AAGL The Founding Years

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Dr. Louis Keith: “Jordan, here we are. Can you believe it?”

Dr. Jordan Phillips: “No, I don’t believe it at all.”

Dr. Louis Keith: “No, it’s certainly a far cry from the day we started all of this.”

Dr. Jordan Phillips: “Twenty-nine years have gone by so quickly.”

Dr. Louis Keith: “The younger members of the AAGL don’t realize where we came from so perhaps you could tell them by means of this interview what your vision was and how you started to activate it because I came in at the very beginning but after it had already been started.”

Dr. Jordan Phillips: “I started doing laparoscopy after seeing Melvin Cohen’s first pictures that he took after visiting Dr. Raoul Palmer, and I was so intrigued with direct vision of the pelvis that I thought it had immediate application that would be successful. I then started to do laparoscopy and in doing so I searched the literature and I was able to get through the Library of Congress from MEDLINE every article written in every language on endoscopy at that time. There were at that time only 263 citations. From these citations I selected thirty-three names and I received all the papers so I had every paper written that was published at that time. I then took those papers and read them and I selected thirty-three from the group that I thought were most important. I sent personal letters to all thirty-three authors telling them that I was interested in forming an association so that we could actually exchange information. Of the thirty-three, I received positive replies from thirty-one, when that large of a percentage answered immediately, I knew that we had something that was viable. I then wrote back to the same individuals telling them that we should get together and actually exchange information. I assigned each one of these people a speaking spot so that they could actually be on a program. I selected the paper that they had already written so I knew that it was comfortable for them to present material that they had already published. We held the first meeting at that time in 1972 in Las Vegas at the Stardust Hotel, and we did not know how many people would come. We had no idea of the attendance or the participation. We distributed this program throughout the ACOG mailing list and we were able to fill the entire hotel. We had well over one thousand people come to attend our first meeting. The following meeting we had after the first international program in Las Vegas was in New Orleans but before that we got together and formed the AAGL as far as it having a scope of membership.”

Dr. Louis Keith: “Yes, that’s where I came in because I was one of the people who was invited to the meeting in Las Vegas. Jordan later told me that the invitation came based upon my presentation at the New York meeting of FIGO in which I spoke on forty-four patients who had had puerperal laparoscopy for sterilization. At that time, if you can believe it, one was an expert with forty-four cases. By the time I went to Las Vegas I had a larger group of patients but I was one of the individuals that you then contacted to meet with you, Richard Soderstrom from Seattle, and Jacques Rioux from Canada. You invited us to a weekend meeting in New Orleans, and we stayed at the Marriott of all places. The story has been told over and over again and people don’t believe it but Rioux, Soderstrom, and Keith all got unto the same elevator and realized that they were going to the suite of Dr. Jordan Phillips; when we arrived, none of us had every met him. We were shown into a nice comfortable area, we sat down wherever on the couches, and as the day progressed we kept the same places. That meeting was critical because Jordan explained to us his concept of how this organization would run, and there was a very interesting initial growth period. He suggested and had bylaws formed that the initial officers would remain in office for the first five years before changing anything so as to put the organization on the map. The distribution of the offices was such that you were President and Chairman of the Board of Trustees, the next person was Richard Soderstrom - based upon where we were sitting - then we went over to Jacques Rioux and then I became the Secretary/Treasurer so that’s how it all started but when we were doing this we really couldn’t imagine the AAGL being what it was. We planned the next meeting which was in New Orleans, and that’s where the story takes place but by that time we realized there was a lot of opposition. The opposition came from the academic organizations who in essence said, ‘Who needs laparoscopy and who needs you guys to run it’ because we were all young. I won’t speak about Jordan’s age but mine was thirty-five and it was incredible that a guy who was thirty-five should be an officer of an organization, which was dreaming to effect medicine in place of ACOG or any of the other things.”

Dr. Jordan Phillips: “Age was not a factor, it was a case of having skill and ability and experience, and you demonstrated that very vividly by your actually adapting the procedure very early and knowing the procedure - that’s why you became involved.” 

Dr. Louis Keith: “Okay, it may very well be but we had to fight off for the first, I don’t know how many, years all of the slings and arrows of the nay sayers who said there’s no need for laparoscopy and so on and so forth. I would say of the twenty-nine years this negativity persisted, perhaps, for ten maybe even fifteen years.”

Dr. Jordan Phillips: “It went on for a long time.”

Dr. Louis Keith: “But what made the organization of great interest to the practicing physician was the fact that we were able to pick up on every new innovation as it came out. When microsurgery came out, we put on the first program on microsurgery ever in the United States.”

Dr. Jordan Phillips: “In the world.”

Dr. Louis Keith: “In the world, when hysteroscopy was…”

Dr. Jordan Phillips: “We put on fifteen programs in microsurgery at the University of California at Irvine…”

Dr. Louis Keith: “Exactly.”

Dr. Jordan Phillips: “We had 200 people at each program so we actually had the maximum number that we could have limited by the number of microscopes that we had so we introduced microsurgery to over 3,000 physicians from around the world.”

Dr. Louis Keith: “Who then went and taught it at their own respective institutions and we picked up on a number of other things. I remember, even in 1975, people said hysteroscopy was an operation in search of a disease but the years have showed that that wasn’t the case, it became a science in itself.”

Dr. Jordan Phillips: “Yes, the AAGL put on the first World Congress on hysteroscopy with Dr. Hans Lindermann as a Chairman; Hans Lindemann is the modern father of hysteroscopy. He came to the United States, we put the first program on in Miami, and it was extremely well attended. Dr. Jacque also came from Paris and many other hysteroscopists from all over the world and so we actually pioneered this procedure also.”

Dr. Louis Keith: “The same could be said for IVF. No one had heard of IVF, and no one had heard of Patrick Steptoe except the members of the AAGL. Why?“

Dr. Jordan Phillips: “We had Dr. Patrick Steptoe as one of the first speakers at our very first program. He came and his first talk was on IVF and this was even before Louise Brown, before they had the first viable child.” 

Dr. Louis Keith: “But when that girl was born he brought the film of her delivery, the mother’s uterus, and the circumstances that required the IVF and showed it first to the AAGL.”

Dr. Jordan Phillips: “We were the first ones to see it and he had, in fact, the first press releases with us. We were inundated with press people and of course at that time many people did not believe it was true but that’s all passed now but AAGL continues to grow and continues to grow in numbers. It continues to grow in prestige, and it continues to grow in capability of what doctors can do through an endoscope.”

Dr. Louis Keith: “Speaking of firsts, you’ll say Lindermann and all the others but we were associated not only with Patrick Steptoe but Raoul Palmer and Hans Frangenheim because now that laparoscopy has been taken over to general surgery, sometimes they forget where they got it, it springs de novo from their operating rooms. We brought the people who really pioneered the instruments to this continent, and we had them lecture to our membership. Now in terms of the name Frangenheim, I remember vividly he was a luncheon speaker and showed us the first ever film clip of human ovulation. You saw the egg; you saw an explosion as it were of the egg being extruded from the follicle followed by all the detritus and all of the liquid, etc. He got a standing ovation which is something that I have very rarely seen in medical luncheon speeches but the audience went wild.” 

Dr. Jordan Phillips: “That was first shown at our first meeting so we have many historical milestones that AAGL has provided but AAGL is open minded and we actually welcome speakers to present new material. Then the members can judge the relevancy of this material - whether it’s a new idea or a new instrument or a new procedure. Actually, it is proven in the world by practicing physicians whether they can use it safely, and AAGL has been the source of all of this. We have a new instrument panel, and we allow anybody and everybody to present their ideas and then we criticize that idea whether it’s relevant or not.”

Dr. Louis Keith: “But one of our frequently stated comments in the Board meetings regarding new ideas, some of which seem crazy, some of which seem hot, is that look gentlemen and ladies, cream always rises to the top. If somebody presents an idea however farfetched as it may seem to the two of us or to the Board of Trustees and the public likes it, then the public makes that decision.”

Dr. Jordan Phillips: “That’s true.”

Dr. Louis Keith: “Here we are in Florida, the public certainly knows how to vote in Florida.”

Dr. Jordan Phillips: “Doctors make their decision very accurately, very carefully, and with a lot of thought.”

Dr. Louis Keith: “Exactly, if it works, it works.”

Dr. Jordan Phillips: “Yes, that’s true.”

Dr. Louis Keith: “It doesn’t make any difference if it’s an American instrument, a German instrument, or a Brazilian instrument.”

Dr. Jordan Phillips: “In our first International meeting, we had Dr. Raoul Palmer, Dr. Steptoe, and Dr. Frangenheim; we had many international people. At that time we used the boat called the Independence. It actually goes along the Mississippi and we had an affair on the boat. It was told to me that if that boat ever sank it would set laparoscopy back twenty-five years.”

Dr. Louis Keith: “Twenty-five, fifty - it would have killed the whole specialty. What else do we want to say that our listeners might be interested in? We have been fortunate I think to have been the accompaniment, the company, and the talent for a Board of Trustees which has not remained static but has rotated over the years and brought incredible numbers of people with new ideas.”

Dr. Jordan Phillips: “That’s true. Yes, I’ve claimed many times that what would your life be like if you did not have laparoscopy and everyone involved with our program has had their lives materially changed, and it’s been changed by their practice and their practice habits. It’s been changed by their social activity and their professional contacts. It’s been changed by what they do, where they go, and it’s changed their entire reputation in their hospitals and in their cities because by looking through a laparoscope they’re able to make exact diagnoses. They can look directly into the female pelvis and actually make a determination. They do not have to use shadows by x-ray or by ultrasound or by MRI, they can actually look directly into the pelvis and see living tissue as it is and the pathology as it is.”

Dr. Louis Keith: “If any of the readers and listeners think that there’s any hyperbole in that, there isn’t. The people who started with you years ago, myself included, became professors because of our commitment to the AAGL, our speaking engagements, our writing, our books, and it has changed our professional lives. Look at the Board of Trustee, not all but many of them are in important academic positions, which they got not because they did fetal oxygenation or something like that but because of their work with endoscopy - it changed their professional life.”

Dr. Jordan Phillips: “The exchange of information and having people meet together and talk is what actually produced the results. Each one has become a better doctor because of coming to the meetings and finding these things.”

Dr. Louis Keith: “And we’ve become a better person so I’ll say, Jordan, thank you so much for giving me your time.”

Dr. Jordan Phillips: “Louis Keith, it’s a pleasure to know you, it has been from day one and it continues to be so.”