The Amazing Doctors Jones

In Remembrance, December 30. 2024

Had Howard Jones Jr. been alive on his birthday today, he would be the oldest living man, but he only lived to 104! He didn’t waste any of those years, nor did his distinguished wife, Georgeanna, who predeceased him.

This is the prologue to Howard & Georgeanna, the biography I compiled as his ghost-writer. I saw the Joneses daily for years after they retired from surgery and clinical endocrinology because they were seldom absent from a shared office even in their ninth decade. They lived through momentous times in medicine, science, and society, and after glittering careers at Johns Hopkins, they launched America’s first successful IVF program. When she slipped into Alzheimer’s disease, the final years would have been harrowing without their immense love and dignity which we observed and admired. I hope this story of an unforgettable couple rewards your reading time.

From Sun to Shining Sea

When someone makes an important discovery, their sun may suddenly break out of obscurity to gleam for a while before it is eclipsed by clouds. There are very few doctors or scientists whose sun glows continuously through a long working life. The Joneses were those kinds of doctors, and their story reads like a history of 20^th-century reproductive medicine. When Howard was still working into his 105th year, it seemed there would always be a Jones shining in the sky.

Georgeanna made her first research breakthrough in the 1930s during her days off as a student (first coining human chorionic gonadotropin for the pregnancy hormone). Howard’s career as a surgeon and gynecological oncologist took off simultaneously until deployed in the 1940s to care for wounded soldiers on the Western Front. From the 1950s through the 1970s, Georgeanna was discovering new causes and treatments of infertility, while Howard pioneered reconstructive surgery. Together, they wrote numerous papers and edited books and journals. And in the 1980s, they established the first successful IVF clinic in the nation and trained many of today’s leaders in assisted reproductive technology (ART). When I asked Howard which advance was most important, he had no hesitation. It was ART because it “conquered the grief of infertility and has a huge societal impact.” I can’t think of another pair of doctors who had crowning achievements after “retirement.”

When they hung up their white coats in the 1990s, they were still engaged with the human fertility field, or at least Georgeanna was as far as the hard road of her last illness allowed. People like us who were lucky to spend part of our careers with them remember how they encouraged junior staff and visiting faculty. They had an uncanny knack for solving problems (personal and clinical).

I benefitted from their wisdom when I joined the faculty of the Eastern Virginia Medical School as a research director in 2001. I wanted to launch an online master’s degree in clinical embryology and andrology. It seemed a fit for the Jones Institute, as it had been in my previous post at a British university. However, the school was skeptical and unwilling to invest a cent in the idea. It would have been stillborn if Howard hadn’t persuaded the Jones Foundation board to stump up funds to get us started. A dozen years later, the course draws embryologists and physicians from around the world, and hundreds have graduated. Where others saw risks, Howard grasped opportunities, and his judgment was rarely mistaken.

We wondered what philosophy animated their energy, boldness, and generous hearts. Perhaps owing to the experiences of living through a world war, they wanted to make the world a better place, and when resources were limited, they knew how to make do.

Family members who worked in the profession before paved their paths. But being raised in comfortable homes wasn’t a preparation for the physical and emotional suffering encountered, which is the lot of caring professions. They faced it in combat injuries and oncology wards, with birth abnormalities and infertility. I think their devotion to work was driven by an existential belief in the nobility of labor after witnessing the hard times of the 1930s and ‘40s. They understood Chekhov’s Irina, who told her sister: “The time will come, and everyone will know the meaning of all this, why there is all this suffering, and there won't be any mysteries, but meanwhile, we must go on living… we must work, we must work!” (The Three Sisters, Act IV).

Their work was demanding in time and energy but never felt like grinding existence, because they had a helper to manage their household and care for three children. They were passionate about applying their knowledge and skills; they took immense pleasure in helping people build families with the new reproductive technologies. Howard once said, “If I have a legacy, it is of someone who thoroughly enjoyed his work.”

After a residency in surgery at Johns Hopkins in Baltimore, he switched to gynecology to be closer to Georgeanna. From then on, they were inseparable, except during his military service in Europe and Asia; their collection of letters in the memoir War and Love reveals the extraordinary bond they enjoyed. And yet they were more like opposite sides of a coin than identical peas in a pod. She had a more scientifically penetrating mind, and he had the charisma to lead and inspire people. He was the busy organizer, and she was the quieter and more understated of the pair. He was fun-loving, and she was decorous. Perhaps opposite natures attract, but they were soulmates in every other way. This manner of success in marriage fascinated us as much as their careers. We thought they made communion an art form, like a harmonious pair of dancers, deftly spinning around a hall without letting go.

See how the couple whirls along the Dance’s buoyant tide,

And scarcely touches with winged feet the floor on which they glide...

Friedrich von Schiller (trans.)

People who never knew the Joneses might wonder if they had outsized egos to match their achievements. Not all! They were as much at ease with the office janitor as with a visiting dignitary, and they embraced the clinical team like a second family.

At journal clubs they held at home for staff, Georgeanna presented as a gracious hostess while Howard sat cross-legged on the floor. At 9:00 P.M. sharp, he raised his baritone voice (practiced as a young man in amateur opera) and clapped hands to announce, “Time for bed!” for everyone to scoot off! When the Jones Institute hosted parties for reunions of IVF babies and parents, they mingled in the crowd on the lawn, and on one occasion, he dressed up to look like a silly clown to entertain the gathering.

House guests received warm hospitality from them, but after Asbury and the Joyners retired (their home helpers), you couldn’t count any longer on a fine home-cooked meal. They didn’t make food a priority, although he might have pulled out a dusty bottle of wine from grateful patients in years past. It may have been a fine vintage at one time, but it had likely turned to vinegar from old age. He thought this hilarious.

They never judged other people’s blunders and put a positive spin on a mistake. Life lessons were learned in their company, at least by people who didn’t think they knew everything.

Most people who knew them had a favorite story, including Lucinda, from traveling with the Joneses to overseas conferences.

On a trip to Taiwan, a professor from a local hospital met the trio at the airport in a limousine. Speaking with a heavy accent, he asked how a “wombat” was used in the Norfolk laboratory. At least that was how Howard it heard after taking an interest in a marsupial of that name. When he realized the questioner was asking about a “warm bath” for preserving cells, Howard bent over double with laughter, so alarming the driver he thought his distinguished guest was having a seizure.

On another occasion in South Africa, the hotel’s desk clerk apologized because the Joneses and Lucinda would share a bathroom with another couple in an adjacent room. As there was only one other couple in the dining room, Lucinda marched over to ask if the Joneses could have first use of the bathroom in the morning because they had an early flight. Unfortunately, this was not the couple next door, but another pair occupying the bridal suite, who protested to the desk clerk. Howard almost passed out laughing that time. Georgeanna said he never could control himself in a droll situation and recalled embarrassing episodes when he played in opera. If someone had accidentally knocked a prop over during the performance, he couldn’t stop giggling on stage.

Howard reserved at least one day on conference trips to explore a new city or the countryside. He planned every hour for the party, which Georgeanna accepted the ordeal with good grace. When they arrived at their hotel with Lucinda after a 31-hour journey from Norfolk to Auckland, the women wanted to collapse into bed, but he left the bags unopened and urged everyone to head straight for a museum before it closed. He was then already in his late seventies, but never lost that verve and curiosity!

Like other energetic people, the Joneses understood the importance of relaxation. They had the gift of shifting easily from the gravity of medicine to the conviviality of home and recreation, including swimming after work. Arriving at my home on a weekend for Devonshire cream tea, they looked serene, like graceful Southern aristocrats. And at my Burn’s Supper, where we had country dancing and bagpipes, they were eager to try a Scottish haggis I had shipped from Florida.

Personal connections often fade when trainees leave to build their careers, like scions cut from a tree, but the Joneses were different. They kept an extensive correspondence with former associates, some becoming friends for life. People craved Georgeanna and Howard’s company. We loved them. They had an amazing way of making visitors feel important by giving them undivided attention, and Howard drew from memory the tiniest details of their last meeting. They sent Christmas cards to many of their former patients, some of whom remembered how Georgeanna would comfort them in the O.R. by holding an anxious hand during surgery. When we visited their home in Portsmouth in later years, he still greeted us from his wheelchair with outstretched arms, exclaiming in a huge voice that hardly faded since the days he sang in opera, “Hey, Cinda and Roger!” and then bundled her into his embrace for a kiss. At our final meeting, he lay weak in a hospital bed on what became his last full day, but the first thing he asked was, “How are your families?” He also inquired about the manuscript of his biography: “Is it worth pursuing?” Of course!

The Joneses were around for so long they seemed immortal. Some of their staff had already retired, and most of their peers had passed while they still occupied offices, although only Howard remained for the past decade. Their longevity and lasting health baffled us. Perhaps it helped that they had no worries at home, and never seemed stressed. They didn’t offer formulas for a long life or dietary advice. Stopping at a fast-food outlet for fried chicken or an occasional hamburger and fries was okay! In an interview for Yale University the year after he became a centenarian, Howard said the secret of longevity is “unique to the individual,” and it takes “the right genes, an exciting and interesting profession, and a serene family life.” Sadly, we can’t engineer the winning combination.

When Georgeanna died in 2005, aged 92, he was looking frail after a bout of flu. Everyone worried he too would sink, as elderly carers often do. How could he dance now without his life partner? But a few weeks later, he was more his old self; his voice came back strongly and there was the familiar twinkle in his eyes. He returned to his office nearly every day for the remaining decade of his life. He read medical journals, attended the journal club, received visitors and journalists, made calls and texts on his iPhone, and dictated manuscripts to Nancy Garcia. He had three more books to write, including an autobiography, and continued to follow debates on medical ethics and law. His office looked as orderly as ever, with a printed manuscript and computer, shelves lined with books, and framed degree certificates hanging on the wall beside a scabbarded sword gifted by a Middle Easterner. He had pictures of Georgeanna, of course.

She began slipping away a decade before she died. She was diagnosed with Alzheimer’s disease, no respecter of intellectual brilliance, and during those final years, Howard looked after her at home. The image of two bright people, one a carer and the other fading intellectually, brings another famous couple to mind. The philosopher and novelist Iris Murdoch was cared for by her husband too, the Oxford don John Bailey, whose story is well known through a book and the movie, Iris. But theirs was a very different “open” marriage the Joneses would not have understood, whose own was complete and sufficient.

Howard managed the challenge like so many others, with sagacity, patience, and love. The first signs of her illness were subtle. She began losing her place in lectures, which was so extraordinary that those who knew her were the first to notice the difference. She admitted to her former office nurse, Doris Gentilini, she was forgetting things, and this became obvious when she lost her way home from a hair appointment just three miles away. At the tenth anniversary celebration of the first IVF baby in Norfolk, she was uncomfortable in the crowd and retired to rest.

Howard knew that patients with this disease suffer from anxiety, becoming distrustful, so he kept their lives highly structured and predictable to give her security as she grew more disoriented. She retired from work, stopped driving, and they moved to a one-bedroom condominium. He watched her diet so she wouldn’t lose weight and waited up to a couple of hours to finish a meal. Doris came out of retirement to help. Yet, they still traveled to conferences around the country and overseas, where she recognized old friends. She seemed engaged listening to lectures on technical subjects if they were familiar from years gone by, even as she forgot if she had ordered a salad.

Howard kept her diagnosis private, but the story couldn’t be hidden forever. Eventually, he spoke about it openly because her memory loss was obvious.

She could joke in the early stages about her confusion, like the time they were in Egypt when she asked if they were on the River Severn or the Chesapeake Bay.

Howard replied, “No, Sweetie, it’s the Nile.” She chuckled heartily.

On another occasion, when he was unfolding a napkin before a meal, she pleaded, “No, no, no!” He reassured her it was alright.

“That belongs to my sister,” she said, staring at the napkin.

“It’s OK, Ginny,” he replied. She dropped the objection.

Flashes of humor continued for a long time, and her old graces were well-preserved because lifelong social skills are deeply engrained. He never raised his voice in frustration, always looking on the positive side, trying to make the best of a tough situation. He admitted, “She was a wonderful conversationalist, and that’s what I miss most.”

In those days, she still occupied an office next to his, but instead of editing papers and arranging slides of ovarian tissue, she worked on jigsaw puzzles or drew with colored pens laid out in neat rows with their caps carefully replaced. After a while, she would nod off in her chair, and Howard would say, “Look at her! She’s so darned sweet!” He believed Alzheimer’s disease laid bare a person’s true nature.

He was still interested in scientific riddles, social concerns, and family matters. Why do eggs age? Why don’t more insurance companies cover infertility? How were his children’s careers doing, and his granddaughter’s soccer league? If he had frustrations with growing immobility and the complications of diabetes, he hid them, perhaps along with other conditions only shared with his personal physician, but which must be expected at a great age. He never whined except to say that perhaps it is easier to pass from life in the way his wife had rather than decay with a fully preserved mind to the end.

Have you noticed how people approaching the end of life are often drawn toward water? Some settle in retirement communities overlooking a river or lake, others downsize to a home in a seaside town. Perhaps it is the peaceful flow that pulls them to the waterside like time itself, or the infinitude of the sea and pounding of surf against round pebbles on the beach. Sometimes, it is the happy memory of vacations around water that is so fascinating.

The people along the sand

All turn and look one way.

They turn their back on the land

They look at the sea all day.

Robert Frost

The Joneses kept their membership of the Norfolk Yacht and Country Club long after their sailing days were over. When I joined the Jones Institute, they invited me to join them at the club for casual dining at The Deck. We would meet on the upper floor with the Andrews. Mason Andrews was an admirable gynecologist and a founder of EVMS and former city mayor. We met on Thursday evenings when it was quieter and we could take a window seat to look down on the marina and out toward the Bay.

Our table was spread with a white cotton cloth and neatly arranged cutlery and napkins. A waiter soon arrived to pour ice-water into our glasses and take our orders. Maryland crab cakes, chicken, and salad were popular choices. Howard chose soft-shelled crab soup for Georgeanna’s starter.

Then the conversation would start with town politics, the hospital expansion, medical care, stem cell project, and almost anything else. Georgeanna sat silently watching and smiling to show she was engaged. These four were old friends from Hopkins days, but they never made a younger buck like me feel out of place, and did much to help me settle in Norfolk. They were lively spirits and enlightened company who, as much as they enjoyed looking back on past achievements, looked forward to new goals. They never stopped working as Improvers and Encouragers.

After the meal, we’d rearrange our chairs in an arc in front of the full-length windows to enjoy the scene. Below us, hundreds of white boats of all shapes and sizes were drawn up in tight rows along the slips. The rigging of yachts slapped against their masts, and sea rods on motor launches leaned forward like the antennae of giant aquatic bugs nodding in the breeze. A fisherman lugged a heavy bucket of fish from his boat over a gangplank with its water sloshing over his gumboots. He waved at a friend on a late boat chugging into an adjacent berth. It was often like that.

The conversation would lull as we watched activity in the dock below, but as the light faded, we raised eyes to the skyline. Georgeanna gazed into the distance. Perhaps she hoped to see the sail of a yawl coming into harbor; then perhaps she could climb onboard and sail off once more to the Chesapeake Bay of deep memory.

We timed our meal to the sun setting over the shining waters of the Lafayette River until it dropped behind the silhouettes of dockyard cranes at the container terminal. Those evenings always seemed miraculously clear, with barely a cloud scudding across the sky. If you ever watched a sunset closely on such an evening, you know how slowly it traces an arc to earth. It starts as a fiery yellow orb high in the sky all day, but makes a descent almost imperceptible until you notice its heat has gone and it turns orange before blood red. For a moment, it looks like it will rest on the edge of the earth to scorch it. But then, and rather suddenly, it is swallowed up and the horizon where earth meets sky turns a royal purple.

When the show was over, we’d rise and take the elevator to the ground floor. There was nothing more to say after the show. We stepped outside in silence, Howard leading Georgeanna with her arm curled around his. Walking into the darkening parking lot, we looked for their car with the “2DOCS” license plate. The first evening stars twinkled overhead.

Next Post: IVF through a Glass Darkly. The Add-on Controversy