Lloyd W. Kitchens, Jr., MD
Lloyd Kitchens was born in Jackson, Mississippi, on October
19, 1946. He grew up in Crystal Springs, Mississippi, attending public schools.
He graduated from the University of Mississippi, or Ole Miss, in 1967 and from
the University of Mississippi School of Medicine in 1971. His internship and
residency in internal medicine were at Baylor University Medical Center (BUMC),
as was his fellowship in medical oncology and hematology. He entered the
private practice of oncology/hematology in 1976 and has been teaching at BUMC
and The University of Texas Southwestern Medical Center at Dallas ever since.
His life with Crohn's disease has not made it easy for him. Severe flare-ups
recently have necessitated his retirement from practice. He remains active in
the American College of Physicians and with his many nonmedical interests. He
is a well-loved physician at BUMC and has a great capacity for friendship.
William Clifford Roberts, MD (hereafter, WCR): I am speaking
with Dr. Lloyd Wade Kitchens, Jr., in the study of his home on September 11,
1998. Lloyd, I appreciate your willingness to talk to me and, therefore, to the
readers of the Baylor University Medical Center Proceedings. Could you talk a
bit about your parents and growing up in Mississippi?
Lloyd Wade Kitchens, Jr., MD (hereafter, LWK): I grew up in
Crystal Springs, Mississippi, a little town 25 miles from Jackson. At that
time, it was an active area in truck farming, particularly tomatoes. The people
there used to refer to the area as the “Tomatopolis” of the world, and a big
tomato festival was held every year. Now Crystal Springs is basically a bedroom
community for Jackson. Its population then was 5000, and it still is.
My father was from a large family. My grandfather had lost
two wives. My father is the only child of my grandfather and his third wife. My
father had numerous half-brothers and half-sisters, many of whom were old
enough to be his parents. He was the first member of his family to finish
college, which he financed by working 2 or 3 part-time jobs. He initially went
to Copiah-Lincoln Junior College, but received his degree at Mississippi State
My mother is a native of Vaiden, Mississippi, which is about
100 miles north of Crystal Springs. Its population was about 500 when the train
used to stop there. When the train ceased stopping in Vaiden, it lost most of
its population. It also was hit by a bad tornado about 10 years ago, and there
is not much left of what was a very genteel community. My mother and all her
siblings studied piano. Mother studied with a lady I later took lessons from
when I would visit my grandmother in the summers. By that time Miss Lena
Armstrong was nearly 100 years old and still a very good teacher.
When my mother was a senior in high school, she taught some
first and second graders. There were 3 or 4 classes in the same room and they
didn't have enough teachers. My mother's youngest sibling was one of her
students. Mother went to a little college located in the northeastern extremes
of the state called Blue Mountain, which at that time was an all-girls Baptist
school. Mother also did some summer work at Ole Miss and Mississippi State,
meeting my father at State. They got married in the late 1930s. Daddy went to
World War II. By that time, he was a college graduate. During the war, he
taught illiterate troops how to read at Camp Shelby in Hattiesburg,
Mississippi, and in several other places. He also began having some intestinal
problems. They were diagnosed as peptic ulcer disease.
I was born in 1946. I have a brother who is 6 years younger
than me. He is in business in northeast Alabama near Huntsville. I also have a
brother, an attorney, who is 3 years older than me. He was a district attorney
for about 3 terms, but he resigned because he has 5 children and was strapped
financially trying to send them to college on a district attorney's salary. He
survived an assassination attempt as a young prosecutor in 1973. One night in
Crystal Springs, he developed a headache and walked home from the evening
Baptist service, leaving his family at church. Shortly after arriving home, he
got a phone call. The caller said he had a tip on a drug deal that was going to
happen: “I'll be there in just a few minutes. I wanted you to know what it was
so you would come to the door.” My brother restrained his dogs. As he walked
back into the house, a person stepped out from behind a bush with a gun and
said, “You are never going to send anybody else to Parchman [the prison farm in
Mississippi].” My brother grabbed the gun and hit the guy. They fought, and my
brother was shot through his upper left leg and left hand. Fortunately, the
bullet didn't hit any bones or major vessels and he did okay. He had FBI
protection for a long time after that. He has had some pretty grizzly cases
through the years.
Our father was elected mayor when I was in the fifth grade.
He had been a city alderman for years before that. Being mayor was a quarter-
or half-time job. The mayor was the municipal judge as well and dealt with
misdemeanor crimes. Many times we would be awakened at home by police bringing
in an inebriated man who had beaten his wife; my father had to declare that
this person should be admitted to the jail. He also frequently had to settle
disputes that did not put people in jail. It was exciting and somewhat
frightening as a child.
The civil rights movement also was really gearing up. I
finished high school in 1964, and there was a lot of activity that year, a lot
of cross burnings. My father, in addition to being mayor, had a large wholesale
grocery operation and some cattle. The wholesale grocery business was
demanding. He worked very hard at it. My older brother and I also worked at the
warehouse a lot. We worked with adult black men, doing the same work they did.
I never had any difficulty with other races, but there was much vigilante and
Klu Klux Klan activity at the time. During my high school years, I was student
body president, student council president, and editor of the annual. I played football
(guard on offense and inside linebacker on defense), although not very well. In
rural Mississippi, one pretty much had to play football to be accepted.
WCR: Did you go to public high school in Crystal Springs?
WCR: How many students were in your high school?
LWK: About 300. My graduating class had 82.
WCR: That was 82 whites?
WCR: About the same number of blacks?
LWK: There were about 30% more blacks.
WCR: The classes were totally separate?
LWK: Yes. Black and white students never saw each other.
They were schooled 2 or 3 miles apart. The black school was in the black area
of town, called “Freetown.” In 1962, when I was in high school, James Meredith
was the first black admitted to the University of Mississippi. That was a
terrible time. There were talks of insurrection among the whites: “They'll put
him in Ole Miss over my dead body” and that kind of thing. The disc jockeys on
the radio would say, “They're going to try to put him in there this Thursday.
Come on up to Oxford and bring your guns.” I heard that on the radio! Under
duress, Governor Ross Barnett was convinced by John and Robert Kennedy to
mobilize the Mississippi National Guard. They became federal troops at that
point. Meredith would not have gotten in there if Governor Barnett and the
Kennedy brothers hadn't made a deal. Despite the presence of these heavily
armed guards, there was a riot. Two people were killed and many were injured.
When I went to Ole Miss in 1964, the troops had left the campus a week earlier
after staying 2 years.
I was a page in the legislature in Jackson several times
during high school. One task we did, in addition to the usual step-and-fetch
kind of things for the legislators, was to stuff envelopes with letters
opposing the Civil Rights Act of 1964. We sent letters to people all over
Mississippi and other parts of the country saying, “If this act is passed,
America will be communist within 6 months.” That was sent on state stationery
through the auspices of the State Sovereignty Commission. It was really the
State Segregation Commission. The boss of the pages told us: “Boys, you just
got to oppose integration; you can't ever give up. You can't ever give in to
the blacks at all or this country will be communist.”
WCR: In high school you were president of the student body,
president of the student council, played football, played the piano. Were there
other major activities as well?
LWK: I played the piano quite a lot. The other large
activity was church work. I was very involved in the Baptist Church. I began
accompanying choirs on the piano at a young age. I would accompany the adult
choirs when the regular pianists were not there. We were “4+ Baptist”! There
was a huge Baptist culture, and we were 4-feet deep in the middle of it. In the
summers, I used to go to small towns to attend youth revivals. There were
several young guys in the seminary at Mississippi College who would go around
and do youth revivals in the summers. They would have an evangelist and a music
director. Often, more times than I could do it, I was asked to play the piano
for these things. I would go for a week to some little town and maybe get paid
$50. I did probably 8 of these when I was in high school. Church work was very
important to me.
My interest in music rapidly increased. I discovered musical
theater and got very excited about it. We had a new stereo record player. I
would do my homework, which didn't take very long, and then read Newsweek cover
to cover or the encyclopedia while listening to My Fair Lady or South Pacific
on the record player. I also dated a good bit. I enjoyed that. There were some
pretty nice girls in Mississippi!
WCR: What was home life like? There were 3 brothers and you
were the middle one. When you would sit around the table at night, did you have
intellectual discussions? Was your family an intellectual one? How would you
LWK: I would say it was pretty intellectual. It was
absolutely dominated by my father. He, during most of the time that I remember,
was mayor. My older brother got into trouble a lot from childhood pranks.
Frequently, the dinner table was where he was disciplined.
About the time I was in the eighth or ninth grade, my
father's illness became a real issue in our family. Although for a long time he
had been thought to have peptic ulcer disease, Crohn's disease was the problem.
This disease had only recently been described by Dr. Burrill Crohn.
Periodically, my father would have gastrointestinal bleeding, which occasionally
was life threatening. I remember going on an emergency basis to the hospital in
Jackson with him about to exsanguinate from gastrointestinal bleeding. When I
was a junior in high school, he started going to the Oschner Clinic in New
Orleans. He might be gone 1 to 2 months, during which time my brothers and I
would be cared for by my grandmother or Daddy's half-brother and his wife who
lived within a half mile of our house. We spent a lot of time there. If school
was not in session, I would go to New Orleans and try to help Mother. Much of
our family life came to be dominated by his illness. He eventually died from
complications of Crohn's disease. He had cirrhosis, although he never had a
drink in his life. Retrospectively, I am sure he had hepatitis C from the many
blood transfusions he received over the years. He developed severe portal
hypertension from which he died despite a portacaval shunt.
WCR: He was born in what year?
WCR: He died in what year?
LWK: The year I started practice, 1976.
WCR: Your mother was born in what year?
WCR: Was there enough money for the family not to have to
worry about that when growing up?
LWK: When I was growing up, we were considered very well
off. My father made good money in the wholesale grocery business. I was in
medical school when his health really began to wane. He sold his wholesale
grocery business to take a job as the manager of a huge vegetable packing plant
in Crystal Springs. Sadly, after my father had already sold his business, the
manager decided he was too sick to take the job. He was left essentially
without employment when he was very sick from Crohn's disease. He started
selling insurance. He was still mayor and had that small salary. He did okay,
but incurred a lot of debt, partly from my brother being in law school the same
time I was in medical school. It didn't cost that much to go to medical school
at the time, but to provide for our living expenses, he borrowed more money
than he probably should have. Looking back, I think he was encephalopathic. He
just wasn't as sharp as he had been. He was taking tricyclic antidepressants,
and they probably were not taken correctly.
WCR: How old was he when the manifestations of Crohn's
LWK: He was probably in his 20s. Burrill Crohn didn't
describe the disease until the 1950s. Eisenhower had it also; his case was
called regional ileitis.
WCR: What impact on your growing up came from your mother?
LWK: A tremendous impact. We remain quite close. I talk to
her on the phone 5 or 6 times a week. Despite being 84, she still has 45 piano
students a week. She is very active. She paid all the debts Daddy incurred by
teaching piano lessons.
She was a tremendous influence on me musically. When my
wife, Connie, and I met 15 years ago, we were astonished to find that we both
knew all the Victor Herbert, Cole Porter, Jerome Kern, and George Gershwin
tunes. Not many people our age like that kind of music. We both learned these
tunes from our mothers.
My mother has enormous energy and talent. She is considered
a virtual saint in Crystal Springs since she taught piano to so many people and
was so visible playing the organ every Sunday at the Baptist church. She was,
and is, a very strong and deeply religious person. She always encouraged my
brothers and me to do whatever we felt we could do in our careers.
One thing I resent just a bit was my parents' not letting me
attend the college I wished. As a National Merit Scholar in high school, I was
recruited by Stanford, Harvard, and Yale. I even had an appointment to West
Point that I turned down. If left to my own devices, I would have gone to
Harvard or Yale. They could have afforded it, but my parents, especially my
mother, were afraid that I would get contaminated by the Yankees or that I
would not like it and would leave college early to come back home.
I wanted to get into medical school as soon as I could. I
took freshman English and inorganic chemistry at Mississippi College my first summer.
English was fine, but chemistry was terrible because the laboratories were
My brother had just graduated from the University of
Southern Mississippi in Hattiesburg. I told him how miserable I was at
Mississippi College, but that I didn't think our parents would let me go
anywhere else since it was only about 30 miles from home. My brother had a
degree in social studies but didn't know what he wanted to do. He said he had
been thinking about going to law school at Ole Miss. At that time, if you were
a graduate of a state university in Mississippi, you were assured admission to
Ole Miss Law School. He said, “Let's go up to Oxford next weekend, and we'll
tell them we are going up there so I can look at the law school.” We went and
he liked the law school. The first guy we met there was Trent Lott, currently
the US Senate Republican Majority Leader, who was the liaison to new students.
My brother thought if he were there on campus, our parents would let me
transfer to Ole Miss. They did. I got through college in 2 years by taking huge
loads. During my first year of medical school, I had to take correspondence
courses from Ole Miss to get my last few hours of college courses. I was
determined to get a bachelor's degree!
WCR: When you graduated from high school, you were how old?
WCR: You started medical school at age 19?
WCR: How was college for you? Did you have any mentors, or
did you meet people who had a considerable impact on you?
LWK: I did. My interest in German started there. I was
admitted to an advanced class taught by Professor and German
Department Chairman Dr. Wilhelm Eickhorst, who was an
I also had a small grant to work in a biochemistry research
laboratory with Paul Russell, PhD. He was doing postdoctorate work under a
renowned biochemist, W. R. Nes, PhD. They worked on steroids, mostly those
derived from plants. I was very happy to get the opportunity because I got
experience with a lot of radioactive material. We ground up green peas and used
rodents a good bit. I learned a great deal.
The first full summer I spent at Ole Miss, Russell was to
present a paper at Harvard. He was 6'7" and had played basketball with Lou
Alcinder, later named Kareem Abjul-Jabar, at the University of California Los
Angeles until he broke his leg. He needed to get from Oxford to Boston. My
brother and I shared a Volkswagen bug at the time. This 6'7" man and I
drove from Oxford to Boston. Of course, he couldn't drive at all because he was
just too big. I drove the whole way. We talked about science, and I got
increasingly excited about science. The summer before I started medical school,
I went to Ohio State and worked there with Russell in the obstetrics and
gynecology department doing some steroid research, such as the effects of too
much estrogen on labor.
WCR: University of Mississippi for medical school? Did you
apply to any place other than the University of Mississippi for medical school?
WCR: Were there any mentors in high school that had an
impact on you?
LWK: Yes, a lady named Dorothy Alford. She was often my
English teacher. She is a very articulate, refined lady who filled a similar
role for my older brother. He likes words, writing, and reading like I do. My
brother is a wonderful author and speaker now. He captures a jury very quickly.
I wish I could speak as well as he does. He got that from Dorothy Alford, and
whatever I eventually got came from her as well. My mother also has beautiful
grammar. Both of my brothers and I, through the influence of my mother and Ms.
Alford, strive not to make grammatical errors. I think for the most part we
There was another man, T. E. Carney, who considered himself
to be a teacher on the side. He had a huge farm south of town and raised
cabbage. He had a lot of money but enjoyed teaching biology, chemistry, and
physics. Although his fund of knowledge was less impressive than his enthusiasm
for teaching, he was the first to get me excited about science.
WCR: Talk a bit about your noncurricular activities in
college. I gather music continued to be a very active part.
LWK: I was in a fraternity, Beta Theta Pi, that was quite
academically inclined. I was very active and was secretary of the chapter. The
biochemistry laboratory took a couple of hours a day. I met my first wife
there. We would study together. At that time she was in premed.
WCR: I gather that you became interested in medicine while
relatively young. I suspect you learned something about medicine from watching
what was happening to your father. Were there physicians in your family?
LWK: No, but there was a rather dramatic event that made me
interested in medicine. Most days when I was not in football practice, I would
go to my father's warehouse after school and work there until it was time to
feed the cattle or go to a piano lesson. The warehouse, where the wholesale
grocery operation was located, was across the street from an old 2-story house
that had been converted into a doctor's office. Dr. Oscar G. Eubanks was
venerated in that town and could do no wrong. Back when the telephone operators
talked to you, his phone number was 1. One day, I was working in the warehouse after
school and stepped out on the loading dock. Across the street they were taking
somebody covered by a sheet out of his office on a stretcher. Dr. Eubanks had
had a heart attack in his office and died. This was in the spring of my senior
year in high school.
At that time, my parents would have allowed me to go to West
Point. I had an appointment there from my congressman, and that is what I
planned to do because I knew they would not let me go to a civilian school that
far away. I started thinking a great deal about the world and decided that if I
wanted to help people and do good, which was a goal of mine, I was more likely
to be able to do that as a physician than as a soldier. After a couple of days
of intense thought, I wrote to my congressman and thanked him, but told him I
was not going to accept the appointment. That is when I really became
interested in medicine. I had always been interested in science but didn't
think about doing it myself until Dr. Eubanks suddenly died.
WCR: You mentioned that your father had cattle. Did you
actually live in town?
LWK: Yes. We lived on the outskirts of town. The farm was 5
miles out of town. Our house, where my mother still lives, is on 9 acres and
has lots of pecan trees. We didn't keep livestock there, but we did keep horses
WCR: How many cows did you have?
LWK: When I was growing up we had about 80. During my senior
year in high school, my father bought 40 hogs and put them in a pen on the farm
so he didn't have to discard spoiled food from his warehouse. All through the
winter, my job was to feed them the stuff that humans couldn't eat. I would mix
this horrible stuff and pour it out for the hogs. It used to get very cold and
the roads were slick. I would frequently get in a ditch and have to hitchhike
home, hoping to make it back in time for my piano lesson.
WCR: You were always busy in high school and college. Did
you need much sleep to be effective?
LWK: At that time I didn't sleep much. I would read late
into the night and get up early in the morning. I require very little sleep
now. That was reinforced in medical school, housestaff training, and my
practice. I was one of those guys who could get a call and be perfectly lucid
at 2:30 am to deal with a problem properly and then turn over and go back to
sleep within a minute or two. I'm able to go to sleep quickly for brief
periods. Since my forced retirement from active practice, I'm compelled by my
physicians to rest a couple of hours during the day. That's been hard for me to
adjust to, but I do fatigue easily from hepatitis C and Crohn's disease. I'm
chronically moderately anemic and do better when I rest during the day. It's
still psychologically hard to do that, never having done it before.
WCR: Did your family have lots of books and did they read a
LWK: My father read very little. My mother read a lot. She
read periodicals like music magazines more than books. The books in our home
were primarily those purchased by my brother and me. Neither of our parents
read many books. My older brother and I read voraciously.
WCR: What does your younger brother do?
LWK: That's been difficult. When my brother was in junior
high and high school, my father was ill. My younger brother didn't have the
benefit of Daddy's strong guidance. My father used to tell us that we would
know how to work even if we didn't learn anything else from him. My older
brother and I have that skill due to our parents' training. We both work a lot.
My father was ill and frightened that my little brother was going to get
drafted, sent to Vietnam, and killed. They were very lenient with him. He has
knocked around in a number of different low-level business jobs. Right now he
probably has the best job he has had, as an assistant manager for a pest
control company in Huntsville, Alabama.
WCR: What were those 4 years in medical school like?
LWK: Do you remember Richard Joseph, an
obstetrician/gynecologist who was the youngest president of the Dallas County
Medical Society? He and I were fraternity brothers at Ole Miss and roomed
together our first year in medical school. When he was inaugurated as president
of the Dallas County Medical Society, they did a big feature on him in the
society's journal. He was asked to prepare some remarks. He talked about what
the early days of medical school had been like. The first day, students,
especially freshmen, had to park far away from the school and walk up a long
hill. Walking uphill, I said, “Joseph, what kind of doctor do you want to be?”
He said that his goal was to take care of healthy people and keep them healthy;
he is an obstetrician/gynecologist and that is what he does. He takes care of
people in a normal physiologic situation and tries to maintain their good
health. He said, “Kitchens, what do you want to do?” I said, “Joseph, I want to
take care of the sickest people around and try to do the best I can for them,”
so I do oncology. It worked out as we said.
WCR: Who influenced you in medical school?
LWK: My first year I loved medical school. I liked the
anatomy lab the first day, being in charge of the remains of a human being. I
didn't have any major medical problems that year except for some abdominal
cramping. That summer I went to Ohio State and didn't think any more about it.
When I came back, I went to the first day's orientation, saw all my friends I
had gotten to know the year before, went home, and had a massive lower
gastrointestinal bleed. My hemoglobin when I got to the hospital was 7 g/dL.
WCR: This was when you were 19?
LWK: Yes. I had just started my second year of medical
school. Things kind of cascaded, and I started having in rapid succession just
about everything you can have from Crohn's disease: erythema nodosum; 9 or 10
recurrent, very painful perirectal abscesses; and several heavy
gastrointestinal bleeds. Finally I had to drop out of school because they
thought I was probably going to die.
I eventually had surgery which, in retrospect, was probably
not the right thing to do. The terminal ileum was extensively involved in
Crohn's. The more proximal ileum was anastomosed to the transverse colon, but
the diseased bowel was left in. Over the next few months, I continued to have
abdominal cramping. The perirectal abscesses continued, and eventually a
diverting colostomy to the left lower quadrant was performed so that the rectum
That's the way I finished medical school. I went back the
next year and joined the class that was coming along, so I finished a year
later than I would have. Looking back, I am simply not sure how I finished
medical school. At one point I remember having to wear 3 different ostomy bags
because I had 2 enterocutaneous fistulas. I was very ill until I came to Baylor
as a medical intern. I couldn't believe that Ralph Tompsett and Mike Reese
hired me but they did. About 2 years into the residency, Dave Barnett, a
wonderful man and surgeon, and Dan Polter, my gastroenterologist, informed me
that my rectum was a disaster, that it would never function again and that I
needed an abdominoperineal resection with removal of all diseased bowel. That
procedure was done. After that operation, I did quite well for 12 years.
Subsequently, I have had several more bowel resections.
Several recurrences appeared in the distal-most part of the bowel at the stoma.
I had Stevens-Johnson syndrome, and Crohn's arthropathy developed. I had
multisystem organ failure from toxic shock syndrome 4 years ago and was in the
intensive care unit for about 3 weeks. I had many debridements and skin grafts
on a huge necrotic area on my left ankle. My internist, Russell Martin, told me
there was just no way I could practice again. I have had manifestations of
Crohn's disease now for about 31 years. About 2 or 3 days a week, I cannot do
the things I would need to do if I were practicing.
WCR: Did Dr. Arthur Guyton have a major impact on you in
LWK: Dr. Guyton, of course, is the world's dean of
physiology. He wrote the definitive textbook, which is used in medical schools
all over the world. While a surgical resident at the Massachusetts General
Hospital, right after World War II, he was stricken suddenly by polio. He
almost died. He kept meticulous clinical notes on himself as to what was going
on. Unable physically to continue surgery, he became a physiologist without
formal training. He was entirely self-taught. Dr. Guyton is one of the kindest
people I have ever met. He has 10 children, all physicians. I was at Ole Miss
with two of them. I got to know their father fairly well. Dr. Arthur Guyton has
very little use of his legs; he has pretty good use of one hand. He gave at
least 80% of our lectures in physiology, one every day. He devised a system
where he could project his writing on a screen. It doesn't sound like much now
but in the 1960s it was impressive.
Once I was in the dog lab doing an experiment, trying to
cannulate a vein. I was so nervous about doing that first real technical
procedure, I could not get it in for love or money. All of a sudden he was
behind me. He couldn't see my nametag, but he knew my name. He said, “Lloyd,
you can do it.” He said do this, that, slip it in, and you won't have any
trouble. I did, and it went right in. I have never been so relieved in my life.
The thought that this man, who should be a Nobel Laureate for his work on
hypertension, did hands-on teaching with me, knew me, and was interested in my
career and my doing well was just fascinating to me. I was not real close to
him personally. I was more of a distant admirer of his. We were all in awe of
him. I still admire him tremendously.
Another was Dr. Jim Hardy who is still alive though
physically beginning to fail. He was a cardiothoracic surgeon. He is the father
of Dr. Kaki Little here at Baylor. Dr. Hardy had 4 daughters, all doctors: 2
MDs and 2 PhDs. I went to the church Dr. Hardy attended, and he was really an
inspirational guy: enormous energy, very kind, and very religiously devout, but
still able to do some high-powered medicine. He did a baboon-to-human heart
transplant several years before the first human-to-human heart transplant by
Dr. Christian Barnaard in South Africa. I admired that he could work as hard
and long as he did and still be extremely active in the church. Those were the
two people who were most influential.
Following closely after those two was an old gentleman named
Dr. Guy Campbell, a sputum and x-ray pulmonary doctor. If you had a “bronch,”
it was done with a rigid scope, usually by a thoracic surgeon. It was not like
it is now where the pulmonologist can “crawl out” almost to the chest wall and
see with their bronchoscopes. He, like many of those older guys, had had
tuberculosis himself. He was just wonderful. I spent a month with him on an
elective at the Veteran's Administration Hospital, which was 500 yards from the
main university hospital. He was extremely kind to me. I was fairly sick and
had another pretty severe bleed one day. My hemoglobin dropped quickly and I
collapsed on rounds. I am very active now in the American College of
Physicians, and part of that is because Dr. Campbell was an American College of
Physicians supporter. He told me it was important. Dr. Ralph Tompsett pushed me
to be active in the organization.
The internist who was my primary doctor while I was in
medical school tried hard to take proper care of me. I think he thought I was
manifesting drug-seeking behavior, which I was not. Perirectal abscesses are
among the most painful things a person can have so I would respectfully ask for
pain medicine. It was as though if you didn't have cancer, you didn't get
anything more than Darvon. Once as a junior in medical school, he said, “We
have to talk. You're talking like you are going to get through medical school.”
I said, “Yes, sir, of course I'm going to get through medical school.” He said,
“Look, it is part of my job to be realistic with you and try to get you
thinking straight.” He thought it was extremely unlikely that I would get
through medical school and that if I did, I could never take care of patients.
His comments made me so furious that I was even more determined to make it
through. I hadn't seen him in 30 years until a couple of years ago when I was
leaving a large ethics session, one I presided over, at a national meeting of
the American College of Physicians. After the session, he said that he knew
there had to be some mistake, that it could not possibly be me up there. That
was very gratifying. His comments when I was in medical school hurt. It was as
if all my efforts were for nothing.
WCR: Did you have difficulty deciding what you wanted to go
into in medicine? You mentioned earlier that you wanted to take care of the
sickest people you could and certainly that is how you ended up. When you were
in medical school, did you know all the way that you wanted to be an internist,
or did you strongly consider other specialties as well?
LWK: During the academic year that I had to take off due to
illness, I got a job in the blood bank at the university. I was cross-matching
blood like I knew what I was doing. The criteria for doing that job back then
were not very strict. The cross-match lab was next door to the cancer ward.
There was not a lot you could do for those patients other than try to make them
comfortable. I would hang out a lot in my white coat on that ward. The guys
treating those patients were people who could not do much of anything else.
They were not cardiologists, gastroenterologists, neurologists, or surgeons.
They were guys who by default wound up taking care of a lot of patients with
hematologic malignancies. Since most of the drugs would make white counts go
down, they became experienced with patients with low counts. The hematologists
became the oncologists. Even today there are not many physicians making a good
living in practice doing “pure” hematology, such as anemias, leukemias, and
coagulation disorders. You have to do some oncology. Many of the people who
were seeing those desperately ill patients were the dredges of medicine of that
time, with some notable exceptions. Oncology has really taken off since then as
the fastest growing subspecialty in internal medicine. It is very respected
now. You do some neat scientific stuff these days in oncology practice, but in
the mid-1960s it was pretty crude. I decided that I wanted to take care of
cancer patients and to try to bring state-of-the-art treatment linked with
compassion to these patients and their families. Once I made that decision, I
never wavered. I knew I wanted to do internal medicine as a stepping-stone into
WCR: Did you keep up your music in medical school?
LWK: Yes. I played at home. My mother always saw that I had
a reasonable piano at home. I still do. I would play it almost every day, not
because I was working toward a performance, but to relax and keep up my skills.
WCR: Did your two brothers also play?
WCR: Did you sing?
LWK: I did more than they did. I have always sung in church.
Each Wednesday night I went to choir practice. I rarely soloed. Although my
mother was the main piano teacher in town, she didn't teach her children, which
was wise. She felt we would do better being taught by someone else. My older
brother plays by ear quite well. He can also read music easily. My younger
brother plays pretty well. He didn't get into it quite as much as I did. I went
after it pretty hard and still do. I enjoy it tremendously.
WCR: In high school you practiced how much each day?
LWK: About 45 to 60 minutes. It was customary for a serious
high school piano student to give a solo recital as a senior. I told my mother
I would be too busy when I was a senior so I did mine as a junior.
WCR: I gather Dallas had not played a part in your life
until your internship. What were the factors that led you to Baylor in Dallas
LWK: Richard Joseph! Because I had to drop out of medical
school for a year, he finished ahead of me. He had interned at Baylor. I was
planning to stay at the University Medical Center in Jackson, where I had gone
to medical school, for my internship and residency, but Joseph said to spend
the weekend with him in Dallas and interview at Baylor. It was a much
sought-after internship, even back then, and it has gotten much more sought
Dr. Mike Reese was the director of the internship program,
and Dr. Ralph Tompsett was the overall director of Medical Education. Reese was
intimately involved with the interns and residents, and he was a
hematologist/oncologist. I liked Reese and I liked Baylor, and I was absolutely
taken with Dr. Tompsett. I was in the upper third of my class in medical school
despite being out a good bit. I was surprised when Reese took me aside from the
rest of the group and asked when I was going back. He asked if I wanted to make
rounds with him the next day, which was Saturday. I said, “Yes, sir,
absolutely, I would love to.” I borrowed Joseph's stethoscope and made rounds
with Reese, which was an all-day affair. I kept up with him. I think he wanted
to see what my physical capabilities were because he knew about my physical
condition related to Crohn's disease. He also wanted to see if I knew anything.
Worried to death, I didn't sleep that night. We made rounds and I was
pleasantly surprised and grateful when I matched here because this is the only
place I put down. I was planning to do the internship at Baylor and the
residency in Mississippi, but Reese convinced me to stay for the residency and
a fellowship in oncology and hematology.
In 1976, I had a faculty job offer at Mississippi after my
fellowship, but the Medical Oncology Group was just beginning to form. We later
changed the name to Texas Oncology, PA (TOPA). Reese was the only guy for a
long time, and then Dick Williams joined him. John Bagwell joined them on
paper, although he continued to work out of his father's office. I finished my
fellowship on June 30, 1976, and went into practice with them, as did Lewis
“Skip” Duncan, who did his fellowship at Southwestern Medical School. The 5 of
us started the Medical Oncology Group that summer. It has grown enormously
WCR: What was internship and medical residency like for you
at Baylor? How many interns were in medicine then?
LWK: About 11, some of whom are still around Baylor and are
quite prominent. The internship was very difficult for me physically. I was
determined that I was going to do everything anybody else did and not ask for
any dispensations. It was hard because I was beginning to get Crohn's
arthropathy in my large joints. At that time, I had a colostomy with a
mucocutaneous fistula, and I was always worried about getting another
enterocutaneous fistula. Just the logistics of having a colostomy complicates
one's life tremendously. I was on call every third night and had to run to
codes. It was hard but I was determined to do it. The call rooms were old hospital
rooms that didn't have baths in them. When I had the abdominoperineal
resection, the colostomy was converted to an ileostomy, which is much worse
because the output is so much higher and the frequency of leaks is increased.
It was challenging, but I enjoyed the housestaff training. The medical
attendings at Baylor were excellent. The ones I respected seemed to respect me.
I got to know Jabez Galt very well. Jabez befriended me, along with a number of
other people, and he was very supportive. Billy Oliver, George Carman, and John
Binion were role models. Just the normal duties of being an intern and a
resident, complicated by not feeling well and worsened by having to deal with
the ileostomy, were challenging. I am proud to say most people didn't know I
had any physical problems.
WCR: When did you get married the first time?
LWK: The lady who is the mother of my older children was at
Ole Miss and was in premed. We got married around Christmas the year I had to
take off from school. She was a graduate student at Ole Miss. I was down at
Crystal Springs. Our daughter, Elizabeth, is married to Dr.
Steve Landers here at BUMC, and our son, TrÈ, is a third-year law student.
WCR: You were only 21 years old?
LWK: Yes. We were married for about 10 years and had 2
children. I was single for a couple of years and then married a girl from
Illinois who I had met at church, which does not guarantee the success of a
marriage. We were married about 21/2 years and divorced. I was single again for
about 2 years.
Connie is a Dallas native. Her maiden name, which she uses
professionally, is Coit. Her grandfather's family were some of the original
settlers in Dallas. She lived in New York for about 8 years before we met,
working in “the business,” and was pretty successful. In 1986 a new theater
opened here in town, and she was invited to come as a guest artist and do Mabel
in Pirates of Penzance. I had supported that theater because I had some friends
on its board. On the opening night of Pirates, which was the inaugural evening
for that theater, I was there with a date. My best friend's son was Connie's
co-star. My best friend's wife had been Connie's voice teacher when she was in
high school. They all wanted me to meet Connie, who, I believe, was very skeptical
of meeting me because I had had 2 children and 2 divorces and, furthermore,
wasn't much to look at. Although she and I are the same age, she looks 20 years
younger. We met that July night and got married the next December. She went
back to New York after the 6- to 8-week run of the show. I started going to New
York as often as I could. We kept her place there, which we have since bought
as a co-op apartment. It's nice to have since I'm in Philadelphia a lot, and
it's easy for me to catch the train and go up to New York. We got married 14
years ago and very unexpectedly had our little boy, Ben. He will be 12 next
month. He's a lot of fun. It's good for his grandparents to have him around and
good for us too. I am a better father this time.
WCR: Let me ask you about your hobbies. Your home is just
loaded with books. Obviously, music plays a big role in your life. Your wife is
an actress, and theater has been important to both of you. Tell about your
LWK: I am very interested in politics, which I follow
closely. I am a Democrat physician in Dallas, Texas, and that is kind of an
endangered species. My church work is important to me. I have always been
involved in the music programs of whatever church I was in, and I continue to do
that. I am in the adult choir and play the piano occasionally at the Highland
Park United Methodist Church. I grew up Baptist, but now I go to a Methodist
church. Connie was placed on the cradle roll at Highland Park United Methodist
Church when she was born. When we got married, I was actually Presbyterian.
Although Connie put no pressure on me, I decided I would offer to go to the
Methodist church so we would see her parents more. It has worked out very well,
and we have some very good friends there.
I like sports, but I am not rabid about them, which is a
good thing because my physical condition would not allow that. I follow
football and baseball. I am very interested in history and book collecting. A
lot of what I have is nice collectable stuff. I love to read. I try to be very
involved with my son's activities. My father was not able to do that much with
me and I didn't, for whatever reason, do as much as I would have liked with my
older son and daughter because I was establishing a practice. I should have
spent more time with them.
I am honored to be a member of the Players Club in New York.
In the 1830s and 1840s, John Wilkes Booth and Edwin Booth traveled around the
country in stagecoaches doing Shakespearean scenes and things like that for 2
or 3 days in each town. About every 2 years, they would return to New York and
do plays there. When John Wilkes Booth shot Lincoln, the rest of the Booth
family was devastated. Edwin Booth, the spokesman for the family, withdrew from
the stage for about 20 years and wrote an impassioned, heartbreaking letter to
the American people apologizing on behalf of the Booth family for what his
brother had done. He eventually returned to the stage in about 1892 and formed
the Players Club. Other founding members included William Tecumseh Sherman and
Mark Twain. They met in Mr. Booth's house, which bordered Gramercy Park, the
only remaining private park in New York City. They had keys to get through the
gate, and no one else could get in. One reason Booth wanted to form the Players
Club was to increase the community's respect for actors by having the actors
associate with physicians, lawyers, and clergy, people like that. Actors were
looked down on at that time. They were considered “show trash.” The Booths,
however, were at a higher level than most actors. This wonderful 5-story
brownstone on Gramercy Park was bequeathed to the Players Club. It is a
beautiful building, and Edwin Booth's bedroom is preserved just like it had
been. James Cagney, Leonard Bernstein, and Helen Hayes have all been members.
One category of membership is called “Men of the Theater.”
Because I am a patron of the theater and because of my wife and her friends, I
was considered eligible for membership, and I was fortunate to be elected to
it. It is a lot of fun. They have the largest, most comprehensive theatrical
library in the world in the building. For decades it was a gentleman's club,
but it has had women members now for several years. Helen Hayes was the first
woman member. They have a wonderful chef. When we are in New York City, we
often have lunch and dinner there. They have a marvelous New Year's Eve party
every year. There is also a Founder's Day party. Sometimes I end up playing the
piano while everyone stands around and sings. For a little boy from
Mississippi, that is “high cotton.” Music and theater really consume a lot of
One member of the Players Club is Sidney Zion, a journalist
in New York who has written many editorials in The New York Times over the
years and the definitive biography on Roy Cohn. About 10 years ago his
daughter, Libby Zion, showed up at the New York Hospital in the middle of the
night just crazy out of her head. She died without the attending doctor coming.
She had been seen by the intern and, briefly, by the resident. The hospital
claimed that she died of a narcotics overdose, and Sidney Zion said there was
“no way.” A big lawsuit ensued, and it led to the establishment in New York
State, and later in other states, of limitations on how long interns and
residents can work each day and week.
WCR: Lloyd, tell me about your activities in the American
College of Physicians. How did you get involved so deeply with that
LWK: Dr. Ralph Tompsett was the most important mentor to me
in my professional life and, indeed, in my entire life ranks second only to my
father in influence. Dr. Tompsett was one of the early workers in penicillin
and isoniazid, and he made the Baylor training program in internal medicine
what it is. It was rudimentary before he came. He was always very good to me,
and I just revered him. I was honored to be one of his 2 physicians toward the
end of his life. When I was a resident and would rotate with Dr. Tompsett, he
would talk to me about the American College of Physicians. At that time, he was
in major national leadership roles. He had been the Texas governor of the
College, regent of the College, and its national vice president. He was granted
a mastership in the College, which is a rare honor.
The state regional meeting of the College was here in Dallas
in 1973 when I was perhaps a first-year resident rotating on his service, and
he said: “I'm going to be at the Fairmont Hotel today for this meeting, and you
should come and participate in it.” There were probably about 30 doctors there
from all over the state. The next time it was in Dallas, about 3 or 4 years
later, Dr. Tompsett was chairman of the program. I had just finished my
fellowship so I was fairly young to be involved. He told me that the College
tried to maintain the highest ideals of medical practice. It was not a trade
association, but an organization most interested in what was best for the
patient. It was an organization that he felt good about, and he put in a great
deal of time in it. He encouraged me to be active in the College. I would do
anything the man said, and I became active, going to all the regional meetings
which rotated among cities in Texas with medical schools. I think it was Woody
Allen who said, “Ninety percent of success in life comes from just showing up.”
I was always there, and when I was asked to be on committees, I always did it
willingly and tried to do my best. Eventually, I was elected to the board of
directors several times in succession and was nominated to be governor for
northern Texas. I was defeated, however, the first time I ran. Eventually in
1988, I was elected governor and at that time was the youngest governor they
I have been in national leadership positions with the
College for 10 years. I served my time as governor and was privileged to have
some wonderful patrons among the older men in the College: Clif Cleveland,
Ralph Wallerstein, and Willis Maddrey, for example. I got to know all the
presidents quite well. Again, it was a question of being there. When I was
asked to do things, I did them. I was privileged to serve 2 terms as chairman
of the national ethics committee. That is a very prestigious, autonomous
committee that churns out an ethics manual every 4 or 5 years. I was chairman
of the committee when the last one came out. The College is probably the best
organization to try to preserve the interests of patients—high standards and
ethical practices. In future years with more managed care, it is going to be a
struggle to maintain those interests, but the College has always embodied all
that is good in medical care. That is why I have spent a heck of a lot of time
with College activities. I am now a regent, having just been elected to a
second 3-year term. I have about 21/2 more years of eligibility for involvement
in the national leadership. I have really enjoyed it. If my health had been
better and I could have met the physical demands, I could have aspired to be
president of the College.
WCR: Lloyd, could you talk a little about your German
interest? You mentioned how in college a German instructor was so influential,
and your wife has been involved in theater work in Germany for some time.
LWK: A number of my fraternity brothers at Ole Miss took
German. I knew that there had been a lot of scientific work done in Germany and
published in German. I had studied Latin in high school, and that experience
helped me tremendously. I liked languages already, but this professor at Ole
Miss was charismatic and turned me on to German. I did well in it and received
a German government prize, which was not a big deal. It was a 2-volume set of
Schiller's Works for being an outstanding student in some aspect of German
studies. As an outgrowth of that, I was offered a year-long opportunity to
study in Germany with most of my expenses being paid by the German government.
I decided not to go because I wanted to go to medical school.
Other than visiting Germany, I always kept up with my
reading. I have always tried to read a little bit of German every week. I
subscribe to a volume called Amerika Woche, which is a German-language
newspaper written for Germans living in the USA. It rehashes the latest news in
German so it is easier to read because I kind of know what it is going to say;
that helps me keep up.
Connie went to Germany right after she got out of SMU 30
years ago and studied opera there for about 3 months. Connie's mentor is a
Broadway conductor, Jack Lee. He directed the music for most of Tommy Tune's
shows for years, such as My One and Only and Grand Hotel. Our little boy's
middle name is after him, Benjamin Lee Kitchens. We are the closest things he
has to blood relatives. He is very protective of Connie. He seemed to approve
of me when I came along because I played the piano. I told Jack and Connie that
I would never do anything or ask Connie to do anything that would impair any
professional opportunity she might want to pursue. She was surprised when she
got an offer to do this very lucrative job in Germany. I encouraged her to do
it. She didn't do it for the money, but they pay Americans with New York
experience who can speak German extremely well. It is hard work. The Actors
Equity union does not function over there, and they do not take very good care
of the actors. At any rate, her working periodically in Germany for 4 years fit
right in with my interest. Every time she went over for 3 or 4 months, I would
go over at least twice and try to learn the language better. I can read it
fairly well and speak it moderately well. Connie can speak it fluently, although
she does not read it that well. She has never studied it. In recent years, one
of my historical interests is the Nazi physicians. They went from being the
cream of the crop in the world at the turn of the century to apparently
espousing what Hitler said and turning their interest to how to kill people. I
have been fascinated by that and by German literature. I have taken 3 different
courses pertaining to German culture taught by Dr. Peter Mollenhauer at SMU. We
have discussed the German perspective, which is quite different from the
WCR: Lloyd, thank you for sharing some of your experiences
and thoughts with me and the readers of the BUMC Proceedings.
LWK: Thank you, Bill.