Hillbilly To Harvard

Books by Leon S. Robertson: INJURIES: CAUSES, CONTROL STRATEGIES AND PUBLIC POLICY (Lexington Books) INJURY EPIDEMIOLOGY (Oxford University Press) INJURY EPIDEMIOLOGY: RESEARCH AND CONTROL STRATEGIES (Oxford University Press) INJURY EPIDEMIOLOGY: THIRD EDITION (Oxford University Press) THE EXPERT WITNESS SCAM (www.lulu.com) BIOLOGY AND SOCIAL BEHAVIOR with Allan Mazur (Free Press). CHANGING THE MEDICAL CARE SYSTEM: A CONTROLLED EXPERIMENT IN COMPREHENSIVE CARE with John Kosa, Margaret Heagarty, Robert Haggerty, and Joel Alpert (Praeger) MEDICAL SOCIOLOGY: A GENERAL SYSTEMS APPROACH with Margaret Heagarty (Nelson-Hall)

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Copyright 2006. All rights reserved.

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Hillbilly to Harvard to Yale Leon S. Robertson

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Foreword The idea for this book germinated while I read Curious Minds: How a Child Becomes A Scientist, edited by John Brockman. Brockman asked prominent scientists to reveal a bit of their life stories in short essays. The paths to science by the essayists vary remarkably but few came from social environments devoid of interest in science. (1) My journey, from birth in the Virginia mountains to the intellectual summits of Harvard and Yale, with interim stops at some other institutions, may have lessons for those who are not born to the manor, so to speak. After 69 years on the planet, I remain curious about how the world works. One of my major pleasures is reading biographies, particularly those of scientists. Among the questions that fascinate me: How did they break out of the conventional thinking that prevails in most homes, schools and places of worship? In most of the cases featured in Curious Minds, parents, relatives or family acquaintances that were scientists challenged their minds. For them, cultural prisons were probably easier to escape. A few, like me, grew up in intellectual backwashes. Here the first three chapters cover birth through college. Those interested only in the scientific issues that I encountered may wish to skip those chapters. They are included to indicate the circumstances from which I was extricated. Those who like soap operas will prefer the first three chapters, but please don’t stop there if you are afraid that you won’t understand the 4

science. I leave out the math and heavy stuff that puts off some people. One curious mind that I regret not having encountered until recently is that of Harvard professor Steven Pinker. In Curious Minds, he writes, “Don’t believe a word of what you read in this essay on childhood influences that led me to become a scientist. Don’t believe a word of what you read in the other essays, either. One of the curses of being an experimental psychologist is the habit of scrutinizing one’s own mental processes. Recounting childhood influences is a mental process no less subject to quirks and errors than falling for the visual illusions on the back of a cereal box.” That is a bit over the top but it reveals one of the traits of a good scientist – skepticism. Question not only the ideas of others but your own as well. So join me on a journey of the mind as I attempt to remember incidents that occurred, within the confines of faulty memory, as I recount them here. If you believe them, fine, and if you doubt, “Good on ya”, as they say in Australia. If you are not a scientist, you have the makings of one. You are a skeptic. Leon S. Robertson Green Valley, Arizona June, 2006

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Contents

1. Childhood in Appalachia 2. Small Town Youth 3. On the Banks of Old Mossy 4. The Making of a Professor 5. Hopkins to Harvard 6. Potomac Fever 7. What Works and What Does Not 8. Yale 9. Expert Witness 10. Facts and Philosophy 11. Failures and Successes 12. Back in the Saddle Chapter Notes

Page 7 26 47 72 98 123 151 176 223 241 270 300 317

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Chapter 1. Childhood in Appalachia My memories of early childhood are not nearly as vivid as those claimed by many autobiographers. One of the difficulties in recall of early life is distinction between the images of memory and the stories later told by parents and others about incidents memorable to the teller. According to my mother, my relatively large head resulted in a difficult and painful birth. She didn’t complain about that, just stated it as a fact. As far as I know, there is no correlation between infant head size and subsequent abilities or behavior. According to a birth announcement found in my mother’s effects after her death, I weighed 9 pounds at birth, a load even by today’s standards. She also said I was colicky for months and cried a lot. In other words, I was trouble from the beginning. The house in which I was born, in the early morning of an October day in 1936, was torn down some years ago. I was only inside it once for a few minutes after age 11, but remember it as a small one-level structure, with a root cellar, fronting a couple of acres of land on Hill Street, about three blocks from Main Street in beautiful downtown Christiansburg, Virginia. Despite the proximity to the main drag, we housed a cow, and sometimes a calf, in a small barn. We had a pig or two in a pen and numerous chickens on the back lot. A large vegetable garden and some apple, pear and cherry trees also graced the property. We also had a beehive that my father attended very irregularly. With those modest assets, we got through the Great Depression 7

without hunger. We drank the cow’s milk and Mom made butter and cottage cheese from the milk as well. We had a wooden churn that was used to make them (don’t ask me how the process works). One of my chores was to pump the churn. Like most families in that trying time, we had little money. My father worked as an electrician on the Norfolk and Western Railroad, when he worked. He was a binge drinker and would occasionally show up at home on a weekend, drunk, sometimes with no money to show for his labor after weeks living in a railroad camp. Among my early memories is fear when I heard a train whistle, knowing that he might be coming home on that train. On the occasions that he arrived without money, he would claim that someone had stolen it while he slept on the train, maybe true sometimes, given his condition. When drunk, he would verbally abuse my mother, accusing her of having men in the house while he was away (untrue) and other forms of disloyalty. She was even prohibited from borrowing a cup of sugar or whatever from the neighbors. For some obscure reason, any action that could be interpreted as dependence on others was verboten. I only remember one instance when my father hit my mother, after which she was unable to speak for a number of days, apparently not from physical effects of being hit but from the psychological trauma. One of my most vivid memories is her standing in front of an ironing board, ironing clothes but unable to talk. She was mute for several days. Needless to say, that incident, as well as the frequent verbal abuse, was 8

extremely scary for my siblings and I. My mother attributed my father’s behavior to his mother, Alice Robertson. She had a brood of 12 children, and allegedly pitted them one against the other. I overheard many discussions of conflict among my father’s siblings. We seldom saw the grandparents but one of my father’s sisters lived near us and she would tell my mother about the family problems. I remember only one visit to my paternal grandparents’ small farm, the location of which I have forgotten. My grandfather Robertson was a large quiet man with a big bushy mustache. He told me that I could grow a nice mustache if I would rub a little chicken manure on my upper lip. I decided that I didn’t need a mustache, until years later when I grew one without the aid of chicken shit. My mother’s maiden name was Catherine Ersell Nolley – she went by Ersell or Ert. Strangely, my father mispronounced my mother’s name. He called her Ershell. Her mother died when I was an infant and her father remarried. Grandfather Jacob Nolley was a frequent visitor in our house. He had a small farm in Floyd County, VA and collected hams, produce and moonshine whiskey from his neighbors to sell from the back of his truck in the neighborhoods of Christiansburg and Roanoke. Were my mother still alive, she would deny that her father sold moonshine, but I have his account book with a few such entries. He often brought us ice cream when he dropped by so we were always glad to see him. While we ate the treat, my grandfather would sit on our front porch and talk, and talk, and talk. If we 9

became restless or talked among ourselves, he would spit his tobacco juice about 20 feet across the porch rail and say, “Children, I’m talkin”. My brother Eddie would go off to the back of the house but I would sit and listen to my grandfather talk, often about my father’s behavior. My grandfather would also show up around Thanksgiving for “hog killin’ time”. He would shoot the pig in the head, cut its jugular and let it hang upside down while the blood flowed from its body. He then butchered the meat and placed it in a large chest between thick layers of salt. On his own farm, he smoked hams for sale but we had no smoke house. Among the best meals I remember include generous portions of fresh pork tenderloin right after “hog killin”, cooked of course. One Thanksgiving when my father was at home, we had what for us was an odd meal that included oysters and cantaloupe. Several members of the family became ill, including me. To this day I will not eat either of these supposed delicacies. In contrast to many people with alcohol problems, my father did not physically abuse his children. My brother Eddie (for Edmond) and sister Mae Dean, respectively, are about two and five years younger than me. They may remember otherwise but I only remember two instances of being spanked by my father. In one case, Eddie and I poked a pitchfork through a hole in the side of the little barn that housed the cow. We laid hay on top of the business end of the pitchfork. One of us ran to the house yelling that someone was under the hay in the barn. When my father ran to the barn, one of us was 10

outside manipulating the pitchfork to move the hay inside. Upon discovery of the ruse, my father was not impressed with our imagination and our bottoms were impressed with his hand. On another occasion, he discovered cigarettes that we had bought and hid in the doghouse. We were “whupped” (as they say in the mountains) for that one too. I didn’t resent such punishment that I knew I deserved. I did resent my father’s lies to my mother and myself, not to mention his drinking binges and tantrums. At some point between my 6th and 11th birthdays, my father told me that, if I would paint the wire fence that separated the yard from the front road and pasture in back, he would pay me. I worked many days painting that fence and was never paid. We had numerous ordinary chores such as feeding the animals, hoeing the weeds in the garden and, for me when I was considered old enough, looking after the younger siblings while my mother worked. We were paid for none of this and didn’t expect to be. It was only when I was promised payment and was not paid that resentment boiled up. I vaguely recall only two vacations. Sometime after my brother was born, he was left with relatives while my father, mother and I took the train to Virginia Beach. I must have been about three years old. The only memories I have of the trip are seeing big ships and a Ferris wheel. When I later recalled the latter to my mother, she said we went to an amusement park at Ocean View. My parents took a picture of me, apparently in one of those coin-operated photo booths, wearing a cowboy hat. 11

Some years later, my brother was included in a trip to Cincinnati, the western end of the Norfolk and Western on which my father had a free pass for him and his family. My brother and I were similar in size and looked much alike. People on the train kept asking if we were twins. A black guy came through the train often, selling “Hot coffee, sandwiches and cakes”. I wanted to try his but Mom had packed food for us. In Cincinnati, we took a stern wheel steamboat on the Ohio River to Coney Island, an amusement park. There we rode the carousel, drove bumper cars and I had my first splash in a swimming pool. I would not have that experience again until high school. Fortunately, my father was not at home most of the time and life was relatively tranquil during those periods. My mother had work experience before a relatively late marriage at age 26 and continued to find various jobs. Neither she nor my father had more than an 8th grade education. She worked as a seamstress in clothing and furniture factories most of her adult life. During the Second World War, she also took in female boarders. At least some of them worked in a munitions plant in nearby Radford, VA. These women occasionally helped look after my siblings and me. There was nothing intellectually stimulating about talk of factory work, hairstyles, and cosmetics, but we did get attention and supervision. I do not remember the sleeping arrangements, but it must have been crowded in that little house. We were only minimally touched by the war. We could hear booms from the munitions being tested at the “powder plant”. Our windows were covered with green 12

shades so that enemy pilots couldn’t see the lights. We had ration stamps for certain goods such as sugar but, since we had no vehicle, gasoline rationing did not inconvenience us. Remarkably, given the size of the US forces and casualties, no close relatives or friends were killed or injured in the war. I can remember the day Pearl Harbor was bombed. My father was at home that Sunday and he walked around the living room cursing the Japanese when the news came over the radio. I also remember VE Day and VJ Day. Even in our little town, there were large street crowds and celebrations. During and after the war, we had a series of baby sitters while my mother was at work. They were even less interesting than the factory workers. One, a Miz Early, was an avid Bible reader. When Eddie and I wanted to engage in a prohibited activity, one or the other would ask, “When are you going to read your Bible, Miz Early?” (The Miz did not reflect sensitivity to sexism. That’s the way we talked.) When Miz Early caught me in some prohibited act, I would run and climb in a tree where Miz Early couldn't reach me and I could watch for my mother’s approach after work. As she arrived, I would jump from the tree and run to greet her. She would ask Miz Early if we had been good and she would say, “Oh, yes. Little angels.” Rather than appreciate her not ratting on us, we thought she was pretty dumb. Even dumber was another baby sitter, named Mary Jones, who would occasionally take us to the movies. She believed that everything that we saw on the screen had actually happened. We were not sophisticated kids, but we knew better than that. Having learned about 13

electric circuits from our father, we once wired the clothes line and gave poor Mary quite a shock when she attempted to hang out the wash. Fortunately, she was not seriously injured and we avoided being labeled delinquents at best and murderers at worst. That and one more incident wrap up my criminal career. My mother took us to the Baptist church regularly. She had grown up Methodist but my father was allegedly a Baptist so that is where we attended church. Not that it made any difference to my father. I never saw him in a church. One Sunday when I was old enough to walk to church without accompaniment by an adult, my mother gave me a few coins for the collection plate and sent me off in my Sunday best. Rather than go to church, I hung out at the bus station eating candy that I purchased with the collection money. The feelings of guilt for many days thereafter were so severe that I never did it again. Incidents such as this suggest some independence, however poorly channeled. We roped the cow and tried to ride her, getting nothing but rope burns for our trouble. I would attempt to pick fruit from the trees and usually got in trouble doing so. In at least one instance, I used my father’s pole climbers and badly scarred a tree. Usually we would use a ladder. Once, I was later told, I got my foot caught in the ladder and was hanging upside down. Eddie ran to the house yelling, “Weon, Weon, Weon”. That one I don’t remember, but I do remember falling out of a cherry tree and landing on my chest. Fortunately, no bones were broken but I had trouble breathing for a few minutes. In another incident that I do not remember, I 14

was found unconscious in the calf’s pen with dirty hoof prints on the chest of my bib overalls. I was probably doing something stupid, like pulling the calf’s tail, and got kicked for bedeviling the poor animal. You may think, given my penchant for getting into mischief, that I was a problem when I entered school. Not so. Since my birthday was in October, I was not allowed to enter first grade until I was almost 7 years old. There was no kindergarten in those days in rural Virginia. I wanted to go to school with the other kids near my age and was crushed when I had to stay at home. My matriculation the following year was greatly anticipated and, when realized, I loved it. Reading, writing and arithmetic were easy for me and my ability was resented by some of the other kids. The only time I remember getting into potentially serious trouble with school authorities involved my luck in dealing with a bully, probably in third or fourth grade. He threatened me and I ran. Looking back, I saw him running after me, steadily gaining ground. I stopped and held up my metal lunch box to protect myself. He ran into it and blooded his nose. My mother was called from work and she had to come to school for a meeting in the principal’s office. Fortunately, by the time she arrived, the principal had talked with several witnesses to the altercation and I was exonerated. After that, the school bullies left me alone. According to my report cards, which I still have, I made good grades and got along well with most of my teachers and peers. When I was in 5th grade, I was given the task of delivering the daily receipts of the school cafeteria to a bank about 6 blocks away, so apparently I 15

was considered trustworthy. I loved the recognition, but was apprehensive that someone would grab the money from me and run. No one did. My 5th grade teacher wrote on my report card that I was “most helpful with the library books”, “has done highly satisfactory work”, but “doesn’t always leave other children to work things out for themselves.” Perhaps some of my colleagues in science can relate to that. There were some sort of science lessons in those first five years of school but I do not recall them. My mother did keep some of my drawings of a variety of flowers that were probably done as part of the science lessons. Curiously, my first through 4th grade report cards show “Natural Science” as one of the subjects but the 5th grade card does not. In the 5th grade there were lessons on health, such as standards for eating among the food groups, but nothing that I remember about how such standards were developed. I was curious about birds and insects and how calves were born, but no more than other children in the neighborhood. We could hear the cow bawling when a calf was born but we were not allowed to witness the birth. I have no idea when and how the cow was introduced to the bull. Sex of any sort, human or animal, was not considered a proper topic for conversation in our house. A girl about my age, named Carol, lived a couple of doors up the street. She would come to our house to play. When I told her about the new calf, she proudly told me that calves came from the cow’s stomach and that human babies grew in their mother’s stomachs. 16

We talked about the anatomical differences between boys and girls and how babies got started. We went into the barn and stripped off our clothes, but we didn’t touch. I wasn’t impressed. That was the extent of my sex education until much later when one or another of my teenaged buddies told me about condoms and their purpose. On another occasion, I dared Carol to walk across a narrow railing in the barn. She fell into a large pile of fresh cow manure, which soiled her pretty dress. She ran home crying and didn’t return to our house for a long time after that. That is no way to treat your science teacher. We went to the same church and I was well aware that she took pains to avoid me. The major source of entertainment in our home was the radio. I was a big fan of the Lone Ranger. Eddie, whose wife and friends now call him Robby, still enjoys kidding me about how dumb I looked sitting close to the set following the adventures of the masked man and Tonto while eating Merita bread, the show’s sponsor, without benefit of peanut butter, jam or butter. But I also liked the more serious dramas, such as Lux Radio Theater, that were broadcast in the evenings. We became baseball fans via the radio. My favorite team was the Brooklyn Dodgers. When Jackie Robinson joined the Dodgers and I remained loyal to the team, a few of the neighborhood kids called me names that they considered insulting, but I stuck with the Dodgers. In our town, there were not many “colored people”, as black people were called in those days. I will not repeat N-word that they were also called, which was included in my peers’ intended insults regarding my 17

admiration of Jackie Robinson. A few rich farmers in the area had slaves before the Civil War, but most farms in the Appalachian south had no need for the labor that was filled by slaves in the Mississippi delta and Atlantic tidewater regions. Those black people who came to the mountains during and after the Civil War undoubtedly hoped to escape racial prejudice, but sadly, they encountered it there as well. No black people lived on the street that our house fronted but the “colored section” began midst a street that branched off below our garden. Several black people would pass in front of our house each day on the way to and from their homes. Some of the kids in the neighborhood made rude and insulting remarks to them. My mother would not countenance such behavior. She said that those people deserved respect just as anyone else. On the only occasion that I remember joining some neighborhood boys in calling a racial epithet to a passing black man, I got my mouth washed out with soap just as I did when I tried out some curse words that I had learned from the same kids. I do not know where my mother learned equalitarianism, but I remain grateful to this day for the example she set. As I grew older and was allowed to leave the yard, I would occasionally play with some black kids who lived down the side street. Also, if my mother had to be away for a few hours on an errand, she would leave my siblings and I with “Aunt Fannie”, an elderly black lady who lived just across the street from the back end of our lot. She was extraordinarily kind to us and we always enjoyed being at her house. These experiences served me well years later when I became friends with 18

a fellow graduate student who is black. We have kept contact over the years and exchange jokes via e-mail almost daily. I also taught the first black undergraduate students who enrolled at the University of Tennessee and at Wake Forest. These students undoubtedly felt like strangers in a strange land. I felt comfortable with them and I think they did with me. Books from the local library enhanced my intellectual development. I have searched my memory without success to recall the teacher or other person who introduced me to the community library in Christiansburg. I can only remember trying to read every book in the place. It was located above a store on Main Street about three blocks from our house at the bottom of a steep hill. I lugged home volumes of the Hardy Boys, Nancy Drew, Tarzan, and Zane Gray’s cowboys, Tom Sawyer and Huck Finn as well as nonfiction. I was impressed by the variety in size and shape of the female breasts displayed in National Geographic and read some of the accompanying articles. The only book related to science that I remember reading was Arrowsmith by Sinclair Lewis, a fictional account of a physician faced with ethical problems regarding scientific experimentation. As far as I can tell, I didn’t understand a lot of it (true of many books that I read) and it made no impression on my career ambitions. I have no idea how I answered the question frequently asked of children, “What are you going to be when you grow up?” On a quiet night in the late spring of 1948, the intermittent trauma in our lives, caused by my father’s 19

drinking, bloomed into tragedy. He was drunk and verbally abusive. My mother feared for our safety. She gathered us up and we fled to a sympathetic neighbor’s house part way down the steep hill to town. Within an hour or so, a fire truck labored up the hill, it’s siren disturbing the peace of the night. We immediately wondered if it was going to our house. It was. To say that we grieved that night is an understatement. The next morning my mother somehow found out that my father was in jail. We proceeded to the house and found it partly burned, certainly to the point of being uninhabitable. Since he was not burned, my mother thought that my father started the fire deliberately. We never learned how it started. My father was a heavy smoker and may have dropped a cigarette or a lighted match, but managed to escape. Whatever the cause, in leaving that property we had lost not only shelter but also major food sources as well (cow, chickens, pig, garden, fruit trees). Some of our clothing and other household goods were salvaged. Upon learning that my father was out of jail, my mother decided that we had to leave Christiansburg. She had no means of repairing the house and, even if she had, she was unwilling to continue to have us traumatized by my father. My mother’s sister and her husband came to take us to their large farmhouse in the Floyd County countryside. Aunt Matt (Madeline) and Uncle Sam Vest were to become our substitute parents for the summer while my mother looked for a job and place to live in some other town, hopefully before school started. I remember that one of my last acts in Christiansburg was to return books that smelled of 20

smoke to the beloved library. I was painfully embarrassed and hoped that the librarian had not heard about the fire. She checked the books without comment. To this day, I cringe at the smell of something that has burned and been doused with water. Aunt Matt and Uncle Sam had married after each of their previous spouses died. By the summer of 1948, when we were there, her daughter was married and he had three grown daughters who had established their own households. There were a couple of bedrooms unused except by visitors. Only Uncle Sam’s son Alvin, who was 18 years old that summer, remained at home. In the years prior to moving in, we enjoyed several visits to their home. Aunt Matt had the deserved reputation as the best cook in the family. Uncle Sam was a kind and gentle man who seemed to have infinite patience. Both traits were manifested repeatedly during that summer. The Vests farmed 160 acres without outside help, except during certain harvests (wheat threshing and corn harvest), when neighbors moved among several farms in mutual aid to fill the grain bins and silos for winter. We were taught to participate in the chores of the farm. Working in a garden for an hour after my mother came home from work in our former life was one thing, but chopping weeds in a cornfield for the better part of a hot day was torture. When hay was mowed, I was placed on top of the stack to stomp the hay tightly as Uncle Sam and Cousin Alvin pitched it from the hay wagon. Added to the heat came the chaff that caused my skin to itch and burn. I longed for the cool library in Christiansburg and 21

prayed for rainy days. When it rained, we worked in the barn stripping corn from cobs and the like, which was much more pleasant than fieldwork. Our reward for fieldwork was to get to ride a horse to and from the field. Mae Dean, who had just finished first grade and usually stayed around the house with Aunt Matt, would run to greet us and beg to be put on the horse. Patient Uncle Sam would lift her there and then she would cry and beg to be put back on the ground. One horse was named Bob and the other had two names, Maude and Mag, for a tactical reason. A neighbor on one side of the farm was named Maude and one on the other side was named Maggie. The mare was called Maude when we were on Maggie’s side of the farm and Mag on Maude’s side. One example of Uncle Sam’s infinite patience occurred when we were bringing a big load of hay to the barn. Even though a storm was approaching, he allowed me to take the reins. I had to get the horses turned and back the wagon to unload. I turned them too sharply and the wagon overturned spilling a good part of the hay. Uncle Sam just said, “Let’s get it reloaded boys.” Other than a recently acquired pickup truck, there were no motorized implements on the farm, except during the community harvests. All work was done either by human muscle or real horsepower. Of course that meant no milking machines. A dozen or so cows had to be milked twice a day, 7 days a week, around dawn and again in late afternoon. I was taught how to milk a cow and, after my first lesson, the next morning a cow kicked me. My uncle said that the cow did not appreciate me trying to milk her on the wrong side. To 22

milk a cow properly, approach from the rear and sit your milking stool to the right. At least I think that is correct. If not, the cow will let you know. The cows were let out to pasture on the other side of a hill above the barn. Uncle Sam had a wonderful dog, a collie called Pooch, who would retrieve the cows on command. If he missed one or more, he was sent for them with the command, “Go back.” Once when Pooch got himself entangled with a skunk, Eddie and I were given the job of washing him. That day, he wasn’t so wonderful. After the morning milking, we were treated to scrambled eggs, sausage or ham, and freshly made hot biscuits and gravy. Uncle Sam liked to kid us with odd names for food, as well as for us. Sausage was “snasnage”, as in “pass the snasnage”. My brother was Eddie Richenbacher and I was Leon Stupalsky. Later I learned about Richenbacher (a WWI flying ace), but I never learned the origin of my new surname. A prayer preceded each meal and, after breakfast, Uncle Sam would read from the Bible and we would kneel in front of our chairs for an extended prayer. On Sunday after breakfast, we would all bath, dress up and proceed to the little Methodist Church at Huffville, in sight of the house across the meadows of an adjacent farm. The contrast to the Christiansburg Baptist church was striking. The interior of the church was quite plain. The preacher in Huffville was more into fire and brimstone and he was backed up by an amen corner. Uncle Sam was a prominent member of that group, emphasizing the preacher’s words with hearty amens. Weekday or Sunday, lunch and dinner were both full 23

meals of meat, potatoes, vegetables and big slices of homemade yeast bread to die for. Actually, what is now called lunch was called “dinner” and dinner was called “supper”. To finish off the midday and evening meals, a variety of pies and cakes were available from a sideboard in the dining room. Eddie and I would make one or more side trips into the dining room during the day to see if anything had been added to that sideboard. Occasionally, when Aunt Matt was preoccupied with her little pass time, a little finger or two was swiped in the crumbs and icing that remained where a slice had been removed. Aunt Matt’s pass time was listening to other people’s conversations on the telephone party line. The phone was mounted relatively high on the wall so she would stand, sometimes for an hour or more, with the phone to her ear. The phone would ring when anyone on the line was called. The sequence of short rings and long rings indicated the intended recipient of the call. I never learned to whom she was listening. If she gossiped about what she heard, she did it out of my earshot. Perhaps the neighbor’s conversations were her form of soap opera. The house had no electricity and, therefore, no radio. There were a few books and I read them all as well as a good bit of the Bible. Reading time was limited by the amount of work to be done and the poor light from kerosene lamps that were lighted between dusk and early bedtime. Our predawn morning alarm clock was Aunt Matt’s voice calling, “Alvin”, followed in a few minutes by, “Son”, often repeated several times. Cousin Alvin was a slow riser. He was also a constant teaser. He liked my brother 24

better than me, so I took the brunt of his teasing. We would accompany him in the pickup to transport the large cans of milk to the main road where they were picked up by the dairy that purchased milk from local farmers. A couple of gates blocked the road along the way. Alvin would tell me to get out and tend the gate and, after he drove through and I closed it, he would speed up the truck just ahead of me for a hundred yards or so while I ran after it until I would get frustrated and start crying. Then he would try to say funny things to stop the tears. When walking in the woods after a rain or heavy dew, he would hold a branch and let it go in time to get me wet. Needless to say, Alvin was not my favorite cousin. Alvin did teach us some things about nature. He hunted squirrels and taught us to recognize the sound that squirrels make. He took us fishing for little “horny heads” in a nearby creek and taught us how to identify the pools where the fish were likely hidden. He showed us where to find berries and chinquapins, a small shrub that yields edible nuts. When picking blackberries, I stepped in a nest of yellow jackets and got a few stings before immersing myself in the creek to escape them. Of course, that wasn’t Alvin’s fault. We learned that, if you throw rocks at a hornet’s nest, the hornets could follow the trajectory and find you. Alvin was good at timing when we should quit to avoid being stung. All in all, it was a bucolic summer that sort of marked the dividing line between childhood and adolescence for me. While we were living the country life, my mother obtained a job in a furniture factory in Wytheville, VA, where our new life began at summer’s end. 25

Chapter 2. Small Town Youth Our new home was a small basement apartment in a building that was originally a convent, several blocks from downtown Wytheville, Virginia, about halfway between Bristol and Roanoke on U.S. 11. Appropriately enough, the apartment building it was known around town as “the convent”. We shared a bathroom down the hall with a woman and her daughter, who was about my age. The indoor bathroom was a welcome luxury. Bathing in a washtub and using the outhouse, as we did at Uncle Sam’s, was okay in summer but I knew from our occasional visits to “the country” in winter how cold that seat could be. Our new neighbors seemed friendly but I doubt that they were keen on having two boys use their bathroom. There were lots of kids about our age in the convent apartments and nearby houses. My brother and I soon made several friends and were participating in pickup baseball and football games. We had not played such games before. Somehow we acquired an old used baseball and a couple of worn gloves to play catch after school. I know that we didn’t steal them. Not that we were that much more virtuous than kids who steal, but we were conscious of the burden that our mother carried and we were cautious not to add to that burden. For the first time, school was an unpleasant and, at times, scary experience. Apparently there was no placement in school based on past performance, or my records had not arrived. I was placed in a 6th grade class made up substantially of kids who had failed one 26

or more grades. Those who had failed only one grade were about my age but there were several older boys who set in the back of the room from which they could disrupt the class with inappropriate laughter, comments and roughhousing while the teacher’s back was turned. The school administrators had compounded the problem by assigning the class to a very nervous woman who seemed intimidated by the unruly boys. I soon became the “teacher’s pet” and was disliked by many in the class for that, as well as for scholastic achievement far beyond their halfhearted efforts. Once, when a fistfight started in the back of the room, the teacher turned her back on the trouble. She faced the board and began writing. She asked me to go get the principal. As I reached the door, one of the ruffians said, “Don’t you go through that door.” I ran for the principal, a very tough lady, who returned with me and settled everyone down. For weeks after that on the playground or elsewhere near the school, I watched carefully for a potential attack. None occurred. Sometime during the year, the teacher was replaced. I don’t remember how long thereafter I learned that she committed suicide. Outside of school, life wasn’t bad. The new town presented economic opportunity. I began to work for people who actually kept their promise to pay. A childless couple lived in a house adjacent to the convent almost directly in front of our door. They approached my mother to ask if I was available to do chores for them. She allowed me to do so and, for some time thereafter, I earned $1 for working the better part of Saturday morning, mowing the yard, cleaning out the 27

basement and the like. The money was usually gone by Saturday night. After lunch on Saturday, I would head for the movies (double feature, serial and cartoon). Wytheville had two movie theaters, the Millwald and the Wythe. Most of the Saturday movies were shoot-em-up westerns and other B flicks. Some Saturdays I would attend both theaters. A child’s entry cost only 15 cents. After the movies I would often blow the remainder of my money on comic books at 10 cents each. It was perhaps a year before I began more serious reading again. A few times I saved my money and played hooky from school to see a matinee of one of the better movies on a weekday. One of my favorites was “Wake of the Red Witch”, a swashbuckler in which John Wayne played a sailing ship’s captain going for the girl and the gold. I saw it again recently on one of the old movie channels. It has a fairly sophisticated plot for its day. We were only occasionally aware of events in the outside world. We mourned Babe Ruth’s passing and heard jokes about President Truman. Moses said, “Come with me, lead your ass, mount your camel and I will take you to the Promised Land.” Truman says, “Sit on your ass. Light up a Camel. This is the Promised Land.” Sometime after my twelfth birthday, my income increased when I acquired a paper route. I walked the route, which circled the outer perimeter of about half the town, carrying a load of papers in a cloth sack draped over my shoulder. It wasn’t long before I had a burning desire for a bicycle. I proposed to my mother that if she would buy me a bicycle for my paper route, I 28

would pay her back from the proceeds. When she agreed, I incurred my first indebtedness, which I carefully repaid. I had all sorts of problems with the bicycle, particularly the brakes. The brakes failed on me once whereupon I sailed through a stop sign and was almost hit by a car. It took several days for me to dissemble the brakes, figure out how they worked and repair them. Other hazards lurked as well. A friend who lived in the apartment above us lost an eye in an incident in which I might have been involved had I not been doing a chore for my mother. He placed a loaded .22 caliber bullet atop an old stone fireplace outside the rear of the building and shot at it with a BB rifle. The struck cartridge fired and the shell casing came back and pierced his eye. His entire eyeball was lost and was replaced with a glass orb, which he would remove occasionally to get attention. My mother was justifiably terrified of guns. In her childhood, her brothers were playing with a shotgun, which they thought was unloaded. The gun discharged and the middle of my mother’s right hand was struck and mangled. The two middle fingers and the bones connecting them to the wrist had to be removed surgically. I thought nothing of having a mother with only a thumb and two fingers on one side but she was somewhat self-conscious about it. She certainly didn’t want her children around guns. In my mid teens I bought a single shot .22-caliber rifle for hunting and target shooting, without telling her about it. I kept it at a friend’s house until I moved away from home. My mother never knew that I had it. 29

While we lived in the convent, another tragedy befell the family of my friend with the glass eye. His father was at a local high school football game, Wytheville vs. the nearby town of Marion, when a riot broke out. Someone hit my friend’s father in the head with a soft drink bottle and he died. After that, Marion was removed from competition with the high school sports teams. In contrast to 6th grade, I loved 7th grade. I was placed in a class with many students that were interested in learning and a teacher who knew how to bring out the best in us. In addition, the teacher, Mrs. Crockett, was a customer on my paper route and would occasionally engage me in intelligent conversation when I knocked on her door to collect. She was the first teacher who treated me like an adult. Another student and I engaged in a contest to see who could turn in the most book reports on books read during the year. I don’t remember who won but we both turned in dozens of reports. Of course, this sort of contest was not conducive to necessarily reading the best books. We resorted to finding the slimmer volumes that were available in the library. Nevertheless, throughout elementary school, I scored a year or two ahead of the average for my age in standardized tests, perhaps because of my reading and perhaps due to some innate intelligence. I was more than ready for high school. There was no eighth grade or junior high in Wytheville at that time. Mae Dean was in the first class to attend eighth grade, which she considered unfair since her brothers had escaped it. We were very fortunate in the summer of 1950 to 30

escape the nearest thing to plague that I have experienced. Wytheville made the national news that year for the highest polio death rate per capita in the country, disproportionately children. Both locals and outsiders were scared of infection. People drove through town with coverings over mouth and nose. I continued to deliver papers but my customers no longer talked with me. They left payment in envelopes on the edge of their porches or stuck in their doors. I went to the movies but felt no danger because the two or three other people in attendance were sitting as far from others and me as they could. By the end of summer, the incidence of polio declined and my family was intact, but I entered high school that fall with a new appreciation of the world’s dangers. High school achievement isn’t easy for many kids when the hormones of adolescence kick in. I was somewhat conscious of being attracted to girls in 7th grade but that was certainly not my primary interest. High school was a different story. My freshman English class was taught by a very shapely 20-something with a pretty face. In addition, I sat in the middle of a group of several girls who were attractive as well. I spent an inordinate number of classes worrying about how I was going to stand up after class without the bulge in my jeans showing. One of the male teachers that I had that year was prissy and effeminate. As you might expect, some of the guys said he was a “homo”. I didn’t know what a homo was until somewhat later when a friend explained it to me. Nor do I know that the noted teacher was homosexual. I did know that I didn’t particularly like 31

him and his teaching style was boring. In contrast, my science teacher was Mr. Livesay, a veteran of the war, who stimulated my interest in science, history and music. Outside of class, he would tell us about the war and, with some urging, show us the shrapnel scar on his leg and the bayonet scar on his abdomen. He was stabbed after being downed by shrapnel during a battle on a south Pacific island and left for dead. His students were happy that he was later found by his buddies and survived. In addition to teaching science, he directed an extracurricular male chorus that I joined simply because I admired him. It turned out that I had a natural ear for harmony and could sing well enough for group singing. My few later performances as a soloist in church are embarrassing to think about, but I stayed with choral music through college. Volumes on WWII became a part of my reading. I joined one of the mail order book clubs and bought mostly war novels. I remember being particularly disturbed by The Caine Mutiny. Several of my friends and I would dress in army fatigues and play war games, including firing on one another with BB guns. It is a wonder that more eyes were not lost. I acquired a bullwhip that I carried around, snapping it with some efficiency. Some friends and I built a raft to float on a nearby creek. A kid once fired a rifle that plunked bullets in the water near the raft, the only time I was afraid during these pseudo adventures. I had my rifle, but fortunately had sense enough not to fire back. There were no girls involved in these activities, so impressing them was not the motive. 32

At my first school dance, where I did want to impress girls, I was hardly impressive. Some guy made fun of me in front of several girls because I did not wear a white shirt. That was because I didn’t have one. Although I did wear a tie, the shirt was a brown sport shirt, not a dress shirt. In those days, colored shirts were not in fashion, but I knew nothing of fashion. As a result of that incident, I paid more attention to what others were wearing and used some of my hard earned bucks to conform. Among the services available in town was a local creamery that delivered milk to homes early in the morning. The milkman needed an assistant and I gave up the paper route and hired on. He would pick me up around 4 a.m. We would load up the truck and wind our way among the neighborhoods picking up empty milk bottles from porches and replacing them from orders left on notes sticking in the bottles. One weekend morning, I walked around a hedge of one of the fancier houses in town and came upon several girls in nightdress sitting on the front porch, apparently after a sleep over. They squealed and ran into the house. Oh well, at least I made some kind of impression but I doubt that any one of them would have dated a milkman’s assistant. After several months, I tired of the early-to-bed-earlyto-rise bit and found another job. A local dentist had a little feed and fertilizer store on the street that paralleled Main Street near the football field. After school and on Saturday’s, I was his sole clerk. There was virtually no business on weekday afternoons so my friends would drop in and we would play penny-ante 33

poker. On one occasion, the stakes got a little higher and I won money that one of the players was supposed to spend on an errand for his mother. He cried and I gave him back his money. I started smoking a pipe during those hours. We played and smoked in a back room with a large window through which I could see the front entrance across the feed sacks. When my mother or some other adult would enter the front, the cards and pipe were scooped under a sack. It was an easy job, except when 100 lb. sacks of feed and fertilizer had to be unloaded from a rail car and transported to the store or a customer’s farm. The worst part, however, was going over the books on Saturday night with the owner. Although I was the clerk for less than half the time the store was open, I was the one there when the receipts were examined and I had to sit with him until every incoming and outgoing penny was balanced, occasionally late in the night even though there was only a few cents difference. I soon learned to go over the books before he arrived and add money out of my pocket when there were shortages or take surpluses from the till. The weekday guy was an elderly gent who was undoubtedly honest so the amounts were small, the result of random errors that he or I had made. The owner didn’t seem to notice that the books were more often perfectly balanced and we could leave early. Whatever the laws in those days regarding age that one could legally work, the enforcement was lax. During the summer after my freshman year, at 14 years of age, I worked 40 hours per week in the chair factory where 34

my mother worked. Someone told me that I had to be sixteen to work so I told the manager that I was 16. I was a big kid for my age and he had no reason to doubt it. I spent the summer attaching springs and backs to the frames of small chairs called “gossip benches”, so called because they had a side surface attached on which one could sit a telephone. The pay was 7 cents a chair and I did about 100 chairs a day - which added to a gross of about 35 dollars a week. I could afford a white shirt, a cool Hawaiian shirt, sharkskin pants and white buck shoes. Look out girls. During the following year I “went steady” for a time at the urging of my best friend’s girlfriend. Ed Cannoy, who was to be a lifelong friend, seemed like a brother. My mom accepted him like one of hers and I felt the same in his home. So I went with the girl mainly to be able to double date with him and his girlfriend. When I “broke up” with the girl to play the field, Edward’s girlfriend lectured me severely for hurting her friend’s feelings, but he stood by me. Later when Cannoy broke up with that girl, she dated an older guy whose family had moved into the convent. One evening as I was closing the feed store, Ed showed up with our friend Robert Shumate and asked to use the phone. Shumate called the police and yelled that a bunch of kids were raising hell behind the new high school, a notorious parking spot. He and Cannoy had spotted Cannoy’s old flame driving with the new guy to the site. We jumped in Shumate’s car and drove up a parallel street to see the action. The new guy’s car left the school lot slowly, with the cops trailing close behind. 35

Perhaps that night, or maybe another, we followed the same couple to the girl’s house and the new guy went in with her. After they had time to settle down in the living room, Shumate pulled out a huge slingshot that he had made. He loaded a cherry bomb in the slingshot, lighted it and launched. It was well timed, exploding just outside a big picture window. Needless to say, we hightailed it. The hardest part was keeping a straight face at school when the girl was telling the tale of the big bang. My family’s status in the community improved when my mother purchased a house. I don’t know how she did it. She made about $40 per week at the chair factory. Eddie had a paper route and I had the jobs I mentioned which paid for my entertainment and clothing. I gave mom some of my summer earnings but surely not enough for a down payment on a house. My father was supposed to contribute child support but never did. He sued for divorce and I went to Christiansburg once with my mother to meet with him and his lawyer. His lawyer asked her all sorts of insinuating questions to the point that I wanted to punch him out. My hatred for my father, which had calmed somewhat in the years after the fire, boiled to the surface again. The divorce went through but I don’t think my mother received any money. Now that I think of it, the down payment for the house may have come from my grandfather Nolley’s estate. But the exact sequence of several events, and the details, during this period of my life is vague in my mind. I learned of my grandfather’s death at a baseball game. During the local semi-pro team’s games, Eddie had the non-paying job of placing on the score board big 36

metal plates with numbers for each half inning’s runs and I became his helper to get into the games free. One evening the game announcer called on the intercom to tell us to go home, our grandfather was dead. I remember an auction sale of his assets. I bought his mandolin, which I still have but never learned to play. Presumably the proceeds of the auction were divided among his four children and his widow. In any event, we now lived in a detached house -- two bedrooms, a kitchen, living room, bathroom and an enclosed basement with a furnace that provided central heating of a sort. There was one heat outlet in the center of the house. Eddie and I shared one bedroom while Mae Dean and mother shared the other. The walk to town was a little farther than that from the convent, but no one in the family seemed to mind. Without a car, my mother had to arrange a ride to work. Eddie and I could no longer walk to school in a reasonable time because the new high school, opened at the beginning of my sophomore and his freshman year, was on the far end of town. Those of us that didn’t have cars rode the school bus. In later years, when parents in many communities made such a fuss about bussing kids for racial equality, I thought their arguments about the hazards silly. Many of them rode busses to school when they were kids. The argument wasn’t about bus hazards; it was about race. In our high school, there was little race consciousness. Although the new high school was a consolidated school for the whole county, greatly increasing the student population, black students were not included. We would see a few black people around 37

town, particularly in the “colored section” on one side of the theater balcony, but where they lived or went to school or what they did for a living was not discussed. You can bet they did not have a nice new school like ours. Many of us were in awe of the new facility. We each had a locker with a combination lock, which, long after for me at least, fostered a bad dream about forgetting the combination. We had physical education, for which we had to purchase proper shorts and tee shirts, as well as basketball games in a new indoor gym. The basketball courts at the old high school were concrete slabs outdoors. Virginia Polytechnic Institute’s basketball team scheduled one of its games in our new gym and the U.S. Marine Band came to give a concert in the new auditorium. Never before had I attended such glorious events. In the men’s locker room of the new gym, several of my friends caught me as I emerged from the shower and forced me out of doors, locking the door. As I stood in my birthday suit pleading with them to let me in, several junior and senior girls came around the corner. Thereafter, when I encountered someone in that group, I was greeted as “nature boy”. In my sophomore year, a junior girl invited me to the junior-senior prom. I don’t know whether she was among the nature sightseers but she didn’t call me “nature boy” that night. She must not have been impressed, or had very strict parents, because she left me at the dance and went home early. The summer before my junior year, I had my first and last experience of being stalked by a woman (well, sort 38

of). A new girl in town would hang around me at the swimming pool and show up frequently at the Millwald Theater, where I worked nights and Saturdays. She sat just inside the door where I took up tickets and watched the audience for troublemakers. She was cute and shapely so I asked her out. We “went steady” for most of that year. Her parents were very nice. They would ask me to stay for dinner on Sunday evenings, after which we would watch the Ed Sullivan show. There was no TV in the Robertson household until my senior year. Eventually the girl became interested in another guy. My junior prom was pretty miserable - she was my date but she paid the sort of attention to the other guy there as she had to me earlier. We “broke up”, but she never got the other guy. When I could get the time in the summers, I would go to the swimming pool. The lifeguard gave lessons and I became a halfway decent swimmer, an activity that I continue to this day. One afternoon at the pool, my swimming, and walking, days almost came to an end. I dived straight down in about 4 feet of water. Those who saw it said that I stopped suddenly with my feet straight up in the air. The top of my head struck the concrete. Many years later, during my research career, I learned that most spinal cord injury occurs from compression when the neck is straight and the blow is to the top of the head. I don’t know how close I came to paralysis in that pool but many years later, when I had a friend who became a quadriplegic in a car crash, I realized the potential seriousness of the incident. I worked at the Millwald Theater a couple of years up until I left home after graduation. I knew the habits of 39

many of its patrons, perhaps better than they would have liked. I knew who was boodling in the balcony (as a friend called necking). Of course, the more serious stuff was going on out of my jurisdiction at the "passion pit" (that's the drive-in theater for those of you too young to remember them). There was a well-known masher who would sit down beside an attractive girl in the Millwald and attempt to "boodle". I kept my eye on him and would tell him to leave the lady alone. Once when I did so, the sweet young thing looked me straight in the eye and said, "Mind your own business." Of course, all of this was before the "sexual revolution" of the 1960s. A friend told me that he didn't mind the "sexual revolution", but he was sure sorry that he missed it. I missed it too, although my mother told me years later there were rumors to the contrary. In the spring of my senior year I was hospitalized with a strep infection of the skin called erysipelas. According to mom, one of my supposed friends was telling it around town that I had syphilis. I didn't have a clue. Many of my classmates visited me in the hospital and, to my knowledge; no one shunned me at school or elsewhere. Small towns can be cruel at times, but good friends are good friends, even when the worst is being said behind your back. I remained a virgin until I was married after college. Remember, this was the 1950s. Sex then was like religion throughout the centuries - a lot more people claimed to be practitioners than actually were. I attended church regularly. My Sunday school class was “taught” by a man who was a big sports fan. About half the class played on the sports teams. Most of the 40

class time was spent in a rehash of the high school teams’ most recent games. The minister, Mr. Massey, was a gentle man whose sermons were more lessons in how to live than the threats of fire and brimstone that I heard in Huffville. The summer between my junior and senior years, I again worked at the chair factory - this time applying a stain to furniture and rubbing it into the wood. It was impossible to keep clean and the stain was difficult to remove. Since I was working two jobs, my time for reading was very limited. Throughout high school and college, I suffered periods of depression during which I didn’t want to see or talk with anyone. The depression wasn’t so severe as to generate thoughts of suicide, as it does in some teenagers, but it was somewhat debilitating, particularly in relating to others. My guess is that constant self-imposed pressure to earn money while trying to be a normal student was a factor. My wife Nancy, who I met during my sophomore year in college, describes me in those days as “moody”. All in all, I was a mediocre student. At the end of my junior year, I was elected President of the Student Council for the following year. The council’s faculty counselor thought I should apply for admission to the Beta club (the club for the school “brains”) but my grades were not good enough - an average on the B-C borderline. Many of my classes were boring and I only did what was minimally required. The exceptions were the math courses taught by Julia Parsons - Algebra, Geometry and Trigonometry. The basics I acquired in those courses were a solid foundation for a good deal of 41

my later scientific work. One of the highlights of those years was my selection to represent the school at Boy’s State in the summer of 1953. During the week there, on the VPI campus, I participated in a choral group and was elected to the Senate. I still have the materials from that week. Among them is a paper on highway safety issues, which apparently was a background paper for some issue being considered by the Senate. During my career as an injury epidemiologist, I did many studies of such issues, having long forgotten that I discussed them earlier at Boy’s State. If the Boy’s State experience had anything to do with later career choices, the effect was subliminal. My studies continued to suffer in my senior year. In addition to work, “going steady’ with a sweet girl, and presiding over the student government, I played football and practiced (though seldom played) basketball. The football team went 7-3 that year. A total of 13 points in the three loses kept us from a perfect season. The Roanoke Times called us the “Wytheville upstarts”. The basketball team went 4-14 with little help from me. I wasn’t good enough to help and also was ill for part of the season. In the spring of 1958, I was in bed at home for a while recovering from erysipelas, after two weeks in the hospital during which a leg amputation was considered. The minister of our church, James Massey, showed up at the house accompanied by a representative of Carson-Newman College. Mr. Massey was an alumnus and had counseled me to apply there. The rep said they wanted me to play football and would guarantee me a 42

job if I could play. Since I was too weak to get out of bed, he seemed skeptical that I could, but I applied to the college and was accepted despite my mediocre grades. There were no SATs in those days, so grades and extracurricular activities were the primary bases of admission. I did recover in time for the junior-senior prom and I had a great time at this one. Maybe feeling whole again had some effect. We danced with abandon and I laughed until I was silly at the antics of my classmates. I heard that some people said I was drunk, but it wasn’t so. After my experiences with my father’s drunkenness, I wasn’t about to fool with alcohol. Nevertheless, I was afraid that my mother would hear the rumor and be hurt, but she never mentioned it. The year before, Cannoy and I were cruising in his Dad’s woody station wagon and picked up one of our friends who had a sixpack of beer. Neither Cannoy nor I imbibed but his Dad smelled beer in the car and questioned us about it. He accepted our explanation and, thankfully, did not speak to my mother about it. There was no drug use among teens in those days, at least not in our town. Our greatest risk was a car crash. One friend obtained a used car and within a day or two, I was with him just outside of town when he decided to “see what she’ll do”. Something happened to the engine at a high rate of speed. He managed to get it stopped without incident but I was frightened. On another occasion, I was in a car with a group when the driver accelerated to more that 100 miles per hour on a straight stretch of a curvy mountain road. He barely got it slowed down to make the next curve. Fortunately, I 43

wasn’t in the car when another group in a similar circumstance didn’t make it and three underclassmen were killed. As the school year wound down, we seniors took the “senior trip” to an amusement park but it all seemed a little juvenile. The 1954 Echo, the high school yearbook, was published and we wrote sappy notes in it to one another regarding future success. In the “Senior Superlatives”, I shared “Most Likely to Succeed” honors with the girl who lived down the hall at the time we moved to the convent. I was also elected “Best All Around”, along with the first girl with whom I “went steady”. Thus I acquired the burden of living up to my billing. A student from Carson-Newman contacted me to ask if I had interest in a summer job. He was assembling a group to go to the eastern section of North Carolina to sell Bibles, dictionaries and cookbooks door-to-door. I agreed to the job. After graduation from high school on a Friday night, I boarded a bus on Sunday for Nashville and a week of sales school in the Maxwell House Hotel. I would have been better off working another summer in the chair factory. After a week of hearing slick salesmen talk about how to deliver a sales pitch, assuring us that riches could be had by copying their methods, I picked up my sample kit and hitch-hiked to Tarboro, North Carolina with my partner, O.J. Bryson. O.J. was a student at East Tennessee State at the time but later transferred to Carson-Newman. We were assigned to cover Edgecombe County. I took the west side and him the east. We found a very nice room, which we shared in a 44

house near the central square in Tarboro. Each day we set forth to call upon the good citizens of the county, hitch-hiking our way about, in an attempt to convince them that they could no longer live without the benefit of our wares. Most decided that they were doing fine without them. For the first time in my life, I was often hungry. Our sample kits contained only a hard cover of each book with a few examples of pages between. Therefore, we could only take orders and ask for a down payment, which we needed for rent and food. Understandably, most of the people who ordered books did not want to pay until delivery. Our meals were meager and I lost a lot of weight. Also, the mosquitoes were in abundance and I had bites on my neck and limbs. I suspect that my appearance contributed to the reluctance of my customers to proffer a down payment. Early on we met, in church, a brother-sister pair near our age who invited us to their house for the noon meal almost every Sunday. Their mother, Momma Corbett, was a tremendous cook and a good-hearted soul. Had it not been for those sumptuous meals, I doubt that I would have lasted the summer. When it came time to deliver the books to my customers at the end of summer, I had no vehicle. Mrs. Corbett loaned me her car for a week or so to make the deliveries. I wrote to them from time-to-time after that and went by to see them once but eventually lost contact. I have always been especially grateful to them. Of course, these were not the only people who helped me that summer. Perhaps hundreds gave me a ride as I hitchhiked along the back roads. No doubt some bought 45

books from a desperate looking kid working his way through college, not because they needed the books, but just to be of help. One day I got no response to my knock on the door of a small farmhouse but thought I heard a noise in back. I walked to the back and came upon an elderly black man tending a smoking barbecue pit. We talked for a bit and he asked me if I was hungry. No doubt I looked it. When I indicated that I was, he took the cover off the pit to reveal a whole pig. He plugged a big slice and set it on a plate before me - one of the best meals I ever tasted. Truly I benefited from “the kindness of strangers”. Years later in debates on whether the actions of human beings are totally selfish, I cited these experiences as examples of gestures from which the people couldn’t possibly have expected a return of the favor. At summers end, with a few bucks in my jeans, I was now headed for college. During a few days at home, my mother sewed my name in my clothes as the college recommended. We purchased a small trunk that I still have, and packed it up with my meager belongings. I took the train to Jefferson City, Tennessee on the banks of Mossy Creek, where I would live, with the exception of summer work, for the next four years.

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Chapter 3. On the Banks of Old Mossy The train station was only a few blocks from the entrance to the college in Jefferson City. Ever frugal, foregoing a taxi, I trudged up the hill and onto the campus carrying my trunk and a suitcase. They were so heavy I had to set them down and rest every hundred yards or do. A few girls, sitting on the porch of a dormitory near the college entrance, had some fun yelling catcalls at me. In the administration building, I was directed to “the barn”, a dilapidated dorm on the backside of the campus. Unknown to me before arrival, I was assigned to room with two other fellows from Wytheville who were also to play football. One was the son of a prominent citizen who spent an inordinate amount of time getting his son, my new roommate, out of trouble during our high school years. The son was a gambler, drinker and brawler. I suspected that, in the hope that my other roommate and I would have a moderating influence on his behavior, his father arranged for us to be roommates. It didn’t work. As I attempted to go to sleep my first night in the room, my rambunctious roommate sat on the edge of my bed engaged in a loud poker game with some guys from down the hall. In the second semester, he allegedly got drunk and threw a brick through a plate glass window, for which he was expelled. By that time, I had moved into another room with a new roommate. Football practice had started before I arrived. I explained to the coach that I was late because I had to wind up my business in order to afford college and he 47

allowed me on the team. The fun I had playing high school football was not to be repeated in college. A combination of my weight loss and the size and experience of several Korean War veterans who joined the team made practice sessions miserable. Freshmen were mainly used as blocking and tackle dummies. In my few opportunities to play in an intra squad scrimmage, I could not handle my opponent lineman. Football players were given an extra serving of meat and milk in the cafeteria, from which I soon gained some weight, but I was not competitive. The team was told to go to bed and rest on Saturday afternoons before a game in the evening. One Saturday a few weeks before the end of the season, I was lying on a couch in the dorm TV room watching a baseball game. The football coach poked his head in the door and asked the score. I told him and he left. That evening, I learned that I was suspended for the remainder of the season. I thought it unfair. I was lying down when he saw me. The assistant football coach was also the Dean of Men. Many on campus also thought him unfair. When he was asked why the men were free to come and go, as they liked, while the women were tightly monitored, he said, “If you control the women, you control the men.” Of course, that was not true for the men who had girlfriends off campus. At football practice, he seemed to take cruel delight in pitting others and me among the less competent against the toughest guys on the team. In the following spring practice, I was tried out briefly at tight end but I had little experience catching passes and was not good at that either. Finally, after a minor 48

knee injury, I gave up football and auditioned for the A Cappella choir. When I first arrived on campus, no one seemed to be aware that I was promised a job. After several inquiries, I was told that I could work several hours a week as a soda jerk in the student center for 50 cents per hour. In that job, I acquired the nickname “scoop” because I gave generous scoops of ice cream to customers in the canteen. From my savings and occasional other help, I was able to pay my tuition, room and board as well as rent textbooks, but I was always short of money for anything extra. The total expenses in those days were only about $1000 per year. My mother made little more than twice that annually, and had two other kids to support, so she could not help. I believe it was in the first year that Mr. Massey kindly arranged for a member of our church, who had come into an inheritance; to contribute money to the college designated to cover some of my tuition. Martha Anderson, my future sister-in-law, worked in the student center office. She and I are about the same age but she skipped a couple of grades in school before college and seemed very mature and distant. One day another soda jerk and I were playing catch with a wet dishtowel. I threw it out of his reach and hit Martha. Oddly enough, she seemed friendlier after that. In her office that year I noticed that Martha had a very attractive visitor who I later learned was her sister. I commented to the other member of the dishtowel battery that I would like to meet that girl. It was a year before that happened. She showed up in the A Cappella choir. Man, was I glad that I quit football. 49

Carson-Newman had no fraternities, the dues for which I could not have afforded in any case. We had two men’s and two women’s literary societies. The leader of the book-selling crew in North Carolina was President of the Philomatheans. He asked me to join them, which I did. As one of the traditions of the society, the President called on a member at the end of a meeting to give an extemporaneous speech on a topic designated at the moment. At a joint meeting with our sister society, he called on me. I must have said something funny because I remember laughter and gaining the reputation as something of an orator. The air came out of that bubble sometime later when I was supposed to give a memorized speech of a famous orator. As I stood up, my mind went blank and I had to sit in humiliation. From that day forward, I never tried to memorize a speech or lecture. When I eventually became a teacher, I constructed notes as a crutch but consulted them only occasionally. Most of my fellow students were hillbillies from Tennessee farms and small towns, which had a similar culture to my hillbilly background in southwest Virginia. A number came from metropolitan areas such as Knoxville, Hampton Roads and the Washington, DC suburbs of Virginia as well as several Florida cities. They seemed more sophisticated, but I soon found that I could keep up with them in class. My second roommate was from the suburbs of Washington. We would discuss various topics. His solution to a disagreement was to produce a book that supported his position. He claimed that if something was published, it must be true. I knew better than that and scoffed at 50

him. We arranged for new roommates the following year. Classes in my freshman year were easy, largely a repeat of what I learned in high school. I breezed through algebra, which I knew about as well as the teacher. Occasionally, I would correct her on a point and she would occasionally have me do a proof on the board. In biology, we dissected frogs and the teacher tried to justify evolution relative to religion by saying that a day was thousands of years in the eyes of God. We had to fill in a workbook that I doubted the biology professor perused. To test him, I wrote "Mickey Mouse" as an answer to one of the questions. He apparently never saw it. There was a required class in religion, which actually meant the Baptist version of Christianity. The textbook was a red covered book entitled, “God’s Redeeming Love”. Some of the less reverent students, of which I was not one, called it, “The Little Red Redeemer.” Each class was opened with a prayer and the teacher often called on me to deliver it. She told me in private that she appreciated my quiet entreaties over the near shouts of some of the ministerial students. A lot of those hillbilly preacher boys seemed to think that God was hard of hearing. The college was saturated with religiosity. We had required chapel at 10:00 am each weekday. There were voluntary vespers each weekday after lunch and various extracurricular clubs, such as the future missionaries and future ministers. I was a fairly regular attendee at vespers and eventually joined the future ministers. Among our Saturday activities was handing 51

out religious tracts on street corners and visiting jails in the surrounding counties to pray with those prisoners who consented to do so. In high school, I gave some thought to becoming a minister but had not received a direct message from God, as I thought being “called” required. As a matter of fact, God never spoke to me about anything and many of my prayerful requests were unfulfilled, but one did not question such things. After talking with ministerial students in college, they were vague about the nature of the call they claimed to have received. It just seemed that my path in life pointed inevitably in that direction. Needless to say, my mother and Mr. Massy as well as other members of my home church were pleased when I announced my intentions during one of my home visits. After being kicked off the football team, I hitchhiked home every few weeks to visit. Most of my high school friends were away at college or had joined the military and were seldom at home on the weekends that I was there. Many I never saw again for 40 years, when we held our first class reunion. In the spring, I had to make a decision about summer work. The book company had an incentive plan whereby a crew chief was awarded a percentage of the commissions earned by the crewmembers. I decided to try to assemble a crew. Only one fellow agreed but I was committed. He and I attended sales school in Nashville and were assigned to Cambridge, MD, a small town on the east side of the Chesapeake Bay, called the eastern shore, in Maryland. Despite lessons on hitchhiking in sales school (dress well, face the traffic, keep a big smile on your face), 52

rides around Washington and across the Chesapeake Bay Bridge were more difficult to come by than on roads farther south. Apparently, drivers in metropolitan areas were reluctant to pick up strangers. When we finally reached the bridge, which had a toll per passenger, a guy stopped and said, “Who pays for you?” “We do”, we said in unison and we had our ride. The “kindness of strangers” was again to save me that summer. We contacted the local Baptist minister, Mr. Medlock, upon arrival. He called a young bachelor member of his church who had an extra bedroom with twin beds in his apartment. The guy rented us the room for a nominal amount and, in addition, cooked many a meal for the three of us. We all pitched in for groceries, which was much less expensive than eating out as I had in Tarboro. I tried to help with the cooking a few times but our host apparently didn’t like the results and assigned us to the cleanup squad. On Sundays after church, the three of us were usually invited to the minister’s house for dinner and to watch a baseball game on television. Mr. Medlock was a big Baltimore Orioles fan. One Sunday in mid afternoon, the coffee pot was empty and I volunteered to make some more. When Mrs. Medlock tasted the coffee, she looked at me with a sly smile and said, “Leon, did you put fresh coffee in the pot?” “No”, says I, “just water.” They never let me forget the fact that I didn’t know that used coffee grounds make bad coffee. I sang in the church choir in Cambridge as I had at home and in Tarboro and Jefferson City. The Medlocks prevailed on me to try a solo on an upcoming Sunday 53

evening. One of their two sons was an accomplished pianist and he practiced with me for several hours. I could tell from the expression on his face that I wasn’t doing well but we performed on the designated night. Thankfully, not many Cambridge Baptists attended evening services. Either my salesmanship had improved or the potential customers were more prosperous in Maryland. Sales were such that I anticipated an improved income at delivery time. Two disasters prevented that from happening. Somehow I lost one of my order books, and despite a lost day retracing my steps, it never turned up. Not only did I lose the profits from the sales recorded there because I had no backup record of the customer’s names and addresses, those customers who had given me a down payment lost their money. The guilt that I felt was palpable. The second disaster was Hurricane Connie. We awoke one morning to howling winds, looked out the window and saw a large tree leaning on the house. Our host, a chiropractor by profession, was a local Red Cross volunteer. We joined him to help out where he was assigned. The National Guard conveyed us to a high school in the county where we set up cots, carried food to the cooks, and the like, to care for people who were evacuated from low lying areas. The county was bordered on the west side by the Chesapeake Bay, which came ashore in many areas as the storm pushed water from the Atlantic into the Bay. After getting refugees from the flooding settled in, we played basketball with the kids in the gym. Fifty years later, I was astonished to see no National Guard troops in New 54

Orleans or southern Mississippi until a week after hurricane Katrina struck. The neglect of the people who had no vehicles to escape that storm was criminal. On the trip back to Cambridge after hurricane Connie, I saw large boats washed up in the woods far from the water. One of the primary industries in the county was crabbing and processing crabs in canneries. When I asked many of my customers what they did for a living, the answer was often “crabbing” or “pick crabs”, the latter referring to the extraction of the meat. One of the finest meals I ever had was crab cakes in a little shoreline restaurant known to our host. Observing the devastation from the storm, I knew that some of my customers would not be able to pay for their orders. Despite these setbacks, by the time I needed a car for deliveries I had $200 with which I bought a car - a 1946 Chevy coupe. It is a wonder that I didn’t get a lemon given the age (10 years) of the vehicle, but it got me through the deliveries and back to home and campus. My new roommate at college was from the Washington DC area. He was not argumentative and we got along fine. We enjoyed playing tennis and occasionally I would fail to make it to a class because I wanted to finish a game. I also played several intramural sports, which took time from studies. The academic work became more difficult but I did not ratchet up my work habits accordingly. My English professor, Ms. Huggins, who was loved by many of the students, disliked me. I took issue with her on several interpretations of literature and she did not like having her authority questioned. I flunked sophomore English, but later repeated it satisfactorily with another 55

professor and went on to minor in English. My favorite course was Introduction to Sociology. It was taught by a minister, Herbert Miles, who left the pastorate to get his Ph.D. Sociology seemed a good major for a minister. Dr. Miles taught most of the sociology courses that I took in the subsequent years, such as Criminology and Marriage and the Family. His specialty was Marriage and the Family and he did premarriage and marriage counseling as well as some research. Dr. Miles was an advocate of equal rights for women long before that became a popular issue. Surprisingly, he got a lot of resistance to that position from women in the class on Marriage and the Family. One sweet young thing from South Carolina would voice her objections in a broad southern accent, “But Doctah Miiiles. We liike things liike they arre.” Dr. Miles took chances in his lessons on sex, openly discussing sexual functioning in the male and female with graphic illustrations of the anatomy. Had some of the more rabid moralists among the Baptist clergy in the state known of these lectures, they would have been after his hide. As is the case today, most evangelicals in those days were far more interested in e sexual behavior than other moral issues such as war, poverty and racial discrimination. Dr. Miles advocated equality of the races, also a touchy subject in a southern school that practiced racial discrimination in its admission policies and in its supporting churches. He invited professors and students from an all-black college in Knoxville to one of our classes. They briefed us on the extent of discriminatory practices in the area and the status of 56

the civil rights movement. As you may have gathered, Dr. Miles was more advocate than scientist but he did teach us that social structures and social issues could be studied scientifically. I read extensively among the references in the class bibliographies. In the spring semester, I took Koine Greek (the Greek in which much of the New Testament was written). I had done okay in high school Latin for two years, but Greek was a different story. The difference in alphabet made learning the language difficult and what I learned about some of the meanings was disturbing. Some Baptist dogma didn’t jibe with the original meaning of passages in the Bible. Given my history, one of the more salient issues involved alcohol. We learned that when Jesus drank wine, it was alcoholic, not grape juice as I had been told. Baptists take a pledge not to use alcoholic beverages and use grape juice when taking communion. I flunked Greek. One of the reasons for my poor performance in Greek was choir tour. Each spring, the A Cappella choir did a 10-day tour by bus, singing in churches and, occasionally, schools in different cities nightly. Members of the churches would take one or two of us to spend the night afterward and we would assemble the next morning for a bus ride to the next community. There was little time for study, and I had an additional distraction. The young lady whom I had seen the year before in her sister Martha’s office was in the choir. I took the opportunity of the tour to sit next to her on the bus if I could. There was some competition from another guy, but usually I got to the seat first. 57

Her name is Nancy and we have been married 47 years. After several days of riding together, we learned a great deal about one another. She trained for years in piano and voice, obviously more accomplished in music than I. We talked of family. She told me of her mother’s illness (breast cancer) and death when Nancy was 11. I talked of the trauma in my family when I was the same age. By the time we returned to campus, we were an item and I was too far behind in Greek to catch up. Of course, that was entirely my fault, not Nancy’s. If my attention to her helped me get rid of Greek, then good riddance. There was a two-lane bowling alley in the basement of one of the girl's dorms. I took Nancy there, telling her I would teach her to bowl. She beat me in the first game. Toward the end of my sophomore year, I again had to decide about summer work. To endure yet again the difficulties that I encountered as a salesman was not appealing. I learned of a program called “Tent Makers”, named for the occupation of the apostle Paul. The Tent Makers would arrange for good-paying summer jobs if the applicants would pledge to work in a church near the work site for the summer. I signed on along with another student. We were assigned to help build a church in Kellogg, Idaho when not working in the Bunker Hill Mine there. When classes were over, we made a short visit to our families and set off cross-country in my little Chevy. We stopped only for food and gas. Driving in shifts, we took turns sleeping in the back seat. Despite the discomfort, it was a marvelous trip. We went through Indianapolis 58

and Chicago. We visited Mt. Rushmore, Cody Park where we saw Buffalo, and Yellowstone National Park, where the snow was 20 feet high along the sides of the east entrance. Arriving in Spokane, Washington, we found a Baptist Church that we thought was the place we were supposed to report before going to Kellogg. After telling the pastor what we were about, he said something to the effect that we were those other Baptists. His church was in the American Baptist Convention and he apparently didn’t appreciate the invasion of western Washington and the Idaho panhandle by Southern Baptists. He was kind enough to direct us to the correct address. In Kellogg, we found the partially built church. The basement was finished enough for the congregation to meet there. We spent many evenings that summer framing and putting up dry wall. Parishioners who knew how to do such work taught us. The minister worked along side us as well. To get a job in the Bunker Hill Mine, we went through the shapeup system. You show up and may or may not be picked on a given day. Since a lot of the miners liked to take jobs as lumber jacks to be out of doors in the summer, there were several jobs available. We were picked the first day we shaped up. Workers in the mine were required to be members of the Mine, Mill and Smelter Workers Union. We obtained our union cards and equipment (helmet, attachable head lamp, belt with battery pack for the lamp, and boots). Since we were to live in company housing and another student from a college in Louisiana was to join 59

us, we arranged for a place for three. When he arrived and we filled him in on the job, he obstinately said that he was not going to join any union. I told him, “Have a nice trip back to Louisiana.” He joined the union. In the mine, we each were assigned to a miner as a helper. To get to the mine face where we worked, we had to ride a train into the side of the mountain and transfer into a multi passenger conveyance in a shaft, something like a roller coaster car. The car was attached to a cable that lowered us below ground some 2000 feet. When being lifted out at the end of a shift, the miners liked to maneuver rookies into the lower end of the car and scrap off stalactites to rain on our heads. The prank was harmless because we wore helmets and thick coats. To my surprise, the ride in and out was cold, but the temperature where we worked was hot and humid. I bought an army surplus jacket for the trip and shed to tee shirt and jeans while working. The senior miner with whom I worked was very good at his job. Each morning, we shored up a 5' x 5' x 8' area that had been blasted and cleared of ore the day before. We tapped the ceiling to be sure there were no large loose rocks, placed posts at the corners where there were none and used slabs of wood, called lagging, to cover the top. Wedges were used to tighten the wood roof against the ceiling rock. We would then drill holes in the ore and place dynamite in the holes. Blasting caps were inserted in the end of sticks of dynamite and the fuses trailing from the various drill holes were wired together. At the end of the shift, we lit the fuses and left. The night crew cleared the ore to a utility shaft where it was dumped into rail cars in the tunnel below. 60

I say my partner was a good miner because his drilled holes and dynamite were placed so efficiently that we had a nice rectangle blasted out most mornings. A minimal amount of work was necessary to build our workspace and drill for the night’s blast. As a result we had a lot of time to talk. He told stories of the days when goons had rounded up strikers and kept them in barbed wire enclosures outside for days. Everyone he didn’t like he called a “cocksucker” and he didn’t like a lot of people. I had heard people curse in the past, and repeated some of the words I had learned when I was with my high school buddies, but this guy was world class. He told me about the whorehouses in Kellogg and nearby Wallace and many of his adventures. Over the forth of July holiday, the area where we worked caved in while we were on holiday. Upon return, we spent several days placing timber so that we could mine safely. To this day, I have tiny scars on the back of my hands where small, sharp rocks fell on them. No one was seriously injured in work spaces near me but our crew was sobered one day by news that a guy in another part of the mine was killed when he walked out under open rock without punching it with an iron bar first. A large boulder fell on him and crushed him. One of my jobs early in the morning was to spray water in our workspace to keep down the dust. The man who handed us our recharged batteries above ground each morning had a horrible wheeze. When I asked my work partner if he had asthma, he said no, silicosis. Breathing rock dust cut up his lungs. I couldn’t understand why most of the miners, seeing the consequences of a dusty workplace, did not wash down 61

their work areas. It was filthy work but the company had a good system for cleaning up. We walked into the shower with our clothes on and cleaned off the mud. After shedding the clothes and washing them and ourselves, we hanged the clothes on a basket attached to the rafters of a high ceiling by a pulley. We pulled them aloft where they would dry overnight. The next morning they were a little stiff but wearable. We were paid overtime for Saturdays, which we worked every week. I made about $100 per week. After expenses, I sent most of it home for mother to deposit in my bank account to pay for the next year at college. At the end of the summer, I had more money than in each of the previous two years but still had many weeks ahead without a penny in my pockets. Since the college severely limited the freedom of women students to leave campus, dates were mainly in the cafeteria and library anyway. While we chaffed at the restrictions, they were help for me. Being unable to take Nancy to movies or other events, I was not embarrassed by lack of funds. On the way home from Kellogg, I dropped my colleague off in Nashville from which he hitched to his home in Georgia. I went to the YMCA to spruce up. Nancy lived in Crossville, Tennessee, a couple of hours east of Nashville. I intended to surprise her. When I arrived, her first words were, “What are you doing here?” It was obvious that I needed to learn more middle class virtues such as calling before arriving. She had something planned with her grandmother, who graciously said that they could do it another time. Over 62

lunch at a downtown café, to my relief, all was forgiven. In my junior year, I took mostly sociology and psychology courses as well as Spanish, all of which I passed, but my grades were not great. The year was largely pleasant. My relationship with Nancy progressed nicely. We especially enjoyed the choir’s tour to Florida. She looked great in a bathing suit. Other than the choir, my major extracurricular activity was the campus radio station where I did stints as a disk jockey. An older ministerial student, who was pastor of a church a few miles from the campus, asked me to direct the music in his church. I agreed to do it but wasn’t very good at it. The congregation sang each hymn like a slow dirge. When I upped the tempo, they complained. Returning to the old way, I felt like every service was a funeral. The major bad incident that year was loss of my car. The guy who accompanied me to Idaho the previous summer asked to borrow it. Sometime later he approached me in the cafeteria line and said, “I totaled it.” We went to see it in a junkyard and, indeed, it was damaged beyond repair. I was furious but there was nothing I could do. Although he was even poorer than I, somehow he scraped together enough money to replace the car with another 46 Chevy, this one a four-door sedan that turned out to be a lemon. We needed the car to return to Idaho for the summer. I took an additional two guys who got jobs in the smelter. The trip was difficult. One night while I slept, the driver made a wrong turn and took us miles out of the way. The car’s transmission froze twice, once in Illinois where we sat until dawn with the rear of the car 63

partly in the road. It’s a wonder that a tractor-trailer truck didn’t destroy it and us. I had it repaired but it froze again near a small town in Nebraska. We were extremely fortunate to find a local junkyard that had a used transmission that I bought to replace the faulty one. In the mines, I was assigned as a repairman’s helper. Our job was to remove rotting or split timbers in the shafts and tunnels. Since there was no natural cycle to the work, as there was when I helped mine a defined space per day, I had to work all day. Fortunately, there was less conversation. The guy I worked with was illiterate and we had little to say to each other. When he was away on vacation, I was assigned to work with a recent immigrant from Germany who spoke little English. One day I heard a rumbling sound and asked, “What is that?” “Dumpin’ ore”, says he. About that time someone yelled, “You guys get out of there.” I passed them all running down the tunnel. When we returned, the place where we had been working was filled with caved rock. In the evenings, four guys living in one small house led to tensions. We had petty arguments over what food to buy, who was to prepare it and who was to do the dishes. On weekends I had something of a respite. I was assigned to direct the music in a church in Sand Point, about 30 miles from the Canadian border. Each Saturday after work I would drive there and spend the night in an apartment of a bachelor member of the church. He was there some weekends but had a summer job as a forest fire observer, which took him away to stay in a fire tower. Toward the end of the 64

summer, my losses from car repairs were partly offset by a generous church member. He invited me to his house for dinner and gave me $100 for my help with the church choir. I told him that my work was a part of my agreement with the Tent Makers and that I did not expect payment, but he insisted. Needless to say I was grateful. Nancy was a year behind me in college and we wanted to be married during her senior year. I planned to stay in Idaho for a year to earn enough money to afford marriage. I moved into a firehouse in August where I was to receive free room and board in exchange for my service as a fireman. I enjoyed the training but never had to attend a fire. After the other guys from college arranged alternative transportation and left, I bought another car - a 1950 Nash Rambler convertible - really practical for an Idaho winter. As time for the beginning of the college school year approached, I decided that I couldn’t stand to be away from Nancy for a year and hightailed it back to Tennessee. Back at school, a minister in a church in Morristown asked me to direct the music in his church for pay. I did so, and was grateful for the income, but was embarrassed at his means of raising the money. Each Sunday, he would take up a special collection for “Brother Leon.” In my senior year, I finally became a scholar, or at least I was so dubbed by my favorite professor, Joe Barnhart, after a semester under his tutelage. Joe had been a CN student just before I arrived as a freshman and went on to Boston University to pursue a Ph.D. in 65

Philosophy. He returned to the campus my senior year to teach philosophy. When the term started, I talked with him about taking his course in ethics but he suggested that I take Philosophy of Religion. So I signed up for that as well as Social Psychology and Contemporary Literature, each with professors new to the campus. The three of them piled on the reading and I thrived on it. The books were thick and packed with ideas to which I had not been exposed. In Philosophy of Religion, I learned of the different schools of biblical criticism ranging from those who attempt to support the scriptures with archeological and other evidence to those who debunk major JudeoChristian concepts with reasoned analysis of the inconsistencies and evidence to support or refute them. Most Baptists believed that the Bible was the divinely inspired “word of God” and that meant that every word was true. The critics pointed out many passages that contained contradictory accounts of the same events. It slowly became clear to me that the God who I had been taught to worship did not exist. An all powerful and loving God would not contradict himself in his “inspired scripture” or, more importantly, visit upon the world the “surd evil”, as the philosophers called it -- the biological plagues and natural disasters that indiscriminately maimed believers, as well as nonbelievers, throughout history. I was not the only one in class to come to these conclusions, but there were other students in the class who refused to acknowledge the truths we encountered and who badmouthed Joe outside class. Given the prevalent religiosity on campus, you can imagine the uproar when the dissident students spread 66

the news that Joe Barnhart was some kind of heretic. Actually he was as kind and gentle a human being as I have ever known and he did not advocate any doctrine. He merely taught us how to think critically about religion and provided a variety of resources for us to educate ourselves. There was no requirement to buy into any of it. Nevertheless, Joe was denounced in private discussions and occasionally in public forums. One student that I had respected until then (I voted for him as President of our literary society), made a passionate anti-Barnhart speech in chapel to the entire student body. Somewhat milder, but more important, was public denunciation by some of the faculty. Many of the “preacher boys” and others spread untrue rumors. There was nothing Christian in their behavior and I called them what they were -- hypocrites. At the end of the year, Joe lost his job, more the college’s loss than his. There was a parody on a college song about dear old CN, sung long before Joe was fired, that signified my reaction: “On the banks of old Mossy, someone happened to find, Carson Newman College, God forgive them their crime.” In both the fall and spring semesters, I was recognized in chapel, along with numerous others, for making the Dean’s list in honor of my grades - all A. Several other Barnhardt supporters were also so honored to the chagrin of his detractors. My grades that year were remarkable, if I say so myself, given that I went on choir tour and was even more ill, for a time, than I had been as a high school senior. The Asian influenza epidemic swept through the 67

college. I was lucky to contract the disease early enough to get a bed in the college clinic. My fever was so high, and the nursing staff so overworked, that I was bathed in alcohol, clothed only in a sheet over my privates, by a couple of coed volunteers. They tittered but I was too sick to care. I was co-manager of the campus radio station in my senior year. In December, I heard one of the DJs make a comment that I thought might lead to disaster. Elvis Presley and others popularized rock music during my college days and we allowed a student to do an hour of rock music. Just before Christmas break, I was studying in my room listening to his show intermittently. Closing out he wished everyone a great holiday. “Spread Joy, make Mary and feel Gay,” he said. Fortunately, there were no repercussions. The defenders of morality on campus apparently were not listening. I was aware that such an incident could be used against me in relation to my support of Joe Barnhardt. After my religious awakening, so to speak, I knew I could not enter the ministry. My religious beliefs were muddled and a succeeding philosophy was yet to be found. It was clear that I would be unable to deliver sermons acceptable to any Baptist congregation of which I was aware. No matter how unintended, causing turmoil in churches and being sacked for my efforts didn’t look promising as a career. Dr. Miles urged me to go to graduate school in sociology and become a college professor. That sounded like a good idea, but I wanted to get married and see Nancy finish school first. I decided to get a job 68

and work for a year. I interviewed for a high school teaching job and took the civil service exam to become a welfare worker. The welfare job came through and I worked in the Knoxville office for a few months. I also worked weekends on a radio station in Morristown, a job that I acquired in the spring semester during the school year. Nancy and I were married in September, 1958, but there was no time for a honeymoon what with her school work and my jobs. Her father did not want either of his daughters to marry before graduation for fear that they would become pregnant and not finish. Martha had defied him and eloped. Nancy saw the problems caused by that and was torn between loyalty to her family and to me. I wrote her father that we intended to get married in his church and invite his friends. I didn’t say it so bluntly but he got the message. If you don’t want to look like an ass, show up and do what you are supposed to do. He did. It was not a costly wedding and Nancy and I paid for most of it. In the wedding, Nancy stopped during the processional and sang At Dawning. There were few dry eyes in the house. Man, did she look fine. Earlier on our wedding day, there was a minor crisis. On the way to Crossville, the fan belt on my car broke and I had to replace it. Arriving at the house late, I looked more like a grease monkey than a bridegroom. Nevertheless, I was able to get cleaned up and get into my monkey suit in time for the luncheon and the wedding. Mr. Massey arrived the day before from Wytheville to preside, Nancy’s pastor being elsewhere occupied. My mother and sister rode with him. My 69

brother, who was supposed to be an usher, didn’t make it. He decided to drive down the day of the wedding but overslept. He called to apologize and one of Nancy’s relatives filled in. My brother showed up at our apartment a block from the CN campus in Jefferson City a few days later to make amends and meet Nancy. We were fortunate to get along well with both sides of the family. We visited each set of parents almost every Christmas-New Year season, with one or two exceptions because of illness, until the last of the parents, my dear mother at age 90, passed away in 1998. In the early years, we saw Nancy’s father and stepmother more often because they lived nearby. In the fall of 1958, the manager of the Morristown radio station approached me, asking me to quit my welfare work to work full time in radio. He wanted me to do a one-hour show daily from an office in Jefferson City and sell ads on the show. I was depressed by the condition of my welfare clients and was able to do little for them but check on their eligibility. The image of an old man with no family living in a single room with one bare light bulb on $50 per week haunts me to this day. Also, the commute to Knoxville was expensive. So I took the radio job. I doubt that I sold enough advertising to justify my existence. Also, the station hired a hotshot salesman who began poaching on my territory. After a couple of months, the manager of a station in Newport called me and asked me to interview for a job there. I did so and became a full time disk jockey - the manager handled the sales. Several weeks after I left Morristown, my old boss there called to ask if I had a record of the ads the 70

hot shot had sold. He had skipped town, at least owing several merchants for goods he had purchased on credit, and possibly taking some ad revenues. I knew nothing of this. To some, disk jockey may seem like a glamorous job. It isn’t. I sat at a microphone for hours trying to say something interesting between spinning records, most of which I didn’t particularly like. One doesn’t play choral music on a small town country station. I did get out of the studio to narrate a few local baseball games. I applied for graduate study in the sociology department at the University of Tennessee in Knoxville to begin in the fall of 1959 and was accepted. Nancy graduated from college and landed a job at Halls Crossroads Elementary School, on the northern fringe of Knoxville. We moved to a miserable apartment in Newport for the summer. A river filthy with pollution ran on one side of the building and the railroad ran by the other side. There was a country song popular at the time called, “Draggin’ the River.” One day after playing it, I told the radio audience that there was something bad in the local river, but it wasn’t a dragon. Almost nightly, we were wakened by train whistles. We were happy to leave Newport and arrive at our apartment in Halls Crossroads. If my mother, Mr. Massey, or anyone else was disappointed about my new ambition to be a college professor, they did not say so to me. I did not discuss my changing religious views with them or any of my religious friends. There was no need of upsetting them just to demonstrate my intellectual independence. 71

Chapter 4. The Making of a Professor Given my lackluster college performance, except for the senior year, it is a wonder that I was admitted to graduate school. Dr. John Knox, one of the UT faculty members, told me later that they took a chance on me because I looked like a possible late bloomer. I guess it just took the right fertilizer to get me started, but I was far from being a flower. The UT sociology department had never granted a Ph.D. in sociology. The graduate program was expanded in 1959 based on a grant from a program authorized by the National Defense Education Act. The Soviets beat the U.S. into space with their orbital satellite “Sputnik” on October 4, 1957. The Congress attributed that partly to an education gap and awarded universities grants to produce more Ph.D.s. Other expenditures in those days were justified on a similar basis. The Interstate Highway System, under construction in those years, was originally called the National Defense Highway System. One of the attractions of the UT sociology program was the possibility of skipping the master’s degree and getting the Ph.D. in three years. If one didn’t pass the exams for the Ph.D., the master’s was still available upon completion of a thesis. None of the Ph.D. candidates in that first class of nine expected to resort to that, but one or two may have thought about it after meeting a few classes. We were required to take calculus in preparation for mathematical statistics. When I sat down next to one of my new colleagues in 72

that class the first day, I noticed that his hands were shaking. He openly expressed intense fear of math. He later obtained the consolation masters. Although I had not been in a math class for 5 years, my old aptitude stood me well and I had no trouble in the class. Actually, I liked it more than the sociology classes but I didn’t have sufficient background at that stage to go for an advanced math degree. The calculus class and subsequent statistics classes were like the traditional lecture classes to which I was accustomed. The calculus professor was among the best I ever had. The first mathematical statistics professor was among the worst. He was a former naval officer and an Episcopalian Rector. At the beginning of class, he would start writing formulae on the upper left of the chalk board with his back to the students and give minimal explanation of what he was doing. By the time he reached the center of the board, he had lost many in the class. Anyone who dared ask a question was pounced on with a short lecture that implied the questioner's stupidity. The sociology classes were seminars in which the professor attempted to stimulate discussion around copious material that we were expected to read, but they lectured only intermittently. One of the unanticipated benefits of the informal hot debates regarding religion in my senior college year was preparation for graduate seminars. Anyone not prepared to speak out and debate was in trouble. A couple of the students said practically nothing in the seminars and eventually dropped out of graduate school. The students came from widely differing backgrounds. 73

All were intelligent but other factors played a role in our debates and friendships. Gene Summers came from a family with even less money than mine. He felt more comfortable at the outset because he obtained his undergraduate degree in sociology at UT the year before. He knew the professors and the campus and had a free and easy manner that appealed to everyone. He was recruited at one time by the Brooklyn Dodgers to play baseball, and had a letter from Branch Rickey to prove it, which put him high in my book. He was smart enough to opt for graduate school over an uncertain future in baseball. Gene often took the lead in debates and eventually obtained the first Ph.D., the only one in three years time. Andre’ Hammonds grew up on the mean streets of a Chattanooga ghetto, the son of a blue-collar worker. Similar to my story, with the help of family and friends he went to college, but to a more prestigious school – Morehouse College -- which among it’s alumni counted Dr. Martin Luther King, Jr. Andre’ was fluent in French and had spent a year at the University of Grenoble in France. He had a great sense of humor and told the best jokes. Even today, he sends the best e-mail jokes in my joke circle. Andre had read many of Freud’s works and would bring them up from time to time. I was not an admirer of Freud. We shared an office where we had some great debates on Freudian theory. Students in other departments would look in our open door as we intensely argued some point. Maybe they thought a racial incident was about to ensue. We remained fast friends despite our intellectual differences. 74

Those two guys became my best friends throughout grad school, as did Fred Dickey during the first year. Fred dropped out after one year, not because of difficulty holding his own with the rest of us, but I think lack of interest in the substance of our studies. He smoked the smelliest pipe and would peer out over it demanding that we discuss the epistemological basis of our arguments. It was an excellent point. Perhaps the professor was amused, but I don’t remember a satisfactory response from a professor or student. In the first semester, the classes were mainly on historical figures in social thought and sociological theory. It took a while for me to get my epistemological head straight. If you are not familiar with the term, epistemology refers to the origin and nature of knowledge. I came to realize that the most reliable and valid knowledge is that obtained by scientific methods. If a scientist, or anyone else for that matter, claims to have discovered a truth, it is more likely to be an actual truth if independent observers, particularly those who are skeptical, use the same or different methods of observation, and verify the observation. Agreement among a group of people per se does not establish truth. Frequently a lot of people believe the same myth without any attempt at verification – remember the flatearth guys. Phenomena that obey deterministic laws are the most easily verifiable. You get the same effect from the same cause every time. If you drop a rock from the Leaning Tower of Pisa, on the side where there is no obstruction between the window and the ground, the rock will fall 75

to the ground every time that you drop it. Outcomes that are more probabilistic are harder to verify. The probability of an outcome of interest is increased or decreased by various factors but is not a sure thing. Unless the phenomenon occurs rarely, it can be studied in large samples until its nature is understood and generally agreed upon. Most human and social behavior is, of course, probabilistic. So are most diseases and injuries. Everyone exposed to pathogens does not get sick or injured. As my favorite graduate school professor, Louis Dotson, said, “We can’t predict which cat will jump, but we are pretty good at predicting the percentage that will jump.” Andre’, Gene and I helped one another both in and out of class. We had to pass reading tests in French and German -- two of the hoops to jump through for the degree. French was a slam-dunk for Andre’ and he helped me pass the test without having to spend time in French class. With two years each of Spanish and Latin under my belt, said Andre’, I should pick up another Romance language easily. Easy for him to say. In any event, I translated articles with the help of a grammar and dictionary. Andre’ would check the translations. One day he told me to take the test and, voila, I passed. Although Gene had some familiarity with German and helped us with that, the three of us took a formal course with the other students. The professor had a sense of humor and we had lots of fun. We passed around a letter reputedly from a German importer to a Brazilian coffee exporter asking that he not send the coffee beans “mit der rat shit gemixt”. Andre’ once read in class his translation of an assigned passage, 76

indicating activities in the herrenzimmer as having happened in the men’s room. The words herren and zimmer are the words for men and room, so their combination was logically men’s room. But the herrenzimmer is the library, not the john. Andre’s translation was logical, but some of the activities noted in the passage that Andre’ read were a bit out of context. At one point, Gene’s apartment needed painting so Andre’ and I pitched in to help. As lunchtime approached, Andre’ volunteered to drive to McDonald’s and get hamburgers. He returned shortly to say that they would not serve him. I boycotted McDonald’s for 40 years thereafter. Nancy said that they didn’t give a hoot about my business, but I wasn’t giving those bigots a dime. It wasn’t the last of my little boycotts. Don’t get me started on Dell computers. In the spring semester we took a course with Louis Dotson called Survey Design and Analysis. As part of the course, we had to design a questionnaire to test some ideas about racial prejudice. We administered the questionnaire in various classes at UT, Carson-Newmen and perhaps other schools that I no longer remember. When we analyzed the data, we found nothing that was statistically significant. Finally, most of us gave up and went on to other things. Gene and Andre’ later revisited the data. When they compared the responses from classes in which Andre’ was present and those in which he was absent, the mere presence of a black guy in the room made a difference in how the respondents answered. Gene and Andre’ published a paper on their findings. (1) 77

Most of the Ph.D. students had an NDEA stipend as part of the program. I did not apply in time to qualify. When one of the students with a stipend dropped out, the faculty asked the government to award it to me, but the feds said no switching after an award. Thus, Nancy’s salary was our main means of support, supplemented with what I could earn during the summer. Charles Cleland, a rural sociology professor at the agriculture school, provided a summer job. He hired me as an interviewer on a couple of research projects to administer a questionnaire to farmers. I got another dose of reality on the reliability of questionnaires during that summer. One of the projects was called the “trial acre program”. Certain farmers were selected to receive assistance if they would cultivate and fertilize an acre of corn according to the specifications of the University’s agronomists. Supposedly, the farmer would see the improvement in yields compared to those in the rest of their cornfields, and subsequently adopt the specifications for all their cornfields. In fact, we were teaching them to do their own simple controlled experiment. My job, along with a graduate student in agronomy, was to survey the farmers regarding their farming practices. In one question, we asked the width between the rows in the cornfield. The responses that I got were much more varied than those of my colleague. He asked me if I had checked the corn planter to see if the width between rows had been changed from the factory settings. I had not. Many of my respondents were giving me guesstimates rather than actual measurements. 78

Another project that summer involved interviewing farmers in the poorest counties in the state. Part of the interview was a series of questions about assets and liabilities in an attempt to assess the net worth of the farmer. As you can imagine, a lot of rural Tennessee farmers are suspicious of someone asking them about their incomes and debts, even if he does have credentials from the University and guarantees anonymity. One afternoon, I questioned a farmer along these lines while he castrated a bunch of piglets. His son would capture a pig and bring it to his dad. The farmer would look at me suspiciously, sometimes refusing to answer a question, and hack the nuts off the piglet. The piglet would squeal loudly and run off while I kept my eye on that knife. Some of the counties in which I worked were west of Crossville where Nancy’s family lived. She was off work for the summer and would ride as far as her folks and stay with them during some of the weeks that I was in west Tennessee. It was 1960, the year that John F. Kennedy and Richard Nixon squared off in the run for the presidency. Kennedy’s religion was a big issue among the Baptists in Tennessee. I was for Nixon, not because Kennedy was a Catholic, but because I thought Kennedy lacked administrative experience and was too much an international adventurer. After church in Crossville one Sunday, I got in a heated argument with the pastor’s wife because she made bigoted statements about Kennedy’s religion. Given my soured views of Baptist doctrine, I shouldn’t have been there, but I didn’t want to upset Nancy’s family with my apostasy. Of course, I didn’t score any points with them by 79

arguing with the preacher’s wife. Although I came to loath some of Nixon’s policies when he eventually became President, I wish he had won in 1960. He would have been less paranoid than when he finally won. And we might have avoided a presidential assassination and Viet Nam, as well as Watergate. What with the intensity of my studies, I had no time for political campaigns or other diversions. During my three years at UT, I did not attend a single sporting or cultural event. I remember Saturday afternoons in autumn working in the library within hearing distance of the roar of the crowd from Neyland Stadium. The stadium was named for a football coach who had brought the program to national prominence. It was known in some circles as “Neyland’s last erection”. Our financial situation improved when I obtained a university scholarship in the second year. Among the qualifications were certain minimal scores on the Graduate Record Exam. Some schools used the exam as qualification for entry to a graduate program but UT did not. I scored in the mid 90s on Math and in the 80s on language skills. These are percentiles, which means that I did better than those percentages of people who took the tests nationwide. Of course, I had one year of graduate school under my belt while most people who took the test were college seniors. Even with that qualification, the results helped boost my confidence that I was professorial material. The scholarship fattened my wallet. I could skip a summer job and concentrate on finishing my work in three years if possible. 80

When the national and regional conventions of sociologists had their meetings, some of us would scrape together money to attend. On one occasion, another student invited the chairman of the department, Professor Bill Cole, and me to ride with him from Knoxville to St. Louis. The student had a convertible and we rode with the top down. When we arrived at the hotel, we looked like a trio of boiled lobsters. After checking in, we approached the haughty looking maitre de in the restaurant. When we said we had no reservation, he said imperiously, “Will you eat and leave?” One of the graduate students, the daughter of a local physician, had led a sheltered life. At the convention one evening, she announced that she had never seen a strip show and wanted us to take her to see one. We demurred, telling her we didn’t want to be seen in such a sleazy place. Finally, she appealed to Jeff Buttrum, a student who was almost totally blind. He could see shadows but little else. Jeff says to her, “I’ll go with you if they got it in Braille.” Jeff was a fellow skeptic who took unpopular positions on issues. He was opposed to the space program, saying the money would be better spent relieving human ills on earth. He also questioned the relevance of a lot of academic research. In one seminar, a psychology professor named Black described experiments in which he gave rats alcohol and measured their ability to run a maze, compared to sober rats. When questions were called for, Jeff piped up and said, “Dr. Black, do any of those sober rats ever help any of those drunken rats through the maze?” 81

Given that most of our reading material was not in Braille, and Jeff had to have someone read it to him, it is remarkable that he completed the Ph.D. In my third year, I was awarded a teaching assistantship, for which I was paid. In many schools, that would involve grading papers and holding small group discussion sessions with students who needed help beyond attendance at lectures. At UT in those days, however, I was given a class in Introductory Sociology to teach on my own. Since, at that time, anyone who had graduated from a Tennessee high school could attend the University as long as their grades held up, I had students of wide ranging ability and ethics. A couple of beefy guys, who sat in the rear, called me “teach”. Near time for the final exam, another student called me on the phone and offered me money for the exam. He wouldn’t tell me his name. I didn’t have the presence of mind to set up a sting. Despite these disconcerting episodes, the experience was helpful in preparing me for the days when I had to teach four or five courses per semester. That job also took time that I could have spent working on my dissertation. For the Ph.D., the dissertation is a document, usually book length, that reviews the literature on a topic, states a research question or hypothesis generated by the review and provides original data to support or reject the hypothesis. As it turned out, I was unable to finish it before the year ended. I had the data in hand and only had to complete the analysis and writing, which did not require me to be in residence at the University. 82

One of the most anxious periods in my life was during preparation for the comprehensive examination at the beginning of the third year, required to continue in the Ph.D. program. Each day for 5 days, we took a written exam on a specific area. The weekend before the tests were to begin, I vomited and broke out in a rash. By the time that I could find a doctor who would see me, the rash had disappeared and he could find nothing wrong with me. Undoubtedly, it was a near panic attack from the fear of failure on the exams. Once I got going on the tests, the answers seemed to flow smoothly. I passed. Reaction to a stressful situation, although not as stressful as the prelims, would be the topic of my dissertation research. During my undergraduate and graduate training, I was more interested in the effects of social factors on individuals than in social structures and other aspects of sociology. My dissertation fell in the cracks among sociology, psychology and biology. My hypotheses stated that, probabilistically, parental roles would predict students’ psychological and physiological reactions to a stressful situation. To give you a flavor of the idea, the first paragraph of the dissertation states: “Recent studies in social psychology suggest that a stressed or frustrated individual will react in one of three ways: (1) aggression toward the external object perceived as the frustrating agent or toward a “scapegoat” (hereafter called other-blame), (2) aggression toward self (hereafter called self-blame), or (3) anxiety. The first described reaction is accompanied by physiological responses similar to those obtained by 83

an intravenous injection of nor-epinephrine, while the latter two reactions are accompanied by physiological responses similar to an intravenous injection of epinephrine. Other variables including expressed attitude toward self and others and probability of committing homicide or suicide have also been related to these patterns of individual reaction to frustration. These reactions have also been shown to be related to the child’s perception of principal disciplinarian, source of affection and role model in his family of orientation.” I went on to cite literature showing that change of pH of saliva during stress was an indicator of epinephrine or nor-epinephrine reactions to stressors. My proposed research, that I had to have approved by a committee of the faculty, called for the collection of family background data on a large number of high school students and the collection of saliva samples from them before and after a stressful math test. To serve on the faculty committee that would judge the adequacy of my work, I asked people who I thought would be intrigued by the science, whether or not they liked my venture across disciplinary borders. Two were from other departments and three were sociology professors. The committee approved the project, but there were voices of dissent among the sociology faculty. I was told that Dr. Cole referred to my project as “spit sociology”. Implementing the project was exhausting. I had to construct the questionnaires and obtain inert plastic vials for the spit samples. I had to obtain permission from high school principals to allow me to conduct the study in their schools. I had to arrange for several of my 84

friends to be in each room of a given high school to dispense and collect the questionnaires, tests, and plastic vials for saliva collection while I manned the public address system to give instructions to the students and issue frustrating time limits during the math test. I didn’t analyze my own saliva before and after those sessions but I should have. We obtained at least partial data from 1009 students, thanks to the help of my friends. Now I had on hand more than 2000 vials of saliva to be tested for pH. After collection, they were immediately frozen on dry ice. Before the study began, I bought a used freezer to keep the samples frozen until I could analyze them. The appliance had to be lugged up stairs to a second floor apartment in east Knoxville where Nancy and I had moved. She had switched from the county to the city school system and was assigned to an elementary school a couple of blocks from our apartment. During the days while she was at school, I sat in front of a pH meter thawing saliva and determining the pH. I recall watching television out of the corner of my eye as John Glenn circled the earth while I worked. There were two apartments on the second floor, the other occupied by a widow well into her 80s. She had few friends or family and was obviously lonely. She got into the habit of knocking on our door each evening and staying a while. Her visits were disruptive of my work and took time that I would have preferred to be alone with Nancy, but I didn’t have the heart to turn her away. To my recollection, she never commented on why I was at home most days or why I had scientific apparatus 85

sitting on the table. Maybe she thought I was the mad scientist that I would have become had the saliva analysis not come to an end. After matching up the pH data and the questionnaires, I punched the data onto IBM cards to be sorted and counted to build tables filled with statistical data. UT had not yet obtained computers for student use at that time so we had to the count the holes in our cards using a counter-sorter. To get a simple two-dimensional statistical count, one had to run cards through the machine which would sort them on one column containing numbers from zero to 9. Then each stack so obtained was sorted on a second column after which the counter on top of the machine gave the number of holes encountered in that column. To build statistical data on three or more factors, the number of necessary sorts multiplied. Occasionally, the machine would jam or chew up some cards, which meant time lost waiting for a repairman from IBM or card reconstruction. One day, Dr. Dotson came upon me with a screwdriver in my hand disassembling the machine. He sternly informed me that I was to call a repairman, not attempt to fix the machine. If I were doing the project today, the data analysis that took months then could now be done in less than a day, actually in seconds excluding time to program the computer. Although Louis Dotson could be stern when necessary, he was extraordinarily generous with his time, to my great benefit. He was my dissertation advisor and, as such, worked with me on several weekends when I returned to campus from time to time 86

during the following year to work on the dissertation. The results of the research are too complex to present here but, on the whole, I was disappointed. Although the research produced some interesting results for certain people in particular social situations, there was no strong support for the hypotheses. Even as small a social unit as the family comes in many varieties. The data suggested that the number of children in a family and the respondent’s birth position, among other things, modulated the influence of parents. I anticipated such complications from reading the literature, but sorting them out completely would have required an even larger sample than I had. One question not addressed in the dissertation is the extent to which physiological reaction to stress, as well as other behaviors, is influenced by genetics and other biological factors. In the 19th and early 20th centuries, the forming discipline of sociology was influenced by evolutionary theory and the possibility of biological influence on social behavior and structures was considered likely. Sadly, some such considerations were racist. Better observation of cultural variety among populations of similar genetic background, as well as reaction of society in general to racism during the Hitler years, led to the neglect of research on potential biological factors in social behavior until some years after my graduate school days. Toward the end of my third year in graduate school, I applied for advertised teaching positions. I was invited to an interview at Wake Forest College in Winston Salem, North Carolina. I knew that it was a Baptist college so I had checked on its reputation for tolerance 87

of differing religious views. I was told that it was tolerant of diversity in many respects. It had fraternities, allowed dancing (taboo at Carson Newman) and, more important to me, there were no recent instances of professors being fired because of their views. Maybe I was attractive to the Wake Forest administration that needed to point to the number of faculty with Baptist backgrounds, but there was no indication in my interviews in the Department of Sociology and Anthropology that anyone cared about my religious views. Sometime after I returned home from the interviews, the chairman of the Department at Wake Forest wrote to offer me a job as an Instructor in Sociology with a promise of an Assistant Professorship when I received the Ph.D. The salary was $6000 per year, only a little more per week than I had earned as a miner’s helper in Idaho. But there was the promise of advancement. Also, it was the “nice office job” that was my mother’s ambition for me when I worked in the chair factory for the last time nine years before. I accepted the offer. Probably because the college was at least nominally Baptist, no one among my family and members of my home church seemed disturbed that I was not in the ministry. When I finally graduated from UT after the winter quarter in 1963, my mother could not make it to the graduation ceremony. Nancy told me that, when the Dean asked that the parents stand during the award of the degree; her folks rose and looked proud. Nancy landed a teaching job in an elementary school in Winston-Salem. Anticipating our upcoming wealth, 88

comparatively speaking of course, we bought a new Ford Falcon and set out over the mountains pulling a trailer containing all our possessions. The trailer almost pulled the bumper off that flimsy car. I had no idea that I would have to make several trips over that curvy road during the fall and winter to complete the dissertation. Having to prepare new courses, grade papers, and counsel students as well as work on the dissertation and travel to see Dr. Dotson proved difficult to say the least. In addition to four courses, including two sections of introductory sociology similar to the one I taught at Tennessee, I had to travel to the nursing school at the Baptist Hospital across town to teach a course. In all, more than 100 students enrolled in my courses that fall. I had no teaching assistant. My office was separated only by a partial partition from another sociologist who was an immigrant from Korea. I enjoyed his company but he talked loudly on the phone and had numerous visitors, which was distracting. To top it off, the Soviets placed missiles in Cuba and I and other faculty members had to spend time calming fears of students, while at the same time wondering if their fears of nuclear annihilation were justified. Wake Forest provided decent apartments to the faculty at reasonable rents. We occupied one on the first floor across a large parking lot from my office. Our neighbors were junior faculty and staff, some of whom had young children. We became friends with one couple who had a little boy. The father and son would drop in on Sunday mornings. The father was an electron microscopist in the medical school and, while some of 89

his research was interesting to discuss, I really didn’t have time to hear about it. Nevertheless, I didn’t have the courage to send them packing. The father had come to Wake Forest from graduate school at the University of Iowa. When he was introduced to the faculty, the college's President made reference to his being from Ohio. My friend piped up, “That’s spelled I-O-W-A.” When my chairman introduced me, he said that I was a native of Christiansburg and Wytheville Virginia. At the reception afterward, a friend of his asked him, in my presence, “How can this guy be a native of two towns?” Before my chairman could answer, I said, “It was a fast train.” By the end of the school year, I was totally exhausted. After 5 years of marriage, Nancy and I had not had a proper honeymoon and, when we could manage a few days off, we felt obligated to visit family. We decided to take some time and travel to New England and Niagara Falls. By the time we got to Connecticut, I had a very painful toothache. We found a dentist who would see me and the tooth was so far gone that it had to be extracted. With little money available as I grew up, I had seldom seen a dentist. Given my lack of exercise and many sleep-deprived nights, I was fortunate not to have something more serious. In Boston, we toured the historic sites and walked around the central campus of Harvard in Cambridge. When I was in graduate school, we joked that we read the same books as the Harvard graduate students. Nevertheless, I was a bit awed by the place. Niagara Falls was awesome in a different way. By the time we 90

returned home, we were energized. That summer the faculty was informed that IBM had contributed a computer to the college and that a representative of the company would teach a one-week course in Fortran programming. I signed up. The course was excellent. I began writing computer programs to do more analysis of my dissertation data. Soon other faculty members were asking me for help, including some who took the course but had waited a while to begin programming. That taught me the lesson of “Use it or lose it.” Since then, I have made it a point to keep up my programming skills and learn about new technology. Those skills would earn me a second trip to Harvard. That summer I had some time to recreate, so I played softball with students. Nancy’s parents came to visit, accompanied by some friends of theirs from Nancy’s hometown. She brought them to the ball field where I was playing, clad only in a catcher’s mask, shorts and shoes, looking very much like a student. Who knows what they thought? Although I was about 4 years older then most of the seniors, I didn’t look that much older than many. One Saturday afternoon I took a huge stack of books to the library at closing time. The student employee behind the desk groused at me for bringing them in at the end of the day. He couldn’t find the cards for the books until I told them they were in the faculty file. Then he looked as though he wanted to crawl under the counter. On another occasion, Nancy and I chaperoned a hayride. A girl sitting between her boyfriend and me struck up a conversation. She mused that she had not 91

seen a chaperone on the trip. “I’m it,” says I. She should have known. Nancy and I were the only ones not “boodling”. My promotion from Instructor to Assistant Professor came through with an increase in salary. Since all but one of my courses were the same as the year before, preparation in my second year of teaching full time was easier. Apparently it became known that I was not hostile to athletes. Several showed up in my classes, two of whom would become famous, one primarily because of tragedy. Brian Piccolo, who died of cancer while later playing for the Chicago Bears, was in my introductory sociology class along with the football team’s quarterback, John Makovic, and several other players. Brian’s story became the subject of a book and a movie, Brian’s Song, about his relationship with Gayle Sayers, his black rival for Bear’s running back, and his graceful bout with cancer. I take no credit for Brian’s attitudes regarding race or his courage in the face of his illness. He was the great guy portrayed by James Caan in the movie long before he first sat down in my class. Caan apparently studied film of Brian. His mannerisms and speech patterns were so accurate as to be painful to watch for those of us who knew Brain. In the spring after he was first in my class, Brian showed up in my office to say that he had some grade problems in other classes and had to attend summer school. He wanted to take the course in Industrial Sociology that I was offering in summer school. He said that he intended to make an A. Perhaps I am not breaking any rule about the confidentiality of student 92

grades to say that he made the A without any relaxation of my standards. During my second year at Wake Forest, a football coach who had been a star at UT came by my office apparently to get me to ease up on a football player who was having trouble in my class. I told him that his pleas for the student were inappropriate. I was known as a tough grader, but Brian and John Makovic did not blink from the challenge. John was a good student and I later enjoyed seeing him on television as assistant coach of the Dallas Cowboys and head coach of several Division I college football teams. I did have to do some handholding of senior sociology majors who were required to take my course in statistics. Some of them probably majored in sociology at least partly to escape math. The requirement of the new course for graduation gave more than a few some pains. The first year I taught the course, I gave an exam that I thought could be finished in two hours. The last student to finish left the room after about five hours. I took pride in making the concepts I taught as understandable as possible, but I had a lot to learn about teaching and testing. By the third year, the students and I were all having an easier time of it. For my Industrial Sociology class, one of the sociology/anthropology majors wrote a paper, based on his work experience in a warehouse that had interesting implications for human relations and management in workplaces. In collaboration with him, I reworked the paper to add the appropriate theoretical background and analysis. We submitted the paper for publication in a journal and it was accepted. (2) It was 93

later adapted for an encore publication in an anthology on human organizational behavior. (3) Although there was little pressure to publish at Wake Forest, a publication was a feather in ones cap. In those circles, prestige is more important than money. I was acquainted with a professor in the political science department who had been a journalist before graduate school. He said that his wife was appalled that he was not paid for articles published in academic journals. In addition to academic pursuits, I occasionally joined colleagues in recreation. I played in a weekly pickup basketball game among interested faculty members until the Chairman of my department, Clarence Patrick, introduced me to golf. He first invited me to join him, and occasionally his wife, at a little par-3 course near the campus. Soon I bought a cheap set of clubs and we played as often as we could on an 18-hole course at a private club that allowed faculty to play there during the week for $1 per round. I was on that course when someone came around to tell us that President Kennedy had been shot. Quickly returning to our apartment, I along with most of the US population stayed glued to the television for the weekend. Jack Ruby shot Oswald in front of our eyes while we ate lunch on Sunday. To convey my golf clubs to the club when Nancy had need of the Falcon, I bought an old used Nash Rambler similar to the one I had in Idaho years earlier. It had lots of rust on it so I painted it green, a brighter green than I thought from the color on the can. It was known among the students as the Green Hornet. If the rich members of the country club objected to that piece of junk in their parking lot, I never heard about it. It had a leaky 94

radiator that had to be refilled after 10 or so miles. One night I had to take a group of students to some function in Greensboro. There were too many for the Falcon to hold so Nancy drove some in the Falcon and I took the rest in the Green Hornet, stopping several times to fill up with water. Nancy taught in a school that had many students from wealthy homes. She was asked why she didn’t have a fur coat. Also, after spring break, the students asked her where she went for vacation. When she indicated that she stayed at home, the students wanted to know why she didn’t go to the Bahamas or Paris or wherever they had been. After several years of teaching in the lower grades, Nancy decided that she would like to work in school libraries. The nearest school that offered a library science degree was Winston-Salem State, traditionally a school that had only black students. Nancy signed up for courses there. She was one of the few white people on campus. We also attended some social events at which we were the only white people present. Invariably, we were treated very well and never felt uncomfortable being in the minority. Also, for the first time, Wake Forest enrolled several black students, some of whom took my courses. There may have been incidents on campus that made them uncomfortable but, if there were, I was unaware of them. Despite the lenient rules for student activities, compared to most Baptist schools, the Wake Forest students threatened revolt against social restrictions. A student leader, who had heard me lecture on crowds 95

and crowd behavior, suggested to the Dean that I be invited to a meeting on how to handle an upcoming student demonstration. They were concerned that it would become a destructive riot. I told the group that, as emotions escalate in crowds, people become highly influenced by whatever suggestion was made. I told them that a student leader who understood the principle should retain control of the audio system used as amplification for the speakers and, when the speeches were over, repeat to the crowd a mantra that they should disperse and go back to their rooms. When the plan was implemented, the crowd melted away without incident. The following year, another demonstration occurred without such a plan and some of the students engaged in property damage afterward. My religious views I kept mainly to myself, but I did have occasional discussions about religion with a couple of philosophy professors who lived in our apartment building. One was a former minister who remained devout but tolerant of my views. Probably at his instigation, he and I were invited to discuss religion before one of the student clubs. I stated my position – characterizations of God, the nature of the universe and the nature of human beings that were incompatible with reason and scientifically established principles were not tenable. My friend kept appealing to subjective religious experience, mentioning several times, “the God that comes to me.” Perhaps with too much derision, I mentioned an old Barnhart line something like, “A person who wants to go through life holding Jesus’ hand may just need a good date.” After the meeting, several students gathered around my friend to 96

ask questions while I stood in splendid isolation. Apparently I had not contaminated any young minds. No “get Robertson” movement ensued and I escaped the fate of my mentor Barnhart. Louis Dotson called to say that James Coleman from Johns Hopkins University was coming to UT to give the W.I. Thomas Lecture and visit with students. The lecture was named for a UT graduate in biology who went on to become a sociologist of some note. Louis said that I should come and meet Coleman. He had just published a book entitled Mathematical Sociology that was to contribute to increased mathematical rigor in sociological research. Coleman and his work made quite an impression on me. We discussed the possibility of my attending Johns Hopkins for a year on a postdoctoral fellowship. Coleman said that he had no funds for such a fellowship but, if I could raise the money, he would be my sponsor. I applied to the National Institute for Mental Health and was awarded a fellowship. Nancy obtained a job as school librarian in Towson, just north of Baltimore, and we arranged for an apartment nearby. I sold the Green Hornet for $25. In the summer of 1965, we were off to “the big leagues” -Louis Dotson’s characterization of our new adventure.

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Chapter 5. Hopkins to Harvard Baltimore was far larger and more densely populated than Knoxville or Winston-Salem. We experienced urban shock. Nancy vowed that she would never drive in that traffic but, of course, she eventually did. Fortunately she could walk to her school but, being married to a grouchy shopper, she relented in order to drive to stores alone. We were the first occupants of our newly built apartment. It had a luxury we had never before experienced in a residence – air conditioning. Since I had no duties at the University, I could work at home when I pleased. Most weekdays, however, I went in to audit classes or work in the library. With the highest advanced degree already in hand, I had no reason to take classes for credit. Along with the graduate students, I attended courses in advanced mathematics and a seminar with Coleman. He had a large grant to study school achievement and was seldom available for individual tutoring. He and other faculty and graduate students were frequently away collecting data from schools around the country. The study would be published the following year and have a major influence on policy, including mandatory bussing to increase racial integration in public schools. (1) Several of the graduate students in Social Relations, as the department was called, had undergraduate degrees in mathematics or engineering but little sociology. They helped me with math, in which I was not as good as I once thought, and I occasionally gave 98

them background or suggested reading in sociology. A couple of the students were interested in biological factors in behavior. We had informal discussions of studies of animal societies and their relevance for human society as well as my interest in the effect of social factors on physiological response to stressors. Some years later, one of those students, Alan Mazur, and I would coauthor a book on these issues. Challenged by Coleman in a seminar, I set out to develop a system for analyzing data in qualitative categories mathematically, but finally gave up on the idea. Some years later I took off my hat to the developers of logistic regression, which does what I wanted to do. During my hours in the library, I read widely in social psychology and became familiar with a series of studies of affiliation – the degree to which an individual seeks the company of others. Numerous such studies were influenced by the experiments of Stanley Schachter. He measured the affiliation tendencies of students faced with the threat of electric shock in a forbidding environment. Females who were the first born in their families preferred to wait with others. Faced with the same conditions, the later born preferred to wait alone. One group of studies focused on birth order and conformity. Another set of studies attempted to sort out the effect of affiliation on self-evaluation. Since I had my dissertation data at hand, I wondered if I had data relevant to these issues. Fortunately, I had included questions on students’ participation in extracurricular activities that I could use as an indicator of affiliation tendencies. Based on findings in 99

several of the previous studies, I stated two hypotheses to be tested: 1. The tendency toward affiliation would be higher among persons whose parents were more expressive, and 2. Affiliation would be higher among those whose physiological response when stressed was epinephrine-like as measured by change in salivary pH. The results were a bit more complicated than hypothesized, but affiliation was strongly correlated to perceived expressive parenting and physiological reaction among first-born children. If their responses to stress were norepinephrine-like, affiliation was substantially higher among those with the more expressive parents. Among those with an epinephrinelike reaction to stress, affiliation was highest among those with the least expressive parents. The correlations were not found in the later born. Neither perceived expressive parenting nor reaction to stress was related to birth order. Apparently, parents are just as expressive to later born children as to first-born children, but its relation to their coping with stress is muddled by experience with older siblings. Since Louis Dotson was my advisor on the project when I collected the data, and we had discussed these issues a lot, I talked with him about what I was doing and he helped with the interpretation and writing. We submitted a paper for publication, which was accepted, but delayed in publication for several years because of a backlog at the journal. (2) At some point during the postdoctoral year, I attended a meeting of one of the sociological societies in Chicago. I went to such meetings to see my buddies from graduate school and meet people from other 100

universities, as well as hear about recent research that might not be published for years. In the hotel lobby, I ran into one of the former Tennessee students, Donald McCalister, who enrolled at UT the year after I did. He was on the faculty of North Carolina State University. We entered the hotel coffee shop and ran into an acquaintance of his who had taught at the University of North Carolina before landing a job at Harvard Medical School. The Harvard professor was John Kosa who spoke with an unfamiliar accent that I later learned was Hungarian. Somehow in the conversation over coffee, I mentioned some of the antics of Johns Hopkins students and me using the computer, such as programming it to make the tones on the printer play “Anchors Away”. He asked me if I could program computers and I told him of several activities including helping others with their programs. He asked me if I would be interested in a job at Harvard. Trying to contain my excitement, I allowed as how I could be persuaded. I gave him my address and phone number and was surprised to receive a letter from him soon after I returned home. He wanted me to meet with Dr. Joel Alpert, a pediatrician who was the medical director of the Family Health Care Program at Children’s Hospital in Boston, a Harvard Medical School teaching hospital. Dr. Alpert planned to visit relatives in the D.C. area and wanted me drop by for a talk. Nancy accompanied me to the interview and it went well. Started by Dr. Robert Haggerty before he left Harvard to chair the Pediatrics Department at the University of Rochester, a large experiment in medical 101

care delivery issues was now being supervised by Drs. Alpert and Kosa. A set of families who had no family doctor was selected from visitors to the Children’s Hospital Emergency Room. They were divided randomly into three sets of about 300 each. One set was offered comprehensive care for the children in the Family Health clinic while the other sets served as control groups. A second control group was necessary to rule out effects of biannual interviews that were administered to the other two groups. Although I had limited research experience and only two articles accepted for publication, Dr. Alpert kindly said that he was in a similar position just a short time previously. Not to worry. It was apparent from my conversations with Kosa and Alpert that they had a pile of data and that no one had been able to extract the first tabulation from it. My computer skills could bail them out. I was invited to Boston for more interviews and passed muster. Somehow I had the foresight to request an agreement that, if I did the major work on a publication from the project, I would be the senior author, and that I would be coauthor on any paper for which I crunched the data. It was a cheeky proposal for someone as junior in the academic pecking order as I, but it served me well. They offered appointments as Research Associate both in the medical school and hospital, which I accepted. I was aware that I was about to swim outside the mainstream of sociology, and perhaps among the sharks, but I was only 30 years old and this was Harvard. After informing my colleagues at Wake Forest that I 102

would not be returning, Nancy and I made plans to move to Boston. We found a roomy apartment on Beacon Street in Brookline, within walking distance of the medical school – no air-conditioning but convenient. Nancy got a job as children’s librarian in the Brookline public library in Coolidge Corner, a couple of blocks from the apartment. Knowing little of Boston, we learned later that we had a rather posh address. The apartment was several miles from Beacon Hill, but at least we were on a street that led there. The rent was certainly steep enough, but with two incomes and no kids, we could handle it. Street parking wasn’t allowed so I had to scout around the neighborhood for a garage. A widow, who lived on a parallel street a block away, had no car and a garage for rent. The subway ran down the middle of Beacon Street so we hardly needed the car for personal use except to tote groceries. At the medical school, I learned that the main computer center was in Cambridge, some miles away across the Charles River near the area we had visited a few years previously. So I had to take the car to the clinic on Francis Street on days that I was to do computer work, which were frequent, and proceed to Cambridge. Within a few days, I figured out the system for using the computer and took a short tutorial on a statistical analysis package that was developed there. Using that package, I generated a printout about an inch thick that included tabulations of data that Joel and John needed many months before I arrived. After that I could do little wrong. Applications for grants could be justified by data. Papers could be written. We were soon introduced to Katy Kosa, John’s wife, 103

who was Irish Catholic, but would have made a fine Jewish mother. After we became well acquainted, Katy told us that she was concerned when she learned that John had hired a southerner. She was a big advocate of civil rights and feared that we would not be sympathetic. It didn’t take long for those concerns to be allayed. The Kosa’s kindly invited us to their home for many meals and holidays. Katy always tried to send us home with leftovers. We also attended parties that the Kosas had for their many friends. Their three boys, less than 10 years of age, were energetic and fun to be around. One evening around Holloween, I told the boys the story of the man whose outhouse was turned over by his sons as a prank. When questioned, the sons admitted to the deed whereupon the father spanked them with vigor. “But dad,” one said, “When George Washington admitted chopping down the cherry tree, his dad didn’t spank him.” The father replied, “Yeah, but his father wasn’t in the cherry tree at the time.” The Kosa boys didn’t laugh at the joke. Finally, one of them asked, “What’s an outhouse?” I knew I had come a long way from my origins. (For those that grew up in the city, or are too young to have seen one, an outhouse is a commode over a hole in the ground surrounded by a wooden structure, often of dubious construction, with no heat or air conditioning. Now, go back and read the joke.) At dinners and parties, the Kosas usually included Dr. Alpert’s assistant director of the clinic staff and the clinic’s education program, a young pediatrician originally from West Virginia named Margaret Heagarty. 104

Like Katy Kosa, Maggie, as she was called, was Irish Catholic so they had much in common. She had completed a postdoctoral fellowship in the clinic and was invited to stay on in a faculty position. She befriended Nancy and I, and the three of us explored some of the better restaurants in Boston. On one such sojourn, she commented that I drove like a Boston taxi driver. Maggie kept me informed about happenings in the clinic and I let her in on what was cooking on the research side. She often referred to her and me as “the junior coalition” and sometimes as “the Appalachian Mafia”. Although the Alperts and Kosas were quite friendly, the Alperts seldom attended parties or dinners at the Kosas. They were involved in many charitable and other endeavors. We were all invited to the Alperts for dinner one evening and I got lost on the way. They lived in a far western suburb. About 70 townships, many of which have streets of the same name, surround Boston. The boundaries among the towns were not well marked. We proceeded up what we thought was the correct street several times before finding the right one. The following Christmas, Maggie Heagarty gave us a compass that mounted on the car windshield. One of the issues of paramount importance to the research project was to prevent information obtained from the research from feeding back into the clinic. If the findings of the research were to be valid for other clinics without research units attached, the clinical staff could not use information on patients collected for research. There was a wonderful Jewish lady named Mrs. Baker who did a lot of the coding of data obtained 105

by the interviewers on the research side. Although she had not met the families, she knew almost all of the children’s names as well as many of the physical and social problems in the families, which were revealed in medical diaries kept by the mothers. Mrs. Baker wanted to be of help and we had to watch her constantly to be sure that she wasn’t passing information to the clinical staff. After several incidents, I had to threaten to fire her if it happened again. Nevertheless, we remained friends. She attended a Temple on Beacon Street a few doors from our apartment house. Once we went to the Temple with the Bakers to observe the ceremony. I appreciated the opportunity and found the atmosphere interesting. Of course, it did not change my religious skepticism. Earlier, when the husband of one of the clinic staff died, John Kosa and I attended the memorial service at a synagogue. When we entered, I removed my hat, but John grabbed it and put it back on my head. Of course, I did not know that Jewish customs included a covered head in the synagogue. At the Baker’s temple, those who didn’t have a yarmulke were handed one at the entrance. Alan Mazur, who I met at Johns Hopkins, was Jewish. He moved to Cambridge to teach at MIT. He would occasionally drop by my office and Mrs. Baker had the notion to become a matchmaker but Alan claimed to be a confirmed bachelor. He would sometimes join us for dinner at our apartment or go out with Nancy and me. Once in Durgin Park, the famous restaurant with the surly waitresses, he ordered ham and I ordered New England boiled dinner. “So much for ethnic origins”, 106

says I. There was a wonderful Jewish bakery in Coolidge Corner where Alan taught us the names and origins of some of the wares. Despite Alan’s aversion to marriage, he did have a steady girlfriend for a time and we went on a few excursions with them. We went to see Plymouth Rock where the Pilgrims from the Mayflower allegedly landed. A hole in the ground contained the small rock, surrounded by a substantial Romanesque structure, columns and all. Alan started laughing at the incongruity of the scene. We backed away and later kidded him, saying that we didn’t want to be associated with someone so irreverent. On another occasion, Alan’s girlfriend invited him, Nancy and I to Seder at her grandmother’s. I participated in reading the traditional texts. Throughout my reading, Alan corrected my pronunciation of the “ch” sound. It was probably even worse than my renderings of undergraduate Greek. My academic work progressed nicely. John Kosa was co-editing a book, Health and Poverty, for Harvard University Press. He invited me to coauthor a chapter. I wrote a section on the literature dealing with stress and disease. (3) We were invited to give a paper at a conference on family and fertility convened at Notre Dame. I analyzed the data from our project, which showed that, corrected for age, family size was related to use of medical facilities by both parents and children. For those interested in such matters, we concluded: “ ... in a low-income population, increase in medical contacts for mothers as family size increased was found only for Protestant mothers who indicated that 107

they were experiencing stress. A similar relationship held for Protestant fathers without stress controlled. Thus, it appears that the management of a large family was not perceived as stressful when the value system supported the norm that families should be large. This was the case among Catholics. For Protestants there were no such values, and the physical and mental energy required to feed, clothe, house, and care for a large family may have produced ambivalence in the parental role. However, the higher incidence of medical contacts among Catholic mothers who did not report strain may be a result of under perception of strain by Catholic mothers with large families. The value system may not have allowed the mothers of large families to express strain, but its existence may have been manifested in medical contacts.” (4) In other words, raising a large family was stressful, whether or not the parents acknowledged the stress. At the conference, I met William Masters and Virginia Johnson who were studying physical responses of people engaged in sex. The reports of their research at the time created a media sensation similar to that in response to the Kinsey reports a decade earlier. Their presentation was boring and they appeared to be a dull middle-aged couple. At the airport on my way back to Boston, I overheard them talking about how boring they found the sociologists, who were in the vast majority at the conference. The feeling was mutual. Although Nancy and I liked our apartment in Brookline, we could not keep our windows open without the place getting dirty. Black coal dust blew in during the times in winter that we had to open windows. We 108

had no thermostat in the apartment. The steam radiators gave heat when the central heating for the entire building was on. The building superintendent couldn’t seem to understand that the heat should be turned up based on the temperature rather than whether it was cloudy outside. In winter in New England, it is often colder on sunny days than cloudy days because the sun shines when cold fronts move in and heat doesn’t radiate into the atmosphere as much when it is cloudy. Even if I closed all the radiators, the apartment was often too hot. Nancy and I decided that it was time to buy a house. Of the houses we saw in our search, my favorite was a rather fancy brick structure just over the Brookline line in Newton. Nancy thought the house was pretentious and probably too close to the source of coal dust, so we ended up buying a two-storied Cape Cod style in Newton Lower Falls, near the Route 128 beltway around Boston. The house needed some work but the $30,000 price seemed reasonable. We bought it and repainted some rooms and the exterior. Nancy wanted an accent wall in the bedroom so we painted it orange. The Kosas lived about a mile away and Katy dropped by to see how we were doing. When she got to the bedroom, she said several times, “But Nancy, it’s orange.” If you know your history, to the Irish wearin’ the green, orange is not a politically correct color. Katy was only kidding. She grew up in Minnesota so she was not involved in Boston’s ethnic wars. In 2003, on my way to a sailing trip in Maine, I dropped in to see Katy who still lives in the same house that she did 40 years ago. She took me by our old Cape Cod and said 109

that it is now worth about $500,000. The U.S. economy is very good at blowing bubbles. In 1967, I had a paper accepted for delivery at the American Sociological Association meeting in San Francisco. Since Nancy had not seen the sights of the western U.S. that I loved, we decided to take a month and drive to some of those places on the way out and back. While we were painting the house, we listened to a song on the radio that went, “If you are going to San Francisco, be sure to wear a flower in your hair.” It was to be the “summer of love” there and we wanted to see what was going on. In addition, my high school buddy Ed Cannoy had moved to California, gotten married, and had a son. He and his wife dropped by our place in Knoxville during an eastern trip and we wanted to see them again. Once past Chicago, we took a route similar to my first trip – Mount Rushmore, Cody Park and Yellowstone, before hightailing it to the Cannoys. They decided to join us in San Francisco. After I read my paper at the meeting, we mostly did sightseeing. Cannoy believes that his second son was conceived during that vacation. We also linked up with Louis Dotson and others for a meal in a fancy Mexican restaurant. I was disturbed by what I saw in Haight Ashbury, the area of San Francisco that was supposed to be the center of the “summer of love”. We mainly saw a lot of kids, many out of their minds on LSD or other hallucinogens, laying around the parks or panhandling on the streets. This was partly the legacy of the Viet Nam War. Some who faced the draft were disillusioned and many returning veterans were introduced to drugs 110

during their Viet Nam tours. Although I was opposed to the war from the outset, I had not been involved in antiwar activity. I vowed to change that when I returned home. Even when I was at Wake Forest, the war was viewed as foolish by faculty who had visited that part of the world. Although Ho Chi Minh was nominally communist, he was mainly a nationalist who wanted the French out of his country. When we sent in “advisors” to the South Vietnamese government, and later, large contingents of troops, he wanted them out as well. The so-called domino theory – other nations will fall to communism if Ho is not defeated – proved false. When U.S. troops were finally withdrawn in the 1970s, Ho stayed home. As Nancy and I made our way home from San Francisco, we visited sites that I had not seen – Yosemite, Death Valley, the Grand Canyon and the Petrified Forest. The wild beauty was overwhelming. We wanted to stay longer but we were scheduled to stop at Nancy’s sister’s place in Tennessee. There I took our niece and nephew fishing on Reel Foot Lake. We caught no fish but the kids were fun. After the better part of a month admiring the beauty of nature, we were greeted with a down side when we returned home. Alan Mazur, who gave up his apartment to spend the summer in Europe, stayed in our house a week or so upon his return. He told us that the house was in great disarray when he arrived. The innards of our couch were spread over the house. With the help of a neighbor who had a trap, he captured the culprit – a squirrel. Our house was surrounded with tall trees. Apparently the little devil had jumped to the roof, come 111

down the chimney and couldn’t find a way out. In addition to the stuffing in the couch, he chewed the wood around the panes on several windows. True to my vow to work against the war, I scouted around and connected with an antiwar group. In our meetings, we discussed strategy and tactics. Several people wanted to push labor unions to take the lead but those of us who had been members of unions, or who had studied them, were not optimistic that unions would take on the job. Finally, we decided to support student antiwar groups. The young had the most to lose. In the following spring, when the presidential primary season heated up, we campaigned for Eugene McCarthy, who ran against President Johnson in some of the primaries. I canvassed my precinct and identified voters who would vote for McCarthy. On primary election day, we recorded who had voted. Late in the afternoon, we contacted McCarthy supporters who had not voted yet to get out and vote. When we heard the news that McCarthy carried my precinct, the local pols were surprised based on the voting history of the precinct. I was invited to join the Newton Democratic Committee and did so. Along with my antiwar colleagues, I was prematurely elated when Lyndon Johnson resigned the presidency. In the summer of 1968, the American Sociological Association (ASA) held its annual meeting in Boston. Gene Summers brought his family to stay in our house. The Democratic Convention was underway in Chicago at the time. On television, we watched antiwar protesters being beaten and gassed by the Chicago 112

police and the crude talk and gestures by Mayor Daly in the convention hall. It was a terrible prelude of worse days to come. Chicago suffered from those actions. The ASA and many other organizations refused to hold their conventions in that city for many years thereafter. At a Democrat caucus in our congressional district sometime later, a local academic priest named Drinnen was the town committee’s choice to run for Congress from our district. A young Viet Nam War veteran, John Kerry, who had returned from the war to oppose it, was also a candidate. Intending to vote for Drinnen, I politely shook Kerry’s hand as he circulated the crowd After hearing Kerry speak, however, I changed my mind and voted for Kerry. The Mayor of Newton backed me into a corner and lectured me on loyalty. I told him to back off; that I would support whomever I thought would do the best job. Of course, Drinnen won the primary and the general election. One evening at the Kosas, I was talking about these events and John urged me to campaign against Drinnen in the general election. For some reason that was never clear to me, John did not like Jesuits, the order to which Drinnen belonged. I wondered if John had Jesuits as teachers in Hungary that he didn’t like, or had been involved in some other conflict with them. John was a journalist in Hungary before the war. He escaped after the Soviets occupied the country and made his way to the U.S. via Canada. He didn’t seem to want to talk about those days and I didn’t push him on it. Although the Hungarians were German allies during World War II, I was sure that John wasn’t a Nazi sympathizer. He had Jewish friends in Boston that he knew in Hungary. I did 113

tell John that a guy with a southern accent campaigning against a priest in Newton wasn’t likely to sway anyone. Also, I intended to vote for Drinnen because of his opposition to the war. I supported Kerry at the caucus because I thought that someone who had been in war had a more credible understanding of it. Some 36 years later, I worked for Kerry for President for the same reason. In my humble opinion, the country would have been better off had he won both elections. But I digress. At work, I was not just responsible for running data through the computer; I mainly supervised the interviewers and coders, several of whom were old enough to be my mother. Occasionally I had to referee a catfight among them. For a time I was housed in an office across the street from the clinic along with 3 or 4 coders, a research assistant and a secretary. During the times that the interviewers were not in the field, some of them served as coders as well. There were several times that petty jealousies among them made my job difficult, but I learned when to apply diplomacy and when to be firm. Since John was more of an authority figure, I was glad when he moved his office across the street to join us. The clinic had several postdoctoral fellows in family medicine who were doing a research project as part of their residencies. I held an informal seminar in statistical analysis for them and helped several with computer programming and data analysis. Some produced published papers from their projects with me as coauthor, nicely lengthening my curriculum vitae. One of the doctors in our post-doctoral program was a 114

physician in the Navy. He supported the Viet Nam war, so he and I had some lively debates. His wife was a physician at Boston Hospital. There she was exposed to a child with meningitis. She died from the disease. Of course, at that point we all rallied around her husband. We had a seminar series for the postdoctoral fellows each Saturday morning to which people from throughout the University were invited. Al Yankauer, who later became editor of the American Journal of Public Health, was a regular attendee, as were several faculty members from other departments. I was pleased to meet Daniel Patrick Moynihan, then a professor and later a presidential advisor, diplomat and senator from New York, who gave a talk at one of those seminars. One of the interests that developed during these sessions was variation in the public’s access to physicians among communities. With the help of our research assistant, I assembled data on the location of physicians in the 70 communities of the Boston metropolitan area at three points in a 21-year period. Using methods I had learned from James Coleman’s work, I showed the changes in location of various specialists in relation to characteristics of the communities. Since no one in our unit was familiar with the math that I employed, I asked a demographer who had a recent Ph.D. from Brown University, and who regularly attended the Saturday Seminar, to read and critique the paper I wrote on the results. (5) He later called me on the phone to say that he was reading the paper and asked what dx/dt meant. I said, “You haven’t had calculus.” He replied, “You don’t have to be so blunt 115

about it.” It means change in some factor x as a function of time. I couldn’t fathom a university granting a Ph.D. in demography without requiring calculus. In those morning seminars and in other forums, I gained the reputation of being a tough debater and critic of ideas and research methods. I think one of the reasons our seminar was attractive to outsiders was the opportunity to get tough critiques of their work out of earshot of colleagues in their departments. Drs. Alpert, Heagarty, Kosa and I were invited to give “Grand Rounds” in the hospital, a grandiose term for a presentation to the medical staff. Of course, we talked about our project and some of the results. During the presentation, an older man asked a question about statistical significance and I gave him something of a smart-ass answer. Afterwards, Joel Alpert told me in no uncertain terms that junior faculty such as I did not address senior faculty is such a manner. The questioner was an internationally recognized pediatric surgeon. Nevertheless, my superiors seemed pleased with my work and I was promoted to Assistant Professor of Sociology in the Pediatrics Department of the medical school. As such, I taught a course offered to medical students called “The family in health and illness.” Joel suggested that he and others should be invited to the course to present on various topics. I resisted, saying that in this course, at least, the students were going to have continuity. Too many courses were made up of fragmented presentations with poor coordination and synthesis of the material. As an advocate of continuous care of children, compared to the fragmented care for those without a regular source of care, Joel understood 116

my point. In what became my final year at Harvard, I was intensely involved in matching up all of the data on the families in the project, performing statistical analyses and, with Maggie’s help, writing a book on the results. Joel and John were preoccupied with various tasks, not the least of which was planning what we would do after the current project was finished and the grants ran out. The data preparation required that each medical visit be coded regarding aspects of the visit. Maggie and I sat side by side for several weeks reviewing and coding thousands of clinic visits. I learned the treatments for common childhood illnesses and she explained medical issues in which I had no background. She was also a good writer and essential in that work as well. We circulated the chapters among ourselves as they were completed, including Bob Haggerty at Rochester, who had conceived and started the project. Because I had written a plurality, if not a majority, of the manuscript, as well as done all the computer work and statistical analysis, I let it be known, that per our agreement when I was hired, I expected to be listed first among the five authors. To my surprise, they agreed with little resistance. Joel said that if he could not be first, he wanted to be last – the position of the senior professor on many team-written works. No one objected to that either, so the matter was settled. Those who are interested in the detailed analyses can read the book which, although long out of print, is available is many university and perhaps some public libraries (6). In sum, continuity of care had an impact on use of medical services but no detectable effect on 117

incidence of illness. Children seen in our clinic had more up-to-date immunizations but the diseases they prevented were too rare for differences with the control groups to be detectable statistically. Hospitalizations of children seen in the clinic were higher in the first six months but lower in the ensuing 2.5 years. The children in the experimental group had fewer illness visits, fewer broken appointments and more health maintenance visits and than their counterparts in the control group. We interpreted the results to mean that, after correcting neglected problems, the physicians who knew the parents were more knowledgeable about those who could be trusted to treat their children at home. There were also fewer lab tests and radiological studies performed for children in the experimental group. The manuscript contained analyses of the impact on the results of various factors such as family size, race and welfare. John had previously worked with an editor named Ann Orlov at Harvard University Press who he attempted to interest in the manuscript. When we had a manuscript on which the research team agreed, I delivered it to Ms. Orlov. We waited a couple of months for a response, assuming that the manuscript was in the hands of independent peer reviewers. Finally, I called the editor and was told that the manuscript was sitting on a shelf in her office. She had not sent it for review nor had she read it. I was furious. Without consulting with my coauthors, I took back the manuscript and told her to forget it. Some of my coauthors were not happy with my action, but I said that we could not trust that woman and, in 118

the absence of a way to circumvent her, there was no way that we could deal with Harvard University Press. Subsequently, I sent the manuscript to Johns Hopkins University Press. It was favorably reviewed and my contact editor wanted to publish it, but his board turned it down. I often wondered if its Harvard origin was the reason. Eventually, after moving to Washington, I found a publisher, but not without an unhappy episode with John Kosa. Without consulting his coauthors, he undertook a major revision of the manuscript, which deemphasized the central experimental and quantitative strength of the study and introduced a lot of issues that we had no data to address. I circulated a tough letter to the coauthors rejecting the revision. Although they disagreed with my tone, they relented and we stuck with the original. Before I left the project, John had stomach symptoms for some time, which he claimed was due to an ulcer. Despite the entreaties of Katy, Maggie, Joel and his internist, for years he refused to see a specialist and undergo tests for a definitive diagnosis for the problem. After his internist told John to be tested or seek another internist, he was tested and diagnosed with stomach cancer. In my first joint publication with John, he had written about the concept of denial. By his behavior regarding his own disease, he proved that intelligent people knowledgeable of the issue are not immune. Beneath that European charm lurked a complex personality that I never understood. Before John’s diagnosis, I had decided to shop around for a position elsewhere. Although I had two years remaining on my appointment, I knew that a sociologist 119

was not going to be tenured at Harvard Medical School. I watched others in a much better position than I cling to the notion that they would be tenured, only to be disappointed. Also, the projects that my colleagues proposed for the future of the program were of little interest to me. I was sick of talk of medical care delivery, the future of medicine, what kind of doctors we should train, and the like. I went for interviews at Boston University and the University of Missouri but each had problems that made them unattractive. Late in the spring of 1970, I received a call from Bill Haddon who identified himself as an MIT graduate with an M.D. from Harvard Medical School. He was taking over a nonprofit “research and education” organization in Washington, DC, after having served as the first director of the new highway safety agency in the federal government. He was coming to Boston and asked if my wife and I would join him for dinner to discuss the possibility of my joining the research staff of the organization. He said that he was looking for an iconoclastic behavioral scientist and he had heard that I fit the bill. I agreed with the characterization and we arranged the meeting. We went to a Polynesian restaurant where Haddon proceeded to tell Nancy and I what we should eat. He barely touched his food as he engaged in a monolog about the organization -- The Insurance Institute for Highway Safety. He was in the process of forcing out the old guard of retired cops and recycled government bureaucrats who he thought clueless as to how to reduce death and injury on the road. He intended to hire a group of scientists, engineers and communications 120

experts who would work on the cutting edge of highway safety. He told me of his 1964 book with Ed Suchman and David Klein and suggested that I read it. After the meal, Haddon invited me to Washington to look over the place and meet some of the new people he had hired already. I accepted his invitation. On the way home from the dinner, Nancy said she thought I would have trouble working with Haddon. Her ability to judge personalities at first meeting was much better than mine, so I approached the Washington meeting with caution. I found Haddon’s book in the clinic library and poured over it. There was no question that Haddon was highly critical of the research published prior to the book, particularly behavioral research. (7). Being one who was skeptical of a lot of what passed for behavioral science, I admired him for that. The Institute’s offices were located in the Watergate office building on Virginia Avenue that would become famous for the burglary of Democratic Party Headquarters on another floor. The interviews went well. Most of my questions had to do with academic freedom and financial support. Some auto insurance trade associations as well as some individual companies that did not belong to such associations supported the Institute. In contrast to many industries where a few dominate, there are hundreds of insurance companies. The two largest, State Farm and Allstate, have less than half the business. Haddon made it clear that he was in complete control of the decisions regarding research projects. While all Institute supported projects would be oriented to reduction of 121

injury and property damage in vehicle crashes, he would not rule out basic research that might contribute to that end. Indeed he did not intend to tell the Board of Directors what projects were underway until we had results to report. The Institute’s annual budget was more than adequate at the time and he anticipated increases if needed. At home, I discussed the move with Nancy and we decided to go to Washington. To say the least, my colleagues and others in Boston could not understand how anyone would give up at least two more years at Harvard to work for a group supported by the insurance industry. Of course, they were gracious about it. At a going away party at the Kosas, attended by the professional staff and others with whom I had worked, I was given a Harvard Chair with a brass plaque on the back commemorating my four years at Harvard. It sits in my home office to this day.

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Chapter 6. Potomac Fever Before we moved, Haddon invited me to a one-week conference sponsored by the Institute to highlight the new scientific approach for a variety of audiences. Representatives of the insurance industry, the auto companies and the government, as well as scientists and engineers in universities and other private institutes, were present. Ben Kelley, the Institute’s Vice President for Communication, showed a film he had just produced, entitled ”In the Crash”. It reviewed issues of crash worthiness of cars, including passenger compartment integrity, seat belts, air bags, and bumpers, the latter in relation to excess property damage in crashes. The film included dramatic footage of crash tests and emphasized the large gap between what was feasible and what actually occurred in currently selling cars. It was an obvious salvo across the bow of the auto industry. The Institute’s 5 mile per hour crash tests, showing the cost of repairs because of flimsy bumpers, became a stable of TV news programs for 35 years thereafter. Even today many bumpers have been little improved. Other presentations emphasized the importance of scientific study of all approaches to the problem –- programs to reduce driver aggressiveness, driver error, and alcohol use, as well as vehicle and road modifications. I was impressed and felt that I was making the right move. This was going to be fun. We easily sold our house in Newton to a couple that lived two blocks away. Since my office was to be on the 123

west side of Washington, we looked for a house to buy in Bethesda. When I told the agent that we sold our house in Massachusetts for $35,000, he said we would have to go to way out to Rockville for that price. We decided to pay more for convenience of commuting. The agent found a split-level a couple of blocks from Burning Tree Elementary School, which we got for $47,500. From there I could be at work in 30 minutes. When I arrived at the Institute, Haddon suggested that I take a month or so to read the literature in the field to get up to speed. Some weeks later, he dropped into my office to see how things were going. I told him that most of the behavioral studies were awful. Their methodology was so poor that one could not have confidence in the results. He grinned and said, “Okay, you are ready.” Among the studies I read were surveys of seat belt use or studies of attempts to increase use. Several states required installation of lap belts in outboard front seats in the early 1960s. As a result, the vehicle manufacturers placed them in all new cars beginning with the 1964 models. While head of the federal motor vehicle safety agency in the Johnson Administration, Haddon issued a standard that required shoulder belts in addition to lap belts in 1968 and subsequent models. The behavioral issue was the extent to which vehicle occupants used the belts or, if not, why not. The Institute had arranged to produce and test some television ads promoting belt use using a television cable system that allowed the ads to be shown only to part of the audience, preserving the rest as controls. Before producing the ads, I suggested, we needed 124

better data on factors related to belt use. One of the better studies that I read was done at the University of North Carolina. The researchers observed North Carolina drivers on the road, recording whether or not they were belted. They identified the cars owners at the Department of Motor Vehicles by the license tag numbers on their cars and mailed them a questionnaire regarding belt use. A lot more drivers claimed to use belts “always” on the returned questionnaires than were actually seen using them. It appeared that the studies I had read, some of which correlated claimed belt use to other self-reported attitudes and behavior, were potentially invalid regarding factors related to belt use. I proposed that we conduct telephone interviews with actually observed users and nonusers and compare them on potentially changeable factors related to belt use. In those days, one got a better response rate in telephone surveys than in those obtained by mail. We selected three communities for study – a large metropolitan area, a city of about 100,000 people and a city of about 10,000 people. Two guys who arrived at the Institute a few months before me, Brian O’Neill and Charles Wixom, agreed to help me collect data. We hit the streets of the chosen cities and identified street corners where one could see the right hip area of drivers making a right turn, to see whether or not the belts were latched. Of course, we could see other things as well. One afternoon when we stopped work, Brian described a muscle car that pulled up to the intersection where he was observing belt use. On the side of the car was inscribed, “Jerry and Jeannie”. 125

Brian said, “When I saw what Jeannie was doing to Jerry, I got the hell out of there.” Some years later, I had a crew of people riding high in a van observing belt use in vehicles around them. The observations, recorded on a tape recorder, included approximate age, gender, and belt use as well as license tag number. One observer recorded something like, “20 year old female, no belt, GGG349, 22 year old male, (pause), oh my god.” We joked that we should write a book called Sex and the Single Vehicle Accident, paraphrasing a popular title at the time, Sex and the Single Woman. Similar to the North Carolina study, we found that the belt use observed in cars was substantially less than people claimed to use them in questionnaire surveys. Use varied by city size and type of road but an average of only 10-15 percent of drivers used belts in cars equipped with them. From the data in our telephone survey of actually observed users and nonusers, we learned that the primary factors related to use were formal education, rating of belts on comfortconvenience scales and whether or not the respondent had a friend or relative who was injured, but not killed, in a crash. Apparently, if the friend or relative lived to tell about it, the story influenced some respondents to use belts. (1) A description of the research was written for the Institute’s newsletter, Status Report, which was distributed free to the press, highway safety advocates, researchers, industry leaders and anyone else who requested a copy. A reporter from the now defunct Washington Star wrote a piece about it that appeared 126

on the front page. He emphasized the fact that people were overly reporting belt use and that the use was quite low. Haddon was very pleased with the news coverage. The Institute was not allowed to lobby legislators or regulatory agencies. Our main influence on public policy occurred through press coverage such as this. With the report on the factors that influenced belt use in hand, we contacted an advertising agency in Philadelphia that produced very creative advertising. Working with its writers, we approved scripts for 6 ads. We were cautious of the comfort-convenience issue. Giving people an excuse not to wear belts was off limits. The ad people did a clever script for children’s shows that featured the Wicked Car Witch and The Good Car Fairy. The Wicked Car Witch tangled belts and stuffed them down between seats. The children watching were urged to help the Good Car Fairy by persuading their parents to untangle or find the belts and wear them. Most of the ads involved surrogates for the friend or family member injured, e.g., a young girl and, separately, a wife preparing to go out with her husband, each with a scarred face that they didn’t want seen in public, expressed regret that they had not used seat belts. A paralyzed son was shown being loaded in a car by his dad and began talking about the football game they were to attend while the father’s conscience voiced over with guilt for not teaching the son to use seat belts. I attended the filming of an ad in which a police officer admonished a driver to buckle up his family after a near crash. By afternoon, I was glad I had not aspired 127

to acting or some other aspect of film production. The director demanded retake after retake. We did not finish until late in the evening. It took about ten hours to produce footage for a 30 second ad. With that kind of attention to detail by the film crew, the ads were very well done. Now it was time to see if the ads made a difference in belt use. We tested the effectiveness of the ads on a cable television system in a city of about 100,000 people that was split so that half the customers were on one cable and half on the other. The split cables ran along streets perpendicular to each other. The advertising industry used the system to test the effectiveness of ads by doing household surveys of product use and measuring increases or decreases in use of products when new ads were introduced on one of the cables. While the distribution of households between the cables was not strictly random, there was not likely to be bias given the crosshatched distribution that cut across all sorts of neighborhoods. The ad guys wanted to do a complicated experiment in which we switched the ads back and fourth between the cables periodically. I insisted that the experiment be simple and clean. We decided to run the ads on one of the cables for 9 months. And they were placed on shows with relevant themes, in contrast to many public service ads shown at daybreak or just before sign off or during some unpopular show. The father-son ad was shown during NFL games on Sunday afternoon. The scarred women were shown on soap operas. The children’s ad popped up frequently on popular kids shows. An ad featuring a nurse and a doctor talking 128

about treating people not using seat belts was shown on prime time medical drama shows popular at the time. When one of our ads was on the designated cable, an ad for a product being tested was shown on the other cable. For 11 months, including one month before and one month after the ads were shown, belt use of drivers was observed at selected sites around the city. To identify in which cars belonged to households on each cable, we obtained addresses from the Department of Motor Vehicles that matched the license tags and then matched the addresses to the cable company’s billing tapes. When the statistical data were compiled, we could find no evidence whatsoever that the ads had any influence on belt use. Actually, belt use declined slightly, but it happened in cars from households on both cables. I was glad that we had stuck to the simple experiment because some people might have inferred that we decreased belt use. Since the period of the experiment ran from summer to winter, we speculated that when people donned heavier winter clothing, they had difficulty adjusting the crappy belts being installed at the time, and some gave up. (2) An odd response occurred when a summary of the results was published in Status Report. We had several requests from safety groups for copies of the ads to run on television. We politely declined, noting that we were not in the business of distributing materials that didn’t have any effect. Those incidents illustrated the mentality of many people in such groups. They measure success by amount of activity in which they engage, not 129

whether they produce effective results. We expanded our seat belt observation studies to several metropolitan areas around the country in which we periodically documented low belt use. A lot of my time was spent traveling, training observers, and arranging with departments of motor vehicles among the states to obtain data on the vehicles observed. The latter was necessary to document the type of belts on the vehicles. Soon after I joined the Institute, the federal auto safety agency was moved from the Commerce Department to the new Transportation Department. John Volpe, a former construction contractor and Governor of Massachusetts was named Secretary of Transportation and Douglas Toms, who had administered the department of Motor Vehicles in the state of Washington, was appointed Administrator of the newly named National Highway Traffic Safety Administration (NHTSA). When Volpe was nominated, John Kenneth Galbraith, the noted Harvard economist, said something to the effect that John would spread concrete from coast to coast. Much to the surprise of many, Volpe took an interest in air bags and, with Toms, proposed a federal motor vehicle standard requiring air bags in all cars by 1973. Although air bags are not substitutes for seat belts, many people not schooled in physics or the variety of auto crash modes considered them so. Even General Motors, whose engineers should have known better, produced a fleet of about 750 cars with air bags but no seat belts. Nevertheless, air bags would provide some protection for non-belt wearers and the low belt use we 130

documented bolstered the argument for their installation. The auto industry lobbied mightily against the standard. In an article in the September 6, 1971 National Observer, “Air Bags for Lazy Drivers”, which implies substitutability, Bill Haddon was accurately quoted as urging field testing of air bags. “We simply have not had experience in actual use with people. It’s as if we had developed polio vaccine largely using animals and immediately said we would immunize people by the tens of thousands.” He called for a test involving far more cars than the 1000 each that GM and Ford promised to produce. Since one of our larger sponsors, Allstate, was a major advocate of an air bag standard, Haddon’s stand took some courage. It would not be the last time that we were at odds with people in the industry. To demonstrate the problem of the differences in crash protection in large and small cars, the Institute conducted a series of crash tests in which small cars were rammed head on into large cars from the same manufacturers. Test dummies in the small cars took a far worse beating than those in the large cars that, by definition, crashed at the same closing speed. Many of our sponsors were giving discounted insurance rates for small cars and some were unhappy with the results. Nevertheless, Haddon was as good as his word and did not back off on any issue that he thought we should tackle. Haddon’s intimidating personal style enabled him to get away with his resistance to insurance industry influence. I attended many board meetings during my years at the Institute and watched Haddon fend off opposition to something we had done or requests for 131

advance notice of what we were planning. Although intellectually brilliant, Haddon was difficult to deal with on a personal level, as predicted by Nancy. He loved to be confrontational and intimidate people. That trait served him well in dealing with our Board of Directors. Ben Kelley, Brian O’Neill and I refused to be intimidated and often there were conflicts that were minor but distracting. Haddon would use a red pencil like a teacher and mark up our writing unmercifully. While many of his criticisms were helpful, he was fond of highly entangled prose that I often thought confusing. When we would get in a verbal tussle and I was gaining advantage, he would bring up some side issue like my hillbilly background, implying that my writing skills had to be inferior to his. I would look him in the eye coldly and say, “Bill, that has nothing to do with the issue here. Please argue the issue on the merits.” When confronted in that manner, he would back off. Kelley was a better writer than I, and proud of it. He and Haddon had some great arguments. After a couple of years, we had more ideas for projects than time to implement them so we recruited another behavioral scientist, Allan Williams. I read Allan’s qualifications and set up a meeting with him during a trip to Boston to decide whether to recommend him to Haddon. His credentials were impressive and he seemed like a compulsive researcher, so I arranged for him to fly to Washington for interviews. Before introducing him to Haddon, I warned him that Haddon was very confrontational and difficult to deal with. During the interview, however, Haddon was Mr. Nice 132

Guy. I expected Allan to refuse the job because he would not want to work with a guy like me who would back stab his boss. Instead, he took the job and learned that I wasn’t lying. My judgment of Allan was correct. He was a prolific researcher and writer for more than 30 years at the Institute. For a time after I joined the Institute, a physicist headed the research department. He had worked in various government departments including the Office of Naval Research and, most recently, the government’s vehicle safety agency when Haddon was the administrator. He was a master of research contract negotiations and keeping up with bureaucratic details. He read all the outgoing correspondence from his department and would sit down with one of us when he didn’t like how we addressed whatever topic, and go over it in excruciating detail. I felt like I was back in the feed store. He was also an arch conservative and made fun of those of us who were opposed to the Viet Nam War. He would sit down in my office for hours and tell me stories of his bureaucratic coups when he worked in government, which I found totally uninteresting and took time from my research. In sum, he grated on my nerves. After several of us had our names in the newspapers regarding one or another research project or defect investigation, our department head announced that we were to contract out all research and monitor the contracts. Since he wasn’t going to do any original research, he apparently wanted to see to it that he was not out shined by his staff. That was not my agreement when I was employed. I 133

was a hands-on researcher and intended to continue as such. Others in the department agreed with me. The upshot of the disagreement was the resignation of the physicist. Haddon appointed Brian O’Neill and I as comanagers of the research department. Haddon liked O’Neill, a British-born and trained statistician, because of his intelligence and efficient manner. When Haddon would circulate a new research report from outside, it often came out of Brian’s office with “Rubbish” written on the buck slip. Brian and I got along famously; we never had a serious argument. After a couple of years of dealing with hiring, firing, salary issues, and listening to ideas for research from other staff, however, I decided that I wanted no more of management. I told Haddon that I wished to only do research and recommended that he appoint Brian as sole department head, which he did. While I was interested in the practical research we were doing at the Institute, I also wanted to keep up with so-called basic research. At meetings of the sociological societies, I would talk with my old graduate student buddies and renew acquaintance with the Johns Hopkins crowd. Also, I had to see Alan Mazur regarding our collaboration on a book. While we were still in Boston, one day Alan called me and said, “How would you like to write a book?” “Okay”, says I, “What about?” Alan was in negotiations with an editor from Free Press to do a book on biological factors in social behavior. He knew a lot of the literature on animal societies and population genetics and wanted me to do sections on physiological factors and drugs. We signed a contract and I began 134

work on the book at night and on weekends. After the move, I spent many an hour in the National Library of Medicine near my home in Bethesda. By the time of the final editing of the book, Mazur the “confirmed bachelor” was a changed man. During his European trip, Alan met Polly, a woman from the Buffalo, New York area and they married soon thereafter. By the time we finished the book they had a daughter. On his first trip to Washington for us to work together on the final draft, I met him in the airport. In the middle of the terminal, with passengers walking around to avoid us, he dropped his suitcase and pulled out photos of his daughter to show me. During his Washington visit, we took Alan and our niece Janet, who was also visiting, to Paul Young’s, a Chinese restaurant that was famous for its Peking duck. Neither of them had experienced that delicacy before. From the airport, when Alan was departing, he called and said, “Guess where I had lunch?” He went back for more Peking duck. Several books on animal behavior, with titles such as “The Territorial Imperative” and “The Naked Ape”, were popular in the late 1960s. They presented lots of speculations about human behavior based largely on analogy. Alan and I thought much of it dubious at best and unfounded at worst. For example, we objected to the notion that animal groups defending territory is analogous to modern warfare. In animal groups, it is usually a dominant male who fights intruders one-onone. In modern warfare, it is usually some dominant male politician who has never been to war who sends the young people of the nation off to get killed and 135

wounded. Lyndon Johnson wasn’t defending U.S. territory or facing off hand-to-hand with Uncle Ho at U.S. water’s edge when he escalated the Viet Nam War. Or if you would like a modern example, we could discuss George W. Bush. But don’t get me started. The last paragraph of our book, written by Alan, is worth quoting: “At their worst, the biological arguments claim not only man is a killer by nature, but also that he is the only species that kills its own kind. This is incorrect. There are many reports of animal ‘murders’ in and out of captivity. For example, of about 150 baboons introduced into a London zoo colony over a six-year period, 38 died in fights. It is true that most agonistic interactions between animals do not result in fatal, or even serious, injury, but that is also true of face-to-face agonistic interactions in human beings. ... We have come to think of murder as ‘commonplace’ because of its frequency in the movies and on television and because the mass media give such wide coverage when a particularly interesting murder does occur in the real world. Yet most of us live our lives without ever engaging in fatal combat. So if we must follow the current fashion of assigning a biological ‘nature’ to man, then let us call him a rather peaceful fellow with a sense of humor.” (3) In the book, I reviewed the racist history of some segments of sociology from its origin until the time that Hitler made it unfashionable, which contributed to the aversion of modern sociologists to acknowledge any biological influence on behavior. Alan’s review of population genetics revealed the superficiality of racial classifications. Some time earlier, I think while we were 136

in Boston, Alan showed me the results of a study he had done on the extent to which people could be identified ethnically by appearance. Alan had showed pictures in his college annual to a number of people and asked them to identify the Jews. They did so at a rate far better than expected by chance. I reminded Alan that one of our colleagues at Johns Hopkins was a blueeyed, blond Jew, so I was skeptical, my normal state of mind anyway. I said to Alan, “Take the same pictures and ask people to identify the Italians.” He came back later to tell me that many of the Jews were identified as Italians. Apparently, anyone with characteristics more common in southern Europe, such as dark hair and eyes, were considered to be Jews or Italians, whichever the instructions suggested. If he had asked them to identify the Greeks, many would likely have been identified as Greeks. In Boston, I once told Alan that I could pass for Jewish. Although I retained some of my former hillbilly accent, I had dark hair and eyes. He thought not. One day when talking with the little Swedish lady whose garage I rented, she made some remark about my background and then asked, “You are Jewish, aren’t you?” I called Alan and told him that I passed. For our book, the literature that I reviewed on hormone systems, natural and surgical brain alterations, and the effects on behavior of alcohol and other drugs indicated clear biological effects on mental illness and other behaviors. Certainly studies by Haddon and others showed the large involvement of alcohol in fatal motor vehicle crashes compared to pedestrians or drivers going in the same direction at the 137

same times of day and day of week. In the course of writing the book, I came across a paper by a neurosurgeon on the Harvard faculty who practiced at Boston City Hospital. He claimed that people with certain malfunctions in a section of the brain called the amygdala were prone to violent behavior. He placed electrodes in the brains of a few patients in an attempt to alter the behavior. I called him for an appointment and went by for an interview. In the course of the conversation, he began talking like a megalomaniac and suggested that he could reduce violence in the nearby ghetto by operating on the brains of its teenaged boys. Needless to say, I was shaken by that encounter. After the book with Alan was completed, I wrote the better part of a novel that I titled “The Brain Buttons”. It was intended as an expose’ of the surgeon without naming him and getting into libel problems. As I was finishing the manuscript, I came across a new book by Michael Crichton –- The Terminal Man. The plot was similar to mine but much better written, and with a nice twist on a feedback mechanism that I had not imagined. I learned that Crichton had been a medical student at Harvard. He rotated through our clinic while I was there, but I didn’t meet him because I wasn’t helping with students at the time. I suspected that he met the same surgeon as I in his rotations and had an even better idea than mine. He went on to become a famous writer, often using themes that painted science as evil. While I don’t share that view, there are practitioners who have the potential for evil and who should be exposed for what they are. 138

Haddon introduced me to Susan Baker, an epidemiologist at Johns Hopkins University, who had an office in the Baltimore medical examiners office where autopsies were performed on all unnatural deaths. She had some data on tattoos observed during autopsy in the morgue among victims of homicide and drivers in motor vehicle crashes. Susan liked to test her visitors’ mettle by taking them through the autopsy room. The gore didn’t bother me. Maybe watching my grandfather kill hogs when I was a kid gave me some immunity. I might have made a decent surgeon had I gone to medical school, but I preferred working with numbers. I helped Susan with statistical analysis and some writing of a paper on her data. (4) Homicide victims who had been in altercation with their assailants prior to death had high blood alcohol concentrations similar to dead drivers who had engaged in acts that could be classified as aggressive just prior to the crash. Both groups also had a high incidence of tattoos, some amateur jobs similar to those seen in prison populations. More than half of the tattooed drivers had 3 or more, at a time when tattoos were not nearly as common as one sees today. One guy had “Pot” tattooed on his penis as well as “Love” and “Hate” on the fingers of either hand. “Airborne U.S. Paratrooper” was found on the body of a man who had no known military service. “Death before Dishonor” was tattooed on a man who was dishonorably discharged from the armed services. This and other studies raised the question of the extent to which driving drunk led to crashes mostly 139

because of error, as the commonly used phrase “alcohol impaired driving” implied, or was there a connection of alcohol use and aggressive driving. If the latter, the effect was possibly mediated by an aggression-related hormone such as testosterone, which peaks in young males during the period of life when they are excessively involved in crashes and homicides, with and without alcohol. On the basis of this logic and sketchy literature suggesting a link between alcohol use and testosterone, I convinced Bill Haddon to approve a grant to my old prof, Louis Dotson, for him and me to do a study of drinking and testosterone. Louis arranged for us to use a nicely appointed hunting lodge near Knoxville for the study. He invited several fraternities to a party there, for which the project would provide alcoholic beverages, soft drinks and party snacks as well as bus transportation to the lodge. No student who drove to the lodge would be allowed to enter. In exchange for the party, participants must agree to have small blood samples drawn before and after as well as to fill out a questionnaire. During the study, I flew to Knoxville on several consecutive Fridays to join the research team for the parties. For the most part, the study went off without a hitch. The presence of a senior professor no doubt inhibited some from rowdy behavior. There was a group who thought it hilarious that someone sneaked up behind various members of the group and jerked down their pants. Our most anxious moment occurred when a very large and very drunk student decided that he wanted to tussle with a bull in a field adjacent to the lodge. He was so drunk that we managed to avoid his 140

roundhouse swings at us as his fraternity brothers and we herded him back inside. Mercifully, he then fell asleep. The results of the research were disappointing. Blood alcohol concentration was associated with an increase in testosterone from before to after the party but the association was so weak that one could not make a strong case for testosterone as a mediating factor between alcohol and aggressive behavior or diurnal changes in testosterone influencing drinking behavior. (5) Self-reports of prior aggressive behavior were not correlated to testosterone but, as I had learned in interviewing farmers and in seat-belt studies, selfreports compared to actual behavior are often invalid. We sent the blood samples to different labs so that the assays of alcohol and testosterone were totally independent. I was glad we had done so when I talked with one of the persons doing the testosterone assays. He wanted more information on the persons from whom the samples were obtained, such as age and gender, but I refused to give it. He asked me what I expected to find. I told him that from him I expected a measure of testosterone in the blood samples, as accurate as possible without influence of other information. Perhaps the information he wanted would have helped him set the sensitivity of his instruments without influencing the results, but I didn’t like the implication that he would find what I wanted him to find. The issue of scientists’ ethics was much clearer in another project that we funded. Haddon had the idea that we should work on a device to detect marijuana in drivers similar to the breath test for alcohol. He 141

contracted with a lab to work on developing immune reactions to marijuana in rabbits that could be incorporated in a detection device. He asked me to monitor the project. I didn’t know anything about autoimmune research. After a couple of progress reports claiming good but incomplete results, with descriptions I didn’t understand, and each accompanied by a request for more money, I told Haddon we needed an independent reviewer. He contacted an expert who agreed to review the reports and to meet us at the contractor’s lab. At the meeting, our consultant asked the contractors three questions and, hearing the answers, said, “I’m done.” Outside in the car, he said, “They are stiffing you.” Thus came to an end our search for a pot detector. The term “Potomac fever” usually refers to a disease manifested by an endless quest for more power in Washington, D.C. It should include the quest for dollars by the “Beltway Bandits”, the contract firms with offices in the towns along the highway that encircles the city. Many such firms are alive and well and helping George W. Bush screw up Iraq. My first brush with the power seeker’s version of Potomac Fever also occurred around the issue of drugs. Sometime prior to the 1972 Presidential election, but before the Watergate burglary, I got a call from the White House office on drugs, the exact name of which I no longer remember. The guy who called had seen something I had done or my name in a newspaper. He asked me to come over for an interview for a job in their group. Never one to turn down an opportunity before being sure of what it involved, I agreed to an 142

appointment. I was not enamored of the Nixon administration mainly because Nixon had not ended the Viet Nam War. He had done some good things such as opening diplomacy with China, agreeing to several regulatory efforts regarding worker health and safety, and signed legislation authorizing the Environmental Protection Agency. He also had appointed Volpe and Toms who were trying to improve auto safety. Nevertheless, the war was eating away at the social fabric of the country. I had contributed to the McGovern campaign and helped one of the staff on the Democratic National Committee in our building with some computer work. I went to the New Executive Office Building adjacent to the White House and met several of the staff. We discussed drug policy and I asked them questions such as “Has anyone considered distribution of an insect that eats poppy plants?” (Poppies, mostly in central and south Asia, are the source of opiates from which heroin is made.) They wouldn’t answer that question or several others that I asked. I tried to get a notion of what they were about but got little satisfaction. They mainly talked about how the bureaucrats around town would jump to attention when the White House called or they went to their offices. I concluded that these guys were mainly on a power trip. If I took the job, I would not be able to do much, if any, of my hands-on research. I told them about my support for McGovern which, to my surprise, didn’t get me kicked out. It would have been fun to write my mother a letter on White House stationary, but that job wasn’t for me. The next day I called them to say that I wasn’t interested. 143

As I recall, our offices in the old Watergate Office Building were on the 7th floor and the Democrats were on the 6th. If my memory serves me, Larry O’Brien’s desk must have been somewhere close to just below Haddon’s at the time of the burglary. Although we soon moved to the new office building on the Kennedy Center side, our address was still Watergate and got attention every time I made reservations or checked in to a hotel after the burglary. Unfortunately, the rest of the country did not read the Washington Post. Nixon was reelected before the extent of the scandal was widely known, and finally accepted as truth, outside the beltway.

144

Mom -- Ersell Robertson

First Vacation 145

First Grade

Mae Dean, Eddie, me 146

Uncle Sam and Aunt Matt

Graduate student and School Teacher

147

Nancy in class

Me, Nancy, Polly and Al Mazur 148

Bill Haddon

Brian O’Neill and Ben Kelley

149

Grad school buddies retired: Andre’ Hammonds, me, Gene Summers, Bill Gunter

Old folks at home - Green Valley 150

Chapter 7. What Works and What Does Not In written submissions to the government as well as press releases and interviews, the auto manufacturers argued that if everyone would use the seat belts provided, there was no need for air bags. The argument was false. In crash tests, air bags spread crash forces over a larger area of the anatomy and reduce injury at greater crash forces than seat belts. Seat belts reduce deaths in non-frontal crashes where frontal air bags have little or no effect. Rather than require a large field test of air bags to study effectiveness in real crashes, as Haddon suggested, the federal standard was revised in March 1971 to allow, as an alternative to automatic protection, a buzzer-light system developed by Ford Motor Company to force belt use. As of January 1, 1972, newly manufactured cars without air bags were to have a weight detector in the front outboard seats. If seat belts were not extended from their stowed position and weight was detected in the seat, a continuous light indicating seat belts unfastened and an irritating buzzer would be activated, to remain on until the belts were extended. With the exception of a few hundred cars with air bags, manufacturers chose to install the buzzer-light system. After there were sufficient numbers sold to get an adequate sample of observations of belt use in the new cars, we asked the manufacturers for indicators on the vehicle identification numbers that would allow us to distinguish the cars with and without the buzzer-light 151

system. They kindly provided the data. As part of our next large survey of belt use, we included a study of the effect of the system on belt use. Using license tag numbers, we obtained from various state motor vehicle departments the vehicle identification numbers of the vehicles we observed. Comparison of 1972 models with and without the buzzer-light system indicated no statistically significant difference in belt use. Apparently people learned quickly how to disable the system. It could be done by leaving the belts latched, or disconnecting a wire, or by pulling out the seat belts and tying knots in them. I encountered the latter at rental car companies during the study. On more than one occasion, I had to wait, as the belts were untied at my request because the knots made them unusable. When by a dog or groceries occupied the seat, the system irritated many people because the buzzer would continually sound. In our report on the study, we noted that studies of the buzzer light system by the government and Ford were horribly biased. (1) In the government study, belt use by government employees was observed in government cars equipped with the system. Not only were the employees unlikely to modify a government vehicle, the government had a policy that employees fastened seat belts were required when using such vehicles. The Ford study included an extensive pretest interview about belt use coupled with “intensive introduction” to the vehicle’s special features – apparently creating substantial social pressure on the 152

drivers to use belts and not disable the system. At the time, no one knew that manufacturers influenced the government policy on air bags in meetings with Richard Nixon in the White House. During a meeting with Ford executives (Henry Ford II and Lee Iacocca), recorded on his White House taping system in 1971, Nixon was not told that the buzzer system was a Ford idea. Here is part of the transcript in which Henry Ford agrees that a light, indicating belts not in use, is adequate: “President: Yeah, well, Paul, I know, is very familiar with your industry, but Peterson now is the head of this investment economic policy thing, and he's, we had, uh, a lot of reading. But it would be worth, just let me hear exactly, you know, uh, uh, uh, exactly as you presented it in terms of how decisions we make may make our industry noncompetitive with the Japs. I can see that, as we have these damn gadgets, and the (unintelligible) light on the seat belt is enough. Ford: Yes. President: Uh, I say ... Ford: (unintelligible) President: ... (unintelligible) the whole thing. Not in my car, never. Unknown: (Laughs) President: Never, I'll (unintelligible). Unknown: (Laughs) Ford: The dealer's not allowed to take it off. That's another thing, 'cause then he's in violation of the law, too, you see, so you take it to an independent garage. 153

He can do it. President: Look around and, uh, and, and, baby, baby bug_buggies. I know. It's, uh, well, I shouldn't express, I shouldn't prejudge the case, and I will not. And that's what counts. I'll have to look at the situation, and I will on the air bag thing and the rest. And, uh, and, uh, but I think this is an element that had, you see, goes beyond the DOT because it involves America's competitive position, it involves the health of the economy, uh, it involves a lot of things.” After other unintelligible comments, Nixon says, "A lot of, what, what it really gets down to is that, uh, (unintelligible), uh, it, it is, uh, (unintelligible) progress, (unintelligible) industrialization, ipso facto, is bad. The great life is to have it like the Indians were here. You know how the Indians lived? Dirty, filthy, horrible." When the transcript was made public years later, I thought: “What’s with the baby buggies?” I guess he didn’t want regulation to protect children in strollers either. Also, I didn't know that Nixon did impressions of Archie Bunker until I read this. Actually the only difference between Nixon and Bunker is that Archie never went to law school, "ipso fatso", his pronunciation was a bit off. If the air bag or other vehicle standards had any effect on foreign competition (“the Japs”), it was in favor of the U.S. companies. The foreign manufacturers had to meet the same standards as those in the U.S. At that time, foreign imports were mainly cheaper small cars. Additional required equipment added disproportionately to their cost. And 154

then there is the stupid comment about Indians, many of whom live in poverty because the U.S. government herded them onto reservations on some of the least cultivatable land in the country. A sad moment occurred in an interview with John Volpe on the popular “TV magazine”, 60 MINUTES. Ed Bradley asked Volpe if the White House had intervened on the air bag issue. Volpe said no, but his facial expression was a classical image of the pain of lying by a man of conscience. Years later, after the Nixon administration went down in flames, one of Nixon’s former aides told Ben Kelley that the air bag mandate was nixed by Nixon. Faced with the failure of the buzzer-light system, the National Highway Traffic Safety Administration issued a standard applicable to 1974 and subsequent models allowing an ignition interlock as an alternative to air bags. The ignition interlock prevented the car from starting if weight was detected in a front outboard seat and the belt was not extended from its stowed position. Knotting the belt was no longer an option and disconnecting the system required a knowledgeable mechanic. Again, with few exceptions, manufacturers installed the interlock rather than air bags. Our 1974 survey of belt use found that the interlock system increased belt use to about 44 percent in urban driving. (2) General Motors and Ford produced studies claiming higher use. We later noted a downward trend in use as the cars aged, apparently as owners found mechanics to disable the interlock system. 155

The system almost killed the federal motor vehicle safety agency. The Congress was bombarded with letters from new car owners complaining about cars that wouldn’t start with dogs and groceries in the seat, fear of not being able to escape attackers in parking lots, and the like. The lawmakers considered doing away with vehicle safety regulation but finally settled on banning the interlock. As an alternative to the ignition interlock system, socalled automatic seat belts were offered as an option on the Volkswagen Rabbit and Jetta to demonstrate that injury could be reduced automatically without air bags. In some of these vehicles, shoulder belts were mounted in the doors such that the belt encircled the driver or front-right passenger when the door closed. No lap belts were provided. Volkswagen claimed that a knee bolster would prevent so-called “submarining” under the shoulder belt. Hyundai was the only other manufacturer to adopt the Volkswagen system. Other manufacturers installed either door-mounted or motorized shoulder belts, but with a lap belt that the occupant had to remember to use. The upshot was that a lot of people were half belted, some without shoulder belts in back seats and some without lap belts in front seats. U.S. manufacturers also installed so-called "window shade belts". A tug on the belt, deliberate or inadvertent, would loosen the belt, supposedly to increase comfort. Unfortunately the loose belts were less effective in a crash. (3) The result of these attempts to increase belt use was more injury 156

than would have occurred with air bags, and injuries to regular belt users that would not have occurred without the gimmicky belts. There were even a few decapitations by shoulder belts that were attributable to missing lap belts that would have prevented "submarining" under the shoulder belts. The most effective method to increase belt use was first adopted on a large scale in Victoria, Australia. In 1970, that state enacted a law requiring that available seat belts be fastened. Nonusers faced a police citation and a fine. The Institute awarded a grant to a team of Australian researchers to study the effects of the law. They found a 24 percent reduction in fatalities in urban areas and a 13 percent reduction in rural areas from what was expected from previous years. (4) By 1972, all Australian states adopted belt use laws. Researchers there were reporting 80 percent use. While impressed with the effects of the Australian law, we were skeptical of the high use rate. I was invited to attend two conferences in Australia and took the opportunity to observe belt use there as well as in New Zealand, which had enacted a belt use law, and Japan, which required use only on freeways. The Australian researchers were correct. Based on my observations in Adelaide, Hobart, Melbourne, Perth and Sydney, belt use was 80 percent. (5) The New Zealand rate was a bit less but both countries were to be congratulated. By then the laws had been in force about 5 years and, if there had been any deterioration in use, it was still remarkably high. 157

The situation in Japan was quite different. Belt use there was less than 1 percent, even at freeway exits. Nancy helped me with the observations. Because we were in a country where neither of us spoke the language, we chose sites to look for belt use within sight distance of one another in case the cops or someone else objected to what we were doing. Nancy would wave at me when she saw someone using a belt. I didn’t get many waves. Because of our language limitations, we didn’t talk with many people, but the few we asked knew nothing about a law requiring use on freeways. The only country in North America to seriously consider a belt use law in the 1970s was Canada. The Nova Scotia Parliament enacted a law but the Governor did not “proclaim” the law, preventing it from going into effect. In anticipation of the proclamation, I was in Nova Scotia in midwinter to observe belt use. I have never been colder in my life. While standing on street corners, I noticed that the tape recorder that I used to dictate my observations would slow to a crawl as its parts froze, stretching out my words when played back. I had to go sit in a car with the heater running frequently to thaw the recorder and my bones. Finally, the following year, Ontario enacted a law and it was proclaimed. The law was enforced at the beginning of 1976 but, in February, the law was changed to exempt shoulder belt use in pre-1974 vehicles. The car models sold in Canada were essentially the same as those sold in the U.S. Many of 158

the older cars had uncomfortable belts with separate lap and shoulder belt latches. We managed to get a set of observations in December, before the law, as well as in February, June and August at the same sites. Belt use increased from less that 20 percent in December to 55-70 percent in February. By June, however, the use had declined to 40-50 percent and remained there in August. In the 1974-76 cars with more comfortable and convenient, single-latch lap and shoulder belt combination, the use was 25 percent in December, 74 percent in February and 58 percent in August. I concluded in my report that inclusion of exemptions in the law may have resulted in a general deterioration in use. (6) I was contacted by a reporter from the major newspaper in Ontario, the Toronto Star, to comment on my results, along with a claim by the transportation minister that the findings were not true. He said that our observers could not see lap belts in use. He said that his department did not plan more surveys because they had better things to do than monitor who is using seat belts. I explained that we had tested the method before first adopting it. We sent belted and unbelted drivers to drive past our observers and then checked their accuracy. The reporter quoted me as saying that I did not want to get into a shouting match with the transport minister because I admired his attempt to increase belt use. Upon reading the story, Haddon complimented me on my response. He said that characterizing the other guy as shouting was very 159

effective. I savored such comments from Haddon because they were so rare. He was much quicker with criticism. I was not involved in the initiation of one of Haddon’s favorite projects but received a backhanded compliment from him for contributing to its demise. The Institute had a department called Operations that did demonstration projects. The project in question was called the Blue Van Project. The operations people installed a computer in the van into which data on stolen cars and outstanding warrants for drivers of the cars, supposedly in force, were downloaded from Maryland computers daily. The van was then driven around the state while a passenger typed in license tag numbers and called the police if a match with a miscreant’s car was identified. At a staff meeting to which I was invited to review the project, I told the group that the lag in data reporting from courts and police departments to the state was likely to result in invalid arrests, and possibly a lawsuit for false arrest. While the state may have immunity from such mistakes, the Institute did not. We had a small kitchen where several of us frequently ate lunch. After the meeting, Haddon walked up to me at the kitchen table and said, “Robertson, you know what’s wrong with you?” “Nothing that I know of,” says I, with bravado in front of some of my fellow researchers. “I feel fine.” Again Haddon said, “Robertson, do you know what’s wrong with you?” So I said, “No, Bill, but I am sure you are going to tell me.” 160

He said, “You are right too often”, whereupon he stalked from the room. He stopped the Blue Van project. Haddon had an M.D. degree from Harvard but had not practiced medicine beyond his residency many years previous to his presidency of the Institute. I told the other people with whom I worked that; if I ever got seriously ill, sneak me out to the George Washington Hospital emergency room. Don’t let Haddon lay a hand on me. If Haddon found that someone had a personal problem or was suffering physically, or grieving, he was quite humane. When Louis Dotson died suddenly of heart failure, Haddon urged me to take time off to go see the family and attend the memorial. The family asked me to deliver a eulogy at the gravesite, which I did. I spoke of Louis’s courage as a man of slight stature playing basketball in Kentucky and his wartime service as an infantryman in the Battle of the Bulge. I noted that he was just as comfortable discussing the weather with his neighbors at the local store as he was in a roomful of contentious graduate students. It was one of the most difficult things that I ever did. Haddon was not one who easily discussed his family or personal beliefs, but he did so when I accompanied him on a trip to Boston, where his mother and John Kosa both lay dying in Massachusetts General Hospital. Haddon spoke of his difficult relationship with his mother and his lack of religious belief, which was much in line with mine. He said, “Dying doesn’t seem so bad if 161

you think of it as simply ceasing to exist.” I agreed. I would prefer, however, that my friends had not died so young. Louis Dotson and John Kosa were in their mid fifties when they died, as was Bill Haddon, when we lost him to kidney failure in 1985. Irrespective of his lack of religion, Bill was one of the most ethical people I have known. He could have put his name on every paper that came out of the Institute but he was listed as coauthor on only those to which he made a major contribution. I offered to include him as coauthor on several of my papers that he helped improve, but he demurred. Bill had terrible allergies. We went to his house one evening for dinner and saw no rugs on the floor or fabric decorations that would retain allergens. Once Haddon claimed there were molds in his office but a search failed to find them. Finally, the carpet was removed and there they were. On another occasion, Haddon, Jack Wong, the Institute’s auto engineer, and I went to my townhouse in Georgetown to brainstorm away from the distractions of the office. Soon after we sat down, Haddon said, “There are flowers in here.” I didn’t think so, but went up to the next floor to check. Sure enough, Nancy had put some fresh cut flowers there. I put them on the back patio so that we could work. Haddon also had severe hearing loss in both ears. Sometimes in the middle of a conversation, he would have to stop and replace a battery in a hearing aid. Perhaps if I had as many health problems as he had, I would have been as difficult to deal with as he. Maybe I 162

became so. Years later, the head of the injury program at the Centers for Disease Control told me that many of my colleagues in injury research considered me intimidating. But I always thought of myself as a gentle fellow with a sense of humor. While in Australia, I gave a paper at a meeting of alcohol researchers and alcohol control program managers. I said that many alcohol countermeasures had been launched but few adequately studied. Those that were studied showed little effect, with some hint of adverse effect in one or two. The rather constant percent of alcohol involvement in vehicle crashes year after year, documented in many countries, suggested that net effect of the programs was minimal. I suggested that programs should be studied experimentally, with adequate control groups, before imposition on large populations. (7) Back at the office, Haddon sent me a copy of a news account of my presentation, which I still possess. He wrote in the margin, “Fame can lead to infamy. Great!” B.F.Skinner, the noted experimental psychologist, was right. If you reward a pigeon at random, it will work harder for a reward. In the mid 1970s, NHTSA began annual belt use surveys using methods similar to ours so I no longer had to organize and supervise such studies. I had more time to work on other research, often in collaboration with colleagues in and outside the Institute. We did numerous studies of programs and laws adopted to reduce motor vehicle injury. It is impossible to get 163

legislators to enact laws in such a way as to be studied experimentally. And creators of other programs are often not interested in objective study of them, particularly if they are receiving salary, royalties or prestige for their efforts. Indeed, many are hostile to such studies when researchers find no effect, or an adverse effect, of the laws or programs. Occasionally, there is hostility from some group or other even when the research shows a good effect. My study of motorcycle helmet use laws drew such a reaction. I compared death rates of motorcyclists in eight states that enacted such laws with adjacent states that did not, before and after the laws’ enactment. The states that enacted laws had a death rate reduction of about 30 percent while there was little change in the comparison states. We had observed helmet use in only four states, at the same time that we were doing seat belt observations, but the results were impressive. Two states with laws had virtually 100 percent helmet use, compared to a wide range in the other two states without laws – 60 percent in California and 25 percent in Illinois. (8) Several motorcyclist organization opposed helmet laws. After the study was reported in the press, a group of anti-helmet motorcyclists showed up at the Institute in their leather and chains and asked to see me. The receptionist had the presence of mind to tell them a fib; she said that I was out of town. In 1971, the supervising judge of Chicago’s traffic courts got a lot of publicity for claims that he had 164

greatly reduced fatalities during the preceding Christmas-New Year’s holiday period and six months thereafter by requiring that all convicted drunk drivers be sentenced to jail time. Knowing that fatalities can fluctuate widely in relatively small areas, we decided to do a study of the effect of the crackdown. A professor at Northwestern University was an expert on such research. I visited him but he had too much on his plate. He suggested that I enlist the help of Professor Larry Ross at the University of Denver who was doing similar studies of alcohol laws and enforcement as well as a graduate student, Robert Rich, who was available to collect data in Chicago. I talked with Ross and Rich and we decided to compare changes in Chicago’s fatalities before, during and after the crackdown with Milwaukee’s fatalities during the same period. The cities are near one another, have similar weather, and both face Lake Michigan to the east. Milwaukee had no change in sentencing or special drunk driving programs during the period of Chicago’s crackdown. We found that Milwaukee had a dip in fatalities similar to Chicago’s. Apparently, weather, economic factors or some unknown factor reduced fatalities in both cities. There were no changes in arrests or tests for blood alcohol during the period of the crackdown. (9) Ross went on to do studies of drunken driving crackdowns in Britain and the Scandinavian countries. He found no effect of jail sentences in Norway and Sweden but a temporary effect of publicity regarding increased threat of arrest in Britain. When the British government 165

changed from a vague definition of drunk driving to a specifically measured blood alcohol concentration, it emphasized that many more drunk drivers would be caught and convicted. Alcohol-related crashes declined for a time but eventually returned to the pre-crackdown rate. Apparently the public learned that the probability of arrest hadn’t changed much. From these studies, Ross concluded that perception of increased probability of arrest is a deterrent but severity of punishment is not. (10) When some of his results were presented at the Australian meeting that I mentioned, one person from Scandinavia stood up and said, “The light still shines from the northern countries.” After the Chicago study was released, Ross and I attended a meeting of safety people and others in Chicago where we discussed the results. At one point a rather heavy-set man who had been glaring at me made a statement about biased, “beady-eyed” Ph.D.s. He asked me, if crackdowns don’t work, what I would do about the problem. I said that improved crash worthiness of vehicles and roadsides prevented deaths to both drunk and sober drivers and their passengers. He said, “You are just saying that because of who I am.” I turned to Ross and said, “Who is he?” Ross replied, “He works for Chrysler.” It was obvious that, since I didn’t know who he was, my opinions were not related to the employer of my critic. I will admit to having unattractive eyes. Allan Williams and I did a study of an enhanced law enforcement program in 5 Michigan counties to 166

evaluate validity of claims for its great success by the National Highway Traffic Safety Administration (NHTSA). The agency proposed to grant $10 million to police departments around the country to implement the program in their jurisdictions. The agency’s study had two problems – the choice of counties and the lack of comparison to counties with no such programs. They chose to increase enforcement in counties that had the highest fatalities during a six-month period prior to implementation. Most people knowledgeable in such statistics would expect a return of the numbers toward average after an extreme number occurred. Allan and I compared the NHTSA chosen counties with 5 other counties in Michigan and 5 in Indiana that had an unusually high fatality rate in the six months prior to the NHTSA program, but were not included in the program. These counties had a large reduction in the subsequent period similar to that in the counties NHTSA chose. If the increased enforcement program had any effect, it was not detectable. (11) I was invited to present that study at a meeting of the Association of Chiefs of Police in a local Washington hotel. During the question period after my talk, the Los Angeles Police Chief stood up and went into a tirade about the validity of sociological measurement. When he finished, I said that there are obviously some problems regarding valid measures in some studies but “we count the dead real good”. The meeting adjourned so that the attendees could hear an address by President Ford in a larger session. I guess you could say 167

that I warmed up a bit of the audience for him. Susan Baker and I did a study that found little possible effect of a “habitual offender” law, adopted in Virginia and under consideration at the time in other states. It was widely thought that drivers in crashes were some small deviant group that could be identified. Previous research indicated otherwise but the notion persisted. According to that research, if one completely removed from the road all drivers one or more crashes in the prior year, 70 percent of the crashes in the next year would occur. (12) The question remained as to whether drivers who would be in severe crashes were identifiable before the fact from prior records. Susan and I compared the prior records of convictions for traffic offenses of Maryland drivers who were involved in fatal crashes with the records of a random sample of licensed drivers in the state. This was before the records were computerized so we had to look through some 4000 files, some literally stored in shoeboxes, for the data. Of 1447 drivers in fatal crashes during the period of study, only 22 would have been identified as “habitual offenders” under the Virginia law. In general, although the probability of a fatal crash increased as number of prior convictions increased, the correlation was not strong enough to isolate a small number of drivers who accounted for most of the fatal crashes. (13) To screen for any public health risk efficiently, there has to be a relatively small number of “false positives” (those identified as at risk who will not be ill or injured) 168

and “false negatives” (those who are identified as low risk who will be ill or injured). To this day, there is no method of screening drivers that doesn’t have huge numbers of false positives and false negatives. Among Ben Kelley’s films to illustrate various aspects of highway safety and available countermeasures, my favorite is “Boobytrap”. The film shows the catastrophic crushing of vehicles when they strike rigid roadside objects. Numerous means of absorbing the energy were available – removal of trees and poles, breakaway poles where they are necessary, energy absorbing materials in barrels placed in front of rigid objects or in guardrails. When the film was released, critics claimed that the implementation of these countermeasures would be too costly. I questioned the extent to which one could identify road sites where modifications would be the most efficient in reducing severe injury. Most state transportation departments had formulae for choosing sites for modification, but they were based on total crashes and miles traveled on the roads, not severe crashes. This despite the fact that it was known that severe crashes occur more frequently in areas of lowdensity traffic. There are a lot of fender benders in highdensity traffic but they are at low enough speeds that the injuries to passengers, if any, are usually not as severe as in the high-speed crashes where vehicle density is often low. Haddon often said that “traffic fatalities” is a misnomer because many do not occur in traffic. 169

To answer the question, I designed what epidemiologists call a case-control study. We would measure road characteristics within 500 feet of crash sites where someone died crashing into a tree, utility pole or other roadside object. As a control, we did the same measures one mile up the road from which the vehicle traveled. If the same driver and vehicle passed through that site without incident but crashed at the second, what was different between the two sites? To obtain the sites and implement the measures, the Institute contracted with Paul Wright, a professor at Georgia Tech, who trained a team of students. The study covered 300 consecutive fatal crash sites in north Georgia. We found that 26 percent of the fatal crashes occurred at road sections with curvature greater than 6 degrees in combination with downhill grade of 2 percent or more. Only 8 percent of the sites the vehicle had passed had these characteristics. Half were on road sections with greater than 6-degree curves compared to 24 percent of road sites a mile back. Only 17 percent of the fatal crashes occurred on local roads, which made up 67 percent of roads in the state. To be cost effective, we suggested, first remove or modify roadside objects on non-local roads at curves greater than 6 degrees on grades of 2 percent or more. (14) For this research, Professor Wright and I received the Best Technical Paper Award of the Southern Section, Institution of Transportation Engineers, in 1976. In another critique of resource allocation, I pointed 170

out that the NHTSA’s formula for awarding incentive grants for highway safety favored small states. The grants were awarded to states that had an inordinate increase in fatalities. Because there are larger year-toyear fluctuations in fatality rates in smaller jurisdictions, the smaller states would have more such spikes in rates. Sure enough, in the following year, almost half of the states and D.C. that received grants had only about one third of the population and fatalities. When public-policy lapses such as this were published in Status Report, the perpetrators of failed programs and inefficient allocation of funds were not pleased. Not all of my studies were critical of government programs. Using data from Maryland on fatal crashes, I was working on a study of motor vehicle safety standards when a University of Chicago economics professor named Pelzman published a study claiming that crash worthiness standards adopted in 1968 were ineffective. He expounded a theory that drivers made safer by crash worthiness, would drive more “intensively” and kill more pedestrians. Based on historic trends in fatal crashes in correlation with trends in other factors, he said that reductions in occupant deaths were offset by deaths of pedestrians. (15) My data from Maryland, which separated the cars that met specific regulations from others, did not support Pelzman’s conclusions. (16) First, I tried to assemble the data Pelzman used from the sources he referenced. I could not get the data to match up. I then wrote Pelzman to ask if he would send 171

me the data he used. He kindly did so. Finding major flaws in his assumptions, data, and analysis, I wrote a critique of his paper for the economics journal in which Pelzman’s article appeared and wrote up my findings based on the Maryland data for one of the safety journals. Among many problems in Pelzman’s analysis was failure to separate motorcyclists from pedestrians and unregulated trucks from regulated cars. He counted all non-occupant deaths as pedestrians during a period when motorcycle registrations were doubling every five years, guaranteeing that the numbers of deaths on these vehicles would increase dramatically, many of them “wipe outs” that involved no other vehicle. Equations using his method did not predict changes in fatal trends prior to regulation and, therefore, could not be used to predict trends in the regulatory period. The editor of the Journal of Political Economy, George Stigler, Pelzman’s colleague at the University of Chicago, who later was awarded the Noble Prize in Economics, wrote me a huffy letter about my critique and refused to publish the paper. It was published in another economics journal. (17) In the subsequent decades, Pelzman’s claims have been cited repeatedly in the economic literature with no reference to my critique or other studies of regulation, more of which appeared in the 1980s and 1990s. The studies repeatedly found Pelzman’s claims regarding “pedestrians” to be wrong. I think that several injury researchers are negligent about citing appropriate literature in their publications, but they are amateurs at 172

this compared to economists. The most severe reaction to my work resulted from my research on high school driver education. One quiet afternoon in 1977, I sat at my desk reading a bunch of research studies. I almost skipped one from the University of Salford in England, which was titled “The Use of Accidents and Traffic Offenses as Criteria for Evaluating Courses in Driver Education.” Since I was familiar with the studies of driver education in the U.S. that found fewer crashes and violations among those who had the course, and I knew well how to gather and analyze crash and violation data, I almost didn’t read what I thought was another boring treatise on the topic. Nevertheless, I browsed through the report and found that it was incorrectly titled. The results were very important. The author and her colleagues had conducted the first controlled experiment on the effectiveness of high school driver education. Furthermore, they found that it was harmful. (18) The problem with the previous U.S. studies was self, or parental, selection into the course by those taking it. There were studies suggesting little or no effect of the course on subsequent crashes of students who selected the course when factors such as grades in school were controlled statistically, but no one had looked for the adverse effect found in England. In that experiment, those who took the course were licensed to drive earlier than they would have otherwise, compared to those in control schools that did not receive the course. The course had no effect on 173

subsequent crashes per licensed driver. The result was more crashes per population among the students that were assigned to take the course. The experimental design eliminated the problem of self-selection by people who would have fewer crashes anyway. It immediately occurred to me that we needed to document whether the effect found in the British research occurred in the U.S. Driver education in public schools was expanding rapidly, funded in part by grants to the states by NHTSA. I gathered data from the National Safety Council’s survey on the number of students completing driver education in public schools annually among the states. Data on fatal crashes where one or more teenaged drivers was involved was available from many of the same states. In this and many other studies, I included only fatal crashes because of the differing criteria for reporting nonfatal crashes among the states, the known fact that some were unreported to police, and some police departments did not investigate all to which they were called. The data from 27 states during several years were available. With the help of Paul Zador, a colleague who had a Ph.D. in statistical analysis, I looked at the trend in crashes per number of licensed drivers in each age group and the trend in licenses obtained per population. We tortured the data until they confessed. The trends were quite clear. There was no correlation of percent of drivers in each age group that had driver education and the fatal crash rate per licensed driver among the 174

states. When we looked at licensed drivers per population, however, licensed drivers increased substantially among 16-17 year olds as driver education per population increased, just as they had in the British experiment. We estimated that some 2000 16-17 year old drivers were involved in fatal crashes per year that wouldn’t happen without driver education in public schools. (19) A brief account of our study was published in Status Report just after Thanksgiving in 1977. It was summarized in many major newspapers, in a few with blazing front-page headlines. A television reporter came by for a filmed interview that was syndicated to local news programs across the country. My father-in-law was impressed when he saw me on the local news in Tennessee, but the general reaction was negative. By the first of the year, the campaign to discredit the study was underway. We first had to contend with the Institute’s Board of Directors. Many of our supporting insurance companies gave discounts to households where students had completed high school driver education. In the Board meeting, one member was so agitated and red in the face, with blood veins bulging in the neck, that I was concerned that he would have a stroke. Haddon managed to head off a revolt, but I could tell that he was concerned. He knew that I had a tendency to argue and he asked me to be quiet during the meeting. It was difficult, but I didn’t say a word. I shouldn’t have been surprised, but I was, when I 175

learned that driver educators had a Washington lobby, the American Driver Education Association. That organization peppered the news media, Congress, NHTSA and even President Carter with letters saying that the study was invalid and questioning the motives of the authors in particular and the Institute in general. They even whined because we released the study not long before Christmas and ruined the holiday for driver educators. I learned, also to my surprise, that several universities offered the Ph.D. in driver education. Several driver education professors wrote critiques of our study. Non-experimental population-based studies are always subject to the phrase, “You didn’t control for x” which is a valid issue if x is a plausible explanation for the results. These critics did not know of a plausible x and they ignored the British experiment in which any potential x was ruled out by the random assignment of experimental and control groups. Our study merely confirmed what had been established by a controlled experiment, the gold standard of research. Even the American Automobile Association got into the act, circulating a claim that the study was invalid, without any supporting data. The AAA has a research arm, but I don’t ever remember seeing a valid piece of research from that unit. After retirement, I saw another claim from AAA in the Arizona Republic newspaper promoting driver education. The paper published my letter to the editor, citing contrary research and suggesting that AAA stick to roadside service and road maps. 176

In the first six months of 1978, most of my time was spent writing rebuttals to critics and responses to letters, some nasty, such as one from Virginia’s coordinator of driver education. I sent a copy of his letter and my response to then Governor Robb who was married to one of President Lyndon Johnson’s daughters. Nancy and I had attended an event in the Robb’s northern Virginia home before he was elected Governor, which I mentioned to him in an accompanying note. I got a nice letter from the Governor and no more nasty letters from Virginia. Also, I had to defend the study before numerous meetings of government advisory groups, NHTSA administrators, and driver education groups. In contrast to their Washington leadership, the front line driver educators with whom I met were uniformly polite. Many of them taught other subjects or coached high school sports teams. My study was not nearly as threatening to them as it was to the leaders and academics, many of which received royalties from driver education textbooks and course materials. That is not to say that the actual teachers of the courses were happy to hear that their well-intended efforts were having a negative effect, but they took it well. Because of my work and Nancy’s work, we had a limited social and recreational life as it was, without having to deal with this irritating sideshow. Now a lot of my extra time was taken up by trips that I didn’t enjoy. My recreational activities were not relieving the tension that I experienced, as they had in the past. 177

While we lived in Massachusetts, I took up running every other morning before breakfast to maintain my physical condition, a practice that I continued in Bethesda. Nancy made friends with a group of ladies who did various crafts. On weekends, when I wasn’t cloistered in the National Library of Medicine working on a book, we would visit Washington sites or nearby Civil War battlefields. In the summers, we usually went to the beach for a week or two. On a trip to Nantucket, a storm interrupted the ferry schedule, which gave me the opportunity to learn a few chords on a classical guitar that I took along. I took classical guitar lessons for a few weeks in Washington but didn’t have the time to practice enough to play well. I did take the guitar to the office Christmas party a couple of times to accompany the carols. We met the Mazurs once in the Catskills and once at a Delaware beach for vacations. Alan and I rented a small sailboat; each thinking the other knew how to sail. After capsizing several times, we swam to shore, pushing the boat in front of us. Years later we each would become competent sailors. In the early 1970s, Nancy and I traveled a month in Europe on a “If it’s Tuesday, this must be Belgium” bus tour. All in all, it was fun, but we missed the Louvre because our only free time in Paris was while it was closed. We did make the Prado in Spain. There, we were standing on a sidewalk when a motorcade rushed by. Someone said that it was Franco’s. I made some caustic remark about fascists and our tour guide 178

warned me that one could be jailed in Spain for such remarks. We did a lot of what the tour guide, a self effacing German, called “ABCs”, for “another bloody cathedral” and “another bloody castle”. Nevertheless, it brought alive some European history. Venice, the British Museum and Shakespeare’s Stratford were also highlights. I particularly liked Venice because there were no cars, just gondolas and motorboats to move us around the canals. On the bus between cities, I hammed it up, telling jokes and singing a song I had written about the passengers. They had their revenge in Switzerland when they pushed me on stage for a yodeling contest. Nancy, ever tolerant, didn’t object to my antics. A couple of years later, we also took a great trip for a month in South America. This time we flew from city to city – Bogota, Quito, Lima, Buenos Aries, Rio and Caracas. In Quito, we stayed some miles outside the city and once rode a local bus back to the hotel. We enjoyed watching the local folks in their colorful costumes carrying all sorts of goods; one had a couple of live chickens. We were unaware of the sun’s power at the cool high altitudes. My forehead began to fry so I bought the first of what would be a modest collection of hats. I had a similar experience on a sail in fog from New London to Block Island when we lived in New England. You can get severe sunburn in fog. These exposures, along with my days hatless in the sun as a book salesman, contributed to the skin cancers that I now have 179

removed periodically. The highlight of the South American trip was Machu Picchu, the remains of an Inca community atop a mountain in the Andes. The engineering and construction of the structures, built before Columbus’s voyages, is a marvel. Of course, they were built with the labor of thousands of slaves, which tempers ones enthusiasm. In Rio, we visited John Kosa’s brother and family, who migrated there from Hungary, and a former neighbor in Bethesda who returned to her native Brazil after the death of her husband, a charming U.S. diplomat. We also enjoyed a couple of the local beaches. In the Spanish speaking countries, I tried out my mostly forgotten vocabulary and came to be able to order meals without embarrassment. Of course, Brazil’s predominate language is Portuguese. I was again at the mercy of translators. Fortunately, our hosts spoke excellent English. Visiting places of varying languages and cultures, and meeting people who seemed more adaptable to such variation than Americans, was an enlightening experience. I recommend foreign travel to those who resist multilingual training for their children. Being childless, of course, makes me an expert. Nancy and I had no children by choice and have no regrets. We enjoyed the children of relatives and friends, but don’t seem to have the propagation gene that human beings are alleged to have. As one of my recreational activities, for a time I attended horse races. One Saturday, on a whim, I went 180

to the track in Laurel, MD, a D.C. suburb. That afternoon, I only bet $2 per race and was losing money after 8 races. I was sitting beside an elderly black man who seemed to be making money. As we each looked at the past performances of the horses in the last race, he said, “He may not stop today.” “Which one?” I asked. “Oak Cross,” he said. I looked at the horse’s record. In his past few races he ran in front for several furlongs, but was passed up in the stretch. He was 19 to 1 on the board. I decided, what the heck, let’s make it interesting. I plunked down $20 on the horse to win. He led all the way and I collected $380 profit, thanks to my seatmate. After that, I went to the tracks in Maryland when a hiatus in other activities permitted. Pari-mutual racing is an intellectual challenge to one who understands probability calculations. Casino gambling is for suckers. If the house takes a percentage, the game is random, and you continue to play, you will eventually loose your shirt. In statistics, it’s called “gambler’s ruin”. There is a house takeout in pari-mutuel wagering as well, but the outcome is not entirely random. If you can figure out the real odds and only bet when the odds are in your favor, called overlays, theoretically you can win. I compiled data on prior performances and the outcomes of races. Of course, you have to have the discipline not to wager when there are no “overlays” or the odds are too short. One Saturday, I stood in line at the $50 window to bet on a horse with short odds that was an overlay, at least on paper. It was difficult to see how the horse 181

could lose. In front of me, an elderly man bet $1000 on the horse. I knew that the odds would go even lower with such a large bet in the pool so I turned and walked away without betting. The horse broke his leg in the stretch and lost the race. I looked around the crowd to see the expression on the big bettor’s face, but I couldn’t spot him. After some analysis, I could average about 5 percent profit on the amount I wagered on the ponies. That was not enough return on which to risk large amounts when winning streaks were sporadic. Also, the amount of time involved relative to the amount of return was unacceptable, so I eventually quit that activity. When we were at Hopkins, Nancy and I attended a Baltimore Colts game at the invitation of the parents of students in her school. There were drunks in front and behind us who yelled at one another throughout the game. This reinforced my aversion to large sporting events. I made an exception that I came to regret when I attended the Preakness Stakes. The roads to the track were clogged and there were no parking spaces. Circling the neighborhoods, I was beckoned into a yard by a youngster who was making a few bucks parking cars in his yard. By the time I got to the track, there were no seats so I sat on the grass in the infield. Before long, some joker stumbled near me and spilled beer on my clothes. There were large hedges around the track so I only got a glimpse of Seattle Slew in the big race. On the way home, I ran out of gas. No more crowded sporting events for me. 182

By the mid 1970s, we accumulated some savings. I contacted a stockbroker and took the plunge on a few stocks. The broker would call me from time to time and I followed his recommendations. After losing some money, I told myself, “I am going to learn this game or stay out of it.” I spent some time reading various theories of market behavior and tested some of them retrospectively. I did a little better but didn’t become really good at it until I obtained a personal computer when they became relatively inexpensive in the early 1980s. I would not recommend compiling racing or stock market data by hand as I did in the 1970s. While we lived in Bethesda, Nancy took some graduate courses in library science at the University of Maryland. Although elementary schools have many teachers, each has one or no librarians and Nancy could not find a vacancy in which she was interested. I chaffed at the time it took to commute and the difficulties of getting gas during the OPEC generated gas shortages in the 1970s. During my commute, I drove the Whitehurst Freeway through Georgetown past an old rendering plant near the Potomac that smelled badly. One day in 1975, I realized that the smell had disappeared. Nancy had expressed interest in moving to Georgetown but the property there was very expensive relative to our income. I mentioned the absence of the smell. She investigated and found that the rendering plant had closed and there were some relatively inexpensive town houses for sale between the canal and the river. We found one that we liked and bought it 183

for about the same price that we could get for our house in Bethesda, which had appreciated substantially. Now I could walk to work and Nancy found jobs a few blocks from our new digs. She worked for a time in a shop where she met the owner of Congressional Digest, a publication that published sections of the Congressional Record on chosen topics along with editorial explication of the issues. High school libraries constituted the main subscriber base. The owner was a crusty old lady who had founded the Digest with a sister, who was deceased. Mrs. R, as she was called, spent most of her time at her townhouse, leaving the daily tasks to the staff, but dropped in occasionally. She offered Nancy a job, which she accepted. Mrs. R turned out to be a racist and often made comments that made Nancy and others uncomfortable. The population of the District of Columbia, in which Georgetown is located, has a disproportionately black population and a poor tax base because so much land is occupied by the federal government as well as religious and educational institutions. The federal government supplements the city budget, but the congressional committee that oversees the budget sometimes has members with sentiments on race resembling Mrs. R’s. D.C. has a nonvoting representative in Congress and no Senators, which clearly puts its citizens at a disadvantage, including one of the causes of the American Revolution – taxation without representation. One day Mrs. R was expounding on her opinion that 184

the District did not deserve representation and that she didn’t believe the citizen’s should even have the right to vote. Nancy piped up, “You vote in the District don’t you, Mrs. R?” The old lady was infuriated and fired Nancy on the spot. When Nancy told me about it that evening, I was never more proud of her. In the first six months of 1978, too many of my nights and weekends were spent fuming over the time I spent dealing with the self-serving leadership of driver education and their witless supporters. With Nancy unemployed and me spending most of my time fighting the critics, I decided to see what positions were available in academics. By then, at 41 years of age, I had coauthored 3 books and published more than 60 articles in the scientific literature, a respectable accumulation of the coin of the academic realm. In addition to the Harvard book and the book with Alan Mazur, Maggie Heagarty and I wrote a textbook in Medical Sociology. (20) It didn’t sell very well but it took up just as much space on my resume’ as the others. Nancy loved Georgetown and I savored my work at the Institute before the driver education brouhaha, but the time had come to move on.

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Chapter 8. Yale Looking through job listings for social scientists and epidemiologists in academic institutions, I came across a notice of new positions at the Institution for Social and Policy Studies (ISPS) at Yale University. I sent in my curriculum vitae and was invited to an interview. At the time, Charles “Ed” Lindblom was director. ISPS was established as an interdisciplinary center to promote collaboration among the social scientists, and people from other disciplines attended faculty seminars there as well. Lindblom told me that he had obtained substantial grants to expand the staff of the Center for Health Studies, a division of ISPS. He asked me what studies I intended to pursue. I replied that I would continue to focus on injuries, but intended to branch out beyond motor vehicle injuries. I wanted to write a book on injury control policy. If a position were offered, he asked, would I be interested in looking at cancer as well. Some of his funds came from the Yale Cancer Center. I agreed to do so. Yale came through with an offer, including a joint appointment in the School of Public Health, which I accepted. My salary was more than a third less than my pay at IIHS, but back in academics I could deal with the politics of highway safety and other issues to the extent that I pleased and on my own terms. By then I thought myself an investment whiz that could make our living on investments if I had to do so. When I tendered my resignation to Haddon, he was 186

quite gracious and did not try to dissuade me. Perhaps he thought that I was becoming more liability than asset. At my last Board meeting, Haddon informed the Board of my resignation and said that the people who hired me at Yale were impressed with my driver ed study. Only one or two Board members laughed. My frustration at having to deal with the idiots defending driver education was palpable. Although no one now monitored the outgoing mail, I sent some of my outgoing letters to Haddon to keep him informed. He sent a young lawyer from the General Counsel’s office to caution me about libel. After informing me of the limits of the law, the lawyer grinned and said, “Well, at least you didn’t refer to their syphilitic mothers.” Nancy and I went to New Haven to look for a house. I was interested in a place on Long Island Sound if we could find one that we could afford. In three years, our town house increased about 50 percent in value when others discovered that lower Georgetown didn’t smell bad anymore. I was hopeful that we could find a house on the water in our price range. A real estate agent asked us to meet her at a huge 16-room house on the water in Branford, next door to a similar house owned by the Taft family, descendants of the Ohio-born U.S. President of that name. They used it as a summerhouse. The house we were shown needed to be winterized. I asked the agent if I could rent rooms to Yale students. She didn’t think that would work in that neighborhood. Of course, I was kidding. The owners were asking $160,000 for the house. There was no way that we were going to buy such a large house, even if we could afford it. We should have 187

bought it. It sold again 10 years later for about $1 million. After looking at a number of houses near the University as well as on the water, we were about to give up on finding a suitable waterfront house. On the way to see a house a few blocks from the water in Branford, I spotted an agent putting a sign in the yard of a modest ranch style house overlooking the Sound. We stopped and looked it over. I was taken with the view from the large windows in the living room. To the left were the Thimble Islands and, straight out in the distance, one could barely make out the shoreline of Long Island. Across the road, there was a small picnic and boat launch area as well as a narrow sandy beach. The size was right and fit our budget, so we bought it. In July, 1978 we moved into what would be our home for more than 20 years. My office at the university was in an old house a half block from the main ISPS building. It had a window planter that the previous occupant had filled with red geraniums. I cultivated the plants and they prospered. Soon other offices in the building filled with the new hires and we became acquainted informally and in a weekly meeting to compare notes on what we were up to. Despite the goal of some kind of integrated effort, widely different interests and pursuits resulted in our mainly circling in our own individual orbits. Since I was the senior member, Lindblom urged me to exert some leadership in the group, but I had no authority over the others and didn’t want any. I intended to lead only by example - work hard and publish. The dress code had certainly changed in universities 188

since my Harvard days. Most of my colleagues seemed to deliberately dress down -- Lindblom was partial to flannel shirts similar to those worn by lumberjacks. In Washington, I often wore a turtleneck under a sport coat when I didn’t have meetings with outside visitors. The freedom to dress even more informally was welcome. As the new kid on the block, I was invited to give a faculty seminar on my work. Afterward, an economist whose wife served in the state legislature in Connecticut told me that driver education was eliminated from the state budget for economic reasons, not the results of my study, and that several towns had dropped the course. I checked around and found that one driver education coordinator remained in the state Department of Education. When I called him, he said that he had records of the numbers of students taking the course in each town. He agreed to let me have them. Although some towns had retained driver ed with local funds, there was a substantial reduction in students enrolled in the courses state wide. Although Lindblom’s grant covered my salary for three years, I intended to help out by raising money in addition. I called Haddon and told him of the Connecticut data. I asked if the Institute would be interested in supporting research on the changes in crash rates of teenagers, if any. He was enthusiastic about the idea. When I ran the contract through the Yale office that handled such business, I encountered a lot of resistance. They were suspicious that I was somehow fronting for the insurance industry, which was hilarious, given the industry’s reaction to my previous 189

study. After altering the wording of the contract to guarantee that I had complete control of the research and writing, the contract was signed. The Connecticut Department of Transportation was very cooperative. Computer tapes were prepared containing the crash records of 16-17 year old drivers for the period before, during and after the reductions in driver ed. The records also contained data on how the drivers had obtained licenses. In Connecticut, a prospective driver less than 18 years old could be licensed if they had high school driver education, a commercial course (say from Joe’s Driving School), or if a parent or guardian certified that the youngster has been trained to drive by an older licensed driver, the latter called home training. Therefore, I had data on who was involved in crashes and the type of training they had. As closely as possible, I matched, by population size, communities that dropped high school driver ed when state funding was no longer available and those that continued the program with local funds. The communities that dropped the course experienced a substantial decline in driver licenses of 16-17 year olds. This decline was only slightly offset by licenses obtained after commercial or home training. The result was a substantial drop in crashes per population among 16-17 year old drivers. The claim that teenagers would be licensed whether or not the course was offered was now proved clearly false for the vast majority of them (1). Haddon was delighted that the results of the earlier study held up. His delight was in the consistency of the 190

results, not that driver education was harmful. Some of his critics claimed that Haddon was opposed to attempts to change behavior because of his emphasis on changing vehicles and environments. In fact, he was fascinated by theories of behavior and, on more than one occasion, I had to dissuade him from support of some behavioral study that I thought would be fruitless. Haddon was interested in scientifically based amelioration of injuries, no matter whose ox was gored. Nevertheless, Haddon was somewhat gun shy of releasing the new study of driver education, given the earlier experience. He asked if the Yale public relations office would release the results. I talked with the editor of the Yale Weekly Bulletin and Calendar who agreed to run a story on the study. The national press picked up the story and again the issue received wide coverage. Of course, the driver education lobbyists, textbook writers and other loyalists stuck to the mantra that kids were better off if they took the high school course. One group that liked my studies was the commercial driver education association. A couple of their representatives came to see me, but I told them that they shouldn’t make any claim that their training lowered crash risk. They did provide a convenience to parents who didn’t want to train their children themselves without apparent harm. By the time the study was released, Lindblom had appointed a political scientist named Ted Marmor to direct the Center for Health Studies. Marmor showed me a letter that he received from a driver education supporter at one of the schools offering a degree in the subject, suggesting that I was a tool of the anti-driver 191

education menace, Bill Haddon, and that I should not employed in an institution of higher learning. Marmor invited him to come to Yale and debate me in a public forum. My adversary declined the invitation. Thus, in this round, I stayed above the fray. As a result of the controversy, the National Highway Traffic Safety Administration conducted a large driver education experiment in Georgia. They had two courses, one the usual 30 hours plus in-car training and another designed by education specialists. Students in the latter course spent extensive time on an expensive driving track designed especially for the course. Nevertheless, the subsequent crash records of those in the special course or the regular course were no lower that those in a control group who received no school training. Since the students were selected from those who intended to get a license, the effect on increased licenses was less than I had found, but it was detectable. The Congress eventually eliminated federal subsidies for high school driver education, but many schools retain the demonstrably harmful program to this day. Meanwhile back at the ranch house, Nancy was depressed. She wasn’t interested in swimming and other water sports. She hadn’t found a job. The neighbors were typical New Englanders, friendly but slow to warm up to strangers. Eventually we became an integral part of the neighborhood and Nancy landed a job in the Manuscripts and Archives division in the Yale library system. She returned to her usually cheerful self and life was good. In addition to swimming in bracingly cool waters of 192

the Sound during the summer months, I acquired a 12foot fishing boat. I had fished a few times from the shore of Tennessee lakes while a graduate student, but didn’t catch much. In Branford, I didn’t do much better except on the days that I went with guys in the neighborhood who had an uncanny knowledge of where the fish were on a given day. One afternoon I saw my crabby old Yankee neighbor, corncob pipe and all, drag a 10-foot shark up the street. It gave me a little pause in thinking about swimming, but that was the only one I saw there in 20 years. For a time, I set out a few lobster traps. To be fair to the lobsters, which would fight if more than one was entrapped, I had to check the pots every couple of days. When I resumed traveling for extended periods, I gave up on lobsters. By the time I paid for the boat, motor, gas and bait, they cost substantially more than those acquired at the store anyway. After a year or so, I bought a little sailboat and learned to sail it. That was the first of a series of sailboats, progressively larger as is the wont of sailors. For those who haven’t tried it, sailing is a great substitute for psychotherapy and probably cheaper if you don’t get into fancy boats. The downside of sailing on the east coast is that hurricane season begins long before you are ready to store the boat for winter. Each year, usually in August, those of us who had boats anchored in the Sound would scramble to get them out as a storm approached. I had one damaged and lost another to storms that weren’t even of hurricane strength. Nancy got her fill of sailing on her third trip. During 193

the first two, she wasn’t all that happy but the winds were gentle and I tried to be so. The third time, I made the mistake of taking her out when the wind was gusting from the northwest between the houses on shore. The boat heeled substantially each time a gust struck the sails. Nancy yelled at me to take her home. To complicate matters, the rudder became entangled in a buoy floating above a lobster pot. By the time I got to shore, Nancy vowed never to sail again. She didn’t with me at the helm of my smaller boats, but she did make an exception on a larger boat in Florida during a vacation. Volvo installed air bags in a new model and we went shopping for one. When the dealer asked me if I wanted a four or six cylinder engine, I said that I didn’t need a big engine. That was in summer. When it came time to pull my boat from the water, I got it on the trailer but, at full throttle, the Volvo would not budge. Our community boat ramp was rather steep and the car just didn’t have the power to do the job. In fact, it appeared that the weight of the boat and trailer might drag that rather expensive vehicle into the salt water. Nancy ran to the house of a friend who had a pickup and we extricated the car and boat from near disaster. Fortunately, there was a slightly graded community boat launch ramp that the Volvo could handle. In my course on injury epidemiology in the Department of Epidemiology Public Health, a student asked me one day what I did for the weekend. Raced my boat, says I. “How did you do?” he asked. I told him I finished fourth. He then asked how many boats were in the race and I told him he had asked one question too 194

many. Of course, there were four. True to my word to Lindblom, I reviewed quite a bit of the literature on cancer and found conflicting studies on the effects of air and water pollution. I scrounged around the Yale libraries for better data and hit a gold mine of data on city water supplies in the geology library. Using these data along with age adjusted cancer mortality rates among cities and registered vehicles per square mile in those areas; I found that, corrected for water pollution as well as migration in the past, those cities with higher vehicle density had higher cancer mortality rates twenty or so years later. I also included cardiovascular disease rates in the analysis and found no effect of vehicle density on them (2). The editor of the Yale Weekly Bulletin and Calendar was pleased with the press coverage of my driver education study. He would call from time to time to see if I had any thing new that would interest his readers. When I told him about the cancer results, he wrote a story about it. Again the press picked up the story and I did several interviews with reporters. On one radio talk show, I believe in Oklahoma City, I was asked what was in vehicle exhausts that would cause cancer. The same type of hydrocarbons that are in cigarette smoke, but in lower concentration by the time they are inhaled, I replied. Previous studies in animals had showed that they were very carcinogenic. Later, epidemiologists would show that nonsmokers breathing secondary tobacco smoke are also at higher risk of cancer. The director of the Yale Cancer Center asked me to join an occupational health professor to write an application to the National Cancer Institute (NCI) for a 195

statewide cancer control effort. I had no experience in cancer control and his was limited to occupational settings. We decided to visit NCI and see what they thought of some our ideas. In the course of the conversations, we brought up our inexperience and asked if that was a problem. No, we were told, as a matter of fact they were interested in fresh ideas from people with experience in other areas of public health. We wrote a proposal and a site visit was scheduled. I was flabbergasted that they brought about 20 people to hear our presentation and question us. Among the visitors was a communications specialist who made it clear that he didn’t like my studies showing that TV ads and driver education didn’t work. When we got the “pink sheets”, as summaries of the reviews written by NCI staffers were called, the first sentence called attention to our inexperience in cancer control. Of course, the application was rejected. At that point, I decided to stick to injury epidemiology and avoid government funding if possible. The latter vow I broke when Haddon called to tell me that there was a government request for proposal to study the effects of seat belt laws in several countries in Europe. He had talked with the new NHTSA Administrator in the Carter Administration, Joan Claybrook, who was his assistant some ten years earlier when he was head of the predecessor agency. Since she had responded favorably to Haddon’s suggestion that I was the best person to do the work, I wrote a proposal and sent it to the contract officer. Some time later I got a rejection along with a nasty letter from an NHTSA employee saying that I did not 196

know how to write a proposal. I inquired around and learned that he was among the permanent bureaucrats in the agency who had been burned by some of my research in the past. It was payback time. They awarded the contract to a beltway bandit firm who eventually produced a report that described a poorly executed effort. I renewed my pledge to myself to avoid government grants but I again reneged some years later, eventually with some success. I did serve on several committees to review federal health policies and funding. My first experience with such a committee came at the recommendation of Ted Marmor, the head of the Center for Health Studies, my base during my first 5 years at Yale. A friend of his was the staff person for a committee to review policies for child and adolescent health, supported by the U.S. Department of Health and Human Services. The committee produced a 4-volume report that included a chapter on environmental effects on children’s health that I wrote. One of the highlights of the committee’s activities was a visit to Jackson, Mississippi. We motored into a rural area where we observed crop dusters indiscriminately spraying cotton fields and farm workers’ houses. The air was thick with the smell of pesticides and herbicides. We visited houses of people in abject poverty where human waste was collected in a bucket and thrown over the fence in back for lack of even an outhouse. In the city, we visited a clinic that was promoting birth control among high school students, including distribution of condoms by school nurses. In the hotel that evening, I was sitting in the lobby 197

talking with others when Ronald Reagan walked in. He was running for President and had a speech scheduled in the hotel. When he won, most of the committee’s recommendations were doomed. In the meantime, I asked Haddon if the Institute would support my work on an injury policy book. The Institute had supported the preparation of several previous books, so there was precedent. He agreed and I contracted with Lexington Books to publish the work when completed. Since I had spent a lot of time preparing materials on a wide range of injury research for my course at Yale, as well as summer lectures in my friend Susan Baker’s course in the Graduate Summer Session in Epidemiology at the University of Minnesota, the writing went smoothly. In the book, I reviewed the toll that injuries imposed on the population in 1978, the most recent year for which data were available. Although more people die from cardiovascular diseases and cancer, motor vehicle injuries alone accounted for similar numbers of preretirement years of life lost because they accounted disproportionately for deaths among the young, a point made earlier in writings by Bill Haddon and Sue Baker. Half of the deaths from heart disease occurred to people older then 76 and half of the deaths from cancer were among people older than 67, but half of those who died in motor vehicle crashes were younger than 27. After a review of the scientific evidence on how human, vehicle and environmental factors contribute to injury incidence and severity; I wrote chapters on demonstrated effectiveness or lack of effectiveness of programs and regulations to change these factors. In 198

general, programs that attempt to educate or persuade people to do something frequently, such as use seat belts, are not effective in the absence of a law requiring the behavior. Persuasive campaigns are more successful for behaviors that are needed less frequently, such as obtaining children’s immunizations. Laws are effective if the behavior is publicly observable, the public is educated about the law, and the police enforce it vigorously. Automatic protection, such as the removal or modification of roadside hazards to absorb crash forces, is the most effective if the technology is sound, because it doesn’t depend on the behavior of millions of people. Of course, modifying products or installing new technology costs money. Manufacturers, as well as some politicians, object to such expenditures. I reviewed the arguments regarding cost versus benefits and cost-effectiveness. Cost-benefit analysis is problematic because it requires that human life be valued in currency -- dollars in the U.S. If the cost of the technology exceeds the value of the lives or nonfatal injuries reduced, many economists argue, the technology should not be adopted. Aside from the fact that people may be willing to pay more than the economists’ dollar value of life, that position has some significant other implications, especially for us old folks. Since we are no longer economically productive, our lives are economically worthless, the argument goes, and nothing should be spent to prevent our early demise. Some economists and others defending tobacco companies have actually made such arguments. 199

Since injuries disproportionately take their toll on a young population, many technologies pass the economist’s test, however obnoxious it sounds. Nevertheless, the studies are subject to manipulation by changing assumptions about the economic value of life. Cost-effectiveness refers to the allocation of funds to the most effective programs, which is less controversial, unless you are promoting driver ed. (3) When the book was published, it was favorably reviewed in several publications. I basked in the praise of my fellow injury epidemiologists at the next meeting of the American Public Health Association. By this time, my work had taken me largely out of the main stream of sociology. I no longer went to the sociology meetings, opting to hobnob with epidemiologists and follow the latest research on injuries. A fun research project was suggested by an insurance company’s offer to each of its policyholders to pay extra benefits to survivors if the policyholder was injured or killed using a seat belt. This was supposed to be an incentive to use belts. I saw a comedy show on TV that portrayed insurance adjustors approaching a porch and ringing the bell. When a woman appeared at the door, she was told that her husband had died in a car crash. After offering condolences, they said that he had his belt on so they would pay her an extra $10,000. The wife jumped up and down, yelling, “I won. I won.” Of course, the effective of such incentives on belt use is a serious question. First offered by General Motors for the first year of new car ownership, now Nationwide Insurance was offering a supposed incentive with no evidence that it would increase belt use. I asked the 200

Connecticut Department of Transportation if they would allow me to link license tag numbers to the names of the insurance companies that insured the vehicles associated with the tags. They would. I then set out around the state to observe belt use at various sites. The results showed no higher belt use among drivers insured by Nationwide than among those insured by companies that offered no seat-belt incentive. (4) One of the research projects that I enjoyed during this period was initiated by a call from Jack Keeve, who was then the chief physician for Atlantic Richfield Corporation. He had a Masters of Public Health from Yale and, when he called the department to find out if anyone was working on injury, he was referred to me. Jack told me that Atlantic Richfield, mainly an oil company, had purchased Anaconda Industries, a mining and metal fabrication company. Injuries in oil refineries are low and the company was shocked by the worker injuries in metal working plants. He asked if I would collaborate on a study of those plants. I agreed. When we visited the plants, the reasons for the high injury rates were obvious to me but I was committed to do a study. Workers were in close proximity to cauldrons of melted metal where a misstep would result in severe burns. Sheets of sharp edged metals wound around rollers near workers. Hands pushed and pulled metals in and out of poorly guarded punch and stamping machines. I hired a research assistant to go through plant medical records and personnel records. She recorded data on injuries in three plants in three states, as well as other factors from the worker histories and time 201

sheets. When the data were compiled into analyzable formats for the computer, I did correlations of injuries to type of job, hours worked and worker background. Although there were some interesting correlations, they were relatively weak and not very useful from the viewpoint of injury control. I noticed large fluctuations in the data among plants at various times. What, I asked myself, are the possible influences that could produce such perturbations? Two candidates were inspections by the Occupational Safety and Health Administration (OSHA) and changes in compensation for worker injury. We obtained data from the plants on dates that they had OSHA inspections. We also got from the states data on changes in worker’s compensation payments. When these data were factored in, a clear pattern emerged. In the months following an OSHA inspection, the injuries verifiable by clinicians, such as burns and lacerations, declined markedly. When workers compensation was increased at a rate faster than inflation, the rate of what I called “subjective injury”, such as unverifiable pain and strain, increased substantially. I then compiled data on injury trends, workers’ compensation changes and OSHA inspections in several states. The data indicated that the effects observed in the metal working plants could be generalized to other industries (5). Others who had claimed little or no effects of OSHA in such analyses had not taken into account the effects of workers’ compensation. When the results were published, at least one press report said that I was accusing the workers of malingering. That wasn’t so. The subjective injuries 202

could have been very real but workers who can’t afford to miss work may live with them rather than report them to the plant nurse. When there is compensation such that they can afford to be off from work, they report the injury. Some may have been malingering, but I had no way to know that. The point was that pain is often subjective and cannot be verified by someone other than the person experiencing it. As part of my developing interest in injuries other than those in or by motor vehicles, I looked for trends in deaths from other causes. I noticed that infant injury death rates unrelated to motor vehicles declined by about half from the late 1960s to 1975, during which time the restrictions on abortions were lowered in several states and finally nationwide by the Supreme Court’s Roe v. Wade decision in 1973. I wondered if there was a connection between the abortion of unwanted children and reduced risk of severe injury. To study the issue, I obtained data from the U.S. government on number of abortions among the states for the years 1971-72 and 1974-75, along with infant mortality data by cause. The data clearly indicated that the reduction in non-vehicular injury deaths among infants was related to a state’s abortion policies. The correlation was nonlinear - such deaths were especially high in states with little or no abortions. The decline in infant deaths from before to after Roe v. Wade was most pronounced in states where abortions increased. It appears that injury deaths to infants caused by factors other than vehicles are substantially to unwanted children. Since there was no apparent effect on infant homicides, the effect appeared to be largely a 203

result of a decline in unwanted babies and the neglect that unwanted babies might experience. (6) I didn’t mention this study to my friend who edited the Yale Bulletin and Calendar because I thought the Supreme Court had settled the issue and I wasn’t inclined to get into the abortion debate. Other studies on the fate of malformed and unwanted children suggested that a total ban on abortions was foolish, but the extent to which it should be allowed was beyond my purview. Science can measure the results of different public policies and hopefully inform the debate. The abortion debates, however, seem oblivious to science. The issue of who should have what freedoms is the primary issue, a matter of negotiation in the political arena, not science. Of course, governmental support for science is political. I was drawn into that issue when I was appointed to the Committee on Trauma Research of the National Research Council/Institute of Medicine - units of the National Academy of Sciences. Often when members of Congress or other national politicians become interested in a scientific issue, they will push for funds for a report from the NRC. Appointment to such committees is an honor that few scientists would turn down. At the first meeting, I was pleased to see two of my friends: Susan Baker, who was vice chair, from Johns Hopkins and Brian O’Neill from the Insurance Institute for Highway Safety. In all, there were 16 members representing various disciplines - behavioral science, biomechanics, epidemiology, statistics, and physicians specializing in pathology, rehabilitation and trauma 204

surgery. The committee was chaired by William Foege, M.D., a former director of the Centers for Disease Control. He asked that we each introduce ourselves. When it came my turn, I said that I was once a sociologist, but became an epidemiologist when Ronald Reagan was elected President. In many cases, such committees discuss issues and direct the staff to write a report along the guidelines provided by the committee. In this committee, however, the committee members did the writing. I took on a disproportionate share of those duties because I knew that he who writes first tends to dictate the agenda. I had some definite ideas about what I wanted the report to say. It turned out that most of the committee shared those ideas. The committee members were the most cooperative and single minded of any of the committees on which I have served. Despite the disparity in disciplinary representation, there were no turf wars. One member was a General Motors employee who worked on biomechanics. Other than one brief but sharp exchange between him and me, we were all on the same page. Everyone was aware of the gross lack of federal support for each of the disciplines represented relative to impact of injuries on the population. In the report, we noted the discrepancy in funding compared to heart disease and cancer given the equivalence in preretirement years of life lost - 4.1 million years from injury compared to 3.8 million years from heart disease and cancer. To document this, I spent weeks going over descriptions of grants and contracts from various government agencies to assess the extent, if any, that 205

they supported injury related research. We found that the federal government spent about 15 times more on cancer and heart disease research than it did on injury research. In the course of the committee’s deliberations on recommendations, we decided to call for a separate funding unit in the government solely focused on injury. We interviewed representatives from various cabinet level departments. Most of us thought the new agency should be in the National Institutes of Health but, to our surprise, the NIH representatives said they didn’t want it. Finally, by process of elimination, we recommended a Center for Injury Control in the Centers for Disease Control. (7) Later, when others and I had problems with that Center, some complained that Foege was at fault for pushing for the center there. That was not true. Foege informed us of CDC’s positives and negatives, but was not an advocate for that placement. We would have had one problem or another no matter where it was placed. Although Foege’s primary interest was infectious diseases - he was part of the team that eliminated smallpox worldwide - he supported injury research in subsequent speeches and writing. One of the members of the committee was John Davis, the Chairman of the Department of Surgery at the University of Vermont. He was a delightful guy who told great stories. Another of the surgeons told me that John was the prototype for Hawkeye in the movie M.A.S.H, as well as the wildly successful TV series. One morning at breakfast, before a committee meeting, I asked John if that was true. He modestly said that the guy who wrote 206

it was in his M.A.S.H. unit in Korea, but that the characters were composites. I asked John if the incident involving Painless, the dentist, actually happened. He grinned and said, “Yes”. The CDC did not immediately form a Center for lack of money and staff, but the congressman who had asked for the report persuaded his colleagues to shift money from the Department of Transportation to CDC to support an injury control unit in the Center for Environmental Health. Using these funds, the new unit announced that it would accept grant proposals. Along with others I applied. I contacted several local health departments in Connecticut and developed a consortium to collect data on injuries, target control tactics to specific clusters, and study the effectiveness of the interventions. Since there were so few injury researchers at the time, some of us who submitted proposals were also on the committee appointed by CDC to review them. As was the policy at NIH, the person whose proposal was being reviewed had to leave the room while his or her proposal was being discussed. To my consternation, my proposal was not funded. I was told that it was not considered scientific enough. Apparently, some people thought that doing something about the problem rather than just studying it wasn’t scientific. I wasn’t the only one who was disappointed. While I didn’t raise a fuss, several surgeons threatened to go to congress and charge that the CDC process was biased. They claimed that the head of the CDC injury unit, an epidemiologist, was giving information to other epidemiologists, putting them at an unfair advantage in 207

the funding competition. I knew that wasn’t true. I met one of the surgeons who had served on the NRC committee to reassure him and asked him to talk with the rump group. I told him that none of us knew the new unit’s director, who was a “clap doctor”, a specialist in sexually transmitted diseases. While I agreed that it was stupid to appoint someone without experience in the injury field to head the unit, I could find no evidence of bias. The storm blew over and the CDC unit was eventually elevated to center status sometime after a Congressional review of the program. After 3 years, the NRC was asked by the Congress to examine the CDC program and recommend any needed corrections. I was appointed vice chair of the NRC review committee. In committee hearings, I questioned the director of the program sharply about lack of progress. At that time, only the original round of grant proposals had been reviewed and funded. The pat answer was lack of adequate funds and the lack of Center status. The Committee’s report noted these problems and recommended elevation to Center status with appropriate funding. (8) When CDC obtained more funding from Congress, an annual proposal review system was established. I was appointed to the committee to rate the proposals on scientific merit. During my years on that committee for CDC, I objected to a problem in their award process, but it wasn’t disciplinary bias. It was raw politics. The injury unit announced that funds were available to finance centers of excellence in a few universities. When the awards were made, it was clear that the universities getting the center grants were not 208

necessarily the ones with the best proposals. This was not sour grapes. I was not an applicant. The CDC had their own committee that ignored the outside reviewers’ recommendations and made the final awards. For several years, the awards included a university in the state represented by whoever was the Chair of the Senate subcommittee that controlled CDC’s budget. I wrote a critique of the process for Susan Gerberich at the University of Minnesota, whose proposals were not funded despite higher scientific ratings than those that were funded. CDC then dropped me from their scientific review committee. I was glad to be relieved of the sham. The organizers of another National Research Council Committee asked me to serve on it. The subject was the precision and accuracy of statistics on worker injuries. In this case, the chairman and members of the NRC staff did the bulk of the writing. Several times I noted the importance of the distinction of injuries verifiable by clinical observation and what I called “subjective injury” in my earlier study of worker injuries. Finally, I had to insist that it be included in the report (9). Of course, all of my national committee work was voluntary and neither the University nor I was paid for it, although I was reimbursed for travel expenses. I was also asked to give presentations on several occasions in places that I enjoyed, such as Seattle, Montreal, and Vancouver, for which I was paid a modest “honorarium”, as it is known in academics. All of these activities in the early 1980s consumed time that I could have spent raising funds for research. 209

After my first 5 years at Yale, in 1983, the Center for Health Studies ran short of funds. The original grant had run its course and was not sufficiently replaced. Although Marmor had promised that those who raised money for part of their salaries would be kept on, he had not raised any money to back up his promise. I decided to look for a job at another university. When the Chair of the Department of Epidemiology and Public Health heard this, he asked me to join its faculty full time as a Research Scientist. Yale has two career tracks - professorial and research. If one isn’t tenured in the professorial track within a specified number of years, the appointment ends. In the research track, however, there is no set period for “up or out” and those who help raise money for their salary and research can stay as long as the money lasts. I wasn’t that concerned about money because my investment income had soared. At the peak of the hyperinflation period in the early 1980s, I bought highly discounted corporate bonds on margin. “On margin” means that I borrowed money from the broker to buy a lot more than I had money in my account to pay for them, the only time in my investment career that I did that. The risk is that the value of the bonds goes down and your losses are multiplied when you have to sell at a discount to meet margin calls. The head of the Federal Reserve had pushed interest rates to unprecedented levels to knock inflation down. My analysis, as well as that of others, indicated that interest rates had peaked and lower rates meant that the bonds would appreciate big time. And so they did. For a few months, our net worth increased about $1000 210

per day. In 1983, I moved my office to the public health building on the medical school campus and looked around for sources to fund my salary and research. The department Chairman and I did a study on vehicle inspections for the Connecticut Department of Motor Vehicle that helped pay the bills. One of the statisticians who had post-polio syndrome had problems so I took on a section of the biostatistics course that he taught. I hadn’t taught statistics since my years at Wake Forest, but it wasn’t that difficult to teach. The major problem was the wide variance in the students’ math skills. In my first class, one student asked me what I meant by the word “percent” and another student, from Hong Kong, sometime later approached me after class, calculus text in hand, to ask if a formula I discussed in class couldn’t be proved a different way. He was right; it could. I had to do more hand holding than I anticipated with the students whose skills were lacking, but most of them survived, as did I. The department had a grant from the government that paid a capitation fee for up to a hundred students each year that enrolled in the MPH (masters of public health) program. Without such funds in several schools of public health, the nation would have had understaffed state health departments and poorer health. The university would accept a hundred new candidates each year despite the fact that some had dubious qualifications. Since I was now teaching in the second or third university that, based on my high school records, I could not have qualified to enter, I 211

sympathized with the plight of the students and tried to help them learn as much as possible. We did have a few weird students relative to what one would expect in a school of public health. One was a gun nut that signed up to work on a community project that I supervised regarding the role of guns in injury. He took other students working on the project to the shooting range and tried to convince them that guns are the greatest thing since sliced bread. The report that they turned in was biased and I had to fight with them to get it in shape. Another student who took my course claimed that meditation would reduce the incidence of injury in communities. I asked him how he would study that and he said that he could get a large group of people to meditate. I was dismayed when I learned that he expected injury rates to decline among people in the community who were not meditating, but who were in the vicinity of those meditating. At national meetings I became acquainted with Rick Smith who ran the injury control program of the Indian Health Service (IHS). IHS, by treaty, provided health services or funding for tribally administered health services for Native Americans. Rick called to alert me to a request for proposal to evaluate the IHS injury program that IHS published in the Federal Register. I reneged on my vow not to seek government funding and applied, this time with success. In Washington to begin work on the contract, I met with the statisticians and computer programmers who educated me in the IHS data systems. They sent me some 70 computer tapes with data on clinic visits and 212

hospitalizations as well as deaths from injury. Although their data systems were not perfect - none are in my experience - they had more complete data than any service I had encountered. The problem was to collate it and relate it to their program activities. To compile data on the latter, I did a survey of the injury control activities of the environmental health officers in the service units throughout what they called “Indian Country”. At the urging of Dr. Everett Rhoades, the head of IHS at the time, the environmental health officers had been given the task of forming community injury control committees in Native American communities, including tribal representatives as well as IHS professional staff, many of whom were also Native Americans. IHS, a division of the U.S. Department of Health and Human Services, had a spectacular record of success in curbing infectious diseases among Native Americans. After 1955, when it took over the health services from the Bureau of Indian Affairs, in the Department of the Interior, infectious disease death rates among Native Americans plunged to near those of the general population. Dr. Rhodes recognized that injury rates among Native Americans remained much higher than those among other Americans and initiated the program in an attempt to narrow that gap as well. The community committees adopted a variety of programs, almost entirely, but not exclusively, education and training programs. In an attempt to evaluate the effects of specific programs, I correlated activities among the service units with changes in injury rates to which those 213

activities were directed. Clinic visits actually increased in several injury categories, but there was a substantial decline in the “other injury” category, so I did not use the clinic visit data. It appeared that the increased emphasis on injury resulted in more care in classification of cases to specific types of injury; so it was not possible to discern the effects of the programs using clinic data. Hospitalizations, which were more thoroughly coded, I could use. There were some correlations of declines in hospitalization rates for falls and the safety training efforts, but none for motor vehicles and other injuries. Hospitalizations for suicide attempts actually increased in correlation with poison prevention training. Perhaps some suicidal people learned of drugs or other chemicals to use in attempts. (10) I recommended that IHS change their data collection system to focus more on specification of locations where injuries occurred and selection of environmental modifications at specific sites where injuries clustered, or at known high risk sites for motor vehicle crashes such as those noted in my earlier Georgia study. Included were data forms for each of the types of injury -- such as motor vehicles, assaults, burns, suicides or attempts -- which concentrated on circumstances or environmental factors that were subject to change. After IHS leadership reviewed the report, they attempted to implement the recommendations. Eventually, they issued a second contract that I won, to travel to several areas that had pilot programs to review what was being done and assess progress. I checked out their data systems, demonstrated how to 214

interview people who had been injured to supplement what could be gained from clinic records, and met with the injury control committees to explain the system and my vision for its use. Many of the environmental health officers and community leaders noted difficulty in compiling data and determining which, among many available countermeasures, might be the most useful in ameliorating the problems. Many also complained that the injury work was piled on their other duties rather than allowing them to reduce other work. Environmental health officers were responsible for water quality, food service safety, hospital infection control and the like, none of which they felt could be neglected. Although all of the people I visited were not convinced of the merits of my recommendations, apparently I did have some influence. In Montana, the district chief of the environmental health officers, a guy named Keith, escorted me as I visited several reservations. In Browning, commercial center of the Blackfoot Nation, I went over my Georgia study on identification of higher risk sites by road curves and grades. One of the physicians in attendance said, “There are no curves on roads here.” I pointed out that a 6-degree curve is subtle, which may be part of the problem, and that there were plenty of them in the area. Driving along the road on the way to the next stop, I pointed out to Keith that we were rounding a curve that the Doc said didn’t exist. The words were hardly out of my mouth when we spotted three white crosses planted by the roadside. In Montana, people often placed such a 215

cross where people died in vehicle crashes. Later, Rick Smith called me and said, “What did you do to Keith?” Nothing that I know of, says I, why? Well, Rick told me, Keith resisted taking on the injury control program until my visit with him and now he is on board. I told Rick the story of the white crosses. During that trip, I visited the grave of Chief Joseph, who the U.S. Cavalry hounded for years until he gave up and said the words carved on his gravestone, “I will fight no more forever.” I was moved to tears. Also, I toured the Custer battlefield and museum with some guys from the Crow reservation. Although their ancestors provided some of Custer’s scouts against their old enemy, the Lakota, they were not teary eyed over Custer’s fate. In my new work, I was happy to be on the side of the Indians. At least partly in response to my report on the need for training in use of the data system and time for the environmental health officers to work on injury, IHS developed several levels of training programs. Included was a yearlong fellowship program for environmental health officers and community members to become injury control specialists. Although they were not given the year off from other duties, the specialist candidates were given several weeks to attend a course especially designed for them at Johns Hopkins, the injury control course in the Graduate Summer Session in Epidemiology, and a week in field training that I conducted on one of the reservations. They were also expected to conduct a research project during the year. At a meeting with the first group to enter the fellowship, Dr. Rhoades pledged to establish full time 216

positions for specialists as budgets allowed. In subsequent years, dozens of people went through this program and several produced remarkable results in injury reduction that I will mention later. Since the mid 1970s I had lectured in the Graduate Summer Session’s injury course periodically, but it was basically Susan Baker’s course, assisted by Susan Gerberich who ran the injury program at the University of Minnesota. When Susan Baker decided to give up the course, Susan Gerberich recruited others and me to help her continue the course. Eventually, the entire Graduate Summer Session was moved to the University of Michigan in Ann Arbor. The first Indian Health Service fellows attended the course the last year that it was in Minnesota. “Fellows” does not refer to gender but to recipients of fellowships. The first group, who called themselves the “Top Picks”, was especially fun to be with both in and out of class. At a reception, the class jokester struck up a conversation with the Chairman of the Epidemiology Department, Lynn Shuman, and asked Lynn, “Where is the tomb of the unknown Swede?” Lynn and I thought it hilarious but when word got back to Washington, the student was reprimanded. One of the “fellows” was a lady who worked on the Cherokee Reservation in North Carolina, named Jackie Moore. Without knowing of my recommendations or me, Jackie had set up a data collection system and spotted a cluster of pedestrian injuries on a road section. She persuaded the tribe and highway officials to carve out the side of a mountain to remove a blind curve. When I arrived to teach my part of the course, Susan Gerberich 217

said that Jackie was scared of me. She had seen me criticize someone’s work at a public health meeting. When I met with Jackie about her project for the fellowship, she talked a mile a minute, ending with a statement something to the effect that she didn’t want to hear any negative comment from me. I held up my hands in a surrender gesture. “Don’t worry”, I said, “I’m not going to fight with a woman who can move mountains.” In the fall training session, we were riding from a crash site on the Navajo reservation when one of the students, Jack Christy, yelled for the driver to stop the car. He did and the Jack got out with his camera. He was asked what he intended to photograph. He said, “There is a dead horse back there. One of you guys come with me and take a picture of me beating a dead horse.” I had met Jack earlier in a trip to Phoenix where he had replaced Rick Smith as area injury coordinator. When I asked Jack how he liked following Rick in the job, he said, “Big shoes.” Although Jack was married and had a child, he looked like a teenager. Once when we were in a restaurant with several people from IHS, Jack was sitting at another table. I tipped a waitress to card Jack if he ordered a beer. He did and she did. Made his day. In the following year, when the summer course moved to the University of Michigan, at the outset I was not invited to teach there. They recruited Jess Kraus, an epidemiologist who had done some nice studies of spinal cord injuries and injuries to motorcyclists, supported by the Insurance Institute while I was there. When Rick Smith learned that I was not invited to teach 218

at Michigan, he contacted the new director of the program to tell him that he was reconsidering the IHS student’s participation in the program if I was not on the faculty. I was then invited to co-teach the course with Jess. Since it was a three-week course at that time, I, and I think Jess, was glad not to have the sole responsibility. The classes lasted for 3-4 hours per day, five days per week, which was a marathon for students and us alike. I was opposed to the schedule because no one can sustain attention in class for three hours, but most attendees at the summer session took more than one class. Splitting our class, or others, into morning and afternoon sessions would have created multiple conflicts. Despite the conditions, many of the students performed well. In addition to conducting successful injury control programs, several rose to major leadership positions in the Indian Health Service. We had other students as well. One, a physician from Spain, eventually was the first to occupy a teaching chair at Johns Hopkins that I helped found. At Yale, my reputation for being critical of ideas and research continued. Once when the publisher of Prevention Magazine was to visit the department, the Chairman, Jan Stolwijk, cautioned me they intended to try to get a grant from him, so he asked me to be tolerant of some of Mr. Rodale's ideas. I said okay, as long as he doesn't say that eating fruits and nuts will prevent injuries in car crashes, I will be quiet. I served on a committee to recruit a new Chair for the health management department. Stolwijk hinted that, if I would apply for the job and got it, I would become 219

tenured and have less concern for raising my salary. Given my aversion to management, I wasn't interested. I was repeatedly frustrated in attempts to raise money for an injury research program. I would develop ideas and discuss them either with the grants and contracts office or the office that handled foundation applications and individual gifts. The grants and contracts office increased the overhead charges to the point that one had to ask a granting agency 1.75 times the amount actually needed for the work. I told Stolwijk that, since my office was only 144 square feet and I purchased my own personal computer, I was not going to subsidize the administration and maintenance budgets, and wet labs in the Medical School, to that extent. The foundations and gifts office repeatedly prohibited me from approaching foundations and individuals because other faculty members were hitting them up for their projects. It was clear that injury research was not on Yale’s priority radar. There was probably no connection to my funding problems, but I also became involved in the controversy surrounding the unionization of Yale’s clerical and technical workers. Those workers, including my wife, were hardly paid a living wage. Although we did not need the money, many of Nancy’s colleagues had difficulty paying their bills, and she became active in the effort to organize a union. The university offered the support staff the same percentage gain in wages that the faculty received. I wrote a letter to the editor of the local paper, the New Haven Register, which was published under the title, “The pernicious percent”. I pointed out that the same percent pay increase for 220

faculty and staff resulted in quite different dollar amounts if one was paid several times the wages of another person. I no longer remember the numbers but 10 percent of $15,000 is $1500 but 10 percent of $50,000 is $5,000. Uniform percentage increases in wages actually widened the income gap. The union was organized and went on strike. A television reporter approached Nancy while she was picketing in front of the library. She shied away but he persisted and she answered a few questions. That evening, we got a call from Al Mazur, who was by then teaching at Syracuse University. He congratulated Nancy for being on the national news. But it was just local, she said, how could it be on in Syracuse? No, said Al, it’s on the CBS Evening News. The news was scheduled later on the Hartford station, so we tuned in and there she was. They showed her, then Bart Giamatti (Yale’s President) and then Nancy again. I thought she did better than “Black Bart”, as the union members called him, but I will admit to bias when it comes to Nancy. Whatever the reason for my funding problems, I decided to take my computer home and raise money through a private consulting entity that I had established, called Nanlee Research. I had licensed the firm a couple of years before to market a consumer information booklet that compared the safety among new cars. With the help of some consumer writers who mentioned it in their newspaper columns, the booklet sold well enough to pay for printing and mailing expenses, but it was not intended to make a profit and it didn’t. I was aware that several Yale professors 221

operated private research and consulting businesses outside the administrative purview of the university. I did a bit of work for one of the university’s star economists, William Nordhaus, reviewing his report on air bag costs before he submitted it to his contractor. I couldn’t have made the move without the availability of affordable personal computers. With my new machine and printer, I could handle not only typing chores, but data analysis as well. Since I often dealt with large data sets, some of my computer runs on my trusty Osbourne took hours, but it got the job done. While the computer chomped away on the data, I would read, mow the yard, go sailing or take a long walk. After a while, I bought a second one so that I could work on one while the other was running statistics on data sets. I was no longer dependent on the university for anything. Dr. Stolwijk asked me to continue teaching my course and I agreed to do so, keeping my appointment as Lecturer in Public Health.

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Chapter 9. Expert Witness My career as an independent researcher and consultant got off to a slow start. Nancy and I took a month off to tour Denmark, Finland, Norway, and Sweden with Canadian friends that we had met earlier on the South American trip. They had been to our house in Branford subsequently and we had visited them in their home in British Columbia, as part of a vacation trip to Alaska. We enjoyed their company and the beauty of the north countries. We had been back only a couple of weeks, in October of 1985, when Branford was hit by hurricane Gloria. Long Island Sound looked like the North Atlantic but we didn’t get the water surge, which was dissipated on the south shore of Long Island before the winds skipped over the Sound. The winds blew up to 100 mile per hour and took about a third of the shingles off our house. The whole top came off a house a block away. Although power lines on the shore were safely underground, falling trees inland were downed over power lines and we had no electricity for a week. Because we heated with gas, we had hot water, which we shared with those in the neighborhood who had electric water heaters and needed a shower. I spent several days in the neighborhood effort to cut and remove fallen trees and limbs. We could have done without the damage but I enjoyed the hands-on labor. Our home was in an erosion control district that had responsibility for the integrity of the shoreline. The sand was washed from our beach by the currents and a wall 223

that prevented erosion near the exit road was breached. I was on the board of directors of the district and was occupied for some time in meetings to deal with contracting for the wall repair. We had to make sure that we were in compliance with state and federal environmental rules. We also considered trucking in sand to rebuild the beach but the old timers said to be patient and it would return naturally. The sand had only washed out onto a long sandbar that extended into the Sound just under water at low tide. Eventually, the currents washed the sand back to reform the beach. Later that fall, Ben Kelley, with whom I had worked at the Insurance Institute for Highway Safety, called me to ask that I review a paper on vehicle rollovers that he had prepared for a group of lawyers. Ben had left the Institute sometime after I did and established his own consulting firm, which, among other activities, provided historical information and documents to lawyers involved in product liability litigation. He was to give a presentation on rollovers at a meeting in Birmingham, Alabama. After I reviewed the paper, he asked me to accompany him to the meeting to answer any technical questions on the statistical studies that he had included in his review. I agreed to do so. About the time I left the Institute in 1978, Professor Richard Snyder of the University of Michigan prepared an extensive study of rollover for the Institute. He noted that rollover propensity of a vehicle is primarily a function of the width between the center of the tires (T) divided by twice the height of center of gravity from the ground (H), expressed in a simple formula, T/2H. This was called the stability ratio. The ratio measures the 224

force equivalent of gravity needed to tip the vehicle on its side while sitting still. If a vehicle has weight higher off the ground, but has the same width as another vehicle, it will overturn more frequently in turning maneuvers at the same speed. The turning maneuver creates the gravity equivalent lateral force, called centrifugal force. Professor Snyder collected statistics that showed higher rollover rates among vehicles with lower values of T/2H. He found that all vehicles with a stability ratio significantly less than 1.2 had inordinately high rollover rates. The worst among these was the Jeep CJ5, a vehicle much like the staff vehicle used by the military during World War II and thereafter, but sold to the public for use as a utility vehicle. Gerry was an experienced traveler in Jeeps. During the Korean War, he was a fighter pilot with a sterling record. He noted military studies that indicated substantial injury to military personnel using the Jeep. It is clear from the stability ratio that, if one needs a vehicle with higher clearance, it can be made rollover resistant by increasing track width (T), but the manufacturers of Jeeps had not done that in Jeeps sold to the military or the modified ones sold to the public. The Insurance Institute for Highway Safety tested the Jeep CJ5 and a slightly more stable CJ7 in turns at various speeds, driven by remote control. In a 90-degree turn, the CJ5 overturned at 22 miles per hour. In a slalom-like avoidance maneuver, the CJ5 rolled over at 32 miles per hour. The Insurance Institute's tests were broadcast on the popular TV news program 60 MINUTES in 1981. The Institute then supported two other 225

statistical studies of rollover at the University of North Carolina’s Highway Safety Research Center. Again the Jeep CJs were found to have very high rollover rates. At the meeting of lawyers, Ben traced the history of the Jeep and I showed some overhead projections of results of the studies and answered a few questions. Attorney Ben Hogan, who chaired the meeting, asked Kelley and I if we would be interested in updating the data and preparing a report. We indicated that we could do that, but I made it clear that I publish my research results in the scientific literature. The lawyers would have no input into the report and it would be published whether they liked the results or not. Hogan consulted with others at the meeting and received pledges to support the work. The one kicker was that we would be available to testify about the results of the study in court. We asked for some time to consider the matter and estimate the cost. Ben and I discussed the issues involved on the way home and decided to do the study if the group came up with the funds. I estimated the cost and he handled the negotiations with the lawyers. Data collected on all fatal crashes in the U.S. since the beginning of 1975 were available from the government. The National Highway Traffic Safety Administration gathered these data from the states. Since the year that the data first became available, at my request, the Insurance Institute made copies of the computer tapes containing the data for me. I found a company that had mainframe computer time available where I could run the computer tapes to pull off data on vehicles in rollovers by make and model. I also included data on 10 environmental factors and 10 driver factors 226

to test the extent, if any, that they might account for the correlation of T/2H and rollover. Since Snyder had already looked at the data from the late 1970s, I ran the data for the early 1980s. The results of the research were similar to that of the earlier studies. The rollover rates of the Jeep CJs and the pre-1978 Bronco, per number of vehicles in use, stood out like sore thumbs compared to more stable Chevy Blazers, Dodge Ramchargers and Jeep Cherokees, as well as eleven models of passenger cars for which T/2H was known. The pre-1984 Jeep Cherokee had a stability ratio near 1.2 and its rollover rate was similar to the combined rate for passenger cars, all of which had stability above 1.2. (Among numerous passenger cars measured later, only the Renault Le Car was below 1.2). Major driver, road and other environmental conditions that were well-known contributors to fatal crash involvement had relatively minor effect on rollover rates by make and model of vehicle compared to the huge effect of vehicle stability. I wrote a report, with the help of Ben Kelley, and we sent the report to the sponsoring lawyers. I was listed as an expert witness in several cases of people injured in Jeep CJ rollovers. (1) In the succeeding 12 years, I testified in more then a hundred injury cases either in deposition, trial or both. A deposition is sworn testimony that precedes a trial. It is part of the "discovery" process in which the lawyers are supposed to find out the potential evidence to be presented at trial, but depositions often go far beyond that purpose. Many of the details of that experience I published in my book: The Expert Witness Scam 227

(www.lulu.com/content/296817). A few issues are worth repeating here. Despite the vigorous efforts of lawyers to hide or distort the truth of what I had to say, I tried to answer their questions honestly. Strangely, the truth is more likely to be heard in a deposition that in a trial. Clever lawyers can ask questions in such a way that misinformation and half-truths are too often what the jury hears. Judges are supposed to hold lawyers to the rules of evidence, but the law and the rules are often quirky. So are some judges. I quickly surmised that the rules of evidence in courts and the rules of evidence in science are not the same. In depositions, there is usually no judge present and the lawyers try to control the situation, but I felt free to get what I wanted to say on the record. Occasionally a lawyer would accuse me of answering the question that I wanted answered rather than the one asked. Rarely, if the issues cannot be resolved, the judge in the relevant case may be called for a ruling during a deposition. Rather than let the expert tell what she or he knows about the issues in the case, the courts require that the testimony be elicited by lawyers' questions. For the truth to be told, the lawyer doing the questioning has to be substantially knowledgeable in the subject. There were instances in which I thought the lawyer to question me knew enough to ask the right questions, but when we were before the jury, the questions did not reflect it. I had done a couple of depositions before I became involved in Jeep litigation so I was somewhat familiar with the process. I was not familiar with a sheriff 228

showing up at my home with a subpoena demanding my presence at the deposition. When that first occurred, I told plaintiff's attorney Ben Hogan about it, and he objected to the tactic immediately after the deposition convened, but American Motors' lawyers continued the game for several depositions. I had already heard that this was a tactic of Jeep’s lawyers. Not only did they do it to voluntary witnesses, they had subpoenaed the records of the Insurance Institute for Highway Safety and required its employees to testify, against their wills, on their research sponsorship and vehicle testing in relation to Jeeps. In those days, American Motors Corporation made Jeeps. They later sold the rights to Chrysler Corporation. To my surprise, not one, but two lawyers representing American Motors showed up at my first deposition, one of whom I had met previously. Kent Joscelyn was at one time on the staff of the Highway Safety Research Institute at the University of Michigan. He was a regular attendee at the Association for the Advancement of Automotive Medicine that I had attended a couple of times before becoming disgusted with the lack of quality of the research presented. Joscelyn was listed in their literature as a lifetime member. Joe Yates, who I learned later had recently lost a $20 million verdict in a Florida rollover case, accompanied him. Yates tried to present himself as a North Carolina country lawyer unschooled in science, so I knew to be wary of him. Joscelyn fancied himself as sophisticated in statistics and computers, but his questions often indicated a superficial knowledge. He would smile like 229

a Cheshire cat and tell me how much better it was to have a sophisticate such as himself question me than some ordinary lawyer. Yeah, right! You have not known true boredom until you have had Kent Joscelyn go over your computer programs line by line and ask you what each instruction does. The second most boring task was going through all sorts of hypothetical statistics on car A and car B that were totally immaterial to the issue of the stability of Jeep CJs. In one of several depositions with the JoscelynYates team, I complained during a break about the amount of time being consumed on irrelevant issues. Yates said, "What do you care? We are all billing." I wished that rare moment of candor were on the record for his client to read. My cross examination during my first trial was a hoot. Joscelyn sat beside the local attorney who represented American Motors and they would confer at length between questions. The jury became restless and so did I. At one point, after an extensive pause between questions, I couldn’t resist. I asked in open court, “Is there a question?” Joscelyn looked like someone had hit him. Fortunately, the judge did not reprimand me for speaking out of turn. I imagine that he was tired of the delays as well. The plaintiff’s attorney told me later that Joscelyn had come to San Jose to cross-examine me, but the local attorney would not allow it. Soon after our rollover paper was completed in 1986, my coauthor, Ben Kelley, sent a copy, along with other studies, to then Congressman Timothy Wirth (D., Colorado). Mr. Wirth submitted a petition to the National Highway Traffic Safety Administration requesting 230

consideration that a minimum stability of T/2H = 1.2 be required for new vehicles sold in the U.S. for passenger use and that recall of Jeep CJs be considered. I was not party to the petition, and learned of it only after the fact. Had I been asked, I would have counseled against it. The Reagan administration was vehemently anti-regulation and such a petition had no prayer of success in such a political environment, particularly one submitted by a Democrat. Republican Senator John Danforth had been pushing for more government action on vehicle safety for years with little success. While I was right that the government would take no action, I was wrong about the petition being useless. Some members of the staff at the safety agency welcomed the stimulus to study the issue. Two of the agency's staff, Anna Harwin and Keith Brewer, collected center of gravity data on a larger set of vehicles than I had examined. They correlated T/2H with total rollover rates, not just fatal, in several states. They found an even stronger correlation of T/2H and total rollover rates than I had found in the fatality data. The study was published eventually, but was initially suppressed by the government. (2) Years later, after she left the government, Anna Harwin told me that people involved in the investigation were behaving like the results were a state secret. She and Brewer wanted to present the results of their study at a meeting of the Society of Automotive Engineers but were not allowed to do so because of opposition from the office of the Chief Counsel. In a memorandum to Michael Finkelstein, who was 231

Harwin and Brewer's boss, Steven Wood wrote: "The very first sentence of the abstract states that statistical confirmation of the relationship between rollover stability and rollover risk has been established. Such a statement is the basis explicitly set forth in the Wirth petition for the requested rulemaking and defect investigation on vehicle rollover." After noting some disagreement in the agency on the issue, Wood wrote: "After the agency has resolved this internal disagreement and published its response to the Wirth petition, you may wish to revise this paper to reflect the agency position on the issue." In other words, one of the top lawyers in the federal safety agency wanted a scientific paper revised to support a political decision. I learned that Kent Joscelyn and an executive of American Motors met with agency staff to criticize my study. I wrote to Diane Steed, then Administrator of the agency, that, according to my reading of the Administrative Procedures Act, such ex parte meetings were illegal. Steven Wood wrote me defending the meeting on the grounds that the consideration of the rulemaking was "informal" and did not require formal notice of such meetings. He did not say why representatives of industry were entertained at the agency to criticize the research of people who were not invited. Ralph Hoar, a streetwise finder of government documents, obtained a copy of the Harwin-Brewer study and placed it in the public docket on the rollover issue at the agency. Within days it was removed. The agency sent the Harwin-Brewer data to be analyzed by researchers at the Transportation Systems 232

Center in Cambridge, MA. The government researchers there used a different statistical technique, but the conclusion was nevertheless the same: "The previous results of Kelley/Robertson and Harwin/Brewer in finding the stability factor important for predicting rollover rate have been confirmed and strengthened by these results." (3) Several senior staff in the agency recommended in memoranda to Barry Felrice, Associate Administrator for Rulemaking, that a rollover standard be adopted. But the petition was rejected at the direction of Diane Steed, the Reagan-appointed Administrator of the agency. Steed had no prior education or experience in motor vehicle safety. She was obviously an administration watchdog who was appointed to the job to quash regulation. The justification for the rejection, written by Felrice in the December 29, 1987 Federal Register, is a tortured, self-contradictory document. (4) In a memorandum on a draft of the rejection circulated before its publication, Michael Finkelstein wrote to Felrice, "It is clear, however, that the inclusion of analyses in this draft has been very selective, and was designed to support a certain rulemaking position." Later Finkelstein again wrote Felrice objecting to false statements put in the Federal Register. "The statement 'while a vehicle's stability factor has some relation to its rollover propensity, etc.', is misleading and grossly understates the high degree of correlation that has been found between Rollover frequency and Rollover Stability Factor."... "We see no new data, analysis, or arguments in this document which would 233

change our previously stated view that this petition should be granted." Nevertheless, the standard was not adopted and, not long thereafter, in April 1988, George Parker, Associate Administrator for Enforcement, denied Wirth's petition for a defect investigation of the Jeep CJs. I was invited to give a presentation at the Society of Automotive Engineers Government-Industry meeting in Washington the following month. Using the data on static stability gathered by the government during consideration of the Wirth petition, I expanded the sample of vehicles to include more recently marketed Bronco IIs, Samurais, and small Blazer-Jimmys. The results were the same. On average, as the stability factor increased, the fatal rollover rates declined precipitously up to T/2H = 1.2. During 1982 through 1987, The Jeep CJ-5 had a rollover death rate 19 times that of passenger cars. The Jeep CJ-7, pre-78 Bronco and Bronco II rolled over about 10 to 12 times the car rate. The Suzuki Samurai, made infamous by Consumer's Union finding of "unacceptable" in Consumer Reports, was actually somewhat more stable than the Jeep and Ford vehicles, but was bad enough to roll at 6 times the rate for passenger cars. (5) During my presentation, a few auto engineers argued that the effect of static stability could be offset somewhat by suspension systems. When I asked whether it could be totally offset, none said that it could. The Consumer Reports article, based on tests showing the Samurari's lack of rollover resistance in a slalom course, caused a media feeding frenzy. I was 234

told that Consumers Union became concerned about the Samurai's stability after a member of the staff rolled one over on the road. While I had no special sympathy for Suzuki, manufacturer of the Samurai, I was disturbed that the criticism was isolated on one vehicle. I wrote David Pittle, who had appeared on TV for Consumer's Union, enclosing my Washington presentation. I indicated that they got one perp, but let some worse ones get away. He never replied. Consumer Reports later carried an article pointing to the stability problems of the Bronco II, but it did not call it "unacceptable." Texas enacted a law that allowed courts to release "court protected" industry documents if a compelling reason to protect public health was indicated. Russ Cook, a Houston attorney, petitioned a court to release Ford's Bronco II history. After hearings, at which I testified, the court granted the petition. Among the documents was a memorandum regarding a meeting between Ford executives and the staff of Consumer's Union. The memo said that the Ford team thought they had clouded the minds of the CU staff. (6) Cloudy mind or no, Consumers Union, the Insurance Institute for Highway Safety and individual citizens continued to submit petitions to the government for a stability standard and the recall of vehicles such as the Jeep CJs, the Suzuki Samurai and the Ford Bronco II. All of these petitions were rejected in the first Bush and Clinton administrations. In that Bush administration, former Army General Jerry Curry headed the National Highway Traffic Safety Administration. After leaving the government, Curry 235

testified on behalf of Ford in rollover litigation. I sat in on one such case in Washington, DC, where Curry said that he had never read the studies of rollover -- just staff summaries. He said that there was a consensus among the engineers in the agency that there should be no rollover standard, ignoring the substantial dissent among engineers and others within the agency to the administrators' decisions. Curry had some safety responsibilities while he was in the Army, but apparently did nothing to protect service personnel from unstable Jeeps. As chief of the civilian safety agency, he continued the tradition for the general population. While still head of the safety agency, he personally appeared at a press conference announcing rejection of yet another petition to recall the Jeep CJs, defending the indefensible. Diane Steed, Curry's predecessor in the agency, also testified for manufacturers after her government tenure. In addition, she headed a lobbying group called Coalition for Vehicle Choice funded largely by vehicle manufacturers. She testified that the main focus of the lobbying was in opposition to fuel economy standards. The income of the organization in relation to expenditures was remarkable. In a deposition, attorney Crady Swisher asked Steed about it: “Q. In 1992 did the majority of your funding also come from motor vehicle manufacturers? A. Yes, that would be true. Q. And would it be fair to say that during the five quarters beginning, let's say, with the third quarter of 1991 through the third quarter of 1992 you took in approximately $6 million and spent approximately 236

$500,000? A. You could be right. I really don't remember.” When newspaper articles critical of sports utility vehicles appeared, Steed wrote letters to the editors defending the vehicles with half-truths. In the Hartford Courant she wrote, "Data from the National Highway Traffic Safety Administration and the Insurance Institute for Highway Safety show light trucks (sport utility vehicles, pickups and minivans), especially the large SUVs, have among the lowest fatality record on the road." (7) In fact, the Insurance Institute for Highway Safety's newsletter, Status Report, reported data indicating that pickup trucks and sport utility vehicles in the same weight class as cars had consistently higher occupant death rates than the cars in that weight class. While it is true that the non-rollover occupant death rates of some of the larger utility vehicles were relatively low compared to smaller vehicles, they were low because their weight resulted in a huge energy transfer to occupants of other vehicles in crashes. (8) In collisions with other motor vehicles, the heaviest pickups and SUVs, of which there are no comparable cars in weight, kill people in the other vehicles more frequently and kill more pedestrians and bicyclists. Their higher bumpers override the side door beams of passenger cars and they strike pedestrians in vital organs rather than the legs. Not counted in that analysis is the greater frequency that vehicles with high center of gravity run over children while backing up in home driveways. The visibility to the rear from the position of a higher seated driver is poorer than that 237

from passenger cars. (9) Several others among the safety agency's political appointees and career bureaucrats, after retirement, went to work for the industry or as expert witnesses on behalf of the industry. The Motor Vehicle Manufacturer's Association hired Barry Felrice, who wrote the Federal Register entries rejecting all of the petitions for a rollover standard prior to 1998. George Parker, who rejected most of the CJ, Samurai and Bronco II defect petitions, retired to work for the Association of International Vehicle Manufacturers. Usually when the media took note of the rollover problem, Felrice or Parker were trotted out by the industry to claim that the problem is behavioral rather than vehicular. In 1998, Parker told Dateline NBC, "But I think if you look at the facts from the large scale accident data, you come to the same conclusion that NHTSA does... I think there's a myth that taking avoidance maneuvers for obstacles in the roadway is going to cause the vehicle to roll over. That's just not the case. The person driving that vehicle did something to lose control of that vehicle. What they are mostly doing is driving on curvy rural roads with high alcohol use." In fact, NHTSA said nothing of the sort. For example, in the June 28, 1994 Federal Register, the agency noted that only 23 percent of the differences among vehicles in rollover was explained by driver and environmental factors. "The results of both the logistic and linear regression analyses performed by the agency suggest that a vehicle stability metric alone can account for approximately 50 percent of the variability in rollover 238

risk in single vehicle accidents, for the population of make/models studied. While ideally it would be desirable to have these variables explain 100 percent of the remaining variability, such statistical correlations are almost never achieved." (10) And many of the rollovers of unstable vehicles do occur in avoidance maneuvers -- the vehicle rolls when the driver turns sharply in an attempt to protect animals as well as human pedestrians, or to keep from hitting other vehicles or objects in the road. Jeffrey Miller, former Chief Counsel of the federal safety agency, joined Steed at the Coalition for Vehicle Choice and testified for manufacturers. Miller was also the Campaign Director for George H.W. Bush's presidential campaign in Pennsylvania. He testified in Fuchs v. Ford that Diane Steed did not veto the recommendation of associate administrators that the Wirth petition for a rollover standard be adopted. When confronted with a memo written by Felrice to Erika Jones, following a meeting with Steed, that says she did order rejection of the Wirth petition, Miller had to admit that the memo's characterization of the meeting was accurate. Yet another rejection of the stability standard, this time by Clinton’s NHTSA administrator Rick Martinez in 1996, was based on the most incompetent policy analysis I have seen in 35 years of professional life. In the Federal Register, the agency claimed that a standard would prevent 61 deaths, presumably per year, but that was unclear. (12) I obtained data on rollover deaths of vehicles in 1990-1994, and projected the fatalities attributable to T/2H less than 1.2 over the life 239

of the vehicles. I concluded that, had the Wirth petition been adopted effective in 1990 and subsequent models, there would have been about 1000 fewer deaths in rollovers per model year. By the early 1990s the CJs and Bronco IIs were no longer in production, but had been replaced in rollover leadership by the Isuzu Amigo, Toyota 4Runner, Isuzu Rodeo and the GEO Tracker. (13)

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Chapter 10. Facts and Philosophy In 1989, I visited the offices of David Perry, an attorney in Corpus Christi, Texas. Mr. Perry asked me if I would take a look at the materials produced by Roger McCarthy, the President of an outfit called Failure Analysis Associates, who testified as an expert witness for manufacturers in so-called “all-terrain” vehicles. Known as ATVs, the vehicles have engines and handles for steering similar to those on motorcycles, but have three or four large balloon tires. First used as work vehicles on farms and in forest areas, they were aggressively marketed in the early 1980s for family recreational use and racing. The more powerful versions were capable of speeds of up to 60 miles per hour. Advertisements on television showed them being used by children. Operating an ATV, as they became known, requires substantial skill. If weight of the rider is not shifted in turns, the vehicle will not turn proportionate to steering input. (1) The vehicles have a high center of gravity relative to their track width even worse than the more unstable utility vehicles and were often involved in injuries where the vehicle overturned. (2) In 1988, under threat of a lawsuit to recall the vehicles, the ATV industry reached an agreement with the Consumer Product Safety Commission to stop marketing the vehicles for use by children. The industry stopped making the three-wheeled version. I learned that, as Honda's expert witness, Roger McCarthy had met with Honda employees in the early 241

1980s and informed them that the increase in injuries and deaths associated with ATVs was normal, similar to increases associated with increased sales of other products. Richard Bowman of the Bowman and Brooke law firm hired McCarthy to testify that ATVs were not unreasonably dangerous. (3) I encountered Bowman in an ATV case in Wisconsin. He was by far the most arrogant and rude lawyer I have met. He pranced around the courtroom like an oversexed peacock. At one point he came up to the witness stand and grabbed the papers I had in front of me and asked what they were? When I answered that they were papers on issues I expected to be asked about, he slammed them down and stalked off. Bowman's partner, Jeffrey Brooke was a bit more of a gentleman. Two of my more humorous experiences as an expert witness came at Brooke's expense. In an ATV trial, a rotund Mr. Brooke decided to make me out a wimp. He asked me if I had participated in a number of dangerous activities such as motorcycling, that I had been asked about in the past. I had done none of them. He then added one that was not in my previous deposition testimony: “Q. Have you ever been bungie jumping? A. No, Mr. Brooke, I have never had the opportunity. Q. Never had the opportunity. We can go over here a few miles and go bungie jumping. A. Okay, Mr. Brooke. I'll go with you if you'll go first”. He had the good grace to laugh with everyone else in the courtroom. In a rollover case, I encountered Mr. Brooke again. He questioned me about what I knew about the lawyers 242

that provided the funds for my first rollover study. He didn't seem to believe that I did not know anything about their practices. I said that I knew lawyers that did both plaintiff's and defense work, so I didn't classify lawyers as exclusively plaintiffs or defense lawyers as he was doing. "Besides, if you've seen one lawyer, you've seen 'em all," I said. Brooke replied, "I guess I asked for that, didn't I." Good straight man. But let’s get back to Roger McCarthy and his meeting with Honda and Bowman. It is one thing for McCarthy to be involved in defending Honda's vehicles in court and another to be meeting with them to tell them that their product is no different than others, implying no need to make the product safer. The latter puts him in the position of giving them a rationale to continue selling an unnecessarily dangerous product from which McCarthy stands to gain by testifying in lawsuits. I suggested to some attorneys that McCarthy should be a co-defendant with Honda, but none would name him. By 1989, Honda's losses in lawsuits from injuries on ATV's were so large that one of the insurance companies involved, Christiana General Insurance Co. of New York, sued another, Great American Insurance Co., for failure to anticipate the losses. Again, perhaps the real culprits for these losses were Roger McCarthy and Richard Bowman, but they were not listed as defendants. In Perry's case, McCarthy claimed that ATVs were not unreasonably dangerous based on their injury rates relative to other activities, which he called "comparative risk". Also, he had done some re-analysis of the Consumer Product Safety Commission's data that 243

he claimed supported his testimony. I disagreed with the basis of his argument, the data he used to support his argument and the ways in which he analyzed the data. I agreed to be a rebuttal witness to McCarthy's testimony in several ATV cases. In the summer of 1992, Russell Stanton, an attorney in Vancouver, British Columbia called me. He said he was in potentially serious trouble because of an incident in a trial where Roger McCarthy testified on ATVs. As he explained the situation, it seemed to me that McCarthy was in more trouble than Stanton, but I had no knowledge of the rules in Canadian courts. While in Vancouver to testify in the trial, McCarthy had given someone in the office of Honda's local defense attorney (Russell, DuMoulin) some pages of a manuscript to be faxed to McCarthy's office. The person apparently misunderstood and faxed it to Stanton. In the manuscript, McCarthy's coauthors were using ATV data to illustrate certain points regarding data analysis. On a graph that showed increasing risk of injury to ATV drivers as engine size increased among drivers less than 12 years old, a handwritten note said: "Bill, I understand the purpose of this example and think it is instructive. However, this example will be used to confuse juries when I testify in kid cases. Can we find an example that works the other way. That is, the gross number is higher than the simple adjusted number." On another graph showing that the relative risk (supposedly per hour of use) for drivers aged less than 12 was higher than that of 12-20 year olds when adjusted for engine size, McCarthy scratched over the graph: "This graph will be used by plaintiffs to confuse 244

juries and show our complete controlled analysis is wrong. If the high side were on the >35, no problem." On the way into court after receiving the fax, a newspaper reporter, shopping among courtrooms for the best story of the day, asked Stanton whether anything interesting would happen in his trial. Stanton told him that there would be some fireworks. A newspaper article, in the next day's Vancouver Sun, said: “A product liability suit against the Honda Motor Co. was halted Wednesday after an expert witness paid by Honda was accused of misleading the B.C. Supreme Court. The allegation against Rodger (sic) McCarthy, who admits that since 1982 he has received $16 million from Honda for testifying in such cases, was made by Vancouver lawyer Russell Stanton. And Justice Lance Finch agreed with Stanton that the matter was sufficiently serious to warrant the case being adjourned until the allegations are dealt with. 'He (Stanton) raises very serious allegations of misconduct on the part of an expert witness,' the judge told Vancouver lawyer William Berardino, representing Honda.” (4) $16 MILLION in 10 years? What in the world could an expert witness say that would be worth that kind of money? When Stanton called me, he said that Berardino would recall McCarthy to the witness stand to explain his handwritten comments. He wanted me to help him prepare for cross-examination of McCarthy. I had no idea what McCarthy would say, but after reading the trial transcript, I could see that McCarthy's 245

fax wasn't his only problem. I went to Vancouver to brief Stanton on my knowledge of McCarthy's previous testimony in ATV cases, help him prepare questions, and to watch the testimony. The trial was before the judge only -- no jury. I will not bore you with a complete quote of McCarthy's explanation of his comments on the draft document. In essence, he said that the paper and the graphs had nothing to do with this trial. Since the plaintiff was 19 years old, he saw no reason to discuss the risks to riders less than 12 years old. He said his comments were made to be sure that the paper would be consistent with other analyses he had done and, besides, the results were not statistically significant. The increase in risk as engine size increased was not unique to children, and he wanted that corrected to include all riders. Stanton asked McCarthy if engine size was such an important factor for riders of all ages, why was it not discussed in his written report in the case. Berardino interrupted and he and Stanton went at one another about the obligations of an expert. Stanton finally extracted from McCarthy that the plaintiff was on the most powerful ATV produced by Honda at the time of the injury. In subsequent answers, McCarthy said that, since engine size was not part of Stanton's complaint in the case, he saw no reason to discuss it. McCarthy had previously showed to the judge charts on which ATV risk per hour of use compared to such activities as skydiving, snowmobiling and swimming. He described the risk as of ATVs as "middling". In these charts he had made no adjustments for age of 246

participants. When Stanton asked him about it, he denied the need to do so, in contrast to his insistence that the graphs in the draft paper were not adjusted for every factor and, therefore, were not presentable in "kids cases". From case to case in the past, regarding ATVs and other products, McCarthy would insert or leave out a given activity on his charts and re-label the charts. The charts were "recreational activities" in ATV cases, but sometimes he needed some other product to be a "middling" or lower risk. Stanton produced a chart that McCarthy had done in a case of a forklift injury in industry. That chart had some recreational activities but also such risks as radiation exposure while flying at high altitudes and forklift operation. McCarthy said, “A. Well, it was a forklift case, I of course referenced forklifts, but as I think have emphasized again and again, you can't use occupational or utility injury rates and compare them to recreational injury rates because occupational and utility rates are so much lower." Obviously the relative size of rates is not the determinative factor in whether they can be compared. The issue is the purpose of the comparison. McCarthy bobbed and wove as Stanton pressed him on every issue. Plaintiff's attorneys in the U.S. do not call him "Roger the Dodger" for nothing. When Stanton attempted to pin McCarthy down on his use of imprecise categories to develop precise estimates of risk, the judge interrupted to say that the issue had nothing to do with the handwritten comments on the miss-faxed transcript and directed Stanton to return to that issue or retire. Of course, the issue in 247

both instances was McCarthy's credibility, but from my position in the back of the courtroom, it appeared that the judge was in love with McCarthy. McCarthy kept sucking up to the judge, calling him "My Lord", in the tradition of the British Empire, virtually every time he addressed the judge directly. McCarthy revealed his ignorance of injury research in his Canadian testimony, "As it works out it's very difficult to put a number on severity. It's very difficult to say, 'is a broken arm more severe or less severe than a broken leg?'" Actually, there is an extensive scientific literature on numerical severity scores going back for more than two decades. (5) On June 22, 1992 in the Canadian trial, McCarthy said that the CPSC did not do an analysis of children on big machines leading to a ban on sales for use by children. The analysis is found in Table 1A in Rae Newman, "Analysis of All Terrain Vehicle Related Injuries and Deaths", Consumer Product Safety Commission, 1986, and the consent decree on marketing to children is the equivalent of a ban. To the Canadian judge, regarding stability of ATVs, McCarthy said, "Over years and years of research no one has been able to find much in the way of a correlation between a static stability ratio or a dynamic g stability and your accident rate" As noted in chapter 9, numerous studies have found that static stability explains most of the variation in rollover of trucks and utility vehicles when static stability is below 1.2 g. When Stanton reexamined McCarthy later, he admitted awareness of the studies when he made the statement. After that judicial hearing, Stanton asked me to write 248

a report on the testimony McCarthy had given prior to the miss-routed fax incident and return to testify on it. I did so and returned in October to be questioned about it. McCarthy also returned and contested what I said either by denying that I represented his positions accurately or with his usual rambling, off-point answers. The judge was an insurance company lawyer before becoming a judge so I wasn't expecting much from him. He lived down to my expectations. When he issued his ruling in the case, he found for the defense and went beyond, exonerating McCarthy of wrongdoing in altering a scientific paper to fit his court testimony. Judge Finch chastised Stanton for bringing in the press and said that McCarthy was an excellent witness. Apparently, British Columbia is more British than Columbia. The British legal tradition is much harder on defamation and press coverage of trials than that in the U.S., but far more tolerant of product hazards. In a trial in Tennessee, Attorney Joe Bednarz questioned McCarthy on improving safety of the vehicle: “Q. Sir, have you ever made a recommendation of any kind over the years to Honda as to any safety improvements at all, either design or labeling or anything like that? A. Not as a specific recommendation from me to improve a specific vehicle. Not as a design improvement. Q. Any safety measure or safety improvement at all, sir? A. I have not suggested one. I certainly have analyzed many safety improvements that have been suggested. But I have not successfully developed one of my own that I would put forward as a recommendation. Frankly, 249

it's a very difficult vehicle to improve on.” In a deposition regarding millions of Ford vehicles that stalled while being driven because of heat sensitivity of electronic parts, Attorney Gary Gordon asked McCarthy: “Q. Have you ever made that claim to anyone at Ford; if they tell you what result they want to achieve, you can design a test to achieve it? A. No.” Three questions later McCarthy volunteered: “A. You know I was thinking about your preceding question. Q. Which one? A. Did I ever offer to Ford making a test to come out any way they want, and I think I did. I did discuss in a letter to Ford once concerning the Consumers Union Test which is such a horrible test that you can make it come out any way you want. And I think I told them in a letter. However, whatever way Consumers Union made it come out for Ford vehicles, I would make it come out the same way for GM vehicles in the same way totally within the parameters of the test; it is such a bad test.” McCarthy’s multimillion-dollar income for his testimony is unusually high but the easy money lures many scientists, pseudo scientists and others. To remove the temptation of the money, I decided that I would contribute my previous and future income from testifying to institutions doing injury prevention research. Johns Hopkins University received a pledge from anonymous donors to endow half of a professorship in injury epidemiology and international health if donors could be found to supply the other half. 250

Although the amounts involved were far more than I had earned or expected to earn as an expert witness, I pledged to contribute the other half, stretched out in a five-year period. That drove the defense lawyers nuts. A standard question of an expert witness is “How much have you been paid for your work on this case? When I indicated that I was contributing my fees, the lawyers didn't understand it. Attorneys asked me numerous cynical questions implying that I was hiding some of the income and not donating it. I was asked why I "hate General Motors" because I have testified that several of that company's products are unreasonably dangerous. Actually, General Motors is no worse, or better, than most other vehicle manufacturers, and I have testified on products of most of the major motor vehicle manufacturers as well as a few other corporations. As one of my professors used to say, "A corporation is a bloodless body with a removal head." I don't hate any of them -- the bodies or the heads. Although I had some onerous experiences, I enjoyed the battle of wits with lawyers who were trying to discredit me, or what I had to say. Also, the antiregulation fervor in Washington that began in the Carter Administration with airline deregulation, and accelerated in the Reagan administration, removed a major incentive for the improvement of safety of products. The pressure of litigation costs is a potential incentive for manufacturers to reduce risk. Even after I tired of the battle of wits, I decided to continue to do my bit to keep that incentive alive. There was (and is) also the issue of justice for the maimed and dead, but I 251

soon became aware, as the public has since seen in recent highly publicized trials, that justice in courts is problematic. Occasionally, innocent people are executed by the state while, in some cases, murderers walk free. There are large differences in laws among the states as to what constitutes negligence, in civil as well as criminal cases. No corporate executives face criminal charges or go to jail for what amounts to statistical murder far beyond the ambitions of the more active serial killers like Bundy and Dahmer, as a result of corporate inattention to the hazards of their products. Some juries understand this and award large sums to the injured or their families. Others in meritorious cases are convinced by clever defense lawyers or "junk science" that the product's designers, manufacturers or distributors were not responsible. The extent that litigation is an incentive to improve products is open to question and hard to document. Few corporations will admit publicly that a product was improved because of successful lawsuits. But the propaganda against so-called frivolous lawsuits and lawyer's contingency fees by corporations and their political toadies suggests that the costs of litigation are motivational. While there are certainly too many frivolous lawsuits, they are mostly for minor injuries and other issues, not major injury or death. Product liability lawsuits against rich corporations are expensive. Few of the injured or surviving families can afford the cost of a lawsuit against a well-heeled corporation. It is not unusual for a plaintiff's case to generate $100,000 or much more in expenses, not counting the lawyers' time. Product liability lawyers often finance such cases and 252

charge the client a percentage of the award. If there is no award or the award covers only a small part of expenses, the lawyer can go bankrupt. The risk of such losses is a powerful incentive against frivolous litigation that requires expensive expertise. In my textbook, Injury Epidemiology, I suggested that blanket liability for injury would be the most effective “tort reform”. (5) If industries knew that they would have to pay for the injuries and deaths associated with their products, they would have an enormous incentive to minimize injury. There would be no need for crapshoot trials populated by highly paid lawyers and expert witnesses. Given the influence that industry has on government, don’t hold your breath until you see such a blanket liability system in practice. When I was at Harvard in the 1960s, I published a letter in the journal Science explicating the difference between scientific work intended to understand how a physical or social system works and that intended to prevent or reduce a harmful outcome. (6) In the latter case, one only needs to identify a necessary condition for the outcome and control the condition to prevent the outcome. That is a lot simpler than the work needed to complete understanding of a phenomenon. Too often manufacturers of products assume that any injuries caused by the products will be caused by misuse of the user and pay little attention to necessary conditions that manufacturers can control to reduce harm. For example, in its 1973 through 1987 C/K (full-sized) pickups, General Motors installed gas tanks outside the frame rails along the sides, just under the external sheet metal, to increase the amount of gasoline that 253

could be pumped into the tanks at any filling. These became known as sidesaddle tanks. The tanks were placed there solely as a selling point -- fewer stops at the gas station. It should have been obvious to General Motors’ engineers and executives that tanks closer to the outer edge of vehicles would be penetrated more often in crashes than tanks placed toward the center of vehicles. In 1973, while I was on the staff of the Insurance Institute for Highway Safety, the Institute's engineers crash tested small passenger cars with the gas tanks mounted just inside the rear sheet metal by running fullsize cars into the parked smaller vehicles. The tanks were penetrated and major gasoline spillage occurred in every test. A spontaneous fire occurred in one. Among these vehicles was the Ford Pinto, a vehicle whose name became synonymous with fire risk. (7) Our tests showed that the Pinto was by no means unique. The films of the crash tests were widely circulated and shown at the time. Anyone in the motor vehicle industry who did not see the tests was not paying attention. One of the most striking scenes was the rapidity of spread of the flames in the case where fire occurred in the crash. The passenger compartment was full of flame before the vehicle came to a stop in the short distance that it moved from its sitting position at impact. During the late 1970s and early 1980s, the gas tanks in most passenger cars were moved over or in front of the rear axle. In the full-sized GM pickups, however, the tanks remained outside the frame rails until they were placed inside the frame rails in the 1988 and 254

subsequent models. I had published a statistical study of the fatal fires in rear-end impacts to passenger cars and found that the fire fatalities in rear crashes were lower by more than half in cars with the tank over, or in front of, the rear axle. (8) Attorneys for the family of Shane Moseley, a young man who died in a GM truck fire, to do a similar study of fires in GM and competitive trucks. I found that deaths to occupants in fires related to side impacts were substantially higher in GM C/K pickups compared to Ford F-Series pickups that had gas tanks near the middle of the vehicle inside the frame. The Center for Auto Safety petitioned the National Highway Traffic Safety Administration to recall the GM trucks. Since GM sold several hundred thousand per year, such a recall covering vehicles made for 15 years would have involved millions of vehicles. A television program, Dateline NBC, did a story on the pickup fires that included a crash test that showed a fire igniting in a GM truck impacted in the side. GM sent investigators to find out how the test was conducted. They were told that a fire-ignition source had been placed in the headlamp of the impacting vehicle for test purposes. GM complained to NBC News because the ignition source was not disclosed in the aired program. GM extracted an on-air apology from Dateline NBC that became a public relations coup. Newspaper editors and pundits wrote self-righteous editorials about journalistic ethics for days thereafter. The impression was that the GM trucks were exonerated which, in fact, was not true. The ignition source did not cause the tank to be penetrated; it just showed the consequence if an 255

ignition source was present. GM submitted to the government a statistical comparison of fires in GM trucks and a large variety of other vehicles prepared by Robert Lange, Rose Ray and the $16 million man, Roger McCarthy, of Failure Analysis Associates. (9) They argued that some other vehicles had similar or higher fire rates when compared to GM trucks. Furthermore, they said, the overall fatality rates of GM trucks were lower than other vehicles. There are two problems with these conclusions. First, the inclusion of dissimilar trucks in the comparison with GM full-size trucks was improper. In virtually any type of crash smaller vehicles will have higher occupant fatality rates than larger vehicles. The fatal fire rates in similar sized trucks with the tank inside the frame were lower, particularly in side impacts. Second, the Failure Analysis report was wrong about the occupant death rates in GM trucks -- they were actually higher than in comparable-sized trucks. After the government found that and other errors in the Failure Analysis report, General Motors admitted that their trucks had higher occupant fatality rates and rejected the Failure Analysis report. Then GM tried to turn the difference in non-fire fatalities to its advantage. It hired William Wecker, a mathematical consultant, to turn the higher fatalities to C/K occupants into an explanation of higher fire rates. In a report that GM submitted to the government and in litigation testimony, Wecker claimed that GM's trucks had higher fatality rates generally, including higher fire rates, because more aggressive drivers drove them. (10) 256

I did another study of GM and Ford pickups and found that the total involvement of GM C/K pickup drivers in non fire fatal crashes, including deaths to occupants of other vehicles as well as pedestrians and bicyclists, was the same as in Ford F-Series trucks. If the behavior of the GM drivers was worse, they should have been involved more in all fatal crashes. Apparently the pre-88 GM trucks had higher occupant death rates because they were less protective of their occupants in other respects besides fires. I also included the 1988 and subsequent models and found that the fire fatality rate in GM trucks, when the gas tanks were placed inside the frame, plunged to a rate less than that of comparable sized Ford trucks. (11) I noted in the study that several of the factors in Wecker's "Aggressive Driver Index", such as posted speed limit 55 miles per hour, had nothing to do with aggressive driving. He also used estimated speed at the time of the crash, which is missing in more than half of the fatal crash records. That alone made the index invalid. Later Wecker changed the name of his index to "non vehicle factors" but the index had no scientific validity, whatever its label. Subsequently in depositions, I also pointed out that data from several states collected by the National Highway Traffic Safety Administration to evaluate the rollover issue indicated no difference in non-rollover, single-vehicle crash involvement of GM and Ford's full-sized pickups. If the drivers of GM vehicles were worse than Ford drivers, or if GM trucks were driven in more adverse environments, they would have higher rates of crashes into trees, poles, and other 257

objects, but they did not. I and others have published numerous papers showing behavioral factors related to vehicle crashes, so attorneys for companies loved to quote me and those other researchers regarding behavioral factors in an attempt to make me look inconsistent. In a chapter I wrote for a book on behavioral factors, I had pointed to GM's attempt to blame driver behavior for gas tank fires. (11) I was questioned about it in a deposition: “Q. Do you agree that behavior is a major factor in injury causation? A. Well, that's too blanket a statement. There are some types of injuries or behaviors, very minor. There's some, it's substantial. And there are lots of cases where behavior may contribute, but that you can completely control the problem irrespective of behavior. Q. Okay. Do you agree fatality rates are significantly influenced by driver behavior? A. Significantly influenced? Q. Yes. A. Sure. Q. Do you agree that fatal fire rates are significantly influenced by driver behavior? A. I don't believe that the difference among pickup truck fire rates is significantly explained by driver behavior. Q. Not my question, though. A. I don't know to what extent the involvement in crashes involving fire are behavior or otherwise. Q. Okay. But you agree that there would be -- that behavior would account for some -- for fire rates. A. That depends on what you mean by behavior 258

accounting for something. Everybody that's in a moving vehicle is behaving in the sense they are operating and driving the vehicle. What happens in a particular collision may be, essentially, behavior. It may be the interaction between behavior and the environment and distractions. It may be environmental and attributed to behavior. The classic example is, particularly with respect to side collisions in intersections, is the timing of yellow lights. There's, like, a six-fold variation in intersection crashes between intersections that have an amber light 25 percent above the standard recommended by the engineering textbooks, and 25 percent below the standard recommended by the engineering textbooks, which is literally fractions of a second in some cases. Q. Have you written a paper on that? A. No, Paul Zador has. I have mentioned it in my book. Q. Okay. You write in your article that behavior is a major factor in injury causation. What do you mean by that? Q. Behavior -- people are behaving when they are injured, and sometimes they are behaving in ways that increase the risk. Sometimes not. But it is - there's no question that behavioral factors contribute to some kinds of variation. I don't think it contributes to the variation we see among the trucks that we are talking about here in fire rates. Q. Okay. And that's part of your criticism of Dr. Wecker; is that correct? A. Yes. Q. Okay. What -- you make an interesting statement in your article that -- well, you write, "Behavior can be 259

changed to reduce" -- let me back up. The statement that I am referring to; "The behavior is a major factor in injury causation. Therefore, behavior must be changed to reduce injury," you indicate that's false in your article? A. Yes. Q. You mean that -- what is false about that, that behavior must be changed? A. Just because behavior contributes, let's say, whatever the percentage is, it doesn't mean that you have to change that behaving. I go on to give illustrations of that. For example, children crawl out of windows in tall buildings, for any number of reasons; their natural curiosity, some of them are hyperactive, some of their parents are not there seeing after them, or the parents are temporarily distracted. And there are all sorts of other reasons. But put a barrier over the window, the kids, 90 percent of them, the kids don't fall out of them anymore. So the point is, just because the behavior of the children and/or the parents contributes to the possibility of a child falling out the window, doesn't mean you can't stop children from falling out the window by changing everybody's behavior. Q. What about curbing drunk driving? Do you put that in the same -- is that analogous to your hypothetical about the baby crawling out the window. (It wasn't a hypothetical. My article noted studies of window barriers in New York where the 90 percent reduction occurred, but I didn't pick up on his reference to a hypothetical at the time.) 260

A. We have reduced passenger car fatalities in the United States by the mile by two-thirds from 1968 to the mid-80s before there was any major reduction in the blood alcohol concentrations by -- mainly by crash worthiness of the vehicles. Q. So to what extent should driver behavior, if any, be curbed to reduce injuries? A. Well, there are driver behaviors that we have influenced by law, in particular, like alcohol use and driving, and seat belt use, and motorcycle helmet use, and children's use of bicycle helmets, and several kinds of things.” Wecker had produced a chart showing that there were more drivers of GM vehicles in fatal crashes that had higher risk characteristics on several factors (such as driver age less than 30 years old). However, when I looked at the data for the fire cases, drivers of Ford or Dodge full-sized trucks were higher as often as GM's. And some of Wecker's use of the data was foolish: “Q. Let me see if I understand this correctly. This is a list of non-vehicle factors that Dr. Wecker identified, right? A. Not all of them, because some of them are virtually nil. For example, he had the driver cited for a violation. Well, dead men don't get cited for violations. So that's not a proper variable to use, and it's very infrequent in the fire cases because almost all of them are dead in the fatal fire. Q. Okay. All right. So for selected factors, then, or factors for which you could find. A. They were factors that -- just to illustrate the point, among the factors in which there's substantial cases, 261

that if you do the same kind of percentage that he did, but just do it for the fire cases, that you do not find the kind of differences that he found. Q. Okay. So, for example, if we are looking at males under age 30, you plotted a particular rate of fatal fires involving GM's relative to Fords and Dodges? A. That is not a rate. This is the percent of fire cases in which there was a driver less than 30, in which there was a male separately, not males less than 30, in which the police officer said "driving too fast" or he said "alcohol" or he said "drunk driving," but the actual variable is "had been drinking." Everybody who has been drinking is not drunk. To do a rate of a factor such as age, you have to know how many people of a given age drive a given make and model of vehicle, such as GM C/K pickups versus Ford F-series pickups. One or the other vehicle may have a higher percent of people of a certain age in crashes simply because the same percent occurs in the driving population, so the factor may not be over represented in crashes. “ There was another problem with percentages in crashes as opposed to rates per vehicles in use that I pointed out in Wecker's charts: “Q. Do you have criticism of this particular chart? A. Yes. Q. What is it? A. Looking at "Vehicle's side impact per hundred fatal vehicles," first of all doesn't tell you anything about fires and, second of all, percent of the total fatal vehicles can give you false implications, because if the vehicle has other kinds of problems that will occur in 262

the denominator, because you're only taking ones involved in fatal crashes. Then you inflate the denominator because of other problems. And in this case I happen to know that that occurred. The Dodge pickup is a stable vehicle, and GM and Ford vehicles are less stable, and the Dodge pickup has fewer rollovers. So that if you have less fatal crashes because of rollovers in the Dodge pickup, the fire percentage will be larger, because you will have reduced your denominator by reducing another problem. So you are penalizing the Dodge vehicle for having something decent in the other part of the vehicle.” The primary tank was on the right side in 1973-1980 GM trucks but on the left side in 1981-1987 models. An auxiliary tank on the other side was available as an option during both periods. Wecker claimed that the point of impact on the vehicles in the fire cases was not correlated to the side of the predominant tank. I went through the data and found that he had missed dozens of pre-1981 cases because of missing codes for make and model of those vehicles in the codes that he chose to look for them. When the missing cases were identified using other codes, the fires were more frequent on the side of the vehicles where the primary tank was located. Wecker also did a Roger-McCarthy type chart in which he supposedly showed that the risk of pickup truck fires is rare relative to other risks having nothing to do with driving. I had testified in previous depositions that fire is relatively rare, indicating that rareness is irrelevant if it could be prevented reasonably, but apparently Wecker thought that he could make headway with it. 263

I was asked: “Q. Let's jump to the Risk of Everyday Life Chart. You have criticism of that I assume? A. Well, there are two levels of issue about this kind of comparison. The first is the fact that there are -- I mentioned this earlier, in summarizing my opinions, I'll restate it for you -- the fact that there are higher risks than C/K pickup truck fires has nothing to do with whether or not GM could have made the vehicle safer. Q. Okay. What else? A. The second is that the data on which this stuff is based is very iffy and, indeed, it even says -- in some of his own data sources says, ‘do not use this to calculate rates.’ Q. And what documents have you put together to show that aspect of your criticism? A. Well, for example, this the Mortality Data Per Population for Fires in the Home, well, fires generally, and fall deaths. They are mainly, utterly in small children. To say that these people are going to be driving C/K pickup trucks, as he says in one of these graphs, is silly if you know the distribution of who is dying at home.” Wecker said that people would be at less risk from fire riding around in a C/K pickup than they would be at home. But the point is that given that they need to be riding in the pickup and would not be at home, they are safer in the truck with the gas tank inside the frame rails. Despite Wecker's misleading charts in GM's submissions to the government, the petition regarding truck fires did not suffer the fate of most petitions to 264

the National Highway Traffic Safety Administration. The agency, in a preliminary ruling, found the trucks defective. It did not recall the vehicles, however. It worked out a deal with GM to contribute funds to safety research, some of which could be done in house at GM. This did nothing to reduce the risk to the people who bought GM pickups with sidesaddle tanks. I later heard that Failure Analysis got some of the money, which if true, added insult to the injured GM truck owners. McCarthy and his clones say that something is not unreasonable if they can find another risk that is the same or higher. But the public health issue is to minimize risk, not design products to be average or even just below average in protecting people. In a case regarding doors opening in crashes, I addressed the issue: “Q. Well, ... would it surprise you if the door opening rate for light trucks between 1986 and '89 were 12.3 percent? A. It's not a matter of surprise or not surprise. I don't have any set number in my mind about what door openings ought to be for vehicles. What kind of question is that? Q. So you don't know if 12 percent is acceptable or unacceptable in terms of unreasonable risk just sitting here today? A. My definition of unreasonable risk, as I stated long ago in this deposition, has nothing to do with any absolute percentage. It has to do with whether it could have reasonably been made safer at reasonable cost. Q. What do you need statistical analysis at all for that, though? 265

A. Well, if you have specific vehicle characteristics that have been in existence for a period of time, that people have ignored the data on, and you can say that this vehicle is more or less risky than that one and associate it specifically with that characteristic, if the data are good enough, as you can with fires, as you can with rollovers, as you cannot do with door openings, as you cannot do with door latches. Q. Well, if you had -- if the S-10 pickup truck had a door opening rate of 5 percent, and the average for the industry for light trucks is 12 percent, assuming that the data were good, would that mean -- would you be satisfied that the S_10 pickup truck did not pose an unreasonable risk? A. That depends on whether or not it had some design that could have made it two percent. I don't know. The issue is not whether it's better or worse than some other vehicle. The issue is whether it's as good as it could be. And the statistical type study may or may not be able to tell you that. Q. So short of zero there is no occurrence at which you'd be willing to say that the performance of door latches was safe? A. That is not what I said. That is a mis-characterization of what I said. Q. I asked a question. A. I said if GM had a design that would have made it 2 percent, if it were 5 percent, and didn't use it, then it's unreasonably dangerous. But if 5 percent is all they can do with the best door latch, that's what you've got to live with. I didn't say -- that's the point of using some absolute number as acceptable or unacceptable as 266

opposed to saying why it is that number or why it is not that number. Q. Well, if you welded the S-10 pickup truck's door closed and sold that, that's something you could have done that would have made it safer in terms of door openings? Is that what the engineer should do? A. That's unreasonable and you know that's unreasonable. I'm talking about reasonable and practical. Q. And how do you define reasonable and practical? A. Something that works within the context of the way vehicles are used and is not unreasonably costly, that doesn't price the vehicle out of the market.” Why any self-respecting judge would let McCarthy and his clones show bogus charts to juries was always puzzling to me. In court, if you begin an answer to a lawyer's question with "I guess", the opposing attorney will jump to object that speculation is not allowed in testimony. Yet several judges have allowed McCarthy and others to present what amounts to demonstrably false interpretation of statistics to juries. One such chart, presented by Alan Donelson of Failure Analysis, indicated how many times one would circle the earth in a vehicle before rolling it over, equating "rare" with "reasonable". If a risk is rare, there was no need for the company to do anything to reduce it, right? Think about it. What if you went to your doctor and he said, "You have a very rare form of cancer. It hasn't spread so we can cut it all out, but we don't do that because it is so rare. You had better get your affairs in order, because you have only two months to live." Say what? 267

Another Failure Analysis product, Michelle Vogler, was asked: “Q. You said that you didn't think that the rate of fatal accidents in rollovers in '78-'79 Broncos rose to a level of unreasonableness, correct? A. That's correct. Q. What would be the level that you would find unreasonable? A. There's not a specific threshold. It's a result of doing the analysis, comparing it to other vehicles on the road as to what are their involvements in rollover accidents. Q. Let me ask this question, doctor. If a hundred percent of the 1978 Broncos rolled over in a single year, would that be an acceptable rollover rate? A. That analysis would have to be calculated using those numbers to see is it indeed statistically different from the other vehicles. Q. In other words, if all of them rolled over in one year, you would still have to do a statistical analysis to determine whether or not that was too many? Is that what you are saying? A. What I would want to do to give an accurate answer is to use numbers behind that to say do you have enough data, because we are talking about an old vehicle. We have a tremendous amount of registrations. So my gut feeling would be, yes, that would be statistically different from all other vehicles because we have so many vehicles. Q. Statistically different from all other vehicles. What if all the vehicles rolled over, if all the models, all of the SUV's, every model of SUV rolled over, every one of them rolled over in a single year, then you would say 268

that the Bronco would be reasonable because it wasn't any worse than the rest. Is that what you are saying? A. That would be a completely different analysis because you would be looking at if all of those experienced nothing but rollover accidents there would be no other mode of accident. In other words, we would have completely eliminated frontals, sides, rears. They would have all rolled over. And if that's the case what is that level of accident, is it less then because they aren't involved in frontals, sides, rears? That is a completely separate situation.” Apparently, the main qualification to be an expert witness is to be without embarrassment when giving silly answers. In 1998, Failure Analysis Associates changed it name to "Exponent." I would have suggested "Data Massage Parlor", but I wasn't asked for my opinion.

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Chapter 11. Failures and Successes While it may seem that I spent a lot of time in litigation consulting, actually it took up less than a quarter of my professional time. At Yale, I taught my course in injury epidemiology and taught in the summer course at the University of Michigan. For more than a decade, I also trained the Indian Health Service students in the fellowship program during a weeklong session at reservation sites each fall. In the remaining time, I worked on two editions of a textbook in injury epidemiology and many research projects. After Haddon’s death, I thought more about who would lead the field after the current leaders were gone. If a student showed substantial interest in the injury field, I would do what I could to cultivate that interest. Although many of the current academic leaders took the course in Minnesota or Michigan, most of them were sufficiently interested when they enrolled in the course to continue work in the field without encouragement from me. Most of the students in my Yale course were not so motivated and only one, to my knowledge, went on to work full time on injury problems and she worked full time on such problems before she took the course. That student, Linda DeGutis, now teaches the course I once taught at Yale. Two especially promising Yale students that I hoped would enter the field went on to other things. One came by my office when the course began to discuss a career in the field. She had read many of my publications and those of Haddon and others prior to enrolling in the course. She proved to be bright and maintained her 270

interest until she was offered about $60,000 per year to work for a health care organization. At the time, there were no salaries in injury epidemiology or prevention that approached that amount. She took the health care job. The other student had an undergraduate engineering degree and came to Yale to obtain a masters degree in public health, a great combination for working on injury. Others and I recognized that she was brilliant and encouraged her to pursue the Ph.D. She enrolled in my course and a statistics course that met at the same time. She attended my classes and only took the exams in statistics, which she passed with flying colors. At the annual meeting of the American Public Health Association, I introduced her to leaders in the field and told them that I expected great things of her. I thought I had found another Haddon. She went to work for Blue Cross and I have not heard of her since. Many of the students in the Indian Health Service fellowship went on to become leaders in IHS but perhaps they would have done so anyway. Several initiated projects that were demonstrably successful in reducing injury among Native Americans and, in some cases, among the general population while they were traveling on the reservations or who lived in proximity to the reservations. Also, in a few cases, I helped students to publish studies that they did during the fellowship or as follow up to injury control projects that they initiated. Before he became a “Top Pick” in the first IHS fellowship group, Doug Akin worked with the White River Apache Tribe to establish one of the pilot 271

programs for the injury surveillance system that I designed for IHS. He found a cluster of 37 severe pedestrian injuries on a two-mile stretch of road along the main road of the reservation. Mostly they occurred at night. Doug reviewed the literature on prevention and found studies suggesting that road lighting would be cost-effective in reducing the injuries. The tribal government, with the help of IHS funding, had lights installed on the identified stretch of road. Only two pedestrians were struck on that road section in the following two years. The second IHS group, the first group to take the course at the University of Michigan included a lady from the Navajo Nation who became a leader in the field. Nancy Bill said little but she listened. She returned to her job as an environmental health officer determined to do something on her West Virginia sized reservation, as well as the road to Gallup where many Navajos shopped. She was among the first of the fulltime injury control coordinators, a job that Dr. Rhodes made good on his promise to create. She repeatedly requested that the state of New Mexico install lights on a two-mile stretch of Route 666 where about 5 Navajo pedestrians per year died. The road was labeled the most dangerous in the U.S. by a magazine. She met a lot of resistance, including racist comments regarding “drunken Indians”, but after some years, the lights were installed. Few deaths occurred on that stretch in the years afterward. Several IHS injury control committees adopted lighting programs in succeeding years. Nancy Bill also worked with tribal leaders to get a belt use law enacted by the tribe that was later found 272

to reduce vehicle occupant hospitalizations. She also served as hostess for the IHS fellowship field-training course for many years. She arranged for motel rooms, a classroom, for patients to be interviewed in the hospital, and for police reports on injury to identify sites where I could take the students for training on data collection. On these visits, she would sometimes accompany us and point out injury cluster sites that she and her colleagues had identified in their injury surveillance efforts. We also enjoyed seeing the varied geographical wonders of the southeastern part of the Navajo Nation as we traveled to particular sites. Among these is Canyon de Chelly, one of my favorite spots in the U.S. One student, who served a branch of the Pequot tribe in Connecticut, was moved to tears at the sight of the Canyon. Nancy Bill also took care to introduce the students and me to some of the Navajo customs. We were warned, for example, to avoid discussion of death when conversing with Navajos, for whom the topic is taboo. There is no word in the Navajo language for “accident”. She invited Rick Smith and me to a typical Navajo meal in her aunt’s home, after which we visited the Hogan where her grandmother died. Of course, we didn’t enter the Hogan, which was sealed in the Navajo tradition, after a death. Nancy prevented a potential injury there when she warned Rick that he was about to step on a rattlesnake. Nancy also drove us to Anasazi ruins that few people have seen in modern times. The Anasazsi, called the old ones by the Navajo, were the people that constructed pueblo communities in a large area prior to the arrival of the Navajos and Apaches. When I 273

suggested that her family could conduct tours to the area, she said that such an enterprise would not be permitted. Traditional Navajos are wary of disturbing the ruins of Anasazi communities. The better-known sites available to the public are at Mesa Verde in Colorado and Chaco Canyon in New Mexico. I learned that the Navajos and Apaches speak a variation of the Athabascan language. Nancy had previously served in Alaska where she met her Athabascan husband. They were surprised that they could converse to some extent in the native language of each. Of course, contrary to common stereotypes, Native Americans are not of a uniform culture. There are many cultures and languages that are as different as the English and the French. To characterize Native Americans as a “race” is also inaccurate. “Red People” are no redder than are “White People” white or “Black People” black. The skin color of people stereotyped in this way has a variety of hues and their other features vary widely as well. Consider one very interesting person who never took my course, but was head of the environmental health division of the Indian Health Service in Bimidji, Minnesota, when I first met him, and later on the Navajo Reservation. His name is Pat Bohan and he was a strong supporter of injury control throughout his IHS career. Pat has straight black hair, dark eyes and skin color similar to a lot of Native Americans but similar to a lot of other people as well. He told me that, when he took a new post or visited areas where he was unknown to the local people, he was often asked about his tribal affiliation. Actually, he grew up in New Haven, Connecticut, the 274

son of a Syrian mother and Irish father. He is now retired from IHS and took a demotion to become a college professor. One of the “Top Picks”, Ron Perkins, became the injury control coordinator for Alaska. My class at Michigan and the field exercises on the Navajo tended to be mostly about motor vehicle injuries because they were the most serious injuries among Native Americans nationwide. Ron wanted me to learn about the problems that his people encountered in Alaska where there were few motor vehicles outside the cities. He invited me to a tour of interior fishing villages that was both enjoyable and enlightening. We took a bush plane from Bristol Bay to the interior where we switched to a boat to visit the villages. Among Ron’s programs was an effort to supply “float coats” to villagers at cost. These are warm coats that also act as an automatic floatation device if one falls in the water, one of the more common forms of injury death in Alaska. Reductions in drowning were associated with that program. When we entered the villages, I was decked out in my yellow lobsterman’s slicker pants and had on an orange float coat. One village headman greeted us by saying, “Hey Ron, long time, no see. And who is this high mucky muck you brought with you?” The Inuit are wonderful people with a great sense of humor. It is impolite to refuse coffee from them. Though I seldom drank coffee before or since, I got lots of caffeine on that trip, as well as lots of slides and new issues to discuss in my classes. On the way up the river, we spotted a large battered 275

aluminum object on the shore. I asked what it was and was told that it was the remains of a house trailer that a grizzly bear destroyed. That night on the river, we stayed in a cabin that had an outhouse with no door. I asked what I was supposed to do if that grizzly came upon me in there. Ron, a man of few words, just grinned. He had told me to bring plenty of insect spray with high deet content to ward off mosquitoes. In the middle of the night, I arose to go to the outhouse and sprayed myself generously, I thought. When I was seated in the outhouse, however, they got me from below. We returned to Sitka, which the IHS people call “bush lite”, for a halibut fishing trip before I left for home. Another student with whom I subsequently worked closely was Dave Short who, when I first met him, supervised the emergency services for the Hoopa Tribe in northern California. After class one afternoon in Ann Arbor, Dave produced a big handful of papers that had OTB stamped on them. I kidded him, asking why he brought off-track betting slips to class. He explained that the stamps stood for “over the bank”, a set of reports on vehicles that left the road and plunged down the steep ravines on and near Hoopa and Willow Creek. He and his colleagues were responsible for repelling down to treat and retrieve the vehicles’ occupants. Dave mentioned that he had video taped the sites and was noticed doing so by the California Department of Transportation. The state eventually installed guardrails at the sites. For some years before and ten years after the installation, Dave collected data on the OTB incidents. On a trip to California, I visited him and 276

we did a tour of the area. We designed a study to evaluate the effect of the guardrails. Using a statistical technique to estimate the deaths prevented, which came to about 21 in ten years, we published a paper on the result in an engineering journal. (1) In the meantime, Dave received a contract from IHS to write a manual for emergency personnel on how to collect data and advocate change to reduce the injuries that such workers see routinely. I provided minor comments on his manuscript. He is a good writer and didn’t need much help. Years later, I put a link to the second edition of his manual on my website, www.nanlee.net. Another of the IHS students, Kevin Meeks, was from Claremore, OK. He was a bright young Native American who at one time had considered medical school, but ended up working in environmental health. He was interested in a series of collisions of motor vehicles with trains at railroad crossings in the Claremore area. I helped him with the design of a case-control study. He compared the crossings where a motor vehicle collided with a train to the next site back from which the train traveled, at the same time of day and day of week, to see if there were differences. Kevin collected data on characteristics of the sites and counted the traffic across the tracks. Some of these observations occurred in the wee hours of the morning when the crashes at those hours occurred. The major difference, he found, was the presence of an automatic gate that lowered across the road at a crossing when a train was on the track. Although drivers occasionally drive around gates, the vast majority of cases occurred at non-gated 277

crossings. There was little difference in vehicle traffic at gated and non-gated crossings. When Kevin showed me his results, I obtained national data on fatalities at railroad crossings as well as the installation of gates. Also, I found data on how many crossings were eliminated, usually by running the railroad over or under the vehicle road. From 1975 through 1988, the deaths declined about 40 percent during the period that elimination of crossings and gate installations were accelerating. Kevin and I published a joint paper on our results. (2) Angela Maloney first attended a session that I taught for IHS and community injury control leaders in Gallup. She was more outgoing than most Navajos, who tend to be quiet and reserved, and asked good questions. I was pleased that she later showed up in the fellowship. After hearing of my studies of rollover, she and another student decided to do a case-control study. The idea was so good that I asked to join the study by collecting data in the same way in Connecticut. If the data showed the same results in rural Arizona as in largely urbanized Connecticut, they would be more convincing. The other student changed to a different project because of the time and effort required but Angie and I persisted. We identified sites where vehicles rolled over and collected data there at the same time of day and day of week for 15 minutes before and 15 minutes after the time of the rollover. The idea was to obtain data on what epidemiologists call exposure, that is, what drivers and vehicles have the opportunity to roll over at those sites. If driver characteristics or vehicle characteristics of the rollover cases differ significantly 278

from those exposed, then those factors likely contribute to rollover. We also used a radar speed detector to measure the speed of the drivers observed. Although we didn’t have accurate speed data on the rollovers, we could correlate speed to other characteristics in the exposure group. Angie’s colleagues helped her in Arizona and Nancy assisted me in Connecticut. The results were similar to the other rollover studies. The risk of rollover declined as T/2H increased up to 1.2. Also, the risk of rollover was reduced by longer wheelbase, the distance from the front to rear axles. Risk of rollover also increased as a function of vehicle passenger load, which raises the height of center of gravity. The only surprise in the study was the excess involvement of women drivers when exposure was taken into account. Per licensed driver, women drivers have about half the fatal crash involvement as men, but such rates do not correct for exposure as precisely as our study. Of course, the licensed driver rate includes all types of crashes and is not directly comparable to rollovers. Finally, there was no correlation of speed and T/2H. Apparently, low stability vehicles do not roll over because of speeding. (3) I also learned that Angie was a very accomplished weaver. The Graduate Summer Session in Ann Arbor was scheduled at the same time as a local art festival. Artists from near and far set up tents on the street for several square blocks that are closed to traffic for the festival. I saw Angie at the art booths a couple of times. Another student told me that one of Angie’s rugs was on display in the Smithsonian Institution in Washington. The Michigan course took on a sour note one year 279

when my co-teacher, Jess Kraus of UCLA, refused to speak to me. This came about because of a problem regarding authorship. We were asked by the editors of the Oxford Textbook of Public Health to contribute a chapter on trauma to the next edition. I had written the chapter in the 1985 edition but was happy to share authorship if that was what the editors wanted. After I had written my part and we were approaching deadline, Kraus sent me a few pages that he said were co-written with his graduate students who he wanted to add as coauthors. I didn’t mind adding coauthors but the material was too short, poorly written, and did not contain a lot of substance that should be in the chapter. I wrote Kraus that I would clean it up and add material but that I expected to be first author on the chapter. He replied to say that was unacceptable and dismissed me as coauthor. I wrote the editors telling them what occurred. They decided to publish two chapters, one by me and one by Kraus and his students, which I thought was a reasonable solution. (4) Usually when I arrived in Ann Arbor, Kraus and I would meet and discuss the progress of the students and the advice he had given them regarding projects or papers they were undertaking. The summer after the chapter dispute, Kraus would not meet with me and refused to talk with me in the classroom when we held a joint session before his departure. Since he was first author when we had co-written a chapter for the MaxeyRosenau-Last text, Public Health and Preventive Medicine (5), and the matter regarding the Oxford chapter had been resolved, I couldn’t comprehend why he was so pissed off. Indeed, some years earlier I had 280

written a letter to UCLA in support of his promotion. I reported his behavior to the committee that organized the Graduate Summer Session, telling them that the students would suffer if we could not cooperate on the course. After representatives of the committee talked with him, Kraus was dismissed. I taught the course alone until my retirement. I helped write chapters for a couple of publications of committees supported by the Centers for Disease Control, one of which was also supported by the National Highway Traffic Safety Administration. The latter was a study of cost of injury in the U.S., which was contracted to Johns Hopkins and U.C. San Francisco. My chapter dealt with the cost-effectiveness of programs that had been found effective, or in the case of driver education, harmful. I led off the chapter by saying that removal of driver ed from public schools would be especially cost-effective because it would save lives and taxpayers money. Indeed, it is immoral to tax the public for a program that places them at greater risk of being killed or injured by a teenaged driver. When I submitted the first draft, Mike Finkelstein at NHTSA asked me to drop by his office in Washington to discuss it. Despite the fact that the CDC program was allocated money that Finkelstein would have controlled otherwise, he was strongly supportive of the CDC program. I respected him for that. Many government bureaucrats would have been as snitty as Jess Kraus under such circumstances. Mike wanted me to move the discussion of driver ed more into the interior of the chapter, which I did. (6) The cost of injury book included a chapter on the 281

personal travails of persons with permanent disabilities from injury. I was not a contributor to that chapter, but my friendship with a person who became a paraplegic in a car crash helped keep me motivated to continue working on the problem. That person was my neighbor, Dr. Harry Conte. Harry was a popular pediatrician in Branford. He was on his way to a hospital to see a patient when his car skidded on ice and crashed. When I went to see him after he was discharged from the hospital, he had little control of his body below the neck. He could only move the fingers on one hand a bit. Harry received heroic care from his wife, Kate, and his children. He also had various caregivers who appeared from time-to-time as well as a nursing aide who helped with many chores, but keeping someone reliable in that job was a problem. When I was there, Harry was always cheerful and optimistic that research would produce a means for him to walk again. Being a physician, however, he must have known that his chances for recovery were slim to none. Harry’s family told me he needed intellectual stimulation. They said that one of his pastimes before he was injured was reading the encyclopedia. I suggested that he might be able to use a computer. I had visited a rehabilitation facility in Houston and watched a quadriplegic operate a computer using a wand in his teeth. Harry had enough finger movement that I thought he could use a mouse. I loaned him an extra computer that I had. He could use it with some difficulty. I bought him a roller mouse, which I thought would make it easier, but his physical therapist thought that the mouse was better, to keep Harry concentrated 282

on improving use of his fingers. Eventually Harry’s family bought him a better computer and he was able to use it for years. He and Kate eventually moved to Sun City in South Carolina where Nancy and I were privileged to visit them some years later before Harry succumbed to his injury. The powers that be at the Center for Injury Control at CDC asked me to chair a committee on Home and Leisure Injury Prevention. The committee was to prepare a chapter of a book to be presented to the Third National Injury Control Conference in 1991. Although I suspected that they wanted to keep me off the motorvehicle injury committee, and told them so, I agreed to the work. The subject was too broad and the committee too large (16 members) but we managed to hammer out a set of recommendations and the backup justification for them. (7) Among the members of that committee was Dr. Fred Rivara, a pediatrician whose work I greatly admired. He was head of Harborview Injury Prevention and Research Center affiliated with the University of Washington in Seattle. I once visited there to give a keynote address at a Ross Conference on the status of the field of injury prevention. (8) Fred and his research group produced a plethora of good studies on a variety of injury issues. When Fred and his group produced a couple of bad studies years later, we came into conflict. I became aware of the latter studies when the editor of Injury Prevention asked me to review a paper by Peter Cummings, who was a researcher in Fred’s Center. The paper claimed that the effectiveness of seat belts was 65 percent in reducing death in crashes. 283

Because belt use was low when the original studies were done, showing belt wearers with about 45 percent reduction in death compared to nonusers, Cummings claimed that a statistical anomaly resulted in underestimation of effectiveness. It turned out that he, Fred and others had published a study of air bag effectiveness, using similar methodology and controlling for belt use at the claimed 65 percent effectiveness, which devalued the effectiveness of air bags. (9) Although I had long been an advocate of belt use, there is no way that belts can be 65 percent effective given the changes in deaths that accompanied belt use laws in various jurisdictions in the U.S. and other parts of the world. I pointed out in my review that the result was likely because of an error in police reports. When belt use laws were enacted, police officers assumed belt use when the person survived and no use when the person died. I knew of such assumptions from police testimony in rollover cases. A systematic bias of that sort would result in an inflated estimate of belt effectiveness. I recommended that the paper be rejected. Cummings then flooded the editor with arguments that shifted ground from one page to the next. Despite my recommendation against it, the editor decided to publish Cummings’ paper accompanied by a comment from me. Fred Rivara took it upon himself to join Cummings in a published rebuttal to my comment. I thought their argument extraordinarily unreasonable and replied to them in the journal. While the issue may seem somewhat academic, an assumption of belt use of 65 284

percent could be harmful to other efforts to reduce highway injuries. (10) I had noted in my injury epidemiology textbook, in a section on the effects of a variety of motor vehicle safety regulations, that 100 percent seat belt use would solve only a minority of the problem. During the 1990s, I published two editions of Injury Epidemiology, a textbook guide to students and practitioners. (11, 12) Since the numbers of students enrolled in injury courses where they were offered wasn’t that large, I was surprised that the book sold well enough to justify a second edition, which was a substantial revision of the first. The books reviewed data sources, the collection of injury surveillance data and the allocation of resources based on such data, problems in causal analysis, and research on what works and what does not to reduce injury. The books received mostly favorable reviews, but I was astonished that some students found the few equations and statistical techniques intimidating. The U.S. is in big trouble if we do not improve our education system such that most everyone understands basic mathematics and scientific principles. Such understanding is not only necessary for good science; it is necessary to function in everyday life (13). Students in countries with surging economies, such as India and China, not to mention the countries with a longer tradition of economic growth, do a much better job of preparing students in mathematics than the U.S. We have a strong scientific community substantially because of the brain drain from these countries. In November, 1992, I was presented the Distinguished 285

Career Award from the Injury Control and Emergency Health Services Special Interest Group of the American Public Health Association. That was just after Bill Clinton’s election to the Presidency. At the awards dinner, I told a story of the Arkansas traveler. “You are going to hear a lot more of these so you had better get used to them,” says I. The Arkansas traveler asked a local farmer, “Have you lived here all your life?” The farmer replied, “Not yet.” I told the gathering that a distinguished career award implied that the career was over, but my reply was “Not yet.” After all, I was only 55 years old. Since I had lost three colleagues who died at about that age, my optimism should have been more tempered, but the prediction proved correct. My research and consulting during the last decade of my career focused entirely on injuries. Projects in injury epidemiology and control often come to mind from awareness of simple physics and observation of vehicles and environments where physical principles have been ignored. The idea for one such project occurred to me when Ben Kelley came by to see Nancy and I at our home in Branford. His mother lived in the same town and we would visit when he was there. He was driving a Lincoln Continental. I asked him if I could take a picture of the front corners of the fenders. They were sharply pointed at about the height of an eight year olds head. Other vehicles from several manufacturers in the 1980s had similar protrusions, pictures of which I later shot and showed to my classes as examples of gross disregard for the welfare of pedestrians. To study the effects of the sharp points on fronts of 286

car fenders, I examined the fatal crash files nationwide for pedestrian deaths by impact point on the vehicle. I compared 11 models that had sharp corners with 18 models that had smooth corners, all large cars. There was no difference among the groups in fatal impacts in the front center of the vehicle but the pedestrian deaths from corner impacts were 26 percent higher on the sharp cornered vehicles than on those with smooth corners. In the discussion section of my report on the data, I pointed out that manufacturers often argue that they do not make safety improvements because they cost more. In the case of sharp points, it takes more sheet medal to make them that way than to make them smooth (14). Nancy, ever the worrier, said that if I didn’t stop beating up on car companies, one day they would send someone to get me. I didn’t say, “Bring ‘em on”, but I didn’t muffle the criticism either. One of my studies I didn’t attempt to publish because the result was so immediate that I didn’t see any point. Ralph Hoar, who left the Insurance Institute after I did, set up an organization to gather and sell government and other documents to lawyers and other parties who did not want to dig for them. A short time after the turn of the century, he called me to ask if I had heard of a Firestone tire problem contributing to Ford Explorer rollovers. I had not. He said a Houston TV reporter had done a piece on several cases and he wondered if it were possible to study the extent of the problem nationally. I told him that I would check the fatal files and get back to him. When I examined the national fatal crash file on 287

factors in rollovers of various SUVs, the incidence of tire failure was much higher in the Explorer than other vehicles. I called Ralph with the news. He distributed a news release noting my findings. Although my role in it faded quickly from public view, the issue became a big news item. Ford and Firestone pointed fingers at each other for months: Ford said the tires were faulty but Firestone said that the vehicles rolled over because they were unstable. Both were right. By that time, I had stopped taking new litigation cases, so I never worked for lawyers on the tire/rollover issue. The tire/rollover story in the Detroit News noted that I was a consultant to Ford Motor Company, which was true, but not on vehicle safety issues. Nevertheless, my payment from Ford for work done just before the news story broke was stopped. It finally came months later. Ford’s contract monitor claimed that it was an error in the accounting department but later said it was the fault of the automaker’s union and was not related to the news story. Whatever the reason, I stopped my work for the company. Prior to that, I was involved in two projects for Ford. The first occurred because The Occupational Safety and Health Administration found lots of unreported worker injuries in a Ford plant. Negotiations resulted in Ford’s agreement to audit OSHA reporting in a sample of their plants nationwide. The company was required to hire a qualified person, acceptable to OSHA, to certify that the audit was conducted according to scientific principles. A representative of Ford called me to ask if I would serve in that capacity and I agreed to do so. I told him that I was consulting with lawyers who 288

had suits against Ford and intended to continue that activity. He said that was okay; it gave me more credibility with OSHA. I sat in on a course in OSHA record keeping at Ford, required of their medical and nursing staff, to learn how they interpreted and coded medical records. Then I selected at random a set of plants to be audited. I only gave the company enough notice of each selected plant to allow the auditors to clear their desks and make reservations. Given the volume of the records and the lack of knowledge of the sampling frame once we got to the plants, the possibility of cheating was minimized. Nurses from Ford Headquarters did the audits and, as far as I could tell, they had strong professional ethics and were not about to cheat for the company. I became friends with a physician who supervised the audit and several of the nurses. After hours, we would sometimes go to dinner together. They enjoyed kidding me and I returned the favor. When the audits were in the vicinity of Dearborn, they were at home and I dined alone. One morning they asked me where I had dinner last night. When I told them, one said, “Only old people go there.” I replied, “I went there to eat, not to pick up girls.” Fortunately, the company passed the audit and I did not have to be the bearer of bad news in that case. The second involvement with Ford included the United Automobile Workers. Ford and the union negotiated the establishment of a fund, contributions to which were to be used for research on worker injury. Several academics, including me, were recruited to review research proposals and the results of the research as it 289

progressed. The project was almost completed when the tire/rollover story broke, so I only missed a session or two. Occasionally, a colleague would ask me to help with a study. Susan Gerberich, who coordinated the Graduate Summer Session course when it was at Minnesota, recruited me to work with her on a study of crashes among farm vehicles (tractors, combines, etc.) and road vehicles on public roads. We examined the national fatal crash files for 1988-1993. During that period, 444 occupants of farm vehicles and 238 occupants of road vehicles were killed in collisions with farm vehicles. Major characteristics of the incidents were rollover of farm vehicles and rear-end hits on farm vehicles at night (15). For several years, Susan invited me to Minneapolis for a day or so to lecture to her class and consult on the direction of her program. I was impressed with her efforts and the quality of her students. Although I would have preferred to be there in summer rather than February, that is when the class met. Sue and her husband Bill once took me to a U. Minn.-U. Mich. basketball game that I thoroughly enjoyed. Scraping an inch of ice off the car afterward wasn’t much fun though. Eventually, Nancy and I contributed funds to endow a scholarship at the University of Minnesota for graduate students to study environmental factors in injury, which Sue administers. Another colleague, Nancy Jones, who was teaching at Hunter College in New York, asked for my help on a study of the effect of changes in the legal drinking age on injury fatalities. Numerous states increased their 290

legal drinking age after the Viet Nam War based on the specious argument that people old enough to fight were old enough to drink. They weren’t old enough to fight and were sent unnecessarily to do so, but that is a separate injury issue. We compared the death rates among the states before and after the age was increased with states that kept the legal drinking age at 21. We found that injury death rates increased an average 2 percent for every year of age below 21 that the limit was lowered. As expected, the effect was significant for motor vehicle fatalities but lowered drinking age was also associated with increases in other unintentional injuries as well as homicides. Although a 21 year-old legal drinking age does not prevent all drinking by those younger, it does reduce the incidence and its harmful consequences. Nancy Jones needed to have the study published in order to achieve a promotion. When we submitted it, it was accepted with the proviso that we cut the length substantially. Nancy did not have time to do it, so I did a quick slash and burn editorial job and the manuscript was published. (16) One of the problems with such a study is the inability to separate alcohol-related and other injury cases. As a result of pressure on the states by the National Highway Traffic Safety Administration, alcohol is more often measured in dead drivers than it used to be. It is often not obtained in the injured who survive and not often enough in other injuries, both intentional and non intentional. At the least, the U.S. needs to develop a data system on all people who are fatally injured, including homicides and suicides, similar to that 291

collected after fatal vehicle crashes. The Centers for Disease control began an attempt to collect data on what it called “behavioral risk factors” by calling a sample of people on the telephone and asking them about drinking and driving, seat belt use, smoking, and the like. As I had known since graduate school, such self-reports are often unreliable. Since measurement of the involvement of alcohol in fatal crashes improved and belt use was being observed around the country, there was no need to collect such shaky data. I compared the results of the “behavioral risk factor survey” and the data on alcohol in fatal crashes and belt use surveys among the states with sufficient data to see if the CDC was getting valid results. There was no correlation between self-reports of driving after drinking and actual alcohol in fatally injured drivers. Claimed belt use was substantially higher than actually observed use in almost every state examined. (17) The CDC said that the results of their “behavioral risk factor” surveys could be used to evaluate the effects of behavioral change programs. I concluded in my report that such use would be risky indeed. My study had no influence on CDCs behavior. They continued to do the surveys. If scientific data doesn’t change the behavior of behavioral scientists and epidemiologists who should know better, why would they expect the general public’s behavior to be altered easily? And, of course, they are wasting taxpayer’s money that could be better spent on more valid work. There was an important behavioral change success during the 1980s indicated by the reduction of actually 292

measured alcohol in fatal crashes from about 50 percent to less than a third. I included the effects of reduced alcohol involvement in a study of the effects of improved motor vehicle crash worthiness. Every few years, as vehicles were redesigned and more fatality data became available, I would update the studies of the effectiveness of federal motor vehicle safety standards that I began in the 1970s. My last publication on that issue was the most definitive. It included increases in seat belt use associated with state laws requiring use and the downward trend in alcohol involvement. How much of the reduction in alcohol involvement was achieved by persuasive campaigns as opposed to stepped up efforts to identify drinking drivers by law enforcement could not be disentangled given the nature of the data. The Australians demonstrated the effectiveness of roadblocks where drivers were randomly tested for alcohol. These were tried for a time in the U.S. until knocked down by the courts as unreasonable search and seizure. Some courts in the U.S. allow roadblocks where everyone is tested and some jurisdictions use them. Whatever the cause, alcohol involvement definitely declined. My analysis indicated that motor vehicle crash worthiness standards imposed by Haddon when he was in the government, beginning in 1968 model cars, were a major factor in reduction of fatalities, correcting for other factors. There were also reductions in nonoccupant deaths from crash avoidance standards such as redundant brakes and reduced glare allowed through windshields. In the post-regulation period, the 293

government and the Insurance Institute for Highway Safety continued to report crash tests that were publicized and the manufacturers continued to improve crash worthiness. The reduced death rates by model year, corrected for belt use, alcohol involvement and other factors, continued but were more gradual. (18) After Haddon’s death, a few people, who didn’t have the courage to attack him when he was alive, began writing articles and feeding falsehoods to journalists regarding his work. I wrote responses to two such attacks that were published. One appeared in a professional journal, written by the editor of another. Haddon’s attacker was Frank Haight, the original editor of Accident Analysis and Prevention. Once in the1970s, I was present when Haight visited the Insurance Institute and Haddon gave him a hard time about the name of the Journal. Haddon considered “accident” to be an unscientific term and accident prevention to be too narrow a focus – severe injury can be prevented by changes in vehicles and environments without preventing the incidents called “accidents”. Haight waited until Haddon was dead more than ten years to attack him under the guise of a debate on the semantic issue. He made false claims regarding Haddon’s positions on a number of issues. I wrote a response, hopefully revealing some of “The Real Haddon”. (19) The second attack came in the New Yorker, a magazine widely read outside the Big Apple as well as within. The author was Malcolm Gladwell, a regular contributor to the magazine. He did not name all of his sources for the article, but one was Leonard Evans, a retired General Motors employee (more about him in 294

Chapter 12). Much of what Gladwell published was false. A few people wrote objections in letters to the editor, which were published, but the editor cut them down so that the full set of lies was not refuted. I circulated a fuller refutation among my friends who work on injury epidemiology and prevention. Barry Pless, the editor of Injury Prevention, asked if he could publish it and I consented (20). Barry also asked me to join him as coauthor on an article assessing the validity of risk compensation theory for the British Medical Journal, which I did. Risk compensation was the old Peltzman hypothesis that people have a risk thermostat in their heads and adjust their behavior to take on more risk when they are protected by public health measures. Although the theory was discredited many years earlier, the editors of BJM had invited a rehash by a proponent that we refuted. The proponent presented theory; we presented empirical evidence. (21) Some of the studies and intellectual battles mentioned in this chapter, including The New Yorker and BJM refutations, came after I retired. In the fall of 1998, my mother passed away at age 90. Since both of our parents were now gone, Nancy and I no longer had to consider the possibility of having to finance care of aged parents. We bought nursing home insurance for ourselves and decided to retire. I wanted to get a cottage in the Florida Keys for the winters and keep our house in Connecticut for the summers, but Nancy wisely counseled against two houses. A Florida cottage that we considered at the time would probably have been blown away by a hurricane by now. We 295

compromised by selling the Connecticut house and building one in Globe, Arizona. We chose Globe because my students in the Indian Health Service recommended it as having the best climate in Arizona. Several of them had lived there while serving the San Carlos Apache Reservation nearby. The climate was good and I could sail year round on Roosevelt Lake some 30 miles away. Unfortunately, because the lake is used for farm irrigation as well as for part of the Phoenix water supply, it can be reduced to 25 percent of capacity during a drought. When that happens, as it did during our second year in Globe, the lake is substantially below the boat ramp. Also, the town is substantially dependent on mining and mine employment diminished to the point that restaurants and stores were closing. Globe would be a good place to develop a retirement community, but the there seemed to be no interest among local officials in attracting a developer. We looked around for a better situation. Some friends introduced us to the retirement community of Green Valley, but it was too far to tow a boat to a sailing lake. On a trip to the Tohono O’odham reservation to give a talk on injuries for the Indian Health Service, I took a side trip to Patagonia and Nogales to look for a place to store a boat near Patagonia Lake. I spotted a golf course community just outside Nogales, called Kino Springs, which had spectacular views and some attractive model homes. Nancy returned with me to look the place over and we contracted to build a house there. When we tried to sell our Globe house, we discovered 296

that we had paid too much for it. The contractor was a Bishop in the Mormon Church who seemed trustworthy. At the time of construction, I asked him several times if the costs were not too high for that community. He said that we would have no trouble getting our money out of the house if we needed to do so. Our real estate agent, also a Mormon, who finally sold the house, was shocked at what we had been charged by the Bishop and told him so. Nevertheless, there was no refund and, for the first time in our lives, we lost money when we sold a house. As an incentive to build a house in Kino Springs, the developers included a year’s membership in the golf club. I hadn’t played since my days at Wake Forest, but decided to try it again. Soon I was playing a lot of golf and seldom sailing. I joined a group of compatible fellows with whom I play regularly to this day. When our house was finished, I spent about 6 weeks working on the yard. I hauled tons of rock to build washes that carried the rain water from the roof to trees and plants in the yard. By the time I finished, my weight had dropped to 190 lbs., 20-25 lbs. below what it had been in Connecticut. It dawned on me that I now qualified to ride a mule into the Grand Canyon. The weight limit is 200 lbs., including equipment. I made a reservation and six months later made the trip – a half days ride to Phantom Ranch, where we spent the night, and another ride out the next day. The sights along the way are fantastic. Out of 150 available mules, the wranglers put me on a mule named “Skidmark”. How did they know? I was impressed with their safety record. Despite 297

narrow, switchback trails, in more than 100 years of taking tenderfoots on mule rides; they haven’t had a single fatality. A few people have been injured when a rattlesnake spooked a mule or someone tried to dismount while the mule was moving, but all survived. I suspect that at least some of that record can be attributed to those sure-footed Tennessee mules. We lived in Kino Springs for 3.5 years until Nancy had a scary time in the Emergency Room of the local hospital. While preparing for a medical examination, which required a liquid diet, she began vomiting and could not stop. I took her to the ER where she was given a medicine that resulted in stroke-like symptoms – difficulty speaking and muscle weakness. I was with her all the time and was watching her vital signs on a monitor by the bed. I had been in an emergency room with a person who had a stroke in the past. From Nancy’s vital signs, I knew she wasn’t having a stroke, but the MD on duty was obviously incompetent and frightened. Finally, we got another physician on scene from our local provider who treated her appropriately. Some weeks later, Nancy had another bout with dehydration and needed an IV. Our health care provider wanted her to go to the ER again but she refused. After I yelled at some people, she was given the IV in the provider’s clinic. I knew that we couldn’t live there at our age with the poor emergency services available. We found a house in Green Valley, near Tucson, where we now live. Nancy is much happier here but I would prefer to be closer to the mountains. I will not compromise on matters of scientific principle, but when it comes to Nancy’s 298

welfare and happiness, I am a poopsie.

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Chapter 13. Back in the Saddle So, does this memoir have any relevance as to how one becomes a scientist? Maybe. I think there are several necessary conditions, none of them sufficient, to be a productive scientist - intelligence, work ethic, curiosity, the tools to execute scientific research (especially mathematical skills), skepticism, and willingness to challenge the conventional wisdom. There is also a trait that is a major hindrance – wanting to be liked. If you would rather be liked than respected, science isn’t for you. You have to be willing to criticize the work of your scientific friends as well as other scientists. While some people appreciate constructive criticism, too many resent it. A modicum of intelligence is required to be a scientist, although modest intelligence can be overcome by hard work. My childhood environment was not conducive to the development of intelligence but my mother was the work ethic personified. She worked unbelievably hard throughout my youth, as well as the rest of her working life, and expected my siblings and I to help out. At her 90th birthday party, my sister correctly described Mom’s defining trait as tenacity. I doubt that I would have accomplished much without that example. The taxpayers who supported the schools and local libraries in the towns where I grew up gave me the skills to develop what innate intelligence I possess. The teachers who help us learn to read, and know how to encourage reading, are at the core of intellectual development. I am saddened when I read in the New 300

York Times that half of the students graduating from high school in the U.S. today are deficient in reading skill, and a third who enter high school do not graduate. I had students in graduate school that grew up in the U.S., yet had difficulty writing a clear English sentence. Many also had difficulty with mathematics. The mathematics that I learned in high school and graduate school I used throughout my career. If I had children, they would see no television, play no computer games and listen to no crap, er rap, until they demonstrated substantial progress in reading, writing and mathematics. I would allow classical music to play in the background while studying. My skepticism and willingness to challenge conventional wisdom began late in college when my religious beliefs were challenged by the logic of biblical criticism and the irrational attack on a reasonable man who introduced me to the subject. Millions of people think that life has no meaning without religion. I have lived a life without religion for the past 48 years and I defy anyone to say that part of my life was without meaning. It is certainly meaningful to me that I loved and helped my wife when she needed it, helped members of our families and friends when they were in need, helped students to better understand how the world works, contributed scientific work that informed public policy to prevent injury and death to an unknown number of people, and endowed professorships and scholarships for others to continue that work. I neither seek nor expect additional reward for these efforts, now or in an afterlife, or punishment for my faults. Common characterizations of an arbitrary and 301

capricious Judeo-Christian god indicate that I will burn in hell for my disbelief. If I have any enemies wishing me such a fate, don’t count on it folks. So far, I have encountered no difficulties that could remotely be construed as punishment for my skepticism. In fact, I have been far healthier of mind and body since my college days than before. Indeed, I am especially skeptical that there is an afterlife. Certainly the heaven conceived by many Christians is not appealing. As much as I enjoy music, an eternity singing praises to God would get boring before long. I wouldn’t mind a longer life to be with my wife and friends, renew scientific investigation and to see how the human condition progresses, if I could keep my health. I am aware of no god who promises that. If too many people lived much longer, the earth’s resources would be depleted even faster and life would become less desirable. Of course, I could be wrong about an afterlife. There could be other dimensions into which our consciousness warps, but I know of no credible evidence that there is an entity (soul or whatever) within us that can survive the death of our cells. The nagging question is whether or not I would have accomplished what I did without the religion of my youth or my intellectual transformation in reaction to its anomalies. No scientist, or anyone else, can answer that question regarding an individual. But there certainly have been many people, whose work benefited humanity far more than mine, who were raised by religiously agnostic parents or developed such beliefs themselves. Of course, I will always be grateful for the 302

love and nurture of my mother and relatives and the help of hundreds of strangers, some of whom became friends, whatever their motives. I certainly don’t reject the entire Bible any more than I accept all of it. For example, the admonition, “Do unto others as you would have them do unto you”, is a great insight that, 2000 years or so later, was shown scientifically to add to health and length of life. In the studies, it is called “social support”, meaning close family and friendship systems. If you are good to your family, friends and strangers, and they are good to you, everyone benefits on average. It doesn’t matter whether Jesus said the "golden rule", or someone put the words in his mouth years, sometimes decades, after his death, when the accounts of his life were written. The thought certainly wasn’t original with Jesus. Buddhists teach, "Hurt not others in ways that you yourself would find hurtful." "That which you want for yourself, seek for mankind" is from Islam. Confucius stated the idea in the negative, "Do not impose on others what you do not desire others to impose upon you." It is not my purpose here to convert anyone from his or her religious beliefs. Indeed, I will defend your right to whatever religious belief (or non belief) that you choose. I will take issue with you, however, if you try to impose on me, or the rest of society, any part of your religion that defies reason and empirical scientific evidence. One attempt by the religious right wing in the U.S. to offset the scientifically proven truths of evolutionary theory is to introduce the teaching of “Intelligent Design” in the public schools. The current President of 303

the U.S., George W. Bush, and the Republican Senate Majority Leader Bill Frist, a physician no less, advocate such education because, they say, the world is too complex to be explained by evolution. Add Frist to the list of MDs that I do not wish to touch me if I am ill. May I modestly propose that, if such education is introduced, it be called “Unintelligent Design”? Would you design a world in which there are pathogens that produce leprosy, plague, AIDS, influenza, polio and hundreds of other killing and debilitating diseases? Would you design a planet that produced earthquakes, tsunamis, hurricanes, tornados, floods, avalanches, mud slides and other natural disasters? If not, then the so-called intelligent designer is either dumber or crueler than you. To top off the absurdity, physical and biological disasters are commonly called, “Acts of God”. Of course, I cannot prove the existence or nonexistence of supernatural beings. I do not know what happened prior to the big bang. For all I know it was the firecracker of some unknown intelligence. But if a lot of the stuff that happened after was by design, pardon me if I do not choose to worship the designer. And while I am on the subject of religion, may I ask a couple of questions of my fundamentalist Christian brethren? If you had the power, would you cast apostates like me, or any of your fellow human beings, into eternal hell fire simply for our lack of belief? If not, how can you worship a God that you claim pursues such a policy? If any of my Baptist friends read this, they undoubtedly think that I am doomed to hell. Baptists, and several other denominations as well, claim to 304

believe that people are saved from hell by faith that Jesus is their personal savior. That is all that is required. A serial rapist and killer can go to heaven if he makes a deathbed profession of faith, but someone who does unto others as he would have them do unto him, and behaves ethically throughout his life, is condemned to hell if he does not accept that belief. If you think this way, and have never doubted it, may I suggest that your mind is more bizarre than mine? In some Christian religious circles, any question about the inconsistencies in the Bible or the existence of surd evil in the presence of an all powerful, all knowing and all loving God, are met with the sentence, “God moves in mysterious ways, his wonders to perform.” In other words, “don’t ask, don’t tell”. Perhaps they can live with the psychological dissonance of the chasm between religious doctrine and scientifically verifiable reality. I could not. I believe that rigid adherence to religious or political philosophy is among the most self destructive of behaviors. Practitioners tend to shut down their minds to consideration of alternative approaches to life and problem solving which is necessary to a productive life in a changing world. My guess is that there are far more religious doubters than meet the eye. Political true believers tend to be more open about their mental rigidity. Years ago, social psychologists came up with the concept of “pluralistic ignorance” to explain individual inaction on personal ethics and beliefs. Repeatedly, individuals remain silent in situations where their ethics or beliefs dictate action. The scientists discovered that the inaction 305

occurred because the person thought that the opinions of the majority of the committee, community or whatever group were different from what they actually were. (1) As outspoken as I am, I often hold my tongue in order to keep peace. Undoubtedly on some such occasions, I misperceive the beliefs of others in the group. I kid my wife when we are on the way to a social event. “I can’t discuss religion, politics, or sex, so why are we seeing these people?” Although pluralistic ignorance undoubtedly lowers interpersonal tensions, one of the down sides is poor decision making in corporate and government settings. Perhaps many of the cases of poor product designs that kill and maim people would not occur if someone in the corporate committees that approve them would stand up and say, “Hey, wait a minute. This is harmful.” And governmental officials are noted for keeping silent in the presence of the President of the U.S. The Mayor of New Orleans, who was highly critical of the federal government’s delay in response to hurricane Katrina in 2005, admitted on 60 MINUTES that he did not voice that criticism when he met with the President soon afterward. One major downside of fervent religious belief is the willingness of nations to go to war to impose their religion on others, or terrorists to intimidate the rest of us in the name of their favorite god. The current claim that “democracies do not start wars” ignores our own history. Many of our founding fathers in the U.S. made war on Native Americans in the belief that their god gave them the right to take the land from “savages”. Some of the southerners who fired on Fort Sumner were 306

Baptist democrats. Now those who want to impose democracy on people who believe “There is no God but Allah and Muhammad is his prophet" are surprised when the believers seek to drive U.S. forces from the lands occupied by the worshipers of Allah. That is not an excuse for terrorism, but the resistance to the U.S. invasion of Iraq only involved terrorists after the fact. The invasion had nothing to do with counter terrorism as was claimed by those with Potomac fever at the time. There was a no-fly zone in place and enforced, the weapons inspectors were back in Iraq and Saddam was even disassembling some illegal missiles. The invasion was not necessary to keep Saddam in check. The Bush-Cheney-Rumsfeld claims that Saddam was linked to the 9/11 terrorists were plainly false. Indeed, not one Iraqi was ever implicated in any of the Jihadist terrorist incidents against U.S. facilities prior to the invasion of Iraq, despite their humiliation in the first Gulf War. Bush’s invasion created a terrorist factory where one did not exist. Before the invasion of Iraq, I told a friend at Johns Hopkins what would happen. The 9/11 attacks emphasized the previous lack of effective actions against terrorists, partly because terrorists have cells in many nations, but represent no nation state that could be attacked. We could oust the protectors of Al Queda training camps, the Taliban in Afganistan, too easily for that war to impact the next election. After that, the “war on terror” would be relegated to the back pages of the newspapers and demonstration of progress would be difficult. The neoconservatives in the government and elsewhere wanted to project U.S. 307

power, and pressed Bush to invade Iraq. Bush lost the popular vote in the previous election and he and his political adviser, Karl Rove, needed ammunition for the next one. Rove saw political capital to be gained by a "shock and awe" campaign led by a “war president”. Quick victory over an unloved tyrant could be used to get Bush reelected. Bush got Blair and a few others to help press the case in the UN, but that process was too slow to get the war started in time. So they would launch an unnecessary preemptive war, at least partly for political reasons. Of course, I cannot prove this. Let’s just call it a reasoned but less than scientific hypothesis. Anyone who was in the White House at the time, and was privy to the decisions, should take a dose of conscience medicine, a cure for Potomac Fever, and call Seymour Hirsch. But let’s get back to how one becomes a scientist. My scientific tools I got mainly from Louis Dotson at the University of Tennessee with a lot of retooling as new statistical methods and computers to maximize their use became available later. Those of us who rely on science for our view of the world are sometimes accused of worshiping science. That is silly. Science is not an entity, physical or spiritual. It is a method - an epistemology if you will. It is a means of reaching agreement among skeptics on the ways of the world and the universe. The scientific life requires continuous retooling. That is not to say that science is flawless. Scientists grope to find the truth, sometimes taking a step backwards for each step forward. The field in which I 308

labored for 30 years, injury epidemiology, has lots of practitioners with half-baked ideas who do poorly designed research. It is little wonder that those who make public policy often ignore the valid scientific work. As an experienced researcher in the field, I am asked by journal editors occasionally to review books and papers of those who publish on that topic. I attempt to educate the novices who lack understanding of the principles or make errors. I am less gentle with those who should know better. In 2005, I got back in the research saddle because of my review of a book. Written by a former employee of General Motors, Leonard Evans, the book was highly praised in medical journal reviews and on commercial web sites such as Amazon.com. While the book contains some reasonable sections on error in belt use in police records that bias seat belt effectiveness studies and the issue of behavior offsetting vehicle safety improvements, its main thesis is wrong. That thesis states that human behavior causes motor vehicle injuries and that, therefore, behavior must be changed to reduce motor vehicle injuries. As noted in Chapter 11, that notion has been completely discredited by environmental changes that work to reduce injuries despite behavior, such as barriers that prevent children from falling out windows. Evans’ big recommendation for reducing motor vehicle injury is cameras placed on roads to record violations of driving laws and to record the license tag numbers of the driver so that the drivers can be arrested. (2) He ignores the fact that the large majority of crashes in the U.S. do not occur in the geographic 309

areas where the large majority of severe injury and deaths occur. If we target our efforts at preventing crashes without accounting for severity, reduction of injury to the extent possible will not be achieved. For example, Massachusetts had one of the highest crash rates among the states, but usually had the lowest road fatality rate among U.S. states in any given year. Evans argued that vehicles have been modified to the extent possible to reduce injuries and failed to review adequately the research on road and other environmental modifications. Within weeks after publication of the book, the Insurance Institute for Highway Safety reported a study of automatic electronic stability control devices that are optional on a few vehicles. That study found that such devices cut severe single vehicle crashes by 50 percent. Evans also claimed in his book, as well as numerous papers, that weight of vehicles is the primary protective factor in occupant risk. If that were so, then reduced weight for fuel economy would be adverse to safety. I decided to look at data on recently manufactured vehicles regarding the main factors that contribute to deaths – vehicle weight, size, crashworthiness and stability. I was surprised, and pleased, to find that most of the data are readily available on the Internet. Detailed vehicle specifications are available at internetautoguide.com. The Insurance Institute’s 40 mph offset crash tests are at hwysafety.org. The National Highway Traffic Safety Administration published stability data on most models and data on almost all the fatal crashes since 1975 can be downloaded from its website. I did have to go to the 310

University of Arizona library to get sales data in Ward’s Automotive Yearbook. To get stable statistics, I looked at 67 models manufactured during 1999-2002 and their involvement in fatalities through 2004. When I put it all together in a statistical analysis called logistic regression, the results were astonishing. If the manufacturers had reduced the weight relative to size achieved in the lightest weight vehicles for their size, the deaths in which those vehicles were involved would be reduced by 26 percent. Drivers in heavier vehicles are somewhat less likely to die in a crash, but that risk is more than offset by the havoc delivered to other road users by heavy vehicles. In addition, I found that If all vehicles received a “good” rating on the Insurance Institute’s crash tests, an additional 25 percent of deaths would not occur. And 3 percent would be prevented if unstable SUVs were stable. In sum, more than half the deaths in passenger vehicles manufactured in 1999-2002 could have been prevented by vehicle modifications. Furthermore, if weight relative to size were minimized, the fuel use would have been reduced by 16 percent. (4) Discrepancy in weights among vehicles puts the occupant of a lighter weight vehicle and other road users at a disadvantage in a crash with a heavier vehicle, particularly if the lighter vehicle also had less deceleration space. Also, the heavier vehicle has longer stopping distance when braking. Sue Baker and I published a paper on that topic in 1976 (5) but it was ignored in the rush to produce SUVs. Increased weight disparity among vehicles increases deaths, and was exacerbated by the promotion of heavy SUVs, many of 311

which have less interior room for occupants than the average sedan. A race among vehicle owners to have the heaviest vehicle is madness. An article in Scientific American in 2005 noted that large vehicles need not be heavy if constructed with lighter materials that are crash worthy. (6). Hybrid vehicles that can increase fuel economy using computer programs to charge a battery when coasting or braking, and use the battery to operate the vehicle part of the time, have been in use for several years. I have one, a Toyota Prius that has good interior room for safety and gets about 51 miles per gallon. Recently, it was reported that some manufacturers of newer hybrids are foolishly using the battery to boost horsepower rather than for fuel economy. A mathematical model developed by a geologist in the 1970s predicted the year in which oil production peaked in the U.S. It now says the peak of world production occurred in 2005 and will decline within a few years thereafter (7). Some of the vehicle manufacturers that produce the least fuel-efficient vehicles are already in serious economic trouble and their stock prices have tumbled. They, and the rest of us, may yet pay for their sins. Unfortunately, it is their employees that will suffer the most. Arguments among scientists about these and many other public health issues unfortunately confuse the public. Of course, the world only needs for a small minority of its citizens to become working scientists. But most of its citizens need to be knowledgeable enough to sort among the arguments and make intelligent choices in the voting booth and in everyday 312

decisions. You may be able to afford to live like a king or queen, depleting the earth’s resources at a breathtaking pace. To the extent that you do, your children and grandchildren may be priced out of the market for the good life. Or you may do so by using your credit card on the way to eventual economic disaster in your lifetime. You may be able to afford a big SUV but, if you crash it into a small car driven by someone who can’t afford a bigger vehicle, you may kill one or more people in that car. People who want the biggest house, the biggest vehicle, and the biggest boat are destructive in ways that they do not imagine, without knowledge of science. One of the things that I do not understand about myself is why I care so much about the future of the human race. Without children, I have no worry about preserving my genes. Of course, I have relatives and friends about whom I care, but somehow that doesn’t seem to justify the intensity of my concern. There are lots of good genes around to serve generations to come. But genes cannot flourish without a sustainable environment, which requires intelligent decisions by individuals, corporations and governments. Those seem to be in short supply. After my review of Evans’ book was published, Evans attacked my motives and I replied. Evans claimed that the U.S. overly emphasized vehicle factors because of “a giant litigation industry devoted to its own financial interests rather than reducing harm. As one who supported and greatly profited from that industry, it is understandable that Robertson should seek to discredit my book.” In response, I noted that personal injury 313

lawyers had nothing to do with injury control efforts in the U.S. and that I gave away my litigation and other consulting fees. In two books I proposed a litigation reform that would do away with case-by-case litigation. That is hardly profiting from or support of lawyers. In my review, I objected to Evans’ reliance on changes in raw number of deaths among countries to make claims of superiority of injury control approaches in one or another. He did not relate specific changes to specific programs as I had in many studies of attempts at injury reduction. Evans response says, “When raw data show no indication of an effect, I have vigorously opposed unintelligible hocus-pocus analyses that somehow manage to find effects that support the analyst’s prior beliefs. I have illustrated this using two frequently cited analyses of the same data (one by Robertson) that somehow ended up supporting diametrically opposite beliefs, characterizing both as ‘the triumph of zeal over science, or perhaps even common sense’.” In rebuttal, I expressed surprise that the methods I used, that are used by thousands of scientists in every branch of science, were described as “unintelligible hocus-pocus”. Since Evans and I have never had a conversation, he had no basis for attributing motives to me. Evans claimed that, since my review was the only dissent from what was uniform praise in other reviews of the book, mine could be dismissed. Fortunately, I had sent my review to Dinesh Mohan who had praised Evans’ book in the British Medical Journal. Dinesh wrote to me, “Leon, I agree with you! I should have read the book a little more carefully. Your review is much 314

more detailed and sound technically.” I quoted Dinesh in the rebuttal. In his book, Evans claimed that the U.S. focus on vehicle regulation in the 1960s and 1970s resulted in a slowing of the reduction of death rates in the 1990s compared to other countries because of neglect of behavioral factors. I looked up the types of vehicles sold in the other countries and found that the U.S. was the only one that had big increases in sales of overweight SUVs and pickup trucks. Evans emphasized that Canada had surpassed the U.S. in death rate reduction despite having the same mix of vehicles. I examined Canada’s vehicle sales in the 1990s and showed that there were big differences in the mix of vehicles sold in the U.S. and Canada and that Canadians drove fewer miles per year than U.S. drivers. When the death rates by make and model in the U.S. were applied to the Canadian vehicle mix and mileage, the difference in the death rate between the two countries was totally explained. Indeed, the U.S. federal government spent hundreds of millions on behavior modification programs while the Canadian federal government had no such program. (8) It is one thing for a writer to produce nonsensical theses that the evidence clearly contradicts. It is quite another when professional people, who should know better, heap praise on the nonsense. Without a critical eye from peer reviews, the nonsense will take over and the good research and policy implications will be lost. The public will suffer the consequences. I can thank Evans and his sycophants for one thing; they got me energized to do science again. I often lose 315

sleep when I wake up in the night thinking about a project but if Evans and his ilk continue to produce junk, I may continue to do a project now and again at this advanced age. Looking back on my life, it appears to me that its course was mainly the result of events and decisions at major turning points. What if there had been no fire and we had stayed in Christiansburg? Would I have murdered my father? Would I have been part of the college bound group in high school that influenced me to go to college? If I had stayed in Idaho during my senior year, would I have missed the influences that led me to abandon religion? Except for a chance meeting in a coffee shop, would I have lived out my days teaching courses that became increasingly boring? One can endlessly speculate about such possibilities, but there will be no answers. One can also speculate about the result of an overly planned life. Based on my own experience, I counseled students not to plan their lives too far ahead. Prepare yourself with the ability to meet life’s challenges and decide when they arrive what is best for you and those whose needs you can serve. People who set milestones too rigidly may only be disappointed when contingencies prevent their achievement. They may also miss seeing even greater opportunities that they never would have anticipated. It worked for me.

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Chapter Notes Foreword 1. Brockman, John (ed.) CURIOUS MINDS: HOW A CHILD BECOMES A SCIENTIST. New York: Pantheon Books, 2004. Chapter 4. The Making of a Professor 1. Summers, Gene F. and Hammonds, Andre' D. Effects of Racial Characteristics of the Investigator on SelfEnumerated Responses to a Prejudice Scale SOCIAL FORCES 44:515-518, 1966. 2. Robertson, Leon S. and Rogers, James C. Distributive justice and informal organization in a freight warehouse work crew. HUMAN ORGANIZATION 25:221-225, 1966. 3. Adapted in Hughes, Helen M. (ed.) SOCIAL ORGANIZATIONS, Boston: Allyn and Bacon, 1971, pp. 112-118. Chapter 5. Hopkins to Harvard 1. Coleman, James S., et al., EQUALITY OF EDUCATIONAL OPPORTUNITY, Washington, DC:U.S. Department of Education, 1966. 2. Robertson, Leon S. and Dotson, Louis E. “Perceived parental expressivity, reaction to stress, and affiliation”, JOURNAL OF PERSONALITY AND SOCIAL PSYCHOLOGY 12:229-234, 1969. 3. Kosa, John and Robertson, Leon S. The social aspects of health and illness. In Kosa, John; Antonovsky, Aaron and Zola, Irving K. (eds.) POVERTY AND HEALTH: A SOCIOLOGICAL ANALYSIS, Cambridge: Harvard University Press, 1969. Revised edition, 1975. 317

4. Robertson, Leon S.; Kosa, John; Alpert, Joel J.and Heagarty, Margaret C. Family size and the use of medical resources. In Liu, W.T. (ed.) FAMILY AND FERTILITY, South Bend: University of Notre Dame Press, 1967. 5. Robertson, Leon S. On the intraurban ecology of primary care physicians. SOCIAL SCIENCE AND MEDICINE 4:227-238, 1970. 6. Robertson, Leon S.; Kosa, John; Heagarty, Margaret C.; Haggerty, Robert J.; and Alpert, Joel J.: CHANGING THE MEDICAL CARE SYSTEM: A CONTROLLED EXPERIMENT IN COMPREHENSIVE CARE, New York: Praeger Publishers, 1974. 7. Haddon, W. Jr., Suchman, E.A. and Klein, D. ACCIDENT RESEARCH: METHODS AND APPROACHES. New York: Harper and Row, 1964. Chapter 6. Potomac Fever 1. Robertson, Leon S.; O'Neill, Brian and Wixom, Charles W. Factors associated with observed safety belt use. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 13:18-24, 1972. 2. Robertson, Leon S.; Kelley, Albert B.; O'Neill, Brian; Wixom, Charles W.; Eiswirth, Richard S. and Haddon, William, Jr. A controlled study of the effect of television messages on safety belt use.AMERICAN JOURNAL OF PUBLIC HEALTH 64:1071- 1080, 1974. 3. Mazur, Allan and Robertson, Leon S.: BIOLOGY AND SOCIALBEHAVIOR, New York: The Free Press, 1972.

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4. Baker, Susan P.; Robertson, Leon S. and Spitz, Werner U. Tattoos, alcohol and violent death. JOURNALOF FORENSIC SCIENCES 16:219-225, 1971. 5. Dotson, Louis E.; Robertson, Leon S. and Tuchfeld, Barry.Plasma alcohol, smoking, hormone concentrations and self- reported aggression: a study in a social drinking situation.JOURNAL OF ALCOHOL STUDIES 36:578-586, 1975. Chapter 7. What Works and What Does Not 1. Robertson, Leon S. and Haddon, William, Jr. The buzzer-light system and safety belt use. AMERICAN JOURNAL OF PUBLIC HEALTH 64:814-815, 1974. 2. Robertson, Leon S. Factors associated with safety belt use in 1974 starter-interlock equipped cars. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 16:173-177, 1975. 3. Robertson, Leon S. Shoulder belt use and effectiveness in cars with and without window shade slack devices. HUMAN FACTORS, 32:235-242, 1990. 4. Foldvary, L.A. and Lane, J.C. The effectiveness of compulsory wearing of seat-belts in casualty reduction. ACCIDENT ANALYSIS ANS PREVENTION, 6:59-81, 1974. 5. Robertson, Leon S. Automobile seat belt use in selected countries, states and provinces with and without laws requiring belt use. ACCIDENT ANALYSIS AND PREVENTION 10:5- 10, 1978. 6. Robertson, Leon S. The seat belt use law in Ontario: effects on actual use. CANADIAN JOURNAL OF PUBLIC HEALTH 69:154- 157, 1978. 7. Robertson, Leon S. Evaluation of community programs. PROCEEDINGS OF THE SEVENTH 319

INTERNATIONAL CONFERENCE ON ALCOHOL, DRUGS AND TRAFFIC SAFETY, Canberra: Australian Government Publishing Service, 1979. Also published as: Road Safety--evaluation of community programs. ACCIDENT COMPENSATION COMMISSION REPORT (New Zealand) 4:52-55, 1979. 8. Robertson, Leon S. An instance of effective legal regulation: motorcyclist helmet and daytime headlamp use. LAW AND SOCIETY REVIEW 10:467-477, 1976. 9. Robertson, Leon S.; Rich, Robert F.; and Ross, H. Laurence. Jail sentences for driving while intoxicated in Chicago: a judicial policy that failed. LAW AND SOCIETY REVIEW 8:55-67,1973. Reprinted as: Deterring the drunk driver. In Johnson,Norman and Savitz, Leonard D. (eds.) JUSTICE AND CORRECTIONS New York: Wiley and Sons, 1978, pp. 390-398. 10. Ross, H. Laurence. DETERRING THE DRINKING DRIVER, Lexington, MA: D.C. Heath, 1982. 11. Williams, Allan F. and Robertson, Leon S. The fatal crash reduction program: a reevaluation. ACCIDENT ANALYSIS AND PREVENTION 7:37-44,1975. 12. Berg, A. The stability of driving record over time. ACCIDENT ANALYSIS AND PREVENTION 2:57-65, 1970. 13. Robertson, Leon S. and Baker, Susan P. Prior violation records of 1447 drivers involved in fatal crashes.ACCIDENT ANALYSIS AND PREVENTION 7:121-128, 1975. 14. Wright, Paul H. and Robertson, Leon S. Priorities for roadside hazard modification: a study of 300 fatal roadside object crashes. TRAFFIC ENGINEERING 46: 2430, 1976. 320

15. Peltzman, S. The effects of automobile safety regulation. JOURNAL OF POLITICAL ECONOMY 83:677, 1975. 16. Robertson, Leon S. State and federal new-car safety regulation: effects on fatality rates. ACCIDENT ANALYSIS AND PREVENTION 9:151-156, 1977. 17. Robertson, Leon S. A critical analysis of Peltzman's "The effects of automobile safety regulation." JOURNAL OF ECONOMIC ISSUES 11:587-600, 1977. 18. Shaoul, J. THE USE OF ACCIDENTS AND TRAFFIC OFFENSES AS CRITERIA FOR EVALUATING COURSES IN DRIVER EDUCATION. Salford, England: University of Salford, 1975. 19. Robertson, Leon S. and Zador, Paul L. Driver education and fatal crash involvement of teenaged drivers. AMERICAN JOURNAL OF PUBLIC HEALTH 68:959-965, 1978. 20. Robertson, Leon S. and Heagarty, Margaret C.: MEDICAL SOCIOLOGY: A GENERAL SYSTEMS APPROACH, Chicago: Nelson-Hall Company, 1975. Chapter 8. Yale 1. Robertson, Leon S. Crash involvement of teenaged drivers when driver education is eliminated from high school. AMERICAN JOURNAL OF PUBLIC HEALTH 70:599-603, 1980. 2. Robertson, Leon S. Environmental correlates of intercity variation in age adjusted cancer mortality rates. ENVIRONMENTAL HEALTH PERSPECTIVES 36:197-203, 1980.

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3. Robertson, Leon S.: INJURIES: CAUSES, CONTROL STRATEGIES AND PUBLIC POLICY, Lexington: D.C. Heath, 1983. (Available free online at www.nanlee.net) 4. Robertson, Leon S. Insurance incentives and seat belt use.AMERICAN JOURNAL OF PUBLIC HEALTH 74:1157-1158, 1984. 5. Robertson, Leon S. and Keeve, J. Phillip. Worker injuries: the effects of workers' compensation and OSHA inspections. JOURNAL OF HEALTH POLITICS, POLICY AND LAW, 8:581-597,1983. 6. Robertson, Leon S. Abortion and infant mortality before and after the U.S. Supreme Court decision on abortion. JOURNAL OF BIOSOCIAL SCIENCE 13:275280, 1981. 7. Committee on Trauma Research, National Research Council and The Institute of Medicine: INJURY IN AMERICA: A CONTINUING PUBLIC HEALTH PROBLEM, Washington: NationalAcademy Press, 1985. 8. Committee on Injury Control (Vice chair), National Research Council and the Institute of Medicine: INJURY CONTROL, Washington: National Academy Press, 1988. 9. Panel on Occupational Safety and Health Statistics, National Research Council: COUNTING INJURIES AND ILLNESSES IN THE WORKPLACE: PROPOSALS FOR A BETTER SYSTEM, Washington: National Academy Press, 1987. 10. Robertson, Leon S. Community injury control programs of the Indian Health Service: an early assessment. PUBLIC HEALTH REPORTS, 101:632-637, 1986.

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Chapter 9. Expert Witness 1. Robertson, Leon S. Robertson and Kelley, Albert B."Static Stability as a Predictor of Rollover in Fatal Motor Vehicle Crashes. Journal of Trauma 29:313,1989. 2. Harwin, E.A. Harwin and Brewer, H.K."Analysis of the relationship between vehicle rollover stability and rollover risk using the NHTSA CARDfile Accident Database." JOURNAL OF TRAFFIC MEDICINE. 18: 109, 1990. 3. Mengert, P., Salvatore, S., DiSario, R., and Walter, R. "Statistical Estimation of Rollover Risk". Cambridge, MA: Transportation Systems Center, U.S. Department of Transportation, 1989. 4. Felrice, B. "Denial of Petition for Rulemaking", FEDERAL REGISTER 52:49033-49038, 1987. 5. Robertson, Leon S. "Risk of Fatal Rollover in Utility Vehicles Relative to Static Stability". AMERICAN JOURNAL OF PUBLIC HEALTH 79:300-303, 1989. 6. J.L. Sloan memo to H.A. Poling, Ford Motor Company, "Report on Visit to Consumer Reports re Bronco II". April 14, 1989. 7. Steed, D.K. "Misguided Criticism of SUVs", Hartford Courant March 21, 1998, p. A8. 8. Insurance Institute for Highway Safety, "Crash Compatibility: How Vehicle Type, Weight Affect Outcomes", STATUS REPORT 33, February 14, 1998. 9. Brison, R.J., Wicklund, K. and Mueller, B.A. "Fatal Pedestrian Injuries to Young Children: A Different Pattern of Injury". AMERICAN JOURNAL OF PUBLIC HEALTH 78:793-795, 1988. 323

10. Felrice, B. "Consumer Information Regulations; Federal Motor Vehicle Safety Standards; Rollover Prevention". FEDERAL REGISTER 59:33254-33271, June 28, 1994. 11. Frame, P. "Has Martinez Dropped the Ball at NHTSA?" Automotive News, June 24, 1996, p 1. 12. Felrice, B. "Federal Motor Vehicle Safety Standards; Rollover Prevention". FEDERAL REGISTER 61:2855028560, June 5, 1996. 13. Robertson Leon S.INJURY EPIDEMIOLOGY: RESEARCH AND CONTROL STRATEGIES.New York: Oxford University Press, 1998. Chapter 10. Facts and Philosophy 1. Deppa, R.W. "Report of the Engineering Evaluation of All Terrain Vehicles." Washington, DC: U.S. Consumer product Safety Commission, 1986. 2. Based on the author's examination of CPSC in-depth investigations. 3. Trial testimony of R.L. McCarthy in Stiles v. Honda, June 15, 1992. Deposition of R.L. McCarthy in Ladd v. Honda, December 3, 1992. 4. Still, L. "Expert Witness in Honda Liability Case Accused of Misleading Court", VANCOUVER SUN, June 18, 1992. 5. Robertson, Leon S. Injury Epidemiology. New York: Oxford University Press, 1992. 6. Robertson, Leon S. Sociology stretches its goals (letter). SCIENCE 160:375-376, April 26, 1968. 7. Birsch, D.and Fielder, J.H.THE PINTO FIRE CASE: A STUDY IN APPLIED ETHICS, BUSINESS AND 324

TECHNOLOGY. Albany: The State University of New York Press, 1994. 8. Robertson. Leon S. "Fatal car fires from rear-end crashes: the effects of fuel tank placement before and after regulation." AMERICAN JOURNAL OF PUBLIC HEALTH 83:1168-1170, 1993. 9. Lange, R.C. Lange, Ray, Rose M., and McCArthy, Roger L. "Analysis of Light- Duty Motor Vehicle Collision-fire Rates", Prepared for General Motors Corporation, October 12, 1992. 10. "Evaluation of the Safety of GM 1973-87 C/K Pickup Trucks. Part III: Analysis of FARS Fire Rates in Side Collisions for Fullsize Pickups and Supplemental Statistical Presentations." Submitted by General Motors to the National Highway Traffic Safety Administration, August 10, 1993. 11. Robertson, Leon S., "Health Policy and Behavior: Injury Control." In D.S. Gochman (Ed.), Handbook of Health Behavior Research, Volume IV. Relevance for Professionals and Issues for the Future. New York: Plenum Press, 1997. Chapter 11. Failures and Successes 1. Short, David and Robertson, Leon S. Motor vehicle death reductions from guardrail installations. JOURNAL OF TRANSPORTATION ENGINEERING, 124:501-502, 1998. 2. Meeks, Kevin D. and Robertson, Leon S. Study of road-rail crashes in Claremore, OK and allocation of resources for preventive measures. PUBLIC HEALTH REPORTS, 108:248-251, 1993. 325

3. Robertson, Leon S. and Maloney, Angela. Motor vehicle rollover and static stability: an exposure study. AMERICAN JOURNAL OF PUBLIC HEALTH, 87:839-841, 1997. 4. Robertson, Leon S. Injury control: Some effects, principles and prospects. In Detels, R., et al. (eds.), OXFORD TEXTBOOK OF PUBLIC HEALTH, New York: Oxford University Press, 1997. 5. Kraus, Jess F. and Robertson, Leon S. Injuries and the public health. In John M. Last and Robert B. Wallace (editors) MAXCY-ROSENAU PUBLIC HEALTH AND PREVENTIVE MEDICINE, 13TH EDITION. East Norwalk, CT: Appleton & Lange, 1991. 6. Robertson, Leon S. Potential savings from injury prevention. In Dorothy P. Rice and Ellen J. MacKenzie (eds.) COST OF INJURY IN THE UNITED STATES: A REPORT TO CONGRESS, 1989. San Francisco, CA: Institute for Health and Aging, University of California and Injury Prevention Center, The Johns Hopkins University, 1989. 7. Robertson, Leon S. (Chair), Committee on Home and Leisure Injuries. Home and leisure injury prevention. POSITION PAPERS FROM THE THIRD NATIONAL INJURY CONTROL CONFERENCE: SETTING THE NATIONAL AGENDA FOR INJURY CONTROL IN THE 1990S. Atlanta, GA: Centers for Disease Control, 1992. 8. Robertson, Leon S. Present status of knowledge in childhood injury prevention.In Bergman, A.B.(ed.) PREVENTING CHILDHOOD INJURIES, Columbus: Ross Laboratories, 1982.

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9. Cummings P., McKnight B., Rivara F.P., Grossman D.C. Association of driver air bags with driver fatality: a matched cohort study. BMJ 2002; 324:1119-22. 10. Cummings P., Rivara FP. Misclassification of seat belt use. Inj Prev 2003; 9:91. 11. Robertson, Leon S.: INJURY EPIDEMIOLOGY, New York: Oxford University Press,1992. 12. Robertson, Leon S.: INJURY EPIDEMIOLOGY: RESEARCH AND CONTROL STRATEGIES, New York: Oxford University Press, 1998. 13. Cohen, I.B. THE TRIUMPH OF NUMBERS: HOW COUNTING SHAPED MODERN LIFE. New York: W.W.Norton, 2005. 14. Robertson, Leon S. Car design and risk of pedestrian injuries. AMERICAN JOURNAL OF PUBLIC HEALTH, 80:609-610,1990. 15. Gerberich, Susan G., Robertson, Leon S., Gibson, Robert W. and Renier, Colleen. An epidemiological study of roadway fatalities related to farm vehicles. JOURNAL OF OCCUPATIONAL HEALTH AND ENVIRONMENTAL MEDICINE, 38: 1135-1140, 1996. 16. Jones, Nancy E., Pieper, Carl F. and Robertson, Leon S. The effect of legal drinking age on fatal injuries of adolescents and young adults. AMERICAN JOURNAL OF PUBLIC HEALTH, 82:112-115, 1992. 17. Robertson, Leon S. On the validity of self-reported behavioral risk factors. THE JOURNAL OF TRAUMA, 32:58-59, 1992. 18. Robertson, Leon S. Reducing death on the road: The effects of minimum safety standards, publicized crash tests, seat belts and alcohol. AMERICAN JOURNAL OF PUBLIC HEALTH, 86:31-34, 1996. 327

19. Robertson, Leon S. Response to the commentary: "The semantics of safety: by Frank A. Haight. JOURNAL OF TRAFFIC MEDICINE 26:73-75, 1998. 20. Robertson, Leon S. Groundless attack on an uncommon man: William Haddon, Jr., MD. INJURY PREVENTION, 7:260-262, 2001. 21. Robertson, Leon S. and Pless, I. Barry. Does risk homoestasis theory have implications for road safety. BRITISH MEDICAL JOURNAL, 324:1151-1152, 2002. Chapter 12. Back in the saddle 1. Thibault, J.W. and Kelley, H.H. THE SOCIAL PSYCHOLOGY OF GROUPS. New York: John Wiley and Sons, 1965. 2. Evans, Leonard. Traffic Safety. Bloomfield Hills, MI: Science Serving Society, 2004. 3. Robertson, Leon S.: INJURIES: CAUSES, CONTROL STRATEGIES PUBLIC POLICY, Lexington: D.C. Heath, 1983. 4. Robertson, Leon S. Blood and Oil: Vehicle Characteristics in Relation to Fatality Risk and Fuel Economy, AMERICAN JOURNAL of PUBLIC HEALTH, in press. 5. Robertson, Leon S. and Baker, Susan P. Motor vehicle sizes in 1440 fatal crashes. ACCIDENT ANALYSIS AND PREVENTION 8:167-175, 1976. 6. Lovins, Amory B. More profit with less carbon. SCIENTIFIC AMERICAN (Special Issue, September, 2005. 7. Deffeyes, Kenneth S. BEYOND OIL: THE VIEW FROM HUBBERT'S PEAK.New York: Hill and Wang, 2005. 328

8. Robertson, Leon S. Motor Vehicle Deaths: Failed Policy Analysis and Neglected Policy. JOURNAL OF PUBLIC HEALTH POLICY, in press.

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