Columbia-Presbyterian Hospital in New York City.

It was a conservative hospital, a place that rarely raced to reach new medical frontiers. Landrum Shettles was a maverick who ignored established procedures as he pushed the boundaries of in vitro fertilization (IVF). Long simmering, the clash between Shettles and his home institution exploded on a September day in 1973.

A Conservative Teaching Hospital
King’s College was founded in New York City in 1754, and its medical school opened in 1767, becoming only the second in America and the first to grant an M.D. Closed during the American Revolution, King’s College reopened after the colonies won their independence with a new name, Columbia. New York’s Presbyterian Hospital, itself founded in 1868, joined forces with Columbia in 1928, and the teaching hospital became known as Columbia-Presbyterian. In the 1970s, Columbia was known for its conservative environment. To then medical student Arthur Caplan, it was “a culture that had still retained a lot of the old formality and almost Yankee, WASPy kind of style of medical care.” The institution did not place a premium on cutting-edge innovation; in Caplan’s words, the attitude was: “Not every new idea is a good idea. We can afford to get there second, as long as we get there. But let’s let other people try the bad ideas out first.”

Landrum Shettles
Just because Columbia-Presbyterian didn’t see itself in the vanguard didn’t mean the hospital lacked for medical pioneers. One of these was Dr. Landrum Shettles, a Mississippi native who had published some of the first photographs of human eggs and was now trying to achieve the world’s first test tube baby. Shettles was socially awkward and didn’t engage in small talk. He was consumed by his work, walked the hallways late at night and never seemed to go home to his wife and seven children. In the words of fellow Columbia doctor Georgianna Jagiello, Shettles “just wasn’t interested in the weather or other non-essential topics.” Nor did he have much use for hospital bureaucracy, a fact that had gotten him demoted by the new chairman of the obstetrics and gynecology department, a Belgian doctor named Raymond Vande Wiele.

Raymond Vande Wiele
Unlike Shettles, Vande Wiele had interests outside of his work. He loved ballet, books, tennis and wine; his patients included Faye Dunaway and Sophia Loren. To Jagiello he was a “Renaissance man,” but Vande Wiele was also authoritarian, determined that the department be run by established rules and the hospital get credit for discoveries within its walls. Thanks to a series of flattering magazine profiles, Shettles was becoming personally famous. Vande Wiele soon grew tired of having to send out press releases distancing the hospital from Shettles’ statements. Though his superiors urged him to fire Shettles, Vande Wiele couldn’t bring himself to dismiss the sole breadwinner for a family of nine. So he demoted the maverick doctor, knocking him down to the level of triage nurse.

The Del-Zio Attempt
Shettles ignored the hospital’s efforts to rein him in. His attention was focused on his attempts to create the world’s first test tube baby. And on September 12, 1973, Shettles set his plan in motion, using egg and sperm that had been collected from Doris and John Del-Zio, then attempting to fertilize and incubate the egg in a test tube. Shettles never informed hospital superiors of his plan, nor did he follow government guidelines for research on humans. When Vande Wiele found out, he was furious. Not only would Columbia-Presbyterian have been liable if anything had happened to Doris after her egg was re-implanted, but he believed that Shettles’ rogue actions threatened the hospital’s federal funding. Vande Wiele put an end to the experiment, the two men had an angry confrontation, and Shettles resigned under pressure one month later. The results of the experiment were frozen on Vande Wiele’s orders in a laboratory at the hospital, and there they stayed for years to come.

Changing Attitudes
Doris Del-Zio never had the child she so wanted, and Shettles never achieved a confirmed IVF pregnancy. But after the birth of the world’s first test tube baby in England in 1978, fears eased and negative attitudes rapidly began to shift. The early American IVFclinics were outside of the mainstream, located in smaller schools away from the big cities. But after the first American test tube babywas born in late 1981, the number of IVF clinics increased dramatically. And in an ironic sign of just how much things had changed, Raymond Vande Wiele himself got involved, co-directing New York’s first IVF clinic in 1983. The clinic had an initial waiting list of 150 couples, but Vande Wiele did not live to see the results of its efforts; he died of a heart attack later that year.

My American Experience

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