[National Medical Audiovisual Center Production]

[in cooperation with The American Society of Tropical Medicine and Hygiene]

[Workers in Tropical Medicine]

[G. Robert Coatney, Ph.D., Sc.D., Retired, USPHS]

[September 1979]

[Interviewed by: Leon H. Schmidt, Ph.D., Sc.D., Retired]

[Southern Research Institute and University of Alabama Medical School]

Dr. Schmidt: Bob, yours has been a remarkable career; it's covered close to forty-five years of continuously active and productive scientific studies, primarily in the malarias. And these studies have ranged widely in scope, from very carefully tooled laboratory work, through controlled clinical trials, on into broad field studies.

In many ways, your career looks like the ring stage of a malaria parasite; it begins with a thin wisp of activity related to your brief academic career, a broad and long thread of activity involving all of your research works in malaria, and then terminating in a teaching academic position.

And locked together with this chromatin mass that we recognize as characterizing the focus of the signet [?] ring. How did all this work in, this parasite life work get its start?

Dr. Coatney: Well, it got its start down in southeast Nebraska in the town of Falls City, and I was the oldest of four children; and our parents held out that each child should do his best.

My father was a plumber, and his axiom was you either do it right or you don't do it at all. And mother held to the same thing.

Well, when I finished high school I went off to the [?] Baptist College. And I intended to stay there just about two years and then go to the University of Missouri School of Journalism, but I was lucky to run on to a most dynamic teacher, by the name of Dr. F. G. Mazur [?]. And he was into biology.

Well, it turned turned out that I forgot all about journalism, and decided to be a biologist. And in my senior year Dr. Mazur said, "Now, I've got everything arranged and I think you ought to go down to the University of Nebraska and get a master's degree."

And I was lucky enough to do that under Dr. Barker, a very famous parasitologist. Well, then, after teaching at the college there for a short while, I went to Iowa State, under Dr. Becker, for a Ph.D. degree.

And in being interviewed by Dr. Becker as to whether I could go study with him, he asked me what I'd like to do. And I told him I'd been doing a good deal of reading and I'd like to study the Haemoproteus infection in the pigeon. He said, "That's a good problem."

And so I thought everything was arranged, so I up and got married! And it was the smartest thing I ever did [chuckles] and Emma May and I have been in double harness ever since.

Well, there was a job opening at Nebraska Wesleyan University, and after I got the degree, I went there. It was a marvelous place to work, and the interesting thing about it was that Dr. Shirk [?], the chairman of the department, his idea was that you only taught for about ten percent of the class. He was interested in producing graduate students, medical students, dental students, and so on.

Well, as you remember, the stock market crash came in 1929. But the impact really didn't hit the midwest until 1932. And when it hit out there, the university was affected financially, and for five months we didn't get any money.

And we, uh, it was kind of tough. But a position opened up in the state teachers college, and I decided to take it. And, uh, because the state employees got paid.

And so I went there. Well, at that time, if you wanted to study malaria, for example, and the Haemoproteus infection is much like true malaria, you had to use the canary as the host animal. And the canary didn't give much blood. [Photo of Coatney as a young man]

So the idea was that if somebody could just find a bird that had malaria--a bigger bird--many of the problems would be solved. And so, when I went down to this school on the banks of the Missouri River, right in the middle of a fly-way, I said, "I'm going to see if I can find that parasite."

So I began studying the parasites of migratory birds, I trapped them, and so on, and also local birds.I found a lot of blood parasites all right, but during three and a half years, no malaria.

But during that time, I treated the blood infections of some of these birds and so on with the anti-malarial drugs then available. And lo and behold, in, I think, the latter part of the fourth year, luck hit me.

And I found a plasmodium, Plasmodium relictum that would grow in a pigeon, would grow in mourning doves, would grow in chickens.

Dr. Schmidt: As I recall, you found these parasitized birds right in the loft of one of the college buildings, not out in the fields where you might expect to find them...

Dr. Coatney: [laughs] That's right, that's right. I don't know why we hadn't looked there before, but we hadn't.

I wrote a short paper about this; thought I was real lucky to have found this, and Dr. Martin Young, who had recently joined the Public Health Service, after graduation from [Johns] Hopkins, read this paper. And told Dr. Williams about it.

Dr. Williams was head of malaria research for the Public Health Service, and Martin's boss. So Dr. Williams wrote to me and said, "Would you be kind enough to share that parasite with the Public Health Service?"

Well, I thought about thirty seconds about what I'd do about that. And I wrote him, and I said, Dr. Williams, here's the situation. I've searched for this parasite or one like it for about five years, and if the Public Health Service wants the parasite, they can have it. But they gotta take me too!

You see, I figured if this worked out all right, I could do full time research, maybe, for Dr. Williams, you see. And it worked!

Dr. Schmidt: Well, this is a very, very remarkable tale in a number of ways. As an interested party, I see that your bent for doing investigative work was very, very strong, because it was difficult in those days to carry on research in a small institution dedicated primarily to training undergraduates.

And yet you managed to pursue this work all the time. And you didn't mention one thing that I think, about your career, and you probably will agree, that had a great impact on your future work, and this was your interest in the mechanisms of relapse.

And you did... and also in the vector transmission of some of these Haemoproteuses. And this did have a very great impact on what you did later, sort of set the stage for a goodly number of your investigations in the human malarias, as well as the simian malarias.

But what did all this... you got an invitation to join the Public Health Service, you accepted the invitation, and what use did you make of it immediately?

Dr. Coatney: [chuckles]  Well, I reported to Dr. Williams in Washington, and he said your first station is going to be in a mental hospital in Columbia, South Carolina.

[Photo of South Carolina State Hospital, Columbia, S.C.]

Well, I didn't know if I was ready for a mental hospital [chuckles] but it turned out that the laboratory down there was named the Williams Malaria Research Laboratory, and so I went down there. Well, lo and behold, Martin Young was already working there.

Well, we hit it off immediately. And we've been friends and colleagues and so on ever since. So I immediately began to work on this what I called prize parasite that I had, in the pigeon. But I didn't lose any opportunity to learn all I could about human malaria. [Photo of Coatney with other staff at Williams Malaria Research Laboratory]

See, Martin was in charge of the human malarias being used for the treatment of central nervous system syphilis at the hospital. And so anytime that I could join him in some of his work, I would be able to learn something about human malaria.

And as it turned out, in the three years that I was there, I not only published papers on this pigeon parasite, but on, collaborated with Martin on studies on the reversal of the sporulation cycle and relapse, and so on, as you mentioned.

And relapse, of course, had been my chief interest with the Haemoproteus parasite. And, as it turned out, relapse followed me all through my career.

Dr. Schmidt: As I recall it, Bob, the parasite which was being used at the mental hospital was a strain of Plasmodium vivax called the St. Elizabeth strain, and you became very familiar with the characteristics of this strain, which stood you in excellent stead in your next assignment.

And my recollection is that your tenure at the mental hospital was brought to an end prematurely by the onset of World War II, and the decision of the Public Health Service to embark on a full-scale search for more effective anti-malarial drugs.

And this decision led to your drafting, your being drafted into the Public Health Service as a man in charge of the search for new anti-malarials. How did you happen to get anointed with that lofty appointment?

Dr. Coatney: [laughs] You can call it "anointed" if you want to -- I was down in South Carolina, as you mentioned, and it turned out that the Surgeon General of the Public Health Serivce was looking for somebody to run this testing program, screening program to find new anti-malarials. And it turned out that the only person in the Public Health Service who'd had any experience in experimental drugs--and that was not very much--was Bob Coatney.

I had done preliminary work when I was teaching, you know, out there in Nebraska. Well, as you say, I got shanghaied into Washington. Now I remember Martin saying one time, "If you'd stayed two more years here at the mental hospital, you'd be better equipped to go to work in Washington!" [both laugh]
But that was denied me, you see.

I went up there to take over the screening of compounds and at that time, by that time, the Department of Agriculture had relaxed their restrictions on bringing in from England Plasmodium gallinaceum, which was a parasite of chickens. And anybody could see why the Department of Agriculture didn't want the parasite, but we were at war, you see. [Photo of Coatney at desk in Washington.]

So the thing was to be set up using Plasmodium gallinaceum in young chicks. Well, the question was, how was this to be done, you see. And the medical officer who was in charge didn't like the way I wanted to do it, and we had a slight difference of opinion there.

Dr. Schmidt: You didn't like the way he wanted it to be done?

Dr. Coatney: That's right, I didn't like the way he wanted it to be done. [chuckles]

Dr. Schmidt: Because he had an idea.

Dr. Coatney: Yeah. Anyway, his idea was that if you take one bird, give it a single dose of drug, you see, the experimental drug, and you got the answer that way. And I just wouldn't buy it.

Well anyway, as it turned out, the medical officer went out to Kansas City or someplace by order, and I was placed in charge of this.

Dr. Schmidt: Well now you had a, at the time this program was envisioned, it was envisioned as, first of all, a grounded Public Health Service effort. Grounded in the sense of identifying more effective anti-malarial drugs than quinine, which was really the only drug of known activity that we had at that moment.

And there was a chemical group, a very well-organized group of chemists, that had been working on morphine analogs and antagonists, which was drafted into this program along with you, and there was also a pharmacologist there who had been testing these anti-narcotics, who was drafted into the program, and you formed a team, did  you not?

Dr. Coatney: We sure did.

Dr. Schmidt: Can you tell us a little bit about the composition of that team?

Dr. Coatney: The team was made up of Dr. [Lyndon F.] Small, who was head of the synthetic chemists, and Dr. [Erich] Mosettig worked with him, and then they had other people working with them, and Dr. [Nathan B.] Eddy was the pharmacologist. So when I got up there and was ready to set up the testing, they had compounds in hand, so to speak, that needed to be tested.

And so when I got the thing set up, re-set the testing procedure, enlarged the insectory, got a larger staff together, we began to screen these compounds to see whether they were effective or not against Plasmodium gallinaceum in the chick.

Dr. Schmidt: And you found a lot of them that were effective...

Dr. Coatney: That's right...

Dr. Schmidt: But their effectiveness didn't compare too favorably with quinines, and you, it was a long drought, really, before you hit on a truly impressive agent. And you did hit on a truly impressive agent, which was coded NIH 204.

And it was a goodie in terms of its superior activity against gallinaceum, but you then were faced with "What do I do with this? I've got something that's good, but I don't want to treat bird malarias, I want to treat human malarias -- how do I get them tested?" How did you cope with this issue, Bob?

Dr. Coatney: Well, that was the problem, as you say. Now, I knew that the St. Elizabeth strain of malaria was being used at St. Elizabeths Hospital in Washington to treat people with central nervous system syphilis.

And I also knew that the Public Health Service was welcome at this installation, and I figured, well now, if we could just try one or two or three of these compounds, to see if we could terminate the disease after the requisite number of paroxysms in the patient, we'd get some test of whether these were effective or not.

But I didn't have a medical officer. Well, I couldn't test, I couldn't do this, and all the other things I had to do. Anyway...

Dr. Schmidt: You couldn't do it legally?

Dr. Coatney: I couldn't do it legally, that's right.  Dr. Sebold [?] told me one day, he was the chief, "You know there's a young man over at Hopkins, he's working for a master's degree, now because of the war, he wants to get into the Public Health Service -- and his name is Dr. Clark Cooper."

Dr. Schmidt: He was a physician?

Dr. Coatney: He was a physician, and a brilliant young fellow. He said, "How would you like to have him join you over here?" Well, one look at his CV convinced me that this guy ought to be real good. So he came. And he was a find, no doubt about it. We hit it off right away.

And we worked together very closely for eight years. Not only was he a good clinician, but he was a born lab man. So that the thing just worked beautifully. He took over the patients testing this new drug, 204, that you mentioned, and it was effective.

But it had some side effects that we'll call cosmetically unacceptable. But it was a good anti-malarial, you just couldn't use it.

Dr. Schmidt: Well, NIH 204 was followed by a whole series of compounds of similar chemical structure which were superior in activity to that agent, but I believe that most of them had some of the same limitations.

Dr. Coatney: Right.

Dr. Schmidt: But by the time you had reached that stage, where you felt that it might be necessary to turn in a different chemical direction than you had been following, the National Malaria Program, which had been organized by the Committee on Medical Research of the Office of Scientific Research and Development,

its activities had progressed to the place where many things were coming out of the pipeline, which were active against gallinaceum, more active than quinine.

Dr. Coatney: Right.

Dr. Schmidt: And so you were deluged, if I can use that word, with the problem of testing potentially, compounds that were potentially superior to quinine. And this kept you busy for quite some time, and did some other things too.

It sort of exhausted the supply of patients at St. Elizabeths; I shouldn't say "the supply"-- the roster of patients at St. Elizabeths, that were candidates for fever therapy, which was what malaria conferred.

Dr. Coatney: That's right.

Dr. Schmidt: And so you were really biting your fingers, trying to figure out, where do I find the wherewithal to continue the testing of these compounds. How did you meet this problem?

Dr. Coatney: Well, we didn't know how we were going to meet it, but Dr. Cooper and I were sitting in my office late one evening, and we had been joined by Dr. Dave Ruhe, a young physician that had just joined our staff. And we were saying, my goodness, what are we going to do?

And finally Dr. Ruhe turned to me and said, "Have you ever thought of using prisoner volunteers?" And I said, "My goodness gracious, I'd never thought of it, but I'm going to think about it now."

Dr. Schmidt: What do you mean prisoner volunteers, Bob?

Dr. Coatney: Prisoner volunteers.

Dr. Schmidt: You mean German prisoners?

Dr. Coatney: No, we're talking about our own prisoners, right in this country.

Dr. Schmidt: Oh.

Dr. Coatney: So, I called up and got an audience the next day down at the Bureau of Prisons, Dr. Marion King, who was the medical director, and I explained to him what the problem was, that the war was on, and we had to have a way of testing compounds in people.

And it all, what had happened at St. Elizabeths and the trials that we'd made in Columbia, South Carolina with the patients down there. And he thought about this a little bit and he said, "You know, I think the prisons ought to get in to this. We ought to embrace this thing. But I can't give an okay until the director gives, I mean he's the one, the final thing." So, we went to see the director.

Now one of the happy things about going to see Mr. Bennett, the director, was that his daughter was working for me at the time in the lab.

Dr. Schmidt: This didn't constitute conflict of interest?

Dr. Coatney: [laughs] Well, anyway, Mr. Bennett listened to the story of what we wanted to do. And he was kind of taken aback by this, no one had ever proposed such a thing. And finally he said to Dr. King, "Marion, what do you think of this?" And Dr. King says, "Well if Dr. Coatney's going to run it, I'm for it."

Well, Mr. Bennett says, "Well, okay. Where do you want to do it?" And I said, "In Atlanta." "Oh my goodness," he says, "That's a tough place down there" and he says, "You know that's not a minimum custody prison."

Well, I said, "Sir, I don't know anything about prisons, but I'd like to have the project there, because then we can get cooperation from Martin Young over in Columbia, as far as supplying us with the mosquitoes, Dr. Jeffrey, another Public Health Service officer over at Millersville, and this is really the place to do it."

Well, he says, "You know, we've got Mr. Sanford, the warden, to deal with."  Well and he decided he'd better not send Dr. King and me down there without, and so right off the bat, so he called the warden and told him that we were coming down there, but that he, Mr. Bennett, had okayed this project, which we would explain to him.

Well, when we got down to Atlanta, Mr. Sanford, he didn't go for this at all. Because he knew, right away, that this was going to take people away from a very important project that he had going at the prison, you see, which were prison industries. In other words, he was making mattresses.

Dr. Schmidt: He was helping to pay the way of the prison.

Dr. Coatney: That's right.

Dr. Schmidt: And he didn't want to look as though he was neglecting his contribution.

Dr. Coatney: That's right, about two million dollars a year. Well, I explained to Mr. Sanford that, by jimmy, the war was on, and what was two million dollars?

Well, anyway, he finally agreed. And he said, well, in a few days, I'll call the inmates together, prisoners, I guess he called them. And I'll tell them that I'm in favor of this, and then turn it over to you, to tell them what you want to do.

Well, when he, Dr. King and I went back to Washington, and he notified us when he wanted to do this. So I took Dr. Ruhe with me and we went down there.

I got up on the platform with the warden, and the men began to come in, about two thousand of them into this enormous auditorium.

And there was a catwalk up there, with men up there with rifles, you know, and here I am sitting up here with this 250 pound warden, scared half to death.

And so the warden gets up and makes  his little speech, and then says, "All right, it's yours." So I got up and explained to the men what we needed.

We had to have volunteers to do this, and that they'd have to be of military age, they'd have to be in good physical condition, and if they signed up for this kind of thing, they had to sign up for six months, to stay with us for six months.

And at the end of that time, we'd give them fifty dollars in money, and a certificate signed by the Surgeon General, certifying that they'd taken part in this thing, you see.

And then I closed the meeting by saying, now any of you people who would like to take part in this, and I hope a number of you will because we'd like to get on with this, just meet me down in front, if you will please.

Dr. Schmidt:  I don't imagine that you glossed over the fact when you explained this to them that they just might be slightly ill if the drug that they were taking turned out to be less than effective.

Dr. Coatney: I did, I should've mentioned that. I told them that some of them would be so sick they'd wish they'd never seen, ever heard of us, much less seen us. And others of them wouldn't.

But if that came about, no matter what came about, that that gentleman standing right over there--and Dr. Ruhe stood  up--was going to take care of all your medical problems. And I mean ALL, anything that you need medically, Dr. Ruhe is going to give you, you see.

And, so when I stepped down, these people came over just like a wave! I was really surprised. One of these fellows came up to me and he says, "Doc, I want to ask you a straightforward question." I said, "Well, okay."  He said, "Did you really mean what you said, that that man over there is going to take care of all our medical problems?"

And I said, "That's exactly what I said. And that's exactly the way it's going to be, if any of you sign up to do this."  He just turned around to this gang, and said, "Come on boys, let's go!"

Dr. Schmidt: When was this, Bob?

Dr. Coatney: This was late in 1943, you see, and the war was really going. Well, it so happened, that we never had to ask for a volunteer, any volunteers, again, in all the years that we...

Dr. Schmidt: How many volunteers did you have in the Atlanta facility altogether, in both, you had two spates of activity...

Dr. Coatney: Yes, well something over a thousand took part in this.

Dr. Schmidt: And before we talk about the accomplishments, I guess we ought to take note of the fact that you did exhaust the reservoir of candidates for volunteer service at Atlanta, and had to go to another federal facility.

Dr. Coatney: [Nods] That's true.

Dr. Schmidt: This one was down at Seagoville, Texas, so that you operated first in Atlanta, then in Seagoville, and then back in Atlanta again.

Dr. Coatney: Later back in Atlanta, that's right.

Dr. Schmidt: Tell us something about the sort of accomplishments that came from this rather remarkable effort.

Dr. Coatney: Well, what happened was, you see, we were given a whole wing at the hospital, and we set out immediately to do a in-depth study of the St. Elizabeth strain of vivax malaria, because that had to be the test parasite, you see.

We also did a very critical study of quinine, which was to be the test drug, against which all the other drugs were tested. And then we began testing these what we'll call potential anti-malarial compounds.

And out of, I only have time to tell you about one of them, or two, became chloroquine. And that drug, as you well know, is now the drug of choice the world over.

Dr. Schmidt: It probably had one of the most, the longest lives of any chemotherapeutic agent, which is, even though resistance to chloroquine is certainly a problem, it nonetheless hasn't been the same dimension of problem as resistance to many of the antibacterials like the sulfonamides and the penicillins and the tetracyclines, and so on, that you could think of.

It's really a remarkable agent; but it was effective only against the erythrocytic forms of the parasite, and there was still another problem involved in getting [?] of vivax malarias. What was your approach to that problem?

Dr. Coatney: Well, one of the other drugs was pamaquine. And I heard you say one time that pamaquine was pretty effective if the patient could stand it [laughs]

Dr. Schmidt: That's an impression that I think can be supported.

Dr. Coatney: That's right -- but it was a clue--it was a clue that you later exploited yourself, you see. But I think that here someplace along I ought to tell you that we started this thing on St. Patrick's Day. We infected the first patients in that prison in Atlanta on St. Patrick's Day 1944. They were infected by a mosquito bite, you see.

Now then, the results then came from the participation by the inmates, and Martin Young and his group supplying mosquitoes for this thing, and then the staff that we had in residence there, you see. It was just going phenomenally.

Dr. Schmidt: Well it went beautifully, and so did the work down at Seagoville, and we'll come back to the second range of activities in Atlanta a little bit later.

As I see it, Bob, the major things you did at these facilities were, first to document the characteristics of the St. Elizabeth's strain; work out the activities of chloroquine and other 4-aminoquinolines so that you could determine which one was the better.

Dr. Coatney: That's right

Dr. Schmidt: And settle on that one so that we could adopt it for use in our troops, and also for civilian purposes. And then to demonstrate that the 8-aminoquinolines did really have a different type of activity than compounds like chloroquine and quinine. Namely that they eradicated what came to be known as the underlying tissue phases.

Now, you haven't said anything at all about whether this had a good impact or a bad impact on the attitudes of the prisoners. You did say, that, indirectly, something that applies to this, and that was that you never had to ask for volunteers after your first request.

But can you think of any instances where there was rather an unusual response of a prisoner to his participation in this program?

Dr. Coatney:  Well, this is an interesting thing, you see. The fact that these people took part in this thing was interesting for the fact that nothing like this had been tried since Goldberger in 1915 had worked with pellagra.

And anyway, these people were true volunteers, they were proud of the fact that they were volunteers, and most of them, well almost all of them, were real happy to receive this certificate signed by the Surgeon General.

Well, and also, the interesting thing was, that many times, when a man had served his time, say, for six months with us, he got five days off of his sentence for every month that he served.

But when he was handed the fifty dollars, which of course was not much money, but it was more than it is now, he'd say, "I don't want it -- give it to the Red Cross, or give it to the children's fund, or something."

But probably the most dramatic thing that I could tell you was what happened one time when we were giving out these certificates.

I'd been passing these out, and I'd forgotten what the man's name was, his name was called and he stood up, and took a step or so toward me, and said, "May I say something?" And I said, "Well, of course." I had no idea what was going to come, you see. [Photo of Coatney shaking hands with prisoner]

He said, "I'd like to ask you if you could please send that certificate to my mother."  He said, "I don't even want to touch it. It's the only decent thing I ever did."  Well, you can rest assured that his mother got that certificate.

Dr. Schmidt: That's a pretty impressive event, I would think. Although others probably didn't say it in the same way, they felt that they had done something a little bit unusual for the country.

Dr. Coatney: And they had!

Dr. Schmidt: They might be in jail for very good reasons, but they still had enough interest in their country to want to serve. And many of them served after the war was over, doing something for less fortunate people.

Dr. Coatney: That's right.

Dr. Schmidt: It's an interesting commentary on the attitudes of the prisoners.

Dr. Coatney: I think in my case, it was a privilege to work with them, that's the way I look at it.

Dr. Schmidt: Something good in all of them.

Dr. Coatney: That's right!

Dr. Schmidt: Well, as I recall, along about 1950, you and others had given evidence of too much success in the conquest of malaria, and it was decided by powers in being, or higher powers than those in your facility, that it would be well to turn the attention of those who were engaged in studies of malaria chemotherapy into other areas in medicine that were in greater need of attention, or needed greater attention.

And one of these areas was the common cold, and it was suggested that you get to work on the common cold, a suggestion that I believe you rejected very quickly.

Dr. Coatney: [laughs]

Dr. Schmidt: And instead of working on the common cold, you took a vacation, a well-earned vacation with the family out to the west coast. But before you could get settled in anyplace there, I think something else happened that brought you back to the malaria. And that's an interesting story.

Dr. Coatney: Well, I had closed that Seagoville facility, you know, in 1950, and as you say, I took the family and we went to the west coast. And while we were out there in Yellowstone Park, we got over the car radio that Mr. Truman had sent American forces into Korea. This is that famous police action of his, you know.

Well, I said to Emma [?] May, look, honey, we'll just as well get in the car and start home, because I'm back in malaria again. And, how true it was!

The patients that were being sent home, surgical patients, sent home to Walter Reed [Hospital] and other places, by the end of December, the first of January, were coming down with malaria.

Dr. Schmidt: Now these men had not had any anti-malarial therapy there.

Dr. Coatney: They were supposed to have.

Dr. Schmidt: They were supposed to have.

Dr. Coatney: They were supposed to have, but -- and while they were there, you see, they'd been given chloroquine, and chloroquine, of course, suppressed the disease.

But here was this long latent period with the St. Elizabeth's strain.

Dr. Schmidt: All over again...

Dr. Coatney: All over again [chuckles]. And that's why the malaria showed up, which said again, we've got to have a drug, you see, that will actually eradicate the infection.

Chloroquine suppressed it, and chloroquine would treat the primary infection all right, you see.

Dr. Schmidt: Well now, the stage was set for that drug, just shortly before the Korean War broke out, with the demonstration, in very small-scale studies at the University of Chicago facility.

Dr. Coatney:  Right.

Dr. Schmidt:  And of the activity of a compound called Primaquine, which probably was about four times as active and one-fourth as toxic as Pamaquine. Which gave it a margin of safety of [?] sixteen, which made the difference between being a usable drug and one that the patient would prefer that you not use.

And you were brought back to the program originally, I think, to the malaria activities originally, to find out whether Primaquine was really effective on a large scale, because there were a minuscule number of patients--four, six--who had ever received that drug.

Dr. Coatney: That's right.

Dr. Schmidt: And this was putting an awful lot of weight on a small amount of evidence. Well, how did you get back into it, Bob? You'd dissolved your staff, you'd gone on to other things. How did you get back into it?

Dr. Coatney: Well, I got back into in because I had to.  And one thing sure, I wasn't going to study the common cold!

And in a way, the malaria problem was still there, so I had to collect a new staff, I had to re-equip the hospital facilities and everything, you see. And I had to alert all the folks who were going to produce mosquitoes. But that was easy.

The one thing that was lacking was the right medical officer, you see. And I wondered, where in the world am I going to get somebody to do that?

You see, I was spoiled with Cooper. There wasn't anybody like him.

And "where can I find that?" So I decided that, even though I didn't think it was quite fair, I was going to call up Clark and ask if he'd come and help us for a few months, to get that thing under way again.

Well, at that time, you see, he was chief of medicine at our hospital out in San Francisco. And when I called him, he said "Oh my goodness -- you're back in again." And I said, "Yeah, and I need you, boy, I really do!"

Well, he said, "Well, I think I'd have to talk this over with Ethel," And I said, "I'm sure you'll have to talk it over with Ethel."  And I didn't know how she was going to think about this thing, you see. He said, "I'll call you back in three hours."

Well, in three hours, he called me. He says, "I'll do it for you. I'll come." And he did. And he stayed with us, as I recall, about five months.

Dr. Schmidt: He set up the facilities in Atlanta again.

Dr. Coatney: He set up the facilities in Atlanta again, and held forth until Dr. [A. V.] Myatt was able to take over.

But here, as you mentioned, here we wanted to go get right into this Primaquine business. Now, you're not going to say this, but I can tell you, that you were one of the prime movers in this thing, you know.

You set up the dosage and everything, and it turns out that the dosage you suggested from your studies in monkeys were the very doses that we used in man. And the one that became the dosage even used today.

But the question was how do we get enough data on this thing to make it worthwhile to try it on a big scale, you see.

And there, then, here's what happened. It came about so dramatically, so to speak.

We succeeded in proving to the satisfaction of most everybody that Primaquine really ought to be tried on a big scale. And so the Army, we reported this to the Army, the Army issued an order that said "All soldiers returning from Korea will be given Primaquine, single dose daily, fifteen milligrams, every day while they're on board ship."

Well you see, we had all figured out that fourteen days was the effective time, you see. And the good Lord at that time made the crossing just fourteen days.

So, as people came back from Korea, they got Primaquine. But the Navy, when they read that order, say[ing] "all soldiers returning from Korea", they had a boatload of Marines that were coming back

Dr. Schmidt: They were sailors [laughs]

Dr. Coatney: [laughs] They weren't soldiers according to the Navy, so they didn't give them Primaquine. Well, no one knew about this, you know, no one thought anything about it, but we had predicted that the seed rate in the Korean soldiers was probably about 20 percent. But we didn't know for sure.

So these Marines came back and were sent to Camp Lejeune over in Carolina, you see, and lo and behold, they began to come down with malaria.

Now these people that'd received Primaquine, these soldiers, you see, they didn't come down, they didn't get sick. But these guys began to come down.

Dr. Schmidt: As I remember, this was a pretty impressive trial, size-wise, Bob, there were about 280,000 soldiers that were returned via ship, who received somewhere between 11 and 14 days of Primaquine. And the relapse rate was almost zero, or the attack rate was almost zero.

Dr. Coatney: That's right.

Dr. Schmidt: And compare that with your 19-plus percent in the Marines, and this was a very significant accomplishment. Well, today, this is a standard way of controlling relapsing vivax malaria.

Dr. Coatney: Curing it!

Dr. Schmidt: Curing it.

Dr. Coatney: That's right. The point is, that the Navy, bless their hearts, performed the experiment that we needed. It was very embarrassing for the Navy at the time being, that they had failed to follow through, you see.

But nevertheless, it was great in the long run.

Dr. Schmidt: Well now, when that job was done, almost by the time that you'd established the efficacy of Primaquine, there was a new drug called pyrimethamine that came along.

It turned out to be a magnificently active drug fraught with one liability: it was very very easy to develop resistant strains, pyrimethamine-resistant strains, and this really destroyed the usefulness of the compound.

Dr. Coatney: That's right, it surely did.

Dr. Schmidt: For the treatment of active infections. And then you went on from that magnificent work to what was a near-miss. The ideal, I think, that you and many malariologists have had, is a drug, in terms of drugs, is a drug that could be given once every six months, and would provide protection. And can you tell us a little bit about this near-miss?

Dr. Coatney: Well, yeah, here you go, this goes back to Paul Russell and other malariologists, and all of us had to, we've got to find a drug that will, that we can inject and it will hold for a long time.

And since we were working with Parke Davis and other drug companies, you see, every time I went up to Parke Davis, I'd ding at 'em, "Why don't you guys set aside some money and try to find a drug that can be injected that will hold for a long time?"

And this went on just like this, you see [hits table with fist]

Well, it turns out that, to make a long story short, that that's exactly what they did. And lo and behold, Paul Thompson was the one that tested it up there, and we learned about it and we got the doggone drug.

Now, the whole thing was, here, we had to put this into [humans], in other words Paul had tried it in monkeys and what not. We put it in, and lo and behold, a single injection of that drug, you see, would hold for 32, 35, 36 months!

Dr. Schmidt: I think it's important to point out that it would hold against infections with drug-susceptible strains.

Dr. Coatney: That's right

Dr. Schmidt: Because you then proceeded to try to exploit this finding in the field.

Dr. Coatney: That's right

Dr. Schmidt: And what happened there?

Dr. Coatney:  [Chuckles] Well, no matter how good a drug you find, there's always something wrong with it [laughs] Even with aspirin, there's something wrong with it.

Yes, we went to the field with the drug. Dr. [Peter G.] Contacos and I went to Pakistan, for example. But we ran into this business of, at the point of injection, you see, there were some difficulties.

And this, well, in the end, we had to give up. Although we had a drug that was just great. And if the right person gave it, in other words, as long as Dr. Contacos did it, you see, or somebody trained like him, you didn't get any local reaction.

But you give it to the ordinary fellow, you see, and he'd just jam this thing in, and you'd have trouble.

Dr. Schmidt: Well, everything was moving along very smoothly, not smoothly in this area, but this was certainly not the end-all as far as attempts to get long-lasting compounds.

But something happened in 19 hundred and 61 [1961], I believe it was, that turned your attention from working on human malarias in humans to simian malarias in humans.

Can you run down very briefly, Bob, what these events were?

Dr. Coatney: Well, you see, it seemed like there was something just over the horizon all the time, and we wanted to know, we knew about these EE [?] [possibly abbreviation for "exo-erythrocytic"] bodies in malaria, and Dr. [D. E.] Eyles who was in charge of our Memphis laboratory, and I decided we'd give Primaquine and some other drugs to see if we could knock out these EE [?] stages in monkeys, using monkey malaria as a test malaria.

Well now, Don was a confirmed cigar smoker, and he'd take a big drag on the cigar, and then he'd blow it into these containers with the mosquitoes, and that'd knock them down. And he'd pull them out and begin pulling legs and wings off, and sometimes he wasn't fast enough and some of the mosquitoes flew away.

But Don didn't matter, he didn't pay attention to that because it was monkey malaria, and people didn't get monkey malaria. Or so we thought.

But lo and behold, he came down with monkey malaria. And he proved this very quickly by taking some blood, taking some of his own blood, and putting it into a clean monkey,  and sent some of it over to Atlanta, and Dr. Contacos put it into prisoner volunteers, and lo and behold, it came down.

Dr. Schmidt: Well, this was the beginning of another great adventure, and maybe you'll let me sort of bring the points together about it, Bob. This led to an intensive study of the monkey malarias in the areas from which this monkey had come that originally given rise to the particular strain of [?] with which Eyles was infected.

And you sent Eyles out there along with Dr. Warren to work on this problem, and this was one of the most amazing, you went out too, but this was one of the most amazingly productive portions of your career.

And it all occurred in a period of about five years.

Dr. Coatney: Or less

Dr. Schmidt:  Yes, and in that period of time, why, I think they described at least five new species of malaria, identified some 20 anopheline vectors that could transmit these, fortuitously found that there was a possibility of a zoonosis, but not a great possibility of the monkey malarias serving as a zoonosis.

And then, I think, lastly demonstrating that a significant variety of these species, some five, not including all the new ones that you obtained in malaria, would infect man.  This was quite an accomplishment. This brought  your career in the Public Health Service to an end.

But before we conclude, and brought it to an end really in 1966 because somebody with not altogether... endowed with all his wits, decided you had to retire. [both chuckle]

And before we leave that part, how did you succeed in attracting all of these elegant workers, and superior workers, to your team? You had a whole roster of them that anybody would have been glad to have had as associates. How did you collect them all?

Dr. Coatney: I don't know -- I was just lucky. I was just lucky, that's all. Guys like Cooper, and Martin Young, and Jeffrey and Contacos, I don't want to name them all because I know I'll leave some out. But they were just outstanding folks who believed in a team effort. And to my way of thinking, that's the way to do this kind of thing.

It's a team effort from start to finish, and I think it pays off.

Dr. Schmidt: Yes, I'm sure it does. Now you left out one thing that impresses somebody who looks over your whole career, and has thought of it very carefully, like a old forty year plan. This is that at the same time that you had all these clinical investigations going on you had a group of laboratories which were involved in basic studies.

And I can think of some wonderful people who contributed, like Howard Bond and John Sherman in the drug metabolism mode of action area, Joe Greenberg, who really started your, all the work on synergy between anti-malarial drugs.

Dr. Coatney: Sure did!

Dr. Schmidt: And dear Dr. Joe Held who developed a simple and elegant technique for identifying malarial exo-stages readily in the liver. And this really made it possible for you to describe all these things.

Okay, this is a wonderful group of people to have been associated with, and I'm sure that the privilege was mutual, that they thought it was wonderful to be associated with you.

Now, you went to Tulane, and Louisiana State University, wrapped up part of your career in the teaching area again. And then before you quit, you returned to a love that I think you'd had before you left the Public Health Service, namely the development of this monograph.

[Photo of book titled "The Primate Malarias"]

on primate malarias, which ties a tremendous lot of the information that you'd acquired over your life together. Tell us just a little bit what your intent was in this.

Dr. Coatney: Well,  you see, Dr. Warren and I had decided in 1965 that we'd like to bring all these primate malarias together. And the main thing was, we were dissatisfied with the plates that had been made up to that time. And so we wanted, we hoped we could produce the best plates that'd ever been produced.

But to do that, we had to have all the material, it had to be our own, it had to be stained only by us.

Dr. Schmidt: Similar staining qualities?

Dr. Coatney: Yes, similar staining qualities, and time, and everything. And, also, the illustrations had to be done by a single artist, that would be supervised either by me or by Dr. Warren.

Then the text was the next thing. And the text had to be concise and free-flowing, and so on. And we decided what the main points would be, you see, the history and the taxonomy, and so on.

And the point is that Dr. [William] Collins and Dr. Contacos joined with us, you see, and this was just great.

So, there you have it!

Dr. Schmidt: Well, you came out with a unique contribution, which I think, in the monograph, which really is sort of the tying together of all the ends of your little portions or big portions of your scientific career. And I think it's going to stand as a monumental contribution.

I think, Bob, that like all of us, we've had one person in our lives who usually goes unmentioned, who has made a major contribution to what we were able to do. And I'm thinking in your case, of Emma [?] May.

[Photo of Mrs. Coatney]

whose sympathetic understandings of what you had to do in order to satisfy your job, and her willingness to carry on throughout your absences, and your preoccupation with your work, really made it possible for you to do what you did.

Dr. Coatney: No doubt about that!

Dr. Schmidt:  I'd like to simply conclude, Bob, by mentioning the fact that the importance of your contributions have been broadly, importance has been broadly recognized.

As indicated by the fact that you've been awarded two honorary degrees, three distinguished service medals, and the presidency of the American Society of Tropical Medicine and Hygiene.

I think that all of us, including those who know you closely, have to be grateful to you for preparing and sharing this chronicle, because it's a unique one. And it may be some time before the activities on which it is based are matched by anyone.

Dr. Coatney: Well, you're very kind.

[G. Robert Coatney, Ph.D., Sc.D., Retired, USPHS]

[Interviewed by Leon H. Schmidt, Ph.D., Sc.D.]

[Retired, Southern Research Institute and Univ. of Alabama Medical School]

[A National Medical Audiovisual Center Production]

[in cooperation with The American Society of Tropical Mecicine and Hygiene]

[Workers in Tropical Medicine]