Caught in History

From Dallas on that historic day in November 1963 to an assault ship in the West Pacific, to a Navy hospital in California, Dr. Rayburn Skoglund ’59 has watched the history of medicine unfold.

caught in historyIf you’re old enough to remember November 22, 1963, odds are you remember the moment when time stopped and history took a new course following the news that President John F. Kennedy had been shot in Dallas, Texas.

While most of the nation paced anxiously near radios, hung on the words of television newscasters and waited desperately for afternoon papers — hungry for information about how, why and by whom its young, charismatic leader had been gunned down, Dr. Rayburn Skoglund, Augustana class of 1959, was watching history unfold from inside the seams.

A University of Texas Medical School intern at the time, Skoglund was on shift in the labor and delivery ward at Parkland Memorial Hospital in Dallas — the same hospital President Kennedy and Texas Governor John Connally were brought to following the shooting.

Now 77 and a retired pediatric neurologist, he has memories of that fateful day that are crystal clear.

“They came in and the IVs were ready. The chest tubes were ready. O-negative blood was ready,” Skoglund recalled earlier this year, following the 50th anniversary of the assassination.

“Kennedy was brought into the ER and Connally was taken to Trauma and prepped for surgery. Vice President Johnson was surrounded in another area. Mrs. Kennedy was in the area, watching everything that was going on.”

After hospital staff declared President Kennedy dead, Skoglund said he and his colleagues were stunned and in shock.

That shock resurfaced days later when Lee Harvey Oswald, Kennedy’s accused assassin, was also brought to Parkland after being shot in the basement of the Dallas Police Station.

“It was just amazing the things that happened. They were televising when they were moving Oswald and we could see on TV when [Jack] Ruby shot Oswald. Then they brought Oswald into Parkland,” Skoglund remembered. “We didn’t know what was going on. For two to three weeks, the whole hospital was sort of numb.”

As Skoglund, a native of Sioux Falls and a biology major at Augustana, tells his story, he’s modest, soft-spoken and unassuming. He was, like so many of his generation would say, “just doing his job.”

Yet, it’s clear that his brush with history in Dallas was the first of many history-making milestones throughout his career.

Surgery at Sea

dr. rayburn skoglundAfter his residency, Skoglund entered the U.S. Navy and served as a full lieutenant and general medical officer for the USS Union, an amphibious assault ship assigned to the West Pacific.

While at sea, Skoglund diagnosed nine USS Union sailors with appendicitis. Eight were able to be transported from the ship to land for surgery.

One wasn’t. The seas were simply too dangerous that day.

“It was one of the scariest times of my life. I had no desire to do an appendectomy at sea if we didn’t need to, but the sea was too rough to get [the sailor] off,” he said.

Operating in less than ideal circumstances, Skoglund was forced to employ some unusual tactics to ensure the procedure was a success.

USS Union“Because we were using a spinal anesthetic, we had to make sure the ship rocked from side to side, rather than from bow to stern,” he said. “It worked pretty well.”

Later that year, Skoglund and his crew mates watched fighters bomb the beaches of Chu Lai, Vietnam, before the USS Union landed U.S. Marines on shore. Skoglund was among the officers who then helped build a 400-bed hospital on the beach.

A Career in Pediatrics

After his service in the U.S. Navy, Skoglund and his wife, Ardell (Augustana class of 1961), moved to Oakland, Calif., where he joined the pediatric department at Navy Hospital.

There, he says he saw an evolution of medicine.

“Early in my career, I saw how the art of medicine was practiced,” he said.

“Now, I see how the art and science of medicine is practiced.”

Over his career, he says he saw significant medical advances due to drugs, such as chemotherapy, penicillin, antibiotics and antivirals, and technology.

“In the past, leukemia was almost a certain death sentence,” Skoglund said.“With chemotherapy, it’s not anymore. Antibiotics and antivirals have saved lives along with hearing and sight. New vaccines eliminated our most common causes of meningitis. And today blue babies, those born with complex congenital heart conditions, are living long lives — long enough to complain about their chest scars.”

Later, as a member of the staff at Navy Teaching Hospital in San Diego, Calif., Skoglund watched as the pediatric medicine discipline underwent monumental changes — perhaps most significant, he said, was the development of specializations in cardiology, neurology, allergy, and other areas.

“Medical information was simply getting to be too extensive for a general medical person to know everything about all of these areas,” he said.

Skoglund elected to specialize in child neurology and spent three years training in neurology at the University of California in San Francisco. Following his training, he returned to Navy Hospital in San Diego in 1974.

At that time, he said, the “dark ages” of pediatric neurology were beginning to fade.

“In the 1970s and before, anticonvulsants were the only medications available to treat children with chronic seizures, which meant they were never able to attend school. When the new drug Tegretol became available, those children went to school within two weeks. Pharmacological advances were so significant,” he said.

“At the same time, social and legal attitudes were changing — children with conditions were accepted into society as disabled people and were granted equal rights. Mothers and fathers were relieved of this sense of ‘shame’ and were able to care for their children in a more open way.”

Skoglund recalled what it was like to diagnose a child with autism in the 1970s — decades before today’s understanding and treatment of the condition.

“You would diagnose a child with autism and the mother and father immediately felt guilty — like it was something they did to make this happen. That whole kind of process changed. We were able to tell parents, ‘This is not your fault.’ ‘We need to stomp on those feelings and get on with how to care for your child.’ Those kinds of changes occurred.”

During his career, he said he also saw pediatric neurology undergo what he called “miraculous changes” thanks to technology.

“I thought the CAT scan was one of the most amazing things I’d ever seen. Before that technology was available, in order to know if a child had a brain tumor, we had to do a pneumoencephalogram. That meant we had to take the child down to radiology, strap them down, and inject air into their spinal fluid. These children would be very sick in the hospital for two weeks just from the procedures. It was a very dangerous and painful process you had to go through and you would only pursue those procedures if you were highly suspicious. Today, you can order a CAT scan or MRI much earlier and, as a result, make a diagnosis much earlier.”

rayburn and ardell skoglundIn 1985, Skoglund retired from Navy Hospital and joined Rady Children’s Hospital in San Diego. Following some personal health issues, he began to phase out of medicine in 2007 and retired completely in 2009.

Today, he and his wife still reside in San Diego and spend time traveling. They revisited Chu Lai in 2012 and last year, in conjunction with the 50th anniversary of President Kennedy’s death, he visited the Texas School Book Depository (now a museum) in Dallas.

Despite being retired from medicine, he still follows the field closely and marvels at the advances he’s seen in just the last decade.

“I wish I could be around in 100 years because I really believe a visit to the doctor for schizophrenia, autism or a number of other conditions could go something like this: ‘Take one of these pills every three days and we’ll see you back in three months. Call me if you’re not better.’”

Because of his experience and perspective, Skoglund is also cautious, explaining that technology and pharmaceuticals cannot advance ahead of medicine’s true art, what he calls “bedside medicine.”

“Technology is so significant to what medicine is today,” Skoglund said. “We just need to be sure we’re also developing new techniques for the art of medicine to continue as well.”