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Interview with George Koseruba, January 5, 2004 | UNCW Archives and Special Collections Online Database

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Title:
Interview with George Koseruba, January 5, 2004
Date:
January 5, 2004
Phys. Desc:

Interviewee: Koseruba, George Interviewer: Mims, Luann / Beth Roberts Date of Interview: 1/5/2004 Series: SENC Health Services Length 90 minutes

Mims: I’m LuAnn Mims for the Randall Library Special Collections on our Health Services series. With me is Beth Roberts from the library and we are speaking with Dr. George Koseruba today.

Mims: How are you today?

Koseruba: Just fine.

Mims: That’s good. I’m so glad that you were able to participate in this. Dr. Koseruba is a long-time Wilmington resident and practicing pediatrician. What we would like to do is for you to give us a little bit of personal background, where you were born, some personal information.

Koseruba: I was born in Canada, Saskatchewan. I’d use the telephone and the operator would ask me how do you spell that, I said I’d believe I would write it if I could spell it. Just kidded her a bit, but I was born in Saskatchewan, Canada in 1913 as a twin. My sister was 15 minutes older than I was. We’re both still living. We celebrated our 90th last April. We’re looking forward to April 19th being 91 to celebrate our birthday again together.

I went to medical school at Loma Linda University, California. Worked my way through school in fact. First year I worked at the crippled children’s hospital where they were treating polio with casts, putting casts on the children to treat for polio. I had to take those casts off and cut those casts off. I said wouldn’t it be wonderful if we could get something done to alleviate this problem and find out how to cure polio. Sure enough we found out later about the Salk vaccine and that was a great thing.

The second year I was with the Queen of Angels Hospital on Wilshire Boulevard. In fact I took the very famous Jean Harlow movie star to the morgue. I worked there as a male nurse. The last two years of medicine I worked at the Queen of Angels Hospital as a male nurse. I did a lot of IV work, scrubbed as first assistant in surgery so I had a lot of experience before I even graduated.

Delivered with a student nurse 22 babies and one set of twins because the residents loved to deliver twins and lo and behold I delivered a twin. When the resident got there, everything was under control. The babies were doing fine. Then I decided to come to a friend that was a taking a residency at James Walker Memorial Hospital in Wilmington, North Carolina. So I picked up a couple of interns that were going to Chicago so I drove them down to Chicago, visited my parents there.

I had a sister living in Chicago. After that I decided to head for Wilmington, North Carolina. I looked on the map and thought well, I’ll start in the afternoon and probably get there in the afternoon. It would take about 24 hours. I didn't know I had to cross all those mountains around Asheville. I remember waking up on the side of a mountain and a rooster woke me up. So I kept on going and I got to Wilmington on a beautiful Sunday afternoon in June 1939 with 13 pennies in my pocket.

I went in the hospital and found a resident and said, “Give me a couple of bucks. I’m a new intern. I want to go see the beach. It’s such a beautiful day and I’ve been hearing so much about the ocean”. The ocean then in California was very rough and cold. We couldn’t enjoy it. I got my two dollars worth of gasoline at the Hughes Brothers, still operating; it was almost a full tank. I took off for the beach. When I saw the beach, I said this is the place for me and I’ve been here ever since.

Mims: That’s incredible. You have an interesting family background as well.

Koseruba: You know my mother had a ticket on the Titanic and she missed the boat because the papers for the two children were not in order so consequently I wouldn’t be here if she had taken that trip. The next trip she came over and that was in 1912. My dad was here two years previously, sent the money for her. In fact at that time there was an exodus of Europeans, the French, the Germans, the Romanians, the Russians and the Hungarians all came to the central part of Canada. They tried to develop Canada at that time, giving them a little portion of land. So even now as you drive through the southern part of Saskatchewan, you’ll find all these different nationalities still existing there.

We lived on a farm of about 600 acres of wheat and horses. We had to get up in the morning and take care of it; it’s not like tractors today. We had to do a lot of work. We had a lot of experience with horses. I know when I was able to stand up and reach the cow, I was milking. That was a good time ago.

Then I had a friend who was in Chicago and the twins decided in 1931 after they graduated as president of the class in Baldric Academy in 1931, we decided to come across. Dad drove us across to Chicago. Where my sister was living and going to school. From there we spent a couple of years there and then I went to Madison, Tennessee. This was a denominational university and then I went back to Berrien Springs, Michigan at the university there and finished up my medical training.

Drove a car for the Pontiac people, a doctor wanted a car driven so two of us took two cars at the Pontiac place and drove them all across country to California. Where were we going, I had no idea. Going to Mohave, California, but we had a good time. I took my training there and came back here. It’s been a good time, but you know when I got to Wilmington, we didn't have any penicillin, we didn't have much of antibiotics, no vaccines and guess what, the babies were dying with scarlet fever, chicken pox, encephalitis, measles, whooping cough, a baby six months old had a convulsion and died because of cerebral hemorrhage.

So this was awful. In fact I saw rabies in a human being. People were dying from tetanus. They didn't have the vaccine. The vaccine came out in 1942. I started a well baby clinic at that time for people who couldn’t pay. We saw those people once a week usually in a little church and took care of those babies. The clinic is still operating in Wilmington today.

Mims: Where is this?

Koseruba: It started in 1942. It’s in various places.

Mims: Oh, just the general concept of seeing the baby before the baby is sick.

Koseruba: That’s right and the Health Department worked with us, different portions of the city. Lake Village was one, there was a church on Fourth Street, we’d rotate the areas every week.

Mims: And these well baby clinics, what would you do?

Koseruba: Give them a physical examination to make sure they were ready for the vaccine and give them the vaccine even though they couldn’t afford it. That’s what they’re doing today.

Mims: What influenced a Canadian farm boy to go into the field of medicine to begin with?

Koseruba: Well, I was interested in medicine even as a child. I know we had a play in school and I was the doctor, tut, tut, we’ll take care of this little girl. A little play that we had in high school and I wanted to be a doctor. That was my vision of the future. I didn't want to be a farmer. You’d have a beautiful crop and then in about five minutes, hail would come and destroy it completely. I remember one time I was in the field milking a cow and this big storm; they’d have really big storms come up within an hour. We’d have a lot of hail the size of a baseball.

I looked at the crop and it looked like somebody ruined it. You’d have a little insurance, but not enough to cover that and I’d think that is not right. I didn't like that. My brother stayed there. I had an older brother and a twin sister and a younger sister, five of us in the family. He stayed with dad and I decided to go to school in the northern part of Saskatchewan, graduated and then came across here.

I got to Madison, I couldn’t understand their language and I couldn’t understand them because of the southern dialect, but it was fun. I enjoyed it. I enjoyed it so much that I decided I’d come to the south.

Mims: By that time you’d already decided on pediatrics?

Koseruba: No, I came here and since I had a lot of experience at Queen of Angels Hospital, they’d rather wake me than the residents and I had a lot of experience. So when I got through I came here and I started hitting veins. Dr. Sidbury who worked at the Babies Hospital found out I could hit those veins and said he’d give me $25 a month if I’d do his IV work (laughter). That was big money then. They gave us $25 a month and room and board. It’s a little different now, but that’s all we got at that time.

Mims: So, basically because you had good nursing training, you fell into the pediatrics.

Koseruba: Well, because I was associated with Dr. Sidbury, I leaned towards that and the more I worked with him, the more I got interested in pediatrics.

Mims: What was Dr. Sidbury like?

Koseruba: Very scientific. You had two pediatricians here, Dr. Crouch did some endoscopy work, get some of the peanuts out and popcorn, things like that out of the children. Dr. Sidbury was very scientific and ran the Babies Hospital and when I joined up with him in 1941-42, when they started pediatric classes. They used to just run the Babies Hospital during the summer months. But when I joined with him, we ran it all year round.

Consequently we had girls coming in from Lumberton, from Wilson, different parts of the state for about six weeks getting their pediatric training at Babies Hospital. Babies Hospital was really a pediatric center. It excelled at that time. People from South Carolina and North Carolina came to that hospital when they got sick. A beautiful reputation.

Mims: I think the community something should have been done to keep the building standing. Who were some of the other old doctors that you worked with?

Koseruba: Dr. Koonce was a surgeon at that time. Dr. Hooper was a very, very good surgeon. In fact he took my appendix out when I was an intern. We were at the table one time and I said I thought I had a tummy ache. They all laughed and said maybe we’d get a blood count. Mine was about 20,000 so they said it was time to do something so they did. Cut my appendix out, but I stayed in the bed for 11 days! When I got up, I didn't know I had any legs.

This incidentally will give you a little experience about what happened in Saskatchewan. My son, no my older brother, his wife had an appendectomy and was in the hospital across the river from Borden where we were, about 50 miles. They called and said she was ready to come home; she was in bed all that time. She sat up, developed a clot and expired just like that. So when he arrived, she was gone. They used to keep them in bed all that time. Found out that that was not the way to go. Now they get up the first day.

When I had my appendectomy, I hardly knew I had legs after 11 days. I was able to walk a little bit. Times do change.

Mims: Since we’re talking a little bit about Babies Hospital, what was the interior of that hospital like? How was it set up? Was it set up with wards?

Koseruba: They had one large ward and believe me at that time the diphtheria epidemic, almost the entire ward was with diphtheria patients and they were treated by endoscopy. Dr. Sidbury was very good at doing endoscopies with these children so they could breathe. An endoscopy is a tube that goes into the trachea, the windpipe, so they could breathe because it chokes them, diphtheria chokes them.

Mims: And that’s the way you were able to lower the mortality rate.

Koseruba: I think we had a little antitoxin at that time that was given to the diphtheria patients. Most of them survived with the endotracheal tubes.

Mims: Did they have a surgical area for the children?

Koseruba: We had a little surgical suite upstairs on the second floor. A lot of T&A’s were done there, pyloric stenosis where children couldn’t swallow. They had a little tumor and they’d have to open them up, make a little slice across the tumor and they got along fine, but if you didn't do it, they would die. We did hernias down there and a lot of exchange transfusions. Babies Hospital was noted for starting transfusions for jaundice.

These babies developed high bilirubin index, which would damage the brain. It would be at a certain level and would keep going up and we’d immediately exchange the blood. How did we do that, with a three-way stopcock. We’d inject into the umbilical vein 10 cc of good blood and then withdraw 10 cc of blood. An exchange transfusion using about 400 cc of blood. That saved those babies, cleared up the jaundice and saved the babies. That was initiated at Babies Hospital in about ’42.

Mims: I’ve heard that one of the reasons Dr. Sidbury chose the Wrightsville Beach area was the benefits of the sea air for children that were suffering from bronchial problems.

Koseruba: That’s right, allergies and things of that nature. Of course when I was there in 1941-42, did a lot of house calls on the beach. I remember during World War II, the girls woke me up and said it’s the yellow light and I’d say wake me up when it was red. It never did get red, but actually there was a submarine offshore that hit one of our liberty ships that we were building. We were building about six liberty ships a week here in Wilmington. One was offshore. I don’t know what it was doing there, but the torpedo hit right in the middle, missed the tanks so it was still floating.

They got that ship and brought it down and parked it and it stayed there for about a year so everybody could see. You could drive a car right through that porthole in the middle and it was floating. That was pretty close. When they get a yellow signal, they found out about that, but nobody landed so we were fine.

Mims: Would you ever treat premature babies?

Koseruba: Yes we did. I raised three babies that went down to 1 pound, 6 ounces. We didn't have neonatologists, we didn't have any techniques and we fed them with a little medicine dropper, intubated with little tubes. I know one little Indian boy came from Maxton, died on me about three or four times with pneumonia, atelectasis and everything else. We revived him and guess what happened. Passed the physical, went to Vietnam. The others were two girls who are living and doing well. But they all dropped to 1 pound, 6 ounces. We had to do that cautiously and carefully.

We had to be careful how much we gave them with tube feedings and medicine droppers and the like. Without neonatology, we were happy to save at least three.

Mims: So they were born elsewhere and brought in to you?

Koseruba: That’s right.

Mims: Must have been a risky ride there.

Koseruba: We had little premature center at James Walker Memorial Hospital. We had patients there all the time.

Mims: So you spent your time between Babies and James Walker. Did you ever go to Bullock Hospital?

Koseruba: Yes, there was a colored hospital here too and I attended patients there. I remember I had several that had chicken pox and developed encephalitis and were real critical for a while, but we managed to save those. We don’t see those complications today like we did then because we didn't have any vaccines or anything else. Vaccines came out in ’42.

Then penicillin came out in ’45. Everybody wanted a shot of penicillin and believe me, it worked. It really did. Baby would be sick with a high fever, you’d give them a shot of penicillin and they would beg for it. The fact was it actually worked. Later on we found out that injectibles could produce later on in life allergies. In fact if you take a lot of penicillin with injectibles, later on in life if they had injectible penicillin, it could kill them. So it was a little dangerous and we would give them oral as soon as we could do so.

Mims: So that was a big turning point in pediatric medicine.

Koseruba: Well, imagine these babies came to us. We weren’t smart enough to have iron in the milk. Here they came with pneumonia, meningitis whatever. Their hemoglobin would be 4 gm, 5 gm. Didn't have any blood to fight with. So, the first thing we had to do was match them up and give them blood transfusions. At Babies Hospital, I kidded Dr. Sidbury one time because I used to match them myself, didn't know anything about the RH factor at that time.

Used to match them myself because usually the parents didn't have any problem at all. I used to give them 15 transfusions a day. I remember the only place I could find a little vein was in the eyelid. I’d give a transfusion in the little vein in the eyelid. The nurses had to hold these babies. We didn't have air conditioning, it was hot. The fans were going all over. These nurses had to hold these babies real still and you had a little vein like the vein in the eyelid and we’d use a two-way stop clock.

We didn't drip anything at that time. We’d use a two-way stop clock. In other words in about 30 minutes, we’d give them all the blood we’d measured out. If they were 20 pounds, we could give them 10cc per pound. If they were premature, we’d give them 5cc all at one time.

Mims: You mentioned something about the milk and I talked to a family in town that had a dairy and they were approached by Dr. Sidbury to do a certain kind of milk for babies. Do you remember anything about a milk program?

Koseruba: No, I don’t remember that. I do remember that we used to use a lot of lactic acid, about 60 drops into a day’s formula, predigest the protein in the milk. So we used quite a bit of that particularly babies that had a tendency for diarrhea. We used a lot of cultured lactic acid milk and it worked. A lot of babies on lactic acid, the healthy babies, did really well. Had to go to soybean formulas, goat’s milk. Some babies that had blood stools, we put them on goat’s milk and they did fine.

Mims: I know there’s been a large movement in the breastfeeding of babies, good, bad, formula’s better, breast is better…

Koseruba: Breastfeeding wasn’t very good then. It improved throughout the years. Most of them had to go on a formula. A lot of babies are trying to use regular milk or Carnation or Pet milk and would have a little lactic acid in it because it’s hard to digest. Of course we didn't know too much about allergies. I know some babies with severe allergies had different types of ointment trying to relieve them, but we didn't know we should change certain milks and that would help.

Mims: So you’ve seen a lot in your career (laughter). Let me back up for a minute. You said that you saw patients at Community Hospital?

Koseruba: Yes, I had patients at Community Hospital, that’s right.

Mims: So they would credential you even though that was a black hospital?

Koseruba: Yes, that’s right. It was all black. It was a good hospital. You know, they had a ward at James Walker Hospital.

Mims: Right, the colored annex.

Koseruba: All black and you had to go in and you couldn’t say Mr. So and So, it was always the first name. That was really something for me coming from Canada to do that. It was hard. I usually said Mr. I had an apartment right above the colored ward and on the weekends they’d sermonize with hymns, beautiful singing every weekend and I used to enjoy that, just listening to them.

We had one ward of central nervous system syphilis, a whole ward of men with central nervous system syphilis. What did we do for that? Well, we had malaria and we’d get the blood from malaria patients and they begged us for that blood. They’d inject into these patients with central nervous system, let them run a fever for three weeks and guess what, they improved and went home! It worked. They didn't have any other treatment for it.

Mims: Wasn’t there a mercury treatment or something at one time?

Koseruba: Well later on, mercury metals were injectable, but that’s even before that. We used to treat them with malarial blood. So they’d beg us. Little babies would come, you know, with a temperature of 101-104 every other day. You’d do a blood smear and see a beautiful signet ring just like a diamond ring on the smear. We had treatment for it, cleared them up nicely, but they always begged for that malarial blood.

Mims: Did you see a lot of tropical diseases like that in this area?

Koseruba: Not too much. Other than malaria, we didn't see too many tropical diseases at that time. There wasn’t that much travel internationally like there is today. Coming in from different parts of the world and bringing those bugs in now. We got all kinds of things now that we used to have overseas so it’s a different world today. But at that time we didn't see too much. We had a lot of worms. Staph worms were terrible.

You’d go to the beach and the dogs come up and down the strand, deposit, they get it from dogs and cats, Ancylostoma braziliense, little worms. They’d sit on it and fiercely be on the layer of the epidermis and they’ll start running around and itch like the devil. Imagine a baby coming in with about six or seven on the fanny and the treatment at that time was ethyl chloride, spraying that little worm at the end and blister him out by spraying him until it got real white.

And here’s a mama or a nurse trying to hold a baby with no air conditioning, the fanny real still so you could splot and freeze that little worm. Each one would stop and three would still be sitting there. You’d freeze them, it would blister and kill the worm, but it was an awful treatment.

Mims: Now is that hookworm?

Koseruba: It’s a sand worm from cats and dogs.

Mims: What is the hookworm?

Koseruba: Hookworm is another worm that we find and had a lot of at that time. Hookworm came from a feces which is a contaminant and so on, round worms, picked it up playing with the dirt. The long worms are about that long and a lot of times could almost produce obstructions in the stomach. You had to be careful when you treated them that you didn't kill them all at one time. They’ll obstruct the intestines. It’s a round worm.

I remember one mother. At midnight I was at the beach, called me at midnight and she was frantic. She was almost having a convulsion. She said her child passed a worm. I asked her how long it was and she said about six inches long and she was hysterical. I asked her if it was round or square, I told her to take a look at it. She said no, about two minutes later she said it was round. I said, “Good, we can go fishing in the morning”. She relaxed and I told her I could give her medicine for that, it was just from picking up dirt. She laughed, it reduced the tension. I’d never heard of a square worm before, but I told her to see if it’s round or square. Had to use a little psychology once in a while calming the mothers down.

Mims: I know there was a movement at one time to make sure that southern children wore shoes on their feet to prevent worms.

Koseruba: Absolutely, had to, that would cut down the incidents. Well, the pinworms are contagious too. Never had any in Canada. It was in the south. We had to treat a lot of babies with pinworms, round worms and hookworms. Sometimes the long worms would come out of the nose. You’d be treating the baby for something else and the nurse would say, “Look what we pulled out of the nose, a round worm”.

Mims: Well, what was working at James Walker like? We don’t have a real good visual reference for it so like physically, what was the hospital like?

Koseruba: It was a good hospital. It had wards. I’ll give you an example. We had a men’s ward with about 12 beds, a woman’s ward with 12 beds, had a few single private rooms, but mostly it was wards. We had good equipment. I was making rounds one time with a nurse at 11:00 and I’d usually have a little lunch and make rounds at 11:00 at night. The supervisor walked in this woman’s ward.

During World War II we had to beg for interns because ours were in the service. Two came from Germany. We thought they were well trained but later found out that the training was very, very poor. Of course I was making rounds this one evening and I saw a little old lady sitting up trying to get her breath, choking. I asked who admitted her. They said Dr. Humbar, one of the interns, German interns.

I asked what the problem was and she said she had a sore throat. I took a flashlight and looked at her throat and it was white with diphtheria. I said, “Get her out of this ward right now, it’s contagious.” We had an old Bear building for isolation called the Bear Building. I guess the Bear family donated money for it. They’re a good family here well satisfied with money so they were able to build that section. That was real useful because all our contagions went to that building.

I told them to take her over there and as soon as I got done making rounds with the men’s ward, I would be right over there. As I walked in they said she had stopped breathing. I asked for a tracheotomy tray, I grabbed a bottle of methiolate, dumped it on her throat, took the knife and it was like doing an autopsy. I’d done tracheotomies before and the blood was rather dark. I went ahead and she was swallowing this. I got to the trachea and opened up the trachea, grabbed a tube and it wouldn’t reach it she was so swollen.

I said, “Get me a rectal tube that’s sterile.” So I cut the rectal tube in half, pushed it in, jumped on her chest and started pumping away and guess what, she gasped. I kept pumping and told her to start breathing. The next day everybody wanted to see a tracheotomy with a rectal tube.

The next day my twin sister got in an auto wreck in Pittsburgh, Pennsylvania and so I packed up. She wasn’t doing real well so I packed up, went to see her and I guess when I walked in there, I asked where my sister was and she said room 203. I walked in room 203 and guess what, she was gasping for air. She had hemorrhaged quite a bit they thought from the intestines.

It actually was from a lacerated tongue that they missed and it swelled up and she was choking. I think if I had been there about seven minutes later, she would have been dead. I got out in the hall, get me a surgeon; get me a tracheotomy tray in 203 at once. Boy, I don’t know where they found him, but they were right there and I helped do a tracheotomy on my twin sister.

Mims: My goodness, that is incredible. It’s almost like fate.

Koseruba: I think 10-15 minutes, she would have been gone. Two in a row within 24 hours mind you.

Mims: And you hadn’t done one before?

Koseruba: No, I helped. I was glad the surgeon came in so I could help him.

Mims: Somebody with that training.

Koseruba: So when I got back in three weeks, I stayed with them and then she finally got conscious. She was unconscious for three weeks and then got conscious. I got back, sitting in my office and here a gray haired lady walks in and asked if I remembered here and pointed to that little scar. She had a real bear hook.

Mims: That was incredible. So the contagious ward was strictly for contagious?

Koseruba: That’s right.

Mims: So how did they separate them, like small pox.

Koseruba: In little rooms, kept them separate.

Mims: How did the staff…

Koseruba: Nurses were well equipped and knew just what to do. They were well trained to take care of the patients. They actually had a rabies man that had rabies and I’ll tell you, I don’t ever want to see another one. He died of course. We had all kinds of pathology in those days believe me.

Mims: And then surgery was upstairs, the surgical suite was upstairs?

Koseruba: Yes, surgery was upstairs. They had a separate ward for the colored, called the colored ward.

Mims: How about your involvement with the nursing students? You helped train them?

Koseruba: Oh yes. We had classes. Particularly in Babies Hospital, we ran classes every six weeks for groups from different parts of the state that came there to get the pediatric training. So I lectured on different pediatric topics for each one of those classes and they enjoyed it. When they left Babies Hospital, they knew pediatrics because the pathology was there; they saw what we did for them, the recovery rate. They had a good training in pediatrics. It’s just a shame that that hospital had to be destroyed.

Mims: Now the whole time you’re working at the hospital, you also had your private practice, is that right?

Koseruba: That’s right.

Mims: Where was your office located?

Koseruba: I started with the office at 420 Orange, downstairs and I was able to get that for my office. Then Dr. Black’s office, he was called into the service. He was at 215 Fifth Street so I used his office for a year and a half while he was in the service. Then I went in the service. When I got back I opened up an office on 420 Orange Street. It was a two-story building, brick, with a baby sitting out front, a little marble baby. That was after I got back from the service in ’46.

I was in a tank destroyer battalion; we were the roughest group in town. We shot the highest rating about the time of the Battle of the Bulge in France. We needed them over there. Where did they send us? Fort Knox, Kentucky to be the demonstration battalion. I check all the units out, but we never did go overseas. Then they transferred me to the service command and I ended up in Carolina treating the 4th Infantry Division that got shot up with the invasion.

I was with the EVAC Hospital at first when I joined the service. I was training the patients and the people there in medicine. That surgeon got sick and I was unattached, I wasn’t married and he said why didn't I take that place. I went down to Mississippi and joined the other group. I had to go in the tent; I was a battalion surgeon with the 652nd Tank battalion. They were a good group, but every time they moved, we had a fatality. They were careless young boys. They were all young.

When it came to shooting and we didn't protect our ears and right now my hearing isn’t quite as good as it should be because those guns were 90mm guns with shells that long, moving targets, about two or three miles away and they hit those babies. We shot the highest rate. So instead of sending us overseas, they sent us to Fort Knox, Kentucky. I said, “Colonel, we’re not going there. We’re going to the Pacific and I know nothing about that.” So they sent me to a tropical disease course in Washington, D.C. and we got a good training in tropical diseases there.

Mims: Did that help you with your practice here?

Koseruba: Oh absolutely. They used to bring malaria up so we could study that, livers from, they didn't know anything about lismaniasis. When our engineers went in the water and got hepatocytes they knew nothing about it. So they sent them over here to find out how they could treat. It was a good tropical disease course. In fact I was making rounds with the colonel one time and we walked to a boy. His head was swollen like this.

I asked the colonel what he had and he said they didn't know. I asked if they had done a spinal tap, he said, “yes.” I asked if they had centrifuged it, he said, “no.” We just had gotten through with trichinosis in our class and they can develop central nervous system trichinosis eating pork. I said we should do another spinal tap and centrifuge it sure enough, it finally showed up. But the case was presented to the class the next day. They treated him, saved his life.

You know, I went to Loma Linda which is a Seventh Day Adventist institution and we then knew that we had patients admitted to one of the largest hospitals in California, L.A. General. Twenty percent of those admitted were on house service so they did autopsies on those and they found out that 20% had trichinosis in their larva in the diaphragms undiagnosed, unknown, but symptoms were weakness, tiredness and fatigue and it had gone undiagnosed. Of course Adventists don’t touch pork at all.

Mims: What was the treatment for somebody with that diagnosis?

Koseruba: There wasn’t treatment for it. It just goes to show you, eating ham, pork, sometimes it’s not well cooked and 20% developed, that’s a high rate.

Mims: Was this all with the Public Health Service when you were in D.C., is that the course you took, with Public Health.

Koseruba: It was tropical diseases, had to study all the different diseases and their treatments. I then told them about this larva under the skin, you know. Oh, nothing to it. I said did you try to freeze it when you had 15 worms on a fanny on a hot day with no air conditioning. They finally came up with a medication orally and now we started giving oral treatments and it worked good, didn't have to freeze the poor little things. It’s no fun, I told the boys, trying to freeze them. Try to do it on a little baby, trying to hold still on a hot day. So they came up with a new preparation and now we just give it orally and it worked so we got something out of that t training besides other things.

Mims: I understand you did tonsillectomies in your office for a period of time.

Koseruba: Well, you know we’d have anybody to take T&A’s out. Dr. Sidbury and Dr. Sloan were here, but they were elderly and they retired. Babies coming in every week with tonsillectomies. Ivory Tower said leave them alone. When a child comes in every week and has great big glands swollen and many Strep throats, I’d organize it and I’d do about four in the morning before breakfast. At 2:00 I’d send them home and I think between 5,000 and 10,000 of those were done before the Ears, Nose and Throat people came in. They started putting them in the hospital or they do today as I did, they’d do it on an outpatient basis and they would do fine.

Mims: So was that the traditional route, not to have the kids in the hospital, just to have it done there.

Koseruba: I did it in the office. I had rooms in the office for them and they’d start taking a little ice cream and liquid and by 2:00, they were doing fine, we’d send them home.

Mims: Because I think Mrs. Newton mentioned that she did….

Koseruba: She did my anesthesia, bless her heart and she was good. We depended on her a lot, used her quite a bit.

About 3:00 or 4:00 in the morning, I remember Hazel was coming, the hurricane. Nobody heard about hurricanes. It was the first time we heard about hurricanes. I had two posted for that morning so I came to the office, met the parents and I said we can’t do it. If the lights go out and I can’t suction the blood out, we can’t do it. They really royally cussed me out and went home mad. But when they found out what Hazel had done, they were thanking the Lord up there that I had enough sense to send them home. As soon as the Ears, Nose and Throat people came, why we stopped doing them. And believe me, when we’d take the tonsils out, we wouldn’t see them for a year. It worked. So when it’s indicated, they snore like anything, adenoids enlarged, recurrent ear infections and today they’re doing them…we did them early then.

I remember my little grandson, ear infection one after another. I took the adenoids out. He stopped having that problem. Now they’re saying today adenoidectomy is in order with recurrent otitis. It works.

Mims: That’s one of those things, up and down, up and down.

Koseruba: We did that in gosh, I’d say ’45, ’46.

Mims: Did you ever have any adults come to you with …

Koseruba: No, I never did that, just children.

Mims: We were talking about some of the older doctors in town. Did you ever have a chance to meet Dr. Fales?

Koseruba: Yes, he’s one of the elderly ones, knew him well. He was a general practitioner. Murchison was another one, he was a good man, had only eye and he did real well. I remember he used to write up patients, this was great, it was wonderful. He was an internal medicine man, very good. Surgeons were Hooper, Graham, Roberson. Finally, we didn't have New York orthopods and Dr. Dineen finally landed on the market, which really was a blessing because nobody else was taking care of them.

Dr. Graham was with Dr. Roberson, a good surgical team. Did a lot of work at the Babies Hospital. Dr. Hooper did a lot of work at the Babies Hospital. And Dr. Sloan did T&A’s at the Babies Hospital. I did a few down there too when the parents wanted me to do it.

Mims: Who were some of the obstetricians in town?

Koseruba: Dr. Lonnesbury, Dr. Johnson was one of the original ones. He was such a lovely man; take us interns out for fishing and things like that. He associated with interns a lot. The interns just loved Dr. Johnson. He finally came and got an assistant, Dr. Wynell. He’s retired now but he used to work with Johnson for many, many years and that was a good team.

Mims: Because the standard today is once the mother delivers the baby, a pediatrician comes to the hospital and does an initial exam.

Koseruba: Well, the sections, we have to do that. With the sections, we were there to watch them and take the baby as soon as it came from a section because sometimes they’re more critical than the others. The regular delivery unless it was unusual we usually didn't attend those. But the section babies, we attended. I’m thinking of some others, Dosher, old, old man, he was there.

Mims: So you would see the new babies in the hospital?

Koseruba: Dr. Cracker then came up on the scene. He’s about ready to retire. As soon as the babies were born, we usually went by the nursery and would check the baby, talk to the mother, calm her down, tell her everything was fine. We’d watch a lot of babies that would start to get yellow and we’d check the index every day and when it got to a level of 17 or 18, a little dangerous point, we’d say we have to exchange the babies and they’d come out fine. You need to watch the yellow babies because if it went too high like 20-24, it could damage the brain. It was permanent so we didn't want that to happen.

I remember one religious mama said no. I said if it gets above 22, we will get a court order and exchange it. Guess what, it went up to 22, stopped and went down so the mommy won. We would have had to do it if it had gone up higher to salvage the baby. Some people are a little religious about it; they don’t like the idea of blood.

Mims: Were there other interventions that you as a physician had to step forward and supercede parents?

Koseruba: There were many of those I guess if I could recount, but mainly it was the jaundice babies where blood is involved because some don’t like the idea of receiving blood. It’s a religious thing and they have their privileges.

Mims: There’s a new trend these days where the gynecologist/obstetrician does not do male circumcision. They’re leaving that up to the pediatricians to do. Is that how it was in your day?

Koseruba: That’s a new trend because every obstetrician did that circumcision. But there was a doctor in Rose Hill that did not circumcise the babies and when those babies came in from Rose Hill and Chinquapin where they delivered many, I knew where they were from because they weren’t circumcised.

Mims: (Laughter) That’s kind of funny.

Koseruba: They had a reason for it, but I shouldn’t mention that (laughter).

Mims: Who were some of the African-American doctors that you had contact with at the Community Hospital?

Koseruba: Well, he has a son working now, I know there’s a little trouble and that’s Dr. Eaton. He was noted for good work, a lot of work, a good physician. There were several others that come to mind, about three of them. Upperman was here at that time. Eaton was here.

Mims: Well, talking about relationships once the integration policy came about and New Hanover Hospital opened up and blacks and whites were at the same hospital, did you see any difference in patient care?

Koseruba: It was an entirely different situation then. Everybody was treated alike. Well, as far as medical training was concerned, they were not separate. Same treatment was given to the colored as James Walker did with the whites, but location was different. That was primarily it and don’t say Mr. or Mrs. (laughter). Those are the things we had to remember when we were interns. James Walker was equal treatment, there’s no doubt about that.

When it came to the new hospital of course there was no segregation at all. The colored and whites were in the same double room. Everybody accepted it and did beautifully. They got along well.

Mims: How about Cape Fear Hospital, did you ever go down there?

Koseruba: Yes, I did much work with the nursery at Cape Fear Hospital. I know when Dr. Mebane came to me he was in charge of that hospital and I was Chief of Staff of the New Hanover Regional Hospital for two years. He came to me crying on my shoulders and asked if I was going to take all patients. I said, “You’ve got a hospital here like a family situation. The atmosphere is entirely different. People love it and you will have no problems keeping this hospital full.” He relaxed because he had been upset.

I told him he’d get that hospital full because the atmosphere was excellent and sure enough it turned out that way. The atmosphere is different and people just love to go to Cape Fear Hospital, a smaller hospital, better attention.

Mims: What is your earliest member of a female doctor practicing in town?

Koseruba: Let’s see, I’m trying to think. They started coming in probably 20 years ago. In fact in my time when I was going to school, I graduated in ’39, we had about three females and now it’s almost half. So the trend is going the other way. I went to Russia and 95% were female doctors, didn't have much in the way of formula there, but they breastfed when they had to have time out of the work area. They would give it to them so they could breastfeed the babies behind the Iron Curtain.

I went there with 78 pediatricians and I was the only one that could talk the language. We’d go into one of the shops, “George, come here, George come here”. The funniest thing happened. One of the professors bought a camera and two days later it broke down so I took it to the baruska shop. I said I wanted my rubles back. I said, no, they should take this one, if it broke down in the U.S., we wouldn’t have parts for it. He was adamant about it. When I talked to him in Russian, I said, you’re going to give me the rubles for this thing, I’m not taking the camera. When he realized I meant business and I was talking Russian to him, boy he started counting out the rubles (laughter).

Mims: Was this a missionary trip to take care of children?

Koseruba: It was just to see for our own sake what they were doing. Some of the upper echelon was getting pretty good medicine, but the lower echelon, we said what are you doing putting plasters for pneumonia. We used to do that in America. A lot of babies came in when I started with mustard plaster and it almost literally burned the skin. We had to treat the blisters on the chest because that was the old treatment. Then sulfa drug came out and then penicillin.

But before that a lot of them did that. Little asphidity things were hanging around the neck to chase away the bacteria. They put them on the screens on the door and would have a big contagion sign, chicken pox, measles, mumps, do not enter, around Wilmington.

Mims: What year was that you traveled to Russia?

Koseruba: This was all happening in ’42, ’43, ’44, ’45. I had a little mama come in. The baby was pretty sick and she had birch all around the neck. I asked her, where did you get the birch. She said I found a birch tree. One mama came in with buttons and I looked at her buttons and I found one button had four holes in it. She said I knew when I put that in, it wouldn’t help. I said, “That’s your problem mama, you go home and change that button.” In the meantime, I gave her a shot of penicillin and she got well.

One granny after I saw a baby real sick on a weekend, I would call them on Saturdays because I was closed on Saturday, went to church on Saturday. I called them and the mom said granny had come by and filled the socks full of onions and it drew the fever out. I said, “Well don’t burn the fever, be careful because that can burn the fever, but I’m glad the fever’s gone.” I’d given them a shot of penicillin the day before so it went down. You have to go along with these mamas; they had all kinds of things.

Mims: We were talking about your missionary work over in Russia. Did you ever travel to any other European countries?

Koseruba: Well, from Russia, we went to some of those temples and they are out of this world. Really beautiful artistry. We went to Leningrad where they have 200 rooms of artistry compiled from all the different countries and put it into those 200 rooms and if anybody wants to see art, they ought to go to Leningrad. It’s there from the floor to the ceiling, every room. The most precious stones are lapis and malachite. Lapis is perfect. You walk in and the pillars in the room are made out of lapis and all the walls. You go to the malachite room, same thing, great big pillars this big with malachite, the two most precious stones they had in Russia.

Talk about Rembrandt and everything else. I’ve been to London, I’ve been to France and they don’t hold a candle to what the Russians accumulated during the czar era and it’s all there in Leningrad. You could see the marks where they did destroy the building. I’ll tell you, it takes you a half a day to walk through it. You don’t stop, you just walk through one to the other and they talk about it. You see art like you’ve never seen it anyplace before and never will I guess.

When I was there, that was about four years ago, they treated athlete’s foot with dye, methiolate, stuff like that. Pneumonias, still mustard plaster. I said, “Don’t you think a little shot of penicillin?” “No this works better.” So you don’t argue with them. Came to Leningrad, there was a big room with sand. I said what do you do here. He said this is where the children come for a couple of hours to get their vitamin D. I said,” Don’t you think a few drops by mouth would be better?” “No, this works better.”

Mims: Hard to change ways I guess when it’s indoctrinated into your culture.

Koseruba: I said, “You know a few good drops of cod’s liver oil- no, this works the same.” In Leningrad, they did admit that cigarettes were two-thirds propaganda and one-third nicotine.

Mims: I understand you’re still practicing medicine.

Koseruba: Well, you know I retired in ’89, closed the shop, had nurses with me for 30-40 years, Barbara my secretary was with me for 43 years. So guess what happened. When we got to the end of that retirement, we knew each other pretty well. She was divorced for 10 years and my wife died with cancer of the bladder; I was single for many years. Not so much fun retiring so we thought well, we ought to get married and we did. It worked out well. We’ve been married now for about 13 years.

Our girl’s work with us at the clinic we’re in. At our office we didn't have much turnover. We had the same girls there and they knew exactly what to do. We had four rooms for examinations. When I walked in, the baby was weighed, the temperature was taken, the history was there. Sometimes I see things mothers never knew they had like rashes and things. We’d undress every baby, examine them, talk to the mother, give her a prescription and ask if she had any questions. One, two, three, four. Sometimes in the winter we’d go up to 80 patients a day, 80 patients a day. We were tired by the end of the day.

Mims: And you were by yourself?

Koseruba: By myself. There’s about three other doctors now. Patients coming in from Lumberton, Sneed’s Ferry, Jacksonville, Myrtle Beach, Whitesville, Tabor City, Rose Hill, Chinquapin, all in through that area, Burgaw, Wallace, all came in. We had some excellent patients.

Mims: Were there no practicing pediatricians in their areas?

Koseruba: Not too many, no. In Whiteville, they didn't have a pediatrician. They do now, but they didn't then.

INTERVIEWER 2: But you’re being modest.

Koseruba: In the mornings we had no appointments because you can’t make an appointment for a sick child. So I asked them to all come in in the morning and believe me, we’d clean them out, but the reception room was full. But we took time out at around 11:00 and have a 15-minute session, talk things over, maybe sip a little soft drink and a cookie and have a joke or two and go back to work and clean them out usually by 1:00.

Then the reception was empty waiting for what? The newborns and immunizations so we didn't have too much contamination. All the sick ones came in the mornings, all the well ones came in the afternoons. A few had to come in the back way. If they were contaminated, we saw them through the back door. It went pretty well. Everybody was happy. They stayed with us for many years. Her mom (Mary Roberts) was an excellent nurse. What was it about 30-40 years?

INTERVIEWER 2: Yes, it was about 41.

Koseruba: Barbara’s, my wife’s sister’s daughter was teaching and it got to the point she couldn’t control the fifth graders. You couldn’t touch them. No support so she gave up. So I said if you don’t fuss with mommy, I’ll take you in to run the office, do some clerical work. Sure enough she was with us for many years working with mom in the front office and they got along fine.

Mims: So it was a real family atmosphere.

Koseruba: Family atmosphere. It was jovial, fun, nice, we got along real well, but we worked when we worked. Patients to see almost all the time.

Mims: Did you ever do house calls?

Koseruba: When I got through at the office, I had 10 or 12 house calls to make and I made every one. A visit at the office was $2 and a house call was $5. Tonsillectomies $25, they get $500 now. You didn't make much money, but it was fun doing it. Yes, we made house calls in different parts of the city. We knew the city, we knew the families. We got acquainted with the families and where they lived.

You’re just a number now. So when Christmas time came we signed off about a dozen who couldn’t pay. It’s a different world now. They would get a Christmas card that said paid in full.

Mims: It is different you know, what we brought ourselves too with all of our medical knowledge, have we lost that human personal touch.

Koseruba: For 10 years I didn't send in any bills that I couldn’t pay. The parents brought in vegetables and fruit and stuff like that.

Mims: Plus you’re dealing with the youngest people in town. You know, what do you do, not treat them.

Koseruba: We never refused. You have to treat them. We started sending bills out about 10 years later. All we had to do was Uncle Sam.

Mims: With all the Medicaid coming into play their part, that probably helped a lot of patients.

Koseruba: Well, now that Medicaid is in, it sure helps a lot. Sixty percent use the Medicaid.

Mims: It just helps to ensure better treatment for the babies.

Koseruba: Well, they wouldn’t come in if they didn't have any money. Now, they can come in and Medicaid would take up the privates. I’d come in and they were dressed better, the devil’s work is done. They looked good. They’d come in every year for a physical and when they’re sick. With a runny nose they’re in. What are you going to do for a runny nose, have to blow it (laughter).

Mims: When you were working with some of these older doctors, what you called the old ones, what did you learn from them about the history of medicine in this area because we do have a pretty rich history in this area. Do you remember any of their old stories?

Koseruba: Not especially that I can recall. As far as surgery is concerned, they started doing the pylorics, which was a new thing. Strange transfusions was a new thing and of course with our treatment of meningitis, the antibiotics started coming in. That was a blessing because we lost so many. Just looking the field over, it’s just been a great change from the time I started practicing medicine to what it is now.

I’d have them come in with the baby. The mama was bringing the head and another bringing the baby, two of them caring the baby in the office. Hydrocephalus. They didn't know that now you can put a tube in and drain it into the harbor, into the peritoneum and salvage those babies to become normal if you would catch it early in the newborn state. Find out about hydrocephalus and treat them properly surgically, you salvage them.

But then we didn't know about that and the head started growing and growing and growing. That baby expired; it was about a year old.

Mims: We hear a lot about like the March of Dimes program and how they brought a lot of changes.

Koseruba: They sure did. Polio was a nasty disease. The started treating it with casts on the legs. I used to cut those casts off when I was in my first year of medicine. I want it changed now, just a few drops. As a matter of fact, I belong to the Rotary Club and for the past four or five years we’ve been donating millions of dollars to wipe out polio in the world and we’re succeeding. There’s only a very fraction of the world yet that still have a little polio and we’ll get that too. That was our prime objective, to wipe out polio.

Mims: Worldwide. I understand that diarrhea is still a major killer of infants.

Koseruba: Oh it is, there’s no question about it, contamination.

Mims: But you didn't see too much of that in your practice.

Koseruba: Well, we had a good portion of it. They’d come in from the country and mama says it’s better, had 15 stools today, only had one today, it was dried up, they couldn’t produce liquid stool. Boy, we had to save those babies with intravenous and that was injectable with a three way stop two or three times a day instead of letting it drip. We weren’t smart enough then.

We’d use the rapid injection and give them two or three injections 10cc a pound of glucose, electrolytes, to bring them around and we’d salvage them in a hurry because in two days they’d be jumping up looking great and they were just about wiped out when they walked in. He was ready to die almost. You could pick up his skin and it would just stay that way. There was no water in the skin. Completely dehydrated with acidosis.

Mims: What about childhood measles?

Koseruba: I remember when I used to make house calls, I’d about break my neck because they knew one thing and that was to pull the shades down to protect the eyes. It would be so dark; I couldn’t find my way to see the patient. I said, Mama, you’ve got have one or two rooms that have some light in it so I can get around before I break my neck.” No kidding, I’d go to those homes, the shades were down, everything was closed in. You had to get a flashlight to find the patient.

Mims: Now there’s a shot for it.

Koseruba: Oh yes, when the vaccines came out, imagine now, they’d get the diphtheria, tetanus, whooping cough shot. They’d get the hip shots, they’d have the Haemophilus, they’ve got the shot for Varicella, which is chicken pox. I’ve seen several cases of chicken pox. I’ve seen a good many scarlet fever. But you treat it with penicillin and it melts away and in a week they come back perfectly normal. The others would run a fever for three weeks with scarlet fever to 103, 104 and they’d shed the skin like a snake. Then two months later, they’d come in with hemorrhage, the endotoxin from the strep would damage the kidneys and they’d bleed from the kidneys. To see that hemorrhage from the kidneys, they died shortly thereafter.

Fifty percent, they swabbed their throats with methiolate, what else. Didn't have any penicillin and we lost those babies to scarlet fever.

Mims: I know there is a group of parents that feel now that inoculations are given at too young an age and they want to hold those off. What would you say to parents like that?

Koseruba: Well, if they’d only seen those babies like with whooping cough die at six months of age with cerebral hemorrhage and a convulsion and then pass away, they would change their minds. Diphtheria, choking those babies, doing an endotracheal, babies would be gone. We salvaged a lot of those babies with an endotracheal tube. Mumps, encephalitis. Now we’ve got a shot for mumps. We’ve got a shot for all those diseases that they didn't have before.

Mims: Those are relatively new because I had mumps. Well, we’ve had a lot of time to discuss your career and the transitions that you’ve seen. Looking back, would you choose the same path? Would you still go into pediatrics?

Koseruba: Absolutely, I love pediatrics and the more I stay in it, the more I love it because you could do so much. A baby would come in critical, mind you, in a few days he’d be jumping up and down in his crib at the hospital laughing at you. The response was so dramatic when you give them the proper treatment. It’s not like an old crippled person, I’ve got a pain here, I’ve got one running down to my big toe.

And you treat them and they come back in three weeks worse, the response isn’t there. They didn’t have the medication initially to help them, but they didn't react like baby does. A baby, you do the right proper treatment, 24-48 hours, it’s a new child looking at you even with meningitis and some of the serious diseases.

Mims: You didn't get discouraged after you helped cure a child, you walk into the office and they start crying or something that never bothered you.

Koseruba: I was a little sharp there. I never gave shots. I let those nasty nurses do it. They got a little perturbed about a nurse, but I didn't stick them so they smiled most of the time when they saw me. I let the nurses do the dirty work (laughter). I learned that a long time ago. I like to be friends with those patients. Every now and then the mother will do this, “I’ll take you to the doctor” if you don’t do this and this and this. That’s the worst thing a parent can do. A lot of them do it.

So when they see the doctor, they want to run away, run out of the building sometimes. The nurse has to go catch them and bring them into the office. They didn't want to be examined, they were scared because mama scared them by saying “I’m going t o take you to the doctor if you don’t behave.” That’s one of the worse things a mother can do.

Mims: I’m sure you’ve seen generations, like maybe you treated mom, then you treated mom’s kids.

Koseruba: On about the 5th generation and a lot of them are still coming in, want a picture made, the 4th generation all in a room together. It’s remarkable. I see these mothers, grandmothers, you raised me, bring their grandchildren. They’re always saying, “You raised me.” That frequently happens today.

Mims: So, you’ve touched on a lot of people’s lives and have been influential in this. How do you think that the field is going to be in the future? We talked a little bit about getting away from hands on. Do you think we’re eventually going to go back to that type of medicine?

Koseruba: I think the future holds a lot because new medications, new advances in surgery and the like. What can happen in the future, what happened in the past. Think of where we are now and I can see the progression forward to where we can salvage a lot more babies than we’re salvaging now. New advances in medicine. Imagine that great big head, that baby caught earlier in the newborn stage. Then the neurosurgeon puts a little tub down there to drain it, and they live perfectly normal lives.

Things like that are developed gradually. Look what they’re doing with the hearts. I don’t know how many heart transplants are done, but that’s wonderful. I never thought of a heart transplant. That was unheard of. Lung transplant, heart transplant, liver transplant. These are being accomplished every day with good results, never heard of it before,

Mims: And there’s also the new science of doing the work in utero like minimizing spinal bifida.

Koseruba: Well finding early things and saying hey, we ought to abort this child because he’s going to be such and such.

Mims: I’ve seen on television where they’re able to correct some problems so by the time they’re born…

Koseruba: That’s right and they’re perfectly normal, those things are all progressive. Never heard of those things.

Mims: When you were a little farm boy up in Canada thinking about medicine, well for somebody starting out today, entering your career, what advice or recommendation would you give them?

Koseruba: Just a good training, that’s what’s important. Be kind to your parents. Considerate. They’re in agony, their child is sick and they’re going to act abnormally and you should realize that, that that’s not them. They’re feeling badly for the child. Have compassion goes a long way in treating babies, compassion for the parents, absolutely. That means a lot besides good training. Remember mothers are mothers and they love their children.

INTERVIEWER 2: How long do you think you’re going to keep doing this?

Koseruba: Oh, I don’t know. I feel fine, maybe another year or two and then I’ll retire.

INTERVIEWER 2: Now we’ve got it on tape (laughter) so when you’re still doing this five or six more years, we’ve got it on tape.

Koseruba: I’m going to be 91 in April and I feel fine.

Mims: I think someone with his experience should keep doing it as long as they can cause it sure benefits the parents and the children.

Koseruba: Granny sits there and says you raised me. I’ve been around a while.

Mims: We want to thank you for participating in this.

Koseruba: Well it’s been a pleasure and I thank you for coming by.

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