue. I never rode a trolley in the city of Boston during my years at medical school. On my trips to Marlboro, to see my fiancée, I did ride them, this trip was serviced only by the trolley in those days, no busses or trains! My friend Dukakis was exceptionally brilliant, he could read a page at a glance and would remember it—in toto, verba turn. He could tell you exactly what was on this or that page of any book he had read, whenever you referred to it!

He had a room, even smaller than mine, which he obtained by taking care of the furnace in that apartment house. If anything, I might say that he worked even harder than I. We studied together at the medical school whenever we had the same free period but we could not study as the others did, gathering in their rooms six or eight at a time—to “cram.” So, before any important examination, Aristides would come to my tiny room (there was barely enough room to turn around when we were both in it) and we would study through the night, often going as much as seventy two hours without sleep to perfect a subject. Dukakis had the ability to memorize and I had the knack of reasoning through and coordinating the vast amounts of material.

In both Anatomy and Histology, we were continuously under oral examination, at any time an instructor might stop and ask a question and we were expected to come up with the correct answer, instantly! At the conclusion of each month we were given a two hour written exam;   God, I passed each one with good marks and this gave me courage to persevere. At the end of the first three months we had a full examination in both subjects. We all awaited the results of these tests, but we especially feared Anatomy which was considered the most important course in the entire medical curriculum. I had better averages than I had anticipated and Anatomy was my best mark! A final test was given at the close of the semester; Dr. Warren personally gave this exam; which consisted of oral as well as written questions and everyone was scared to death. I passed this with a mark of 90%. The Histology examination was a three hour written test and this gave me no trouble at all, I completed my first semester with excellent marks.

We had a week’s vacation and then started the second semester; some students had flunked out and those who remained felt that, because they had passed their previous courses, they could now let up on studying— they thought their hardest work was over. We had Physiology in our morning class and the afternoon was devoted to Biochemistry. I was certain I would have no trouble in these courses and was especially anxious to get on with the chemistry (my college major) wished me luck and success and reassured me that my first year’s study had been more than satisfactorily completed.

How could I explain my real problem to him? Without a passing mark in Biochemistry it was impossible to request scholarship aid and it would be too late to make the solicitation in the fall—even if they did find a way to have my real marks established. I thanked him and left, closing the door gently on my hopes of continuing at Harvard Medical School.

Interim

I went disconsolately to President Mirlan at Boston University and explained my predicament. I assured him that I could easily pass the Biochemistry if only they would take the time and patience to read my examination books. President Mirlan informed me that, during the past year, Boston University had been given international recognition and I would be able to practice medicine anywhere in the world should I decide to return. “But, Harry, if you still desire to complete your studies at Harvard, I will personally finance your remaining three years. However, you still have your full scholarship here—we have a great respect for your work and confidence in your ability.”

I was so thoroughly disgusted with the manner in which Dr. Foliin had treated me that I immediately answered, “I think I want to spend my next three years here at Boston University.”

“You have made an excellent decision, not only will you be able to pick up your scholarship, but you will obtain your Bachelor of Science degree in 1922 as well as your medical degree in 1924.”

My immediate future was settled. In September I took another Biochemistry examination with the excellent Dr. Fiske at Harvard and I passed with outstandingly good marks; this removed any condition against my entrance to Boston University School of Medicine.

Back at Boston University

October 1st, 1921, armed with my credentials from Harvard, I walked to East Concord Street to register for my second year of medical study. The first person I met was Dr. Alexander S. Begg who had been my instructor in Anatomy and was now the Dean of Boston University School of Medicine.

He called out, “Welcome, Cicma, I’ve been expecting you. Our good friend, President Mirlan, told me that you were coming back. I’m really very glad to see you here.”

“I’m happy to be back and it’s nice to have you as Dean.”

“President Mirlan gave me a free hand in reorganization of the medical school; almost all the teaching staff are famous clinicians, even the department heads are active in clinical work; in this respect our school is different from Harvard where the majority of the professors are only engaged in research work. Here we are dealing with actualities, not with theories. We have also added, as I think President Mirlan told you, the issuance of a Bachelor of Science Degree upon the completion of your second year medical study.”

“I think that the really great accomplishment has been getting international recognition for the school, this means a lot to me as I want to go back to Macedonia to practice when I have my medical degree.”

“That is a very worthwhile objective and I am certain you will accomplish it; if you do half as well here as you did at Harvard, you will certainly graduate with honors.”

This conversation with Dean Begg was very inspiring to me and I registered and then went to my first assembly. The class looked odd to me, so small, only fifty or sixty students. Boston University never took more than ninety students in their beginning class and, of course, there were the usual drop-outs and a few who flunked. Most of these students had been my fellow classmates in College of Liberal Arts and they were all glad to have me back, especially my old (Greek) friend, Constantine Zarifis.

Dean Begg greeted the class and told us briefly, “This will be an important year in your medical study, the subjects presented will enrich your medical knowledge; they are many and varied and you will have to apply yourselves assiduously if you are to accomplish all we expect from you.”

Dr. H. W. Walters, Professor of Pathology, gave us a series of lectures about the signs and symptoms of Tuberculosis—lectures so vivid that I am sure none of my classmates have ever forgotten them.

We were strongly advised by all our professors to attend every lecture, to take as many notes as possible and to correlate these notes with the recommended textbooks— this we had to do if we expected to succeed. Some of the students used shorthand for notes, others had the ability to write rapidly but for myself neither of these methods was possible. This situation was very discouraging, there was not enough time to check through all the textbooks, especially without proper notes. I started to look around to team up with someone who took good notes; I was lucky enough to meet three Canadian boys who, collectively, took excellent notes, they had two typewriters and by taking turns they always had complete, individual, sets of notes. I explained my predicament and they promised to let me read and/or copy their sheets.

At first I tried to copy them in longhand but this took too much time from my study schedule; finally a bright idea came into my little head—I would rent a typewriter and have my fiancee, Ioana, do the work of typing them. The next weekend I brought the typewriter to Marlboro with me and I then proceeded to show her what to do. “Just punch every letter exactly as you see it on the paper!” I watched her closely until she had finished the first page. “Thank God,” I said, “You did it.” This made me very happy and encouraged but I did feel sorry that I had brought so much extra and difficult work to poor, dear Ioana.

This four-tenement house in which my Ioana lived was divided into two apartments on the first floor and two on the second. Her door was to the right as you entered and the door on the left was the entrance to the home of a young, newly-wed, Italian couple. Ioana worked all day and her nightly routine was to return from work at about 5:30 or 6:00 P.M., prepare and serve supper for her father, wash the dishes, and occasionally to sew or embroider. Prior to my having brought the typewriter, theirs had been essentially a very quiet apartment (the house was so poorly constructed that everyone knew what was going on in the rest of the tenements); now when the dishes were done, Ioana would go to the typewriter and start to punch the keys with one finger, continuing until very late at night.

The young neighbor across the hall was a secretary and she could not understand what was going on every evening; she finally decided to try to get acquainted with Ioana and find out what the mystery was. The two girls took an immediate liking to one another and Ioana explained that I was a medical student and that I worked very hard and I had “showed” her how to copy the necessary medical papers and so she had to work very late every night as I needed the copies for Saturday. Her new friend offered to help and also showed Ioana how to type properly, doing some of the work while she demonstrated the technique. Many times, later, she would help us both, not only was she a wonderful neighbor but proved to be an excellent friend.

When I came home the following Saturday, I nearly fainted to find that the notes were nearly ready and Ioana was using the typewriter like a professional, even using the correct typing method. We were indeed fortunate to have such a fine couple for neighbors.

A month or so later, my Professor of Gynecology recommended our reading a small book dealing with Female Anatomy, Physiology and Life. I brought this book to Marlboro that weekend and forgot to take it with me when I returned to Medical School. Our helpful neighbor saw the book, looked at the index (there was a chapter dealing with virginity) and asked Ioana for permission to borrow the book. She and her husband read this chapter and so resolved a problem which had been so delicate that they didn’t even wish to discuss it with their family physician. Both were full-blooded Italians and good Roman Church Catholics and, because of some doubt as to her virginity, they had decided upon voluntary abstinence rather than get a divorce. The accidental finding of this book, reading the facts and becoming more open minded now rejoined them for a lifetime of happiness—three months later she was pregnant!

When I arrived that weekend, my notes were complete, Ioana was very happy and started to tell me the story but, before she could finish it, the neighbors rushed in and thanked me for saving their marriage! This incident strengthened our friendship and it has endured to this day.

Their first child was a beautiful, eight-pound girl; at the age of three months she developed a skin eruption, they took her to their family doctor and he told them that it was an hereditary eczema. Again they started to quarrel, each blaming the other for the baby’s trouble.

As soon as I arrived for the weekend they asked me to examine the child and perhaps recommend some specialist in Boston. Luckily enough our Professor T. Wesley Lee, an excellent lecturer and clinician, had recently presented material on the subject of children’s skin diseases; he had even demonstrated various cases to the class. I examined the baby and made a diagnosis of Infantile Eczema (today we call it Atopic Dermatitis). This is not an actual hereditary condition but a pre-disposition—that is, a member of the family might develop Eczema and all the others would be completely clear. I told them not to worry, the baby would get well soon and that when I returned to school on Monday, I would discuss the case with Dr. Lee and see what he could suggest. I did this and I was very proud when he said that I had made a correct diagnosis! I suggested Crude Coal Tar Ointment as the proper treatment and was gratified when he agreed. Dr. Lee added, “Since this is your diagnosis and these people are good friends of yours, I suggest that you take care of the baby; keep me informed as to the progress and I will help you all I can.” He wrote and signed the prescription and wished me good luck. I had this filled at the hospital pharmacy and when I went to Marlboro I showed them how to use it, I also advised them to stop putting sugar into the baby’s bottle of water! The infant improved rapidly and in about two months she was completely clear—there has been no recurrence. They have two other children and neither of them had any skin disturbance. Needless to say, the family was very happy and Professor Lee congratulated me not only on my diagnosis but on the handling of the case.

I passed, with the help of my typewritten notes, all my mid-year examinations and with very good marks. During this year at Medical School, I did not have to bother President Mirlan with any personal problems; he kept my checking account active and took me to lunch several times to encourage me and to praise my industry—the New Year’s dinner at his house was, of course, one of the high points of my year.

I was now confronted with another and important problem; I needed a new top coat and at least one suit of clothes! I did not wish to ask President Mirlan for additional money so I began to inquire where I could get some good woolen cloth. One of the Jewish boys in our class promised to take me to a good place which charged reasonable prices. We went to this store and I was able to secure excellent material for both projects. Saturday afternoon I went again to “surprise” my Ioana. She saw the package and immediately wanted to know what was in it. I said, “wait until after supper and I will show you.

After an excellent meal, I told her that the time had come for the surprise. I opened the package and took out the material. “Here are two pieces of good cloth which I got for very little money, one is for a top coat and the other for a suit. I will show you how you can make me the coat.” I then took my old coat and ripped it apart at the seams. “Now, you can use these pieces  or a pattern. I know that you are an excellent stitcher and you can make the coat in only a short time.”

She just stood and look at me, speechless.

“Please,” I begged, “Don’t look like that. We have to try. I know that you can do it. I need a coat badly and I don’t want to ask my benefactor for any more money.”

“OK., I’ll try.”

She cut the cloth, stitched the pieces and in about four days the coat was ready and fitted me perfectly. We were both happy and she said, “Well, next we try the suit.” Her enthusiasm soon turned to despair, “Oh dear,” she cried, “how are we going to make the buttonholes?” She tried many and various methods on a piece of cloth but without success; finally I told her not to worry,  would take the coat to Boston and ask some tailor shop to make them.

I tried two shops and they both told me that I was a smart Alec, doing the easy work and asking them to do the hard part—they would not believe that my fiancee had made the coat, stating flatly that no woman could do such good stitching. The next day I tried still another tailor, this time I kept the coat in the bag and asked the man if he was willing to do me a favor; I explained that I was a student in Medical School and did not have sufficient money to buy a top coat and I had asked my fiancée to make me one but she couldn’t make the buttonholes, could he please help me?

“Let me see the coat.” He inspected it very carefully and then said, “My God, but she is a very good stitcher. I will make these buttonholes for you now and I will also tell you where you can get the special scissors needed and then she will be able to make any kind of buttonholes she wishes.” He did not charge me very much for his work and I thanked him profusely for his kindness.

I went back to Marlboro, bringing the special scissors which the tailor had recommended, Ioana immediately tried them and they worked exceedingly well, the good tailor had solved our problem. She then ripped up an old jacket and a pair of trousers and, using them as a pattern, she had my new suit of clothes ready the next weekend; they fitted me perfectly and I said, “Thank God, this looks like a miracle, my new coat and now this!”

My joy was short-lived—in conjunction with our studies, we were required to go to the nearby Homeopathic Hospital (now the Massachusetts Memorial Hospital) to watch autopsies and to have actual cases demonstrated during some lectures. On Wednesday I had such a class, I hung up my coat with the others as usual; when I was ready to leave, my new coat was gone. I never found out who stole it. I was fortunate to have sufficient money to return to the same store and I purchased enough material for another top coat and a suit.

Ioana was extremely disappointed at my loss but she told me not to worry as she could make the new coat right away and work on the suit later. She also made my shirts!

My clothing was not the only difficulty Ioana solved for me, she continued to type my lecture notes and now we formulated a way to save on my food (I needed every cent I could get for books and materials).

Ioana figured out a schedule whereby she packed dinners for my entire week: Monday, egg sandwiches; Tuesday, meat sandwiches, Wednesday, a jar of potatoes and onions cooked a la Macedonia; another, larger, jar of beans carried me over Thursday and Friday. I kept the sandwiches in my suitcase and the jars were placed on the window sill; at first this worked out well as the weather was cold, but as spring approached and the air was warmer, my food began to spoil—I arrived at my room one Thursday evening at about six-thirty, eager to eat my   supper of beans and bread, I opened the jar and they had fermented, bubbling up and smelling so bad that I had to throw jar and contents out.

I had a maximum of $1.00 a day available for food and I tried to spend much less than that. Often I had to go without breakfast and at noon I would buy a half-loaf of bread or a few rolls and then I would go to a cheap restaurant and order a fifteen cent plate of Boston Baked Beans. I’d sit in an inconspicuous corner and try to fill my stomach with the beans and the other items I had brought with me. I had to change eating places frequently as they soon realized what I was doing and, after a few days, I was sure to feel a tap on my shoulder and to hear, “You’d better get outta here, Buddy, we ain’t goin’ to have a guy like you comin’ in here wit their own bread, yer supposed to pay for what yer eats here, so scram.”

My friend Zarifi knew the owners of a good Greek restaurant on Washington Street, their food was excellent and the prices more reasonable; one day he suggested that we and one of our colored classmates have lunch, Dutch treat, there. We knew the Greek menu and both ordered Tass Kebabs (beef with onions and potatoes) but the young Negro ordered only toast and coffee. The owner loaded our plates generously with vegetables and a really good sized piece of beef. The meat was quite fatty and I ate only the lean, leaving the rest on my plate. Our classmate asked me if I was going to finish my food and by the time I had said, “No,” he had polished off the plate. Actually this was the first time I had realized that there were other students who were as badly off or in an even worse situation than I.

I continued to work very hard, struggling, hoping, praying. Occasionally my old friend, Lester Whitaker, would take me out to dinner and we would have a very enjoyable time, I’d always feel more cheerful after these visits.

Final examinations for the second year of medical study came and went, I again passed all my subjects with good marks. Our class was awarded our Bachelor of Science Diplomas as promised.

President Mirlan invited me to lunch and congratulated me on my good marks and having “received my sheep-skin”—now I was really on my way. He advised me not to look for a job during the vacation period as the third year at Boston University School of Medicine was the final year of didactive work and was considered to be extremely difficult. He advised me to take it easy, review all my subjects and generally gather strength for the coming work; he also assured me that he would continue to take care of my expenses for the coming year.

To Be Continued