Jack G.S. Maxfield was the second President of the Southwestern Chapter, and the second of three brothers extensively involved in pioneering nuclear medicine. The Maxfields’ involvement with radiology began with the practice of their father, James Robert Maxfield, Sr., M.D., in Grand Saline, Texas. Dr. James Maxfield, born in Smith County, Texas in 1871, grew up in the east Texas area. He attended a local college and became a teacher, accumulating enough money to enter Fort Worth School of Medicine in Fort Worth, Texas in 1889. Fort Worth Medical School eventually became Baylor Medical School. He graduated in 1901 and returned to Grand Saline, Texas to establish his medical practice. At that time, Grand Saline was somewhat of an unusual rural community in the Texas area because in addition to the agricultural activities, it had the Morton Plant Salt mine and also had service by Texas and Pacific Railway. Dr. James Maxfield became the plant physician for Morton Salt Company mines and also was the regional surgeon for the Texas and Pacific Railroad. Therefore, in addition to his patients from the agricultural community of Grand Saline, he had an active industrial practice.
When he learned of the developing field of radiology, Roentgen having published the first paper on x-rays in 1895, Jack's father sought training in the new field of roentgenology. He attended the Emil Grubbe, M.D. School of Electrotherapeutics in Chicago in 1903. When he returned to Grand Saline he brought back with him a 1903 Betz x-ray unit (to the right). Although many early radiologists had injury from radiation, my father was always very radiation safety conscious. For example, in the picture of his Betz x-ray unit, there are electrical wires coming across the ceiling and going down the wall. He was in the process of installing an electrical motor to drive the Betz x-ray unit so that he did not have to have someone in the room cranking the unit while he was x-raying. Grand Saline was unusual in that time for having electricity available which was needed
Jack G.S. Maxfield was born in Waco and attended Baylor University College in Waco, Texas with also stints at SMU and some other colleges before he graduated from Baylor and entered Baylor University College of Medicine in 1936. Dr. Jack graduated from Baylor University College of Medicine in 1940 and had a general rotating internship at Southern Pacific General Hospital in San Francisco, California. Upon completion of his internship in July of 1941, as a member of the U.S. Army Reserves, he entered the Army as a lieutenant stationed initially at Fort Bliss, Texas. Jack then was transferred to the U.S. Army Hospital at Dutch Harbor, Alaska in the Aleutian Islands in October 1941. He participated in the Aleutian campaign attaining the rank of captain and then major. He received a bronze star medal for his service in the Aleutians. Upon completion of the Aleutian campaign Jack was transferred back to the states where he remained for about three months before being transferred to England as a part of the preparation for D-Day and the European campaign. Jack was assigned to the 124th General Hospital rising to the rank of Lieutenant Colonel. Jack became executive officer for the 124th General Hospital. The 124th General Hospital eventually ended up at the end of the war in Salzburg, Austria. Jack was awarded the Legion of Merit for his service in Europe. Upon the close of World War II Jack was decommissioned and returned to Dallas to join Dr. J.R. and their father in practice in Dallas, Texas.
They established the Maxfield Clinic-Hospital at 2711 Oak Lawn, Dallas, Texas, in 1947, incorporating a nuclear medicine laboratory into the hospital as one of the first Texas hospitals to have a functioning nuclear medicine laboratory. They also had one of the first Atomic Energy Commission approvals for a nuclear medicine program. At that time, they had only Geiger-Mueller (GM) counters, and for high level monitoring, the QTPIE unit. The cutie pie monitor was developed for the Manhattan Project. The story told is that they were looking for a code name for the monitor. Part of the formula for the detection chamber was QT π, hence the name of QTPIE.
Scintillation crystal system detectors were not developed until the early 1950's. At the Maxfield Clinic-Hospital, they were using radioactive iodine-131 for diagnosis of thyroid problems and for treatment of hyperthyroidism and thyroid cancer. One of the interesting cancer patients was a young child with pulmonary metastasis from an undifferentiated thyroid cancer. The uptake of her undifferentiated thyroid cancer of I-131 as expected was very low. Therefore, she was treated with an unusual program of 1 MCI of I-131/day, 5 days per week for 300 doses. She had an eight-year survival. The Maxfield Clinic-Hospital also used radioactive phosphorus P32 for treatment of leukemia, and other blood dyscrasias. They also developed the technique of using P32 as a diagnostic procedure similar to the sentinel node biopsies of today. Prior to surgical resection of the colon, colon cancer patients would be given 2 MCI of radioactive phosphorus (P32) intravenously. After resection of the colon cancers, they would do an autoradiograph of the surgical specimen, which would be obtained before sending the surgical specimen to the pathologist. This technique could find hot spots of P32 localization on the autoradiograph. We could, therefore, tell the pathologist where to go to make pathologic sections to confirm the presence of metastatic disease if the initial pathology report was negative for lymph node metastasis. This study with autoradiograph P32 technique showed that in about 30% of the cases we could demonstrate metastatic nodes in patients who had been given a clean bill of health for metastasis on the original routine pathology report.
Another unusual use of P32 was treatment of brain cancer. P32 with a needle type GM counter had been used at surgery to assist in removal of brain tumors by checking the margin of the tumor for radioactivity. We used P32 to treat brain cancers that had failed standard therapy. An example was an eight-year-old boy who had a brain stem medulloblastoma that had not responded to external radiation therapy. With a total of 20 MCI of P32 given 2 MCI/day, 5 days a week they achieved a 13-year survival for this patient with failed radiation therapy.
Dr. J.R. and Dr. Jack recognized the need for a low cost nuclear medicine scanner that was also space efficient. With their physicist friend, they developed the prototype 3” scintillation crystal scanner that was manufactured and sold by Picker as the Clini Scanner. This unit had a number of firsts. It was the first unit to use a preset window for the various isotopes. Also the unit had a teledeltos paper readout system. The unit measured only about 3’ x 3’ for floor area. While an excellent clinical scanner, the Clini Scanner never achieved wide utilization as at the time it was introduced the trend in nuclear medicine was to the camera system which could provide function studies as well as static scans.
The need for a Society of Nuclear Medicine (SNM) was conceived in 1953 by the individuals who were involved in clinical nuclear medicine at that time. The Society of Nuclear Medicine (SNM) was formed in 1954. Jack attended the first SNM meeting in 1954 at Seattle, Washington. Both Jack and J.R. were charter members of the national society.
The Southwestern Chapter of the Society of Nuclear Medicine was formed in 1956 and Jack, along with his brothers, was a founders and charter member of the chapter. Vincent Vermooten, M.D., the urologist who worked with us in urology, was also a founder of the Southwestern Chapter of the Society of Nuclear Medicine.
After the Society of Nuclear Medicine and the Southwestern Chapter of Nuclear Medicine had been in operation for a number of years, it was recognized that there was a need for another spokesman for the field of nuclear medicine which would be predominantly physician-based. The need for a physician-based spokesman for the field occurred when the Airline Pilots Association threatened to stop shipment of radioactive materials on passenger planes after an accident when a technetium generator leaked causing contamination of the plane. This incident highlighted the need for a physicians based group to speak for the field of nuclear medicine. The Maxfields, therefore, became in 1971 the incorporators of the American College of Nuclear Medicine, which has provided a sound basis of clinically oriented scientific programs for practitioners of the field of nuclear medicine through the years.