In 1948, at the age of 20, I got my first taste of the Galapagos, under peculiar circumstances. In those days, there was no hint of tourism, no scheduled ships, planes, or organized tours to the islands of the sort that are common now. In fact, going there called for mounting an expedition and was considered an adventure. An occasional freighter or a ship of the Ecuadorian navy sailed there on an irregular schedule. A couple of the islands had small settlements of fishermen and small farmers who had recently migrated from the mainland, the islands having been previously uninhabited. There were also a few daring Europeans who went there looking for a tropical paradise and an escape from decadent Europe. Many of them wrote books about their adventures.
That year, a group of newspapermen and other professionals in Quito decided that the time had come for another expedition to visit the islands to raise the consciousness of Ecuadoreans about their faraway possessions. Overtly, to justify the trip, the organizers planned to bring material goods as gifts to the settlers on the islands. They approached my boss at La LIFE, asking for free medicines that they could take along. Dr. Muggia was glad to provide this but in return asked them to include a member of his staff in the expedition. This was agreed on, and I was the one chosen. I was ready for an escapade. Oddly enough, this was the first time that I had ever been away from my parents for more than a couple of days, for all the extensive travels of my childhood. I was a bit uneasy about being away from home and, it crossed my mind, going to places where there were not any Jews around.
We traveled to the Galapagos on a small warship of the Ecuadorian navy, a rusty corvette given to them by the U.S. after the war. The ship presented a disconcerting picture because it carried aboard a few settlers who were returning to the islands. Their bundled possessions and cages of live chickens were all over the decks. Clearly, everyone had to be ready to accommodate to the circumstances. With foresight, my mother had sent me off with a large salami wrapped in my clothes. This turned out to be providential. Soon after we left the port of departure, Guayaquil, the ship’s refrigerator broke down much to everyone’s consternation. Much of the perishable food that it held soon spoiled and had to be thrown overboard. There remained rice and bananas, but not much else. I, however, had my salami. For the two or three days of our outward trip, I nibbled away at it in hiding, justifying my greed by saying to myself that it would not have gone very far had it been equitably distributed. Even so, I was quite hungry by the time we got to the islands. No sooner did we land there that local people waded to some rocks near the shore and returned in no time with spiny lobsters they had caught with their bare hands. They boiled them in old 5-gallon cans over open fires and they tasted delicious. These were my first crustaceans and, under the circumstances, an unforgettable experience. The rest of the party, having been un-salamied, must have felt even more fulfilled. Soon I had another food “first.” We sailed to the small island where the U.S. had a naval base staffed by the few remaining Americans. The base had been used for reconnaissance flights during World War II to protect the Panama Canal but was now falling into disuse. The Americans allowed us into the mess hall and that’s where I had my first hamburger and my first ketchup.
As a member of the expedition, I had a job to do. I was to collect samples from people with athlete’s foot to find out what kind of fungi caused the disease on those islands. Don’t ask me why. I had worked in Quito on these fungi and knew how to cultivate them from skin scrapings and infected hairs. In fact, I was the national expert. Armed with a set of sterile test tubes, scalpels, and cotton swabs, I went from hut to hut, asking the people if they suffered from athlete’s foot. “¿Tiene hongos del pié?” I asked in as official a voice as I could muster. Nobody seemed to think that this was an odd request. This skin condition was quite prevalent, so I got to scrape the spaces between the toes (the “intertriginous surfaces”) of a whole bunch of people, giving me a satisfactory number of specimens. When I eventually cultured them, it turned out that the fungus that caused athlete’s foot in the Galapagos was the same one as on the coast of Ecuador. This isn’t as trivial as it sounds because the fungi that cause athlete’s foot are different on the Ecuadorian coast and the Sierra. How about that? The second scientific paper I ever wrote described these findings.
We didn’t get to visit as many of the islands as planned because one of the sailors came down with a mild form of smallpox called alastrim. This being a highly contagious infection, the wise decision was made to cut the trip short. We still sailed to some of the islands but didn’t spend any time there and only a few people were allowed to go ashore. I did get to see the spectacular silhouettes of the islands, filled as they are with volcanic cones and strange rock formations. The immediate result of the sailor’s illness was that the passengers had to scrounge for a place to sleep. Originally, we had been assigned to the sick bay, but this was now declared off limits because that’s where they put the patient. This in part was a blessing because the sick bay was tiny and smelly and located at the front of the ship where the motion was the most forceful. I found a small mattress somewhere and at night laid it out on an outside passageway, stashing it somewhere out of sight during the day. But, because of the shortened visit, I didn’t get to carry out my other original assignment, which was to determine the blood groups of the people living in the Galapagos. The reason for wanting to carry out this piece of work was even less obvious than looking for fungi. Still I had the required reagents, and I didn’t think I should be taking them back unused. The ship’s doctor suggested that I determine the blood type of the ship’s crew, as this had never been done before. Everyone lined up to have their finger pricked and their blood group determined, including the captain. I felt very important.
In 1988, during the last year of Barbara’s life, our whole family went on a trip to Ecuador and Peru, which included the Galapagos. We flew there from Quito and spent eight days on a small sailing boat, which held the four of us plus captain, cook, and naturalist. This voyage was memorable not only for the beauty and wonderment of the landscape with its animals, but also because it differed so greatly from my first trip. The contrast was not only in the living conditions and the food, but in the kind of experience we encountered. The first time I went there, I saw no semblance of environmental conservation or care for the wild animals. The sailors from the ship hunted the trusting iguanas just for the sport. On our second trip, the Ecuadorian authorities had implemented strict policies for taking care of the environment. We had to walk on prescribed trails only, and had to keep at least three feet away from all animals. This proved hard to do with the baby sea lions, which kept coming up and nuzzling against our feet. The blue-footed boobies and other birds acted unconcerned by our presence and looked at us as we kept the prescribed distance from them. Once, when I happened to lean against a large tree-like Opuntia cactus, I was told by the naturalist not to touch it. The Ecuadorians had come a long way in discharging their responsibilities as keepers of their treasure.
Needless to say, one could not major in microbiology at the Universidad Central del Ecuador in 1949 (one still can't). The thing for me to do was to follow in the steps of many early microbiologists, which was to study medicine first. I had to take off one year after graduating from high school due to my family’s relative penury, but then I enrolled in the School of Medicine. As in most non-Anglo-Saxon countries, there was no college and one went straight from high school into professional schools. I didn’t think of myself as a future physician, and indeed, the first chance I got, I abandoned that course. Still, my two and a half years in medical school allowed me to get a taste of that profession. For all the deserved and undeserved bad press it gets nowadays, medicine as a calling has some wondrous aspects. I, for one, was aware that I was to become a member of an ancient guild. Like most people, I wanted to belong to a distinctive group, and this one had many obvious worthy attributes, not the least of which were the white coat and stethoscope. It didn’t matter that I didn’t really mean to become a doctor. I felt I was in good company, being aware that Axel Munthe, William Carlos Williams, A. J. Cronin, and Chechov, writers I had read and admired, had also been doctors.
At the age of eighteen, earlier than students in this county, I experienced several medical student “firsts.” I drew my first blood (not counting the pinpricks on the ship to the Galapagos), gave my first intravenous injection, and for the first time, measured blood pressure, listened to the chest, felt the abdomen, peered into eyeballs, examined reflexes, looked down a vaginal speculum—not all on the same person, I hasten to say. This is not a complete list, because in Quito we had the chance to perform a physical examination at any time on almost any patient in the municipal hospital. One simply walked up to an unfortunate soul lying in a bed in an open ward, asked him to lift his hospital gown, and poked around chest and belly. Often the patient was left with his torso and abdomen decorated with lines drawn with a grease pencil that outlined his innards. I doubt that they were happy to know that their viscera had been located. It probably did not occur to us that these people were sick and weren’t there just for our education. Some of my classmates took advantage of such opportunities and helped out in operations in the early years of school, and even performed some later on, still as students. A number of them went on to become fine surgeons.
Medical education in Quito was not exactly advanced, but, on reflection, it had some good points besides providing access to patients. The entire faculty taught only part-time because nobody could live on a professor’s salary. Some of the professors had studied abroad and were well grounded; many others simply read in lecture from notes they had used for years. The subject matter that was emphasized beyond all others was anatomy, which was taught throughout the first two years. We used a venerable text by a Frenchman, Leo Testut, in Spanish translation. It consisted of three thick volumes and had a red cover. We had to learn practically every word, sometimes even the footnotes. We had to be able to describe the places where muscles adhere to bones, where major and minor blood vessels are located, which nerves go to what organ. For practical exams, we were given a bag with the small bones of the wrist and ankle and told to fish out a particular one without looking. Preparing for such formidable tasks was not made easier by the lack of suitable cadavers for dissection, so it involved mainly memorization. Bones were no problem; you could always buy a set, surreptitiously, from the assistant working at the anatomy institute.
The sphenoid bone. Source.
One particular bone in the head, called the sphenoid bone, held me in awe. It’s located in the base of the skull and is mighty complicated. It resembles a bat or a giant moth in flight and is baroque in its complexity, with little projections and cavities all over its surface. I couldn’t believe that we have such an intricate structure within our head. The sphenoid didn’t yield its identity easily and learning about its shape and its connections to nerves, eyeballs, and the rest was challenging indeed. It even has a place for the pituitary gland in the shape of a Turkish saddle (whatever that may look like), which bears the Latin name of sella turcica. Most of my knowledge of anatomy was lost right after the exam, but this intense experience left me with a strong visual impression of the human body. Even if I don’t remember the names of most muscles, arteries, and nerves, I have a good sense of what we are like inside.
My experience at La LIFE would later come in handy. I had learned how to make tissue sections and to examine them. This gave me a leg up on histology, the study of tissues, which has its own fascination. Had I stayed in Ecuador and finished medical school, I almost surely would have become a pathologist. I doubt that I would have become a regular clinician, with such a strong pull towards the laboratory.