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#15 August 24, 2007 Dr. Wyckoff's untimely death by Ron Roizen  Photo from the New York Times, June 1, 1937 “Unfortunately, while Jolliffe was still in Europe, Dean Wyckoff died suddenly,” wrote Keller (1991, pp. 58-59), "and the Rockefellers used that as an excuse for withdrawing from supporting this research. I have always suspected that there was some other reason and that this was just an excuse – we always have had difficulties in getting the big foundations to fund alcoholism research." At the time of his death, John Henry Wyckoff, known among friends and family as “Jack,” was a distinguished cardiologist, dean of the New York University College of Medicine, and director of the Third (i.e., NYU) Medical Division of Bellevue Hospital. Jolliffe, Keller’s then boss, was chief of the medical service of Bellevue’s psychiatric division and an assistant professor at the NYU’s medical college. The Rockefeller establishment had initially sent Jolliffe on a tour of European alcoholism research and treatment institutions, partly, Keller suggested (Keller 1991), to enhance the young physician-researcher’s professional standing in the field. My own research on this history (see Roizen 1994, 1991) also found that the Rockefeller rejection of Jolliffe’s proposal touched on the matter of Wyckoff’s death. In a December 2, 1937 letter, the Rockefeller establishment’s Alan Gregg wrote to Jolliffe in part: Though Dr. Wycoff's [sic] role in the investigations might not have been direct, I had counted heavily upon his interest and his general experience, and his death has been in this particular as well as so generally a great loss and disappointment. His successor is I presume not yet selected, nor will it be possible I am afraid to find anyone so useful and valuable. (quoted in Roizen [1994])With the rejection of his own proposal, Jolliffe was before long put in charge (starting in May, 1939) of a quite different study – namely, the Carnegie Corporation grant study aimed at reviewing the scientific literature on “the effects of alcohol on man” (see Roizen, 1991, ch. 8). This was the study, incidentally, that would soon bring E.M. Jellinek into the fledgling alcohol science field. Wyckoff's Death What Keller’s accounts did not also mention (and what I have only recently come to know) was that Wyckoff’s death had been a suicide, an act apparently prompted at least in part by a burgeoning scandal that struck both Bellevue Hospital and the New York City medical community in the spring and summer of 1937 (Burchell 1983). A large and well organized disability insurance fraud -- involving crooked physicians, lawyers, “runners” (who recruited new fakers into the scam), and disease-fakers -- had employed digitalis to distorted electrocardiogram results and other methods to simulate serious cardiac disease in disease-fakers. After a substantial medical record had been established for fakers, each was brought to a reputable cardiologist, someone not involved in the scam, for final certification (on the scam's mechanics, see Hadley 1943). Disability insurance benefits were then divvied up among the fraud’s collaborators. Wyckoff had served unwittingly in this certifying role in relation to a number of fakers. It was perhaps a particularly bitter professional embarrassment for Wyckoff as he had published a number of articles on the medical use of digitalis. Wyckoff’s death occurred in the pre-dawn hours of Tuesday, June 1, 1937. The circumstances of his death were reported in some detail in a front-page June 1st New York Times article (“Dr. Wyckoff, Stricken” 1937). At about 7:40 pm on the evening of May 31st a watchman on patrol in the medical college at 477 First Avenue “heard moans” on the fifth floor in the anatomy laboratory. He found Wyckoff in an unconscious state. An ambulance was summoned from Bellevue Hospital. When the ambulance surgeon and a police patrolman, who had also been summoned, failed to revive Wyckoff by artificial respiration he was transported by ambulance to the hospital’s “emergency ward.” There, at about 8:00 pm, Wyckoff was placed in an iron lung respirator. At 11 pm, “the hospital reported that he was still in a coma.” The respirator treatment was terminated “just before midnight,” and Wyckoff was reported to have died at 3:10 am the next morning. The same June 1st Times’ article also conveyed the presence of some confusion around the question of the cause of death. Wyckoff’s “record card” at Bellevue was initially filled-in as “morphine poisoning” but was later changed to read “coronary thrombosis” (“Dr. Wyckoff, Stricken” 1937). The existence of a note to Wyckoff’s wife was also reported but the note’s contents, said the article, were not made public. As to how to comport the morphine poisoning with the heart attack, the article offered the following: Hospital authorities and police were reluctant to discuss the case. Dr. Charles D. Crandell, assistant superintendent of Bellevue, said, however, that Dr. Wyckoff had suffered from a heart ailment the last few weeks and might have taken morphine as a sedative. (“Dr. Wyckoff, Stricken” 1937)The next day’s Times’ article on the Wyckoff case (“Dr. Wyckoff Funeral” 1937) added a seemingly important detail: Gonzalez believed Wyckoff had felt a fatal heart attack coming on. This article also reported the results of Wyckoff’s partial autopsy, which had been performed the morning of June 1st by Assistant Medical Examiner Benjamin Morgan Vance. Based on the autopsy, the cause of death was now characterized as “coronary arteriosclerosis and general visceral congestion.” A subsequent Times' article on June 3rd noted: …in some quarters it was believed that chagrin and fear of possible damage to his prestige over the innocent part he played in the alleged frauds had aggravated Dr. Wyckoff’s condition and hastened his death of heart disease” (“Insurance Fraud Traps” 1937).Finally, in a June 12th Times' article, Acting Chief Medical Examiner Gonzales announced “Dr. Wyckoff’s case had been established as a suicide.” The toxicological report had found a large quantity of morphine in the vital organs, according to Gonzales. The article did not also explain how the new suicide designation might have comported with Gonzales’ theory Wyckoff had given himself a lethal dose of morphine because he felt a fatal heart attack coming on. Across the Atlantic in faraway Copenhagen, Norman Jolliffe noted much the same diagnostic dilemma in his diary: Letters from Brenner & Keller both indicate that it was suicide – I can’t believe it. I don’t believe the chief took the suicidal dose of Morphine unless he felt a fatal attack of Coronary occlusion had occurred. If under those circumstances he took the fatal dose I don’t blame him.Wyckoff’s short note to his wife was probably a key factor in the medical examiner’s decision to declare the case a suicide. The main body of Wyckoff’s note read: “This is awful but I feel sure right. You are better off with integrity and a little insurance than with a man who has through carelessness let his profession down.” Wyckoff’s note made no mention of an impending heart attack. The note’s mention of “a little insurance” for his wife was an oddly ironic comment, perhaps even harboring a final touch of gallows humor on Wyckoff’s part. Was Suicide Plausible? Still, suicide must have seemed to many observers an incomprehensibly great price to pay for Wyckoff’s hapless role in the scam. Also, there would seem to be many reasons for the good doctor to keep on living. He was at the height of his career. According to one colleague, According to one source, Wyckoff was very much looking forward to the graduation of his daughter Cornelia from Bryn Mawr the on Wednesday, June 2nd. Samuel A. Brown, dean emeritus of the medical college, said that Wyckoff had anticipated the graduation as “the happies [sic] day of in his life” (“Dr. Wyckoff, Stricken” 1937). Wyckoff was not the only honorable physician the scammers had exploited. Nor was he a target of the criminal investigation. Indeed, on learning of the scam and the prosecution, Wyckoff had immediately expressed a willingness to “cooperate in every way with authorities,” including showing them records of his cases (“Wyckoff Was to Aid” 1937). Wyckoff also knew that misinterpreted cardiogram analyses were a regrettable but not an entirely preventable risk of the craft. “Dr. Wyckoff stated, as other heart specialists,” United States Attorney Lamar Hardy was quoted as saying, “that any claimant who had been medicated and hospitalized could easily fool any heart specialist” (“Insurance Fraud Traps” 1937). All of this made it difficult indeed to regard Wyckoff’s suicide as plausible. The mystery no doubt deepened both the public’s interest and contemporary newspaper coverage of Wyckoff’s tragic end. The mystery was still alive as recently as 1983. An article by cardiologist Howard B. Burchell (1983), which offered a thoughtful treatment of the circumstances of Wyckoff’s death, included a long excerpt drawn from a letter authored by fellow cardiologist Charles Kossmann, who, Burchell wrote, was “a junior physician at the time at Bellevue Hospital”: When all of the dirty business came to a head in 1937 I was a clinical assistant visiting physician at Bellevue. . . . Wyckoff was a strict disciplinarian with himself and with others. One evening, I believe in February or March, 1937, I was called by Wyckoff to come to his private patient office, I think on East 37th Street. When I arrived he handed me two electrocardiograms and asked me what I thought of them. Each showed abnormalities of the T wave. I gave my standard correlative interpretation of them, namely, ‘that they displayed abnormalities of the T wave ascribable to myocardial disease, digitalis or both.’ The light in the waiting room, now devoid of patients, was dim but I thought I perceived a further tightening of his usually tightly compressed lips. He thanked me, turned to enter his consulting room, and left me to find my way out, a brusqueness I had come to expect from him. I thought no more of the episode . . . until after the holiday week-end of 1937. On returning by train, I was shocked to read . . . that John Wyckoff had been found in coma in the anatomy laboratory of the Medical School. This straight-laced, rigidly honest, puritanically ethical man just could not cope with the disgrace that might be heaped upon him by colleagues and the public who would never believe that he had been duped by dishonest and avaricious doctors and lawyers. . .Conclusion It cannot be said with any degree of certainty whether Wyckoff’s suicide and the notorious scam that unfolded in New York City in 1937 had much impact on the Rockefeller Foundation’s decision not to fund Jolliffe’s proposed project. It is known that the Rockefeller philanthropic establishment avoided controversy, but they may have also had a number of other reasons for declining to fund Jolliffee's study. Yet Keller's disinclination to tell the story of Wyckoff's suicide and the medical insurance fraud surrounding it did, it seems to me, did have a downside for students of the early history of post-Repeal alcohol science. For one thing, the story of Wyckoff's death in some sense connected the New York medical and research establishment of the time to the contemporaneous difficult economic circumstances of the Great Depression. A popular historian has written (Dornstein 1998, p. 188): For many people during the Great Depression houses of pain and heart attack schools became as important a set of institutions as banks and workplaces had been before the stock market crash..Burchell (1983) offered a second interesting, if indirect, indicator of the connection between the scams and the depression. During the trials of the conspirators, wrote Burchell (p. 512) popular sentiment ran against the defrauded insurance companies, reflecting perhaps "...considerable feeling against bit corporations among the general population." Above and beyond enriching our sense of social context, Wyckoff's death presents us with a study in tragedy, wherein a man's high sense of honor could not be fitted to the scandal that brewed around him. References:
©
2007 Ron Roizen
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