UNIVERSITY OF WISCONSIN-MADISON ARCHIVES
ORAL HISTORY PROGRAM

Interview #1070
RIESELBACH, RICHARD

RIESELBACH, RICHARD (1933-)
Professor Emeritus of Medicine
At UW: 1965-

Interviewed: 	2009 (1 session)
Interviewer: 	Anne Peckham
Index by: 	Stephen A. Pierce
Length: 	49 minutes

Abstract: In his December 2009 interview with Anne Peckham, Dr. Richard Rieselbach overviews his career as a clinician and researcher at the University of Wisconsin-Madison School of Medicine and Public Health. Concentrating especially on the decades from the 1960s to the 1990s, he discusses major contributions to transplant nephrology, through the creation of a kidney transplant program at UW, and an emphasis on urban and community health care through the Milwaukee Clinical Campus that operated during the 1970s and 1980s.  This interview was conducted for inclusion into the UW-Madison Oral History Program.

Key Words: Milwaukee WI; University of Wisconsin-Madison; Harvard University; National Institutes for Health (NIH); Washington University at St. Louis; transplant nephrology; Fritz Bach; Mt. Sinai Hospital; Medical College of Wisconsin; Pat Lucey; Milwaukee Clinical Campus; Health Professional Education Program (HPEP).

First Interview Session (December 18, 2009): Digital File

Time	Keywords
00:00:00	Start of Interview/Interviewer’s Introduction

00:00:18	Question: Your background. Answer: Rieselbach was born in 1933 in Milwaukee WI. He quipped that his mother was clever about subliminally influencing him to go into medicine by slipping books into his experience that encouraged this path.

00:01:50	[no question] He discussed going to Milwaukee University School for HS, where he met science teacher Wm. Leaker, who stimulated his growing interest in biology and encouraged him to go to UW so that he could get a GPA that would ensure his entrance to medical school.

00:02:55	[no question] After 3 years of undergraduate training, he “sailed into” medical school, which he found to be challenging but left something to be desired. So he transferred to Harvard by way of its summer school program, a path he later suggested to others. Suggesting that moving to Harvard was the best decision he ever made, he recounted how he was tremendously stimulated by his Harvard classes and attending physician at Boston City Hospital, who spurred his interested in nephrology.

00:06:00	[no question] He discussed his research at the NIH Cancer Institute residency (initially prompted by a friend from his University of Illinois-Chicago residency)> While at NIH, he did research on acute leukemia, especially on kidney complications. This research later led to his editorship of an influential textbook and a ground-breaking treatment for meningeal leukemia involving introducing folic acid antagonists directly into the spinal fluid—this drastically increased the cure rate for children with leukemia.

00:08:10	[no question] After his NIH research, he said, he became a fellow at Washington University at St. Louis, where he helped develop the “intact nephron hypothesis” and also helped develop the kidney transplant program.

00:10:24	[no question] After his training at Washington University, he joined the faculty at UW, where he was attracted by the forthright manner of chairman Bob Schilling and where he wanted to develop a kidney transplant program. He discussed the good fortune of joining at the same time as Fritz Bach, an immunologist who had deve-loped tests for the suitability of donors for kidney transplants, and William Kisken, who was studying the genetics of transplantation. He talked about choosing siblings for many of the transplants at UW and the great long-term success of the program.

00:13:22	[no question] He discussed the transplant nephrology program at UW, including its inter-disciplinary nature, its project grants, and extensive staff.

00:14:11	[no question] After being the head of the nephrology group at UW, he became interested in helping students train in urban medicine, which had been previously impossible because of a lack of infrastructure in Milwaukee. But the administration recognized that this was a “marked deficit,” and encouraged him to review options for an inner-city program in Milwaukee in medicine and OB/GYN. This led to a relationship with Mt. Sinai Hospital in Milwaukee.

00:17:23	[no question] While new dean Robert Cook was on board with developing a relation-ship with Mt. Sinai Hospital in Milwaukee, he explained the political difficulties, primarily opposition from Medical College of Wisconsin, which contended that UW would generate competing and unneeded programs. Gov. Pat Lucey got involved in the debate, and eventually the legislature approved the affiliation with some compromise with MCW.

00:20:15	[no question] He explained setting up the affiliation program with Mt. Sinai, discussing staff they hired to serve at the hospital and the growing contingent of students who wanted to work in units there. By 1979, they were able to implement a research program there and they quickly became known as a well-recognized urban medicine program.

00:24:18	[no question] While the Milwaukee program continued to grow, he observed that in the mid-1980s, the “financial stormclouds began to gather.” This especially involved managed care for OB patients in Milwaukee, which suffered from disadvantageous financial arrangements that had been made earlier. He and others found that their only recourse was to approach St. Luke’s Hospital to merge Mt. Sinai with Samaritan Hospital. St. Luke’s was impressed with UW’s program and an affiliation agreement was made.

00:29:50	[no question] He observed that the St. Luke’s affiliation agreement went well until the late-1980s, when the financial situation became even more difficult and it became clear that the Mt. Sinai financial arrangements would have to change. They then developed HPEP (Health Professional Education Program), a cooperative program with UW-Milwaukee’s schools of nursing and social work. But while this situation seemed promising, political considerations unraveled the plan and it became clear that UW’s Milwaukee Clinical Campus wouldn’t survive in its current form

00:32:42	[no question] He explained what happened to the Milwaukee Clinical Campus in the 1990s, when most of the clinicians went into private practice, clinics began developing in Milwaukee, and it began to appear that the original goal of training students in inner-city medicine could be fulfilled. The concept of a permanent location for students to spend their last 2 years of training in Milwaukee (called TRIUMP—Training in Urban Medicine and Public Health) generated widespread interest from students.

00:36:38	Question: Doctors who have left the program? Answer: He explained how many of these doctors continued to be involved in clinical practice and training, such that UW still continued to have a strong presence there.

00:39:50	Question: Are you still involved? Answer: No; he discussed what he did after Milwaukee, including his work as a staff member in Washington DC in the mid-1980s. They talked about current medical reforms in Washington.

00:42:10	Question: Marriage and family? Answer: He talked about getting married, going to Boston with his wife, and quipped about his wife having their first child while he was delivering a baby at the other end of the hall.

00:43:10	Question: The future? Answer: He reflected on what he thought was the future of Milwaukee and other urban campuses, observing that delivering primary care for newly covered patients would be an important element of health care reform. Thus he’d proposed that medical residents get a significant part of their training in community health centers, where lower-income patients often went for care.

00:48:53	End of First Interview Session

End of Oral History #1070