Early in 1955, while working in the Vanderbilt Clinic, I received a telephone call from a Mr. Stephen Schwartz, a total stranger, who introduced himself as a friend of Dr. Marianne Wolff, a former medical student of mine who was an outstanding young attending on the surgical pathology staff of P&S. Dr. Wolff had suggested that he get in touch with me regarding an important innovation in medical education. He quickly came to the point, asking, “How would you like to teach 20,000 doctors in one evening on closed-circuit television?” I was a little staggered by this proposal but managed to blurt out, “Tell me more.” He proceeded to outline his plan, saying that he had major financial support for the project. What he had in mind was using the format of Grand Rounds with case presentations of live patients before a panel of renowned experts under the guidance of a seasoned clinician-moderator. To enhance the suspense, the panelists would have no prior knowledge of the actual diagnosis of the patients being presented. The aim was to demonstrate to an audience of doctors how world-renowned clinicians go about diagnosing and managing patients they are seeing for the first time.

In 1955 television was in its infancy and subject to considerable censorship. To preserve privacy of the patients and panelists and to avoid upsetting some viewers, closed-circuit television would be employed on channels unavailable to the public at large. Mr. Schwartz assured me that nothing would be spared in bringing together the very best men and women in the world of medicine. There would be a minimal or no sales pitch for pharmaceuticals but the sponsor would, of course, be credited with supporting the program. Approval had already been obtained from a number of organizations, including the AMA and specialty societies. Steve's next question was, “What topic would you select for the first Grand Rounds?. My answer was “The Acute Abdomen,” a title I felt would bring in doctors in droves because of its universal appeal and practical significance for most practicing physicians and surgeons. Steve's next question was, “How would you go about getting this done?” My first proposal was to start with an ambulance ride in response to an emergency call to the home of a patient with severe abdominal pain. Having made many of these calls by automobile in my early days of practice in the Bronx and Manhattan, before the 911 system was installed, I knew from personal experience what it was like to be called out in the middle of the night to see strangers in distress and to have to make important decisions without laboratory or x-ray help, quickly and without a committee to advise me on what to do.

As Steve and I kept talking, I agreed that it would be well-nigh impossible in 1955 to get a mobile television crew involved