199 84 14MB
English Pages 505 [512] Year 1959
The dMassachusetts Qeneral Hospital 1
9 3 5—J9 5 5
Airplane view of the Massachusetts
General Hospital in Boston
(1956).
The ^Massachusetts Qeneral Hospital 1
9i5~I955
N A T H A N I E L W. FAXON, M.D. Director Emeritus Massachusetts General Hospital Massachusetts Eye and Ear Infirmary
Harvard
University
CAMBRIDGE,
'Press
MASSACHUSETTS
I 9 5 9
© 1959 by the President and Fellows of Harvard College
Distributed in Great Britain by Oxford University Press, London
Library of Congress Catalog Card Number
sg-i2g68
Printed in the United States of America
Preface The history of a hospital is officially expressed in the minutes of its trustees and committees. Although these arç summarized and, together with the reports of departments, published in annual reports, the resulting effect is like seeing only the trees and missing the picture of the forest. From the Annual Reports of the Massachusetts General Hospital, supplemented by the minutes of the meetings of the Trustees, the General Hospital Committee of the Trustees, and the General Executive Committee and by departmental reports, a reasonably complete history of the institution during any year can be obtained. While satisfactory for the understanding of the happenings of a single year, such reports and minutes do not give a picture of developments which occupy several years. For instance, the receipt of funds from the will of Mrs. Harriet Bradbury which made possible the George Robert White Memorial Building occurred in 1930. Because of the Depression, plans for the building were not started until 1936 and the building was not completed and dedicated until 1939. Reorganization of the School for Nursing and of the Resident Staff extended over several years. Both of these changes profoundly affected the operation of the hospital. Today it is well recognized that hospitals have three functions: the care of the sick, teaching, and research. The founders of the Massachusetts General Hospital in 1811 clearly had in mind the first two functions. In their appeals to the public, after explaining the inadequacy of the Leverett Street Almshouse to serve as a hospital, they detailed the need for and the advantages of suitable accommodations for the care of the sick, especially the sick poor. They noted further that "there are a number of collateral advantages that would attend the establishment of a hospital in this place. These are the facilities for acquiring knowledge which it would give to students in the medical school established in this town. ν
PREFACE
"A hospital is an institution essential to a Medical School and one which would afford relief and comfort to thousands of the sick and miserable. On what other object can the superfluities of the rich be so well bestowed?" While the care of the sick was and still remains the primary function of the Massachusetts General Hospital, the educational function which thus began through its association with the Harvard Medical School has grown since then to include many disciplines and nearly a thousand students annually. The third function, practically nonexistent at the foundation of the Hospital, although latent in the minds of the founders, developed slowly, beginning as clinical research carried on by a few exceptional individuals but gradually extending in scope, with an increasing number of participants. With the coming of Dr. David L. Edsall as Medical Chief in 1912, there began an emphasis on research on a more comprehensive scale which has resulted, during the last twenty years, in a tremendous expansion of personnel and facilities. The story of the Massachusetts General Hospital during the period from 1935 to 1955 chronicles the rise in importance of teaching and research and the happy amalgamation of the three major hospital functions. The Massachusetts General Hospital has been fortunate in having had its history ably recounted from the beginning. Nathaniel I. Bowditch, a Trustee, wrote the early history, for the years 1811 to 1851. The Reverend George E. Ellis, Trustee, continued the story to 1872. Mrs. Grace W. Myers, Librarian of the Treadwell Library, took it from 1872 to 1900. Dr. Frederic A. Washburn, Director for many years, brought the history up to 1935, including a comprehensive description of all of the departments of the Hospital and a reference list of the Officers and Trustees, the present members of the Administrative Officers and Staff, and a list of house officers, resident physicians, and surgeons who had graduated from the institution. The objective of the present history is to recount the activities of the Hospital from 1935 to 1955. It is relatively easy to document additions to the physical plant of an institution and to enumerate the advantages that come from new buildings and improved facilities. It is more difficult to show the development of projects, the growth of departments, or changes in policy that often start with an innocentlooking statement in the minutes of some committee and then after a lapse of time, without any explanation, are found to be in full force vi
PREFACE
and effecting important changes in the institution. Moreover, the official life of a hospital can be very prosaic and uninteresting, but the real life that goes on, affecting patients, doctors, nurses, and employees, is full of unrecorded incidents of humor and pathos. The writing of a history of an institution like the Massachusetts General Hospital is no easy task. Mrs. Myers in her preface noted, "As the writer of the following pages, I have been more and more impressed as the work has grown, first by my own boldness in attempting the task, and secondly by the confidence shown in me by the Trustees in allowing me the privilege." The present writer has the same misgivings, but having put his hand to the plough cannot turn back, so herewith craves the reader's indulgence for his deficiencies. Impressed by the high quality and readableness of Mrs. Myers' history, I shall begin by following her plan of chronological presentation by single years, a chapter to each year. Some subjects, however, are of such magnitude and importance and their story covers so many years that I have felt it necessary to add separate chapters covering their development, following in this procedure the plan adopted by Dr. Washburn in his history. I trust that this combination will not be confusing. The principal value of a history such as this lies in its synthesis of events, in presenting a connected story of some developing activity, and in recording important happenings in a manner that makes them available for ready reference. Such a chronicle will be of interest primarily to persons who have been connected with the Massachusetts General Hospital or who are interested in medical and hospital history. Most of my material is taken from the annual reports of the Hospital, supplemented by the minutes of the Trustees and the General Executive Committee, and by the "M.G.H. News," with background information from the Bowditch, Myers, and Washburn histories. A few of the special chapters have been written on request by members of the Staff. For the drawing of the Bulfinch Front on the title page, I am indebted to Dr. James Howard Means, friend, physician, author, and artist. The plot plans showing the expansion of hospital grounds and buildings were prepared by Mr. Carleton Goff of the Planning and Construction Department. The airplane view was taken by Mr. Bradford Washburn, Director of the Boston Museum of Science. Miss Lenore Wilson has been a faithful secretary who has labored uncom-
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PREFACE
plainingly to decipher my handwriting, to assemble a disjointed manuscript, and to prepare the complicated directories of officers and staff. I am indebted to so many of the Hospital family for their assistance in collecting and correcting data that to try to name each one would be invidious. Suffice to say that without their help there would have been no history, and I am duly grateful. Nathaniel W. Faxon, M.D. Director Emeritus Boston, Massachusetts 1959
viii
Qontents FOREWORD BY FRANCIS
C. GRAY
PART I Chronological History 3
LOOKING BACKWARD 1
1
935~ 954 8 POSTSCRIPT SUMMARY
129 133
PART II "Qare of the Sick, Teaching, and rResearch" ι. A RECORD OF STRUCTURAL DEVELOPMENT 141 INTRODUCTION
THE GEORGE
I44
I817-I955
BAKER MEMORIAL HOSPITAL
ACQUISITIONS,
AND
I4I
A YEAR-BY-YEAR ACCOUNT, THE
GROWTH
1821-1956 ROBERT WHITE
154
155 BUILDING
IÓ2
T H E STORY O F T H E D O C T O R S ' O F F I C E B U I L D I N G A N D T H E MASSACHUSETTS G E N E R A L STAFF ASSOCIATES 165
2. THE McLEAN HOSPITAL PERSONNEL
I79
SERVICE AND NURSING
T R E A T M E N T AND RESEARCH
3. AFFILIATIONS
SCHOOL
WITH OTHER HOSPITALS
P. H U N T I N G T O N
THE CONTRIBUTIONS LABORATORIES
GENERAL
MEMORIAL HOSPITAL
4. WHAT ARE THE REWARDS
OF RESEARCH?
OF M E D I C I N E AND T H E 212
ix
193
I93
THE HALL-MERCER HOSPITAL, MASSACHUSETTS HOSPITAL DIVISION 201 COLLIS
181
183
T H E VINCENT MEMORIAL HOSPITAL
THE
172
180
TEACHING NURSING
IN WAVERLEY
MEDICAL
204
208
CONTENTS THE CONTRIBUTIONS OF S U R G E R Y AND THE LABORATORIES 215
SURGICAL
THE CONTRIBUTIONS OF OTHER SERVICES
221 228
THE OFFICE OF SCIENTIFIC RESEARCH AND DEVELOPMENT NOBEL PRIZES
230
EXPANSION OF RESEARCH A F T E R WORLD W A R II (PAUL C. M. ZAMECNIK, M.D.) 231 T H E RESEARCH BUILDING AND THE WARREN BUILDING
TEACHING AT THE MASSACHUSETTS HOSPITAL 241
GENERAL
THE MASSACHUSETTS G E N E R A L HOSPITAL AS AN INSTITUTION (DEAN A . C L A R K , M.D.) 24I T H R E E POSTGRADUATE COURSES
235
EDUCATIONAL
246
THE MASSACHUSETTS G E N E R A L HOSPITAL AND THE H A R V A R D MEDICAL SCHOOL 248 HOUSE P U P I L S ; HOUSE OFFICERS; INTERNS AND RESIDENTS THE DEVELOPMENT OF THE RESIDENCY (OLIVER COPE, M.D.) 258
CERTAIN
SYSTEM
SERVICES AND DEPARTMENTS
264
E A R L Y HISTORY OF CHILDREN'S MEDICAL DEPARTMENT, MASSACHUSETTS G E N E R A L HOSPITAL, I 9 O 3 - I 9 3 2 (FRITZ B. T A L B O T , M.D.) ΐΒΖ THE CHILDREN'S MEDICAL S E R V I C E , I 9 3 2 - I 9 5 5 ( A L L A N M. B U T L E R , M.D.) 276 A N E S T H E S I A : THE ANESTHESIA SERVICE AND THE ANESTHESIA LABORATORY OF THE HARVARD MEDICAL A T THE MASSACHUSETTS G E N E R A L HOSPITAL ( H E N R Y K. B E E C H E R , M.D.) 282 THE DEPARTMENT OF RADIOLOGY, ( L A U R E N C E L. ROBBINS, M.D.) THE TUMOR CLINIC THE BLOOD BANK. PHYSICAL MEDICINE
SCHOOL
I935—1955 288
292 295 3OO
WOMEN AND THE MASSACHUSETTS HOSPITAL 307 THE LADIES* VISITING COMMITTEE X
307
GENERAL
ΊΖΊ
CONTENTS THE M A S S A C H U S E T T S G E N E R A L H O S P I T A L WIVES* A S S O C I A T I O N 3I4 THE DISTAFF CLUB VOLUNTEERS
STAFF
3I5
316
8. THE NURSING SERVICE AND THE SCHOOL 324 9. MEDICAL
SOCIAL SERVICE
10. THE DIETARY
NURSING
336
DEPARTMENT
343
lì. SOME OTHER DEPARTMENTS
349
THE APOTHECARIES
349
P H O T O G R A P H Y AND T H E M E D I C A L A R T D E P A R T M E N T M E D I C A L RECORDS A N D RECORD L I B R A R I A N S
12. THE WAR EFFORT AND THE 6TH HOSPITAL 364 H I S T O R Y OF THE 6 T H G E N E R A L H O S P I T A L (THOMAS R. G O E T H A L S , M . D . ) 365
355
359
GENERAL U.S.A.
ςAppendixes A. WARREN PRIZE, DALTON RICHARDSON LECTURES B. TABLES
SCHOLARSHIPS, 389
395
I . INCOME AND E X P E N S E
STATEMENT, I 9 3 5 — 1 9 5 5
1 . VITAL STATISTICS, I 9 3 5 — 1 9 5 5 3.
PROFESSIONAL
STAFF, I 9 3 5
395
AND I 9 5 5
396
4 . RESIDENT AND INTERN STAFF, I 9 3 5
AND I 9 5 5
5 . G R O W T H IN P E R S O N N E L , I 9 3 5 ~ I 9 5 5
397
6 . B E D C A P A C I T Y OF M A S S A C H U S E T T S HOSPITAL, I 9 5 5
GENERAL
398
7 . COMPARATIVE STATISTICS, GENERAL HOSPITAL, 1 9 3 5 - 1 9 5 5 399 8. C O M P A R A T I V E S T A T I S T I C S , B A K E R HOSPITAL, I 9 3 5 - I 9 5 5 4OO
xi
395
MEMORIAL
397
CONTENTS 9. COMPARATIVE STATISTICS, PHILLIPS HOUSE, 1935—1955 IO. MC LEAN HOSPITAL STATISTICS, I935—1955
C. OFFICERS HOSPITAL, D. LADIES'
OF THE MASSACHUSETTS 1935-1955 403 VISITING
E. ADMINISTRATION,
COMMITTEE, 1935-1959
414
I. HONOR ROLL
McLEAN
458
J. CITATIONS
L. ACT
GENERAL
STAFF OF THE MASSACHUSETTS HOSPITAL, 1935-1959 444
H. ADMINISTRATION AND STAFF, HOSPITAL, 1935-1959 450
K. LETTERS
GENERAL
1935-1959
F. STAFF OF THE MASSACHUSETTS HOSPITAL, 1935^959 417 G. RESIDENT GENERAL
402
459 462
OF INCORPORATION,
NOTES
467
INDEX
473
SECT.
xii
/
464
408
Illustrations Airplane view of the Massachusetts General Hospital in Boston (1956)
Frontispiece
Bulfinch Building, 1823
144
From Bulfinch Steps, 1876, 1956
144
From Longfellow Bridge, 1857, 1957
144
Airplane View, 1956
145
Across Bulfinch Lawn, 1895, 1955
145
From Corner of Parkman St., 1905, 1955
145
Baker Memorial, 1930
176
George Robert White Building, 1939
176
Vincent Memorial Hospital and Burnham Memorial Wards for Children, 1947
176
Research Building, 1951
176
M.G.H. Medical Officers of the 6th General Hospital, U.S. Army, May 13, 1942
177
xiii
Charts Renaming of the Bulfinch Wards (1939)
36
Plot Plan, 1823
144
Plot Plan, 1873
145
Plot Plan, 1901
146
Plot Plan, 1921
147
Plot Plan, 1935
148
Plot Plan, 1956
149
Interns and Residents, 1910-1955
257
Volunteer Services, 1925-1955
319
The Photography Department, 1935 and 1957
357
xiv
Foreword The Massachusetts General Hospital in 1961 will be one hundred and fifty years old. It was organized to afford hospital care for the sick, to provide the Harvard Medical School with a place to teach medical students at the bedside, and through this joint endeavor to advance medical knowledge. The undertaking with the Harvard Medical School, operating more actively today than perhaps at any time in its long history, has been of outstanding significance in the growth and development of the Hospital. The history of the Massachusetts General Hospital to 1935 has been written by others, but the twenty years which Dr. Faxon covers — fourteen of those years under Dr. Faxon and six under his successor, Dr. Dean A. Clark — demonstrate anew how greatly fortunate the Hospital has always been in the capacity and quality of its staff, in their devotion to the care and the cure of the sick, and in their unswerving leadership in the never-ending battle against disease and pain. The period 1935-1955 saw the trinity of the care of the sick, teaching, and research unite for the good of mankind as never before in the history of the Hospital. And with this great and forward development there flourishes today, as it has for nearly a century and a half, that intangible quality — the unquenchable life and spirit of the institution. It is this spirit, so difficult to define, that gives us the sense of unseen forces within the walls of the Hospital — the healing by physicians, the teaching of youth, the clear light of science, the ministry of nurses, the fortitude of patients, and the thoughtful generosity of generations of benefactors. One senses, too, that forces have been kindled by men and women who have unsparingly volunteered their services and whose work and wisdom have added depth and strength to the Hospital. From the background of these things comes the knowledge that to be identified with this institution is something for which we can each be eternally grateful. XV
FOREWORD
The Trustees have been indeed fortunate in the gift of the services of Dr. Nathaniel W . Faxon as historian. Through his long association with the Hospital he links easily the past and the present. He is a graduate of Harvard, the Harvard Medical School, and the Massachusetts General Hospital. Dr. Faxon practiced in Stoughton, Massachusetts, until the outbreak of World War I, when he saw active duty in command of Field Hospital No. 28. In 1919 he was appointed Assistant Director of the Massachusetts General Hospital, leaving in 1922 to become Director of the Strong Memorial Hospital in Rochester, New York, the teaching hospital allied with the Medical School of the University of Rochester. In 1935, when the Massachusetts General Hospital greatly needed a strong and experienced hand as its directing head, Dr. Faxon was unanimously chosen. To some of us it seemed as if Dr. Faxon was just coming home and perhaps he felt so too, for in no time at all he was quietly and effectively directing the complex problems of the Hospital, and in the process finding the time to plan and build the George Robert White Memorial Building at the General Hospital. Dr. Faxon is too modest to see in this history any reflection of himself. A glance at the chapter headings, however, gives à fair idea of the activities of the Massachusetts General Hospital, with each of which he was in some way connected. In a real sense, therefore, the history is testimony to the ability and character of Dr. Faxon. W e thank him, not only for his work as historian, but even more for the wisdom and fidelity with which he guided the Hospital during his service as its Director. Francis C. Gray Chairman, Board of Trustees February 1959
XV
PART
I
Qhronological History
J^ooking backward proceeding with the history of the Hospital it may be worth while to pause and look backward to the time of its birth and see if it still remains true to the ideals of its founders. Viewed in retrospect, they were men of vision, for the principles and policies that they formulated in 1821 are still the guiding principles and policies of the Hospital today. When the Reverend John Bartlett in 1810 wrote his letter "to fifteen or twenty-five of the wealthiest and most respectable citizens of Boston," urging the building of a hospital, he planted a seed in fertile ground. They were all men of economic power and political influence, some belonging to established well-to-do families, others representative of the rising merchant and industrial class. They were leaders in civic improvement who felt that their economic prosperity carried with it a definite social obligation; that property acquired was a sacred trust never to be entirely used for their own benefit. Their religious affiliations led them to accept in an active sense the Christian teaching of the virtue of charity. They recognized the need so ably set forth by the Reverend Mr. Bartlett and by Doctors John C. Warren and James Jackson, and they acted. In 1 8 1 1 there were few precedents to guide them. The Pennsylvania Hospital in Philadelphia, the New York Hospital in New York, together with a few scattered Marine Corps, military, and quarantine hospitals, comprised the hospital system of the United States. Through visits to the Pennsylvania and New York hospitals and through correspondence with medical acquaintances in Europe they received some help, but in general they had to decide for themselves how to form their corporation, collect the money, plan the building, select the staff, make the rules under which the Hospital would operate, and, once started, guide its destiny. Receiving their charter from the General Court in 1811, they formed a corporation and wrote the by-laws under which, with few changes, the Trustees operate today. It was and is a lay board, with EFORE
B
3
CHRONOLOGICAL HISTORY
the Commonwealth represented by four members. Although the Hospital in its early days received considerable state aid, this support never resulted in political interference or control. Care was exercised also to see that the medical profession did not have control either, on the principle that the Hospital was for all the people. The War of 1 8 1 2 hit New England hard, so these experienced businessmen delayed their appeal to the people until prosperity began to return in 1816. They planned carefully and developed what is now the modern community-fund-drive principle: they would ask all the people to give and see that all were asked. The city was thereupon divided into small districts with each solicitor residing in "his" district so that no one would be asked to give to a stranger. Clergy, doctors, and press all took an active part and the drive went "over the top" in 1817. Gifts ranged all the way from $20,000 from William Phillips to a twenty-five-cent subscription from a poor negro. It was truly a hospital of the people. "By the first of March 1817 the total subscription was in excess of $107,000, sending the hospital well over the top. . . . The whole number of donations, including those from surrounding towns, was 1,047, which 245 were gifts of $100 or more; the thirteen largest amounted to $56,000, well over half the total sum. The figures indicate both the generosity of the Boston merchants and their wisdom in opening the subscriptions to the public." 1 These figures should be interpreted in the light of the facts that in 1810 the population of Boston was 33,250 and that the Pennsylvania Hospital charged its patients only $3.50 a week, including all expenses save those for clothing and burial. It shows that 802 people gave $27,800, an average of $34.66 apiece, that 252 persons gave $100 or more, or $25,200, and that 13 gave $56,000, or over $4,300 each. It is fair to estimate that the $100,000 collection of 1817 would mean more than $1,000,000 today. The building was designed by Charles Bulfinch, the leading architect of the city, after visits to and careful study of other hospitals, and the noble Bulfinch Building set a standard in hospital construction for the United States. Next the Trustees decided that there should be no restrictions as to race, color, creed, or ability to pay in the admission of patients; all in need of hospital care were to be welcomed. The staff was chosen from the leading physicians of Boston, with Dr. John C. Warren and Dr. James Jackson as the most prominent representatives. All gave their professional services without charge.
4
LOOKING BACKWARD
The high standard set by this early staff has been steadfastly maintained. This staff was notable in that in addition to being competent physicians many of its members were connected with the Harvard Medical School and so interested in teaching. Furthermore some were interested in research, an idea with which they had become imbued while studying in France. Thus teaching and research started at the same time as care of patients at the Massachusetts General Hospital when it opened. Together with the Managers of the Pennsylvania Hospital and the Governors of the New York Hospital, the Trustees of the Massachusetts General Hospital were the pioneers who established the principles, policies, and standards which have largely governed the development of the charitable hospital system of the United States. Finally w e must remember that the strength of an institution lies in the individuals w h o have carried it forward. T h e Massachusetts General Hospital from its beginning until its present has been served b y men and w o m e n w h o in serving it, have come also to give it their affection. It has sought and it has been sought b y the best in the medical profession; its integrity has been guarded b y a long line of devoted trustees, directors and benefactors; b y its staff, its nurses, its volunteers, its secretaries, its social service and its employees. It has been generously supported b y the community that it has helped to safeguard through so many years. This is the basis of its present greatness and the foundation on w h i c h its future will rest. 2
The men who formed the Corporation, the Trustees, and the early Medical Staff were men with a prophetic vision, who had a deepseated social consciousness, and who believed that they were responsible to their community for their economic prosperity. How wise they were! On February 23, 1934, Dr. George H. Bigelow assumed the duties of Director of the Massachusetts General Hospital. Dr. Frederic A. Washburn, who had guided the hospital for twenty-six years, became Director Emeritus. Although conditions were still far from satisfactory the country was gradually recovering from the Depression and the prospects for a happier period were brighter. Dr. Bigelow's former position as Commissioner of Public Health of the Commonwealth of Massachusetts, which he had filled with distinction, promised well for the integration of the Massachusetts General Hospital with developments in the fields of medicine and public health. These bright prospects were shattered by his tragic death in the latter part of the year. The burden
5
CHRONOLOGICAL
HISTORY
of administration fell upon the shoulders of the Assistant Director, Dr. Norman C. Baker, who continued as Acting Director until the arrival of Dr. Nathaniel W. Faxon on July 1, 1935. During Dr. Bigelow's administration many important projects were begun. Foremost was a start in the reorganization of the Dietary Department. Hospital accounting was and is complicated and Dr. Bigelow started the changes and improvements in accounting which are still going on. He laid the foundation for a budget system and for inventory control in the Stores. With the support of the Rockefeller Foundation, the Massachusetts General Hospital and the Harvard Medical School completed plans for the formation of a Department of Psychiatry at the School and provision for a Psychiatric Service, under Dr. Stanley Cobb, at the Hospital, with twelve beds for patients on Baker 3 and offices and laboratories on the ground floor of the West Wing of the Bulfinch Building. From this demonstration has come the acceptance of the feasibility of caring for selected psychiatric patients in general hospitals and the important role of psychiatry in the care of other hospital patients. After the support of the Rockefeller Foundation was withdrawn in 1941, the favorable experience of the Hospital in the operation of this service compelled its continuation. A new subdepartment, Anesthesia, was just getting under way, with Dr. Bigelow's support, at the time of his death. Although the historic demonstration of ether as an anesthetic took place at the Massachusetts General Hospital on October 16, 1846, nevertheless by the turn of the century it was evident that the practice of anesthesia at the Hospital was behind the times. Realizing this situation, the Trustees in 1903 appointed Dr. Freeman Allen as Consulting Anesthetist, to oversee and instruct house officers and nurses in the administration of ether. The next forward step was taken in 1933, by the appointment of a salaried anesthetist, "who will devote himself not only to supervision of anesthesia but will serve as instructor to the House Staff and nurses, and will carry on investigation in the field."3 At that time Anesthesia was made a subdepartment of Surgery and two residents, with salaries commensurate with the salaries of other residents, and one house officer were authorized. Dr. H. H. Bradshaw was appointed Anesthetist and Dr. Monica Harden, Assistant Resident. The development since 1936 under the leadership of Dr. H. K. Beecher has been spectacular, and Anesthesia now ranks with Pathology and Radiology as an important full-fledged department.
6
LOOKING BACKWARD
The Depression of the early 1930's was still felt in 1934. The working hours of special-duty nurses were shortened to eight per day in order to spread the work and so relieve unemployment. Two floors in the Phillips House (2 and 8) and one in the Baker Memorial (10) were still closed, while the ward patients of the General Hospital overflowed into the second and third floors of the Baker Memorial. This period of too many nurses and too few patients did not last long. Now there are too few nurses and too many patients! So swings the pendulum of our affairs. Hospitals throughout the world were having financial trouble in 1934 so that there was great interest in the visit of Mr. Sydney Lamb of Mercy Hospital Council, Liverpool, the author of the "penny in the pound" plan, by which large groups of people were encouraged to give to the Council one penny for every pound earned. In return the Council defrayed a portion of any hospitalizing illness, financially helping the hospital as well as the patient. From experiments like this, Blue Cross ultimately developed. This year the Hospital had to give up what had been considered since 1918 as a most desirable joint educational arrangement with Simmons College. After a five-year undergraduate course the qualified student received a degree of B.S. from the College and a diploma of nursing from the Hospital. In 1934 the Simmons College School of Nursing replaced the School of Public Health Nursing, and both the college degree and the diploma of nursing were given by Simmons. While Simmons students continued to receive practical training at the Massachusetts General Hospital, their status was that of affiliates. The Hospital immediately sought arrangements with other colleges to restore the cooperative arrangement formerly held with Simmons. During 1934, Mr. Robert Homans, Trustee for fourteen years, and Mrs. Nathaniel Thayer, Trustee for eighteen years, died. Both had given renowned service to the Hospital. Mr. John R. Macomber was elected to succeed Mr. Homans; Miss Betty Dumaine was appointed by the Governor in place of Mrs. Thayer. And so 1934 leads to the beginning of this history of the Massachusetts General Hospital from 1935 to 1955.
7
CHRONOLOGICAL
HISTORY
I935 Staff changes. The Boston Hospital Council formed. Massachusetts General Hospital joins the Community Fund. Neto clinics. Surgical Executive Committee formed. Harvard students and the Massachusetts General Hospital. State tuberculosis patients. New accounting system. Changes in food administration. The School of Nursing. Red Cross Volunteer Aides. Social Service invited to ward rounds. Physical changes.
npHE year 1935 began with many changes. Because of the death, after only nine months in office, of Dr. George Hoyt Bigelow, Dr. Norman C. Baker, the First Assistant Director, had been appointed Acting Director. In February, Dr. Nathaniel W. Faxon, Director of the Strong Memorial Hospital of the University of Rochester, New York, and a former Assistant Director of the Massachusetts General Hospital, was appointed Director, effective July 1, 1935. Dr. Baker's able administration successfully bridged the gap between the death of Dr. Bigelow and the arrival of Dr. Faxon. Mr. William Endicott, who had been Chairman of the Board of Trustees from 1928 to 1935, declined re-election, and Bishop Henry K. Sherrill, one of the Trustees, was elected in his place. Mr. Francis C. Gray was elected to fill the vacancy on the Board. Dr. Beth Vincent, Chief of the East Surgical Service, resigned and was appointed to the Board of Consultation. He had been a member of the Surgical Staff since 1906. The Hospital suffered the following losses through death: Dr. William J. Herman, Associate Psychiatrist, Mr. Joseph H. O'Neil, a State Trustee appointee from 1912 to 1935, Mrs. A. Lawrence Hopkins, who had been a member of the Ladies' Visiting Committee for over thirty years and who had been keenly interested in the Hospital, and Mrs. James Lawrence, a member of the Ladies' Visiting Committee for eleven years and its Chairman during the period 1934-1935. A development in the Boston community affecting the Hospital was the formation during this year of the Boston Hospital Council,
8
1935 embracing twenty-three hospitals. Previous to this there had been an informal club of the directors and superintendents of some of the Boston hospitals, and for several years the American Hospital Association had been urging the formation of regional hospital councils, where hospital problems could be considered on a community basis. During the succeeding years, right up to the present time, the Boston Hospital Council has played a useful and important role in the welfare of the hospitals of Boston and vicinity. In this year, also, all the hospitals were asked to join the Community Fund, now known as the United Community Services. This organization was an outgrowth of the "war chests" of World War I and the emergency drives of the Depression. The Trustees of the Massachusetts General, although reluctant to curtail their freedom of action and somewhat dubious of the success of this joint money-raising effort, felt that the welfare of all was involved and that their participation would help, so they agreed to support the Fund. In 1935, the General Executive Committee noted that there was a "definite tendency for a more closely united staff with an increased singleness of purpose." This was demonstrated by the formation of special clinics, with the joining of the medical and surgical staffs for the study of some special problem. For instance, the Medical and Surgical Services joined their efforts in the Thoracic Clinic; in the Fracture Clinic, Surgery combined with the Orthopedic Department; Medicine and Urology joined forces in the Renal Stone Clinic, and X-ray, Medicine, Surgery, Dermatology, and others in the Tumor Clinic. In the General Hospital these special clinics have steadily increased in number, continuing to bring diverse points of view to a common focus, and have resulted in many advances. Most departments, whether medical or administrative, have their ups and downs, and the Department of Dermatology and Syphilis, for one, was in a slump. Consequently a committee of the Trustees and Staff was appointed to consult with the Harvard Medical School in the hopes of putting Dermatology and Syphilis on an academic basis. This was ultimately successful, and later in the year C. Guy Lane was appointed Chief of the Service, to take his position on February 1, 1936Th e General Executive Committee also stated that in their opinion the Hospital was large enough as regarded the number of beds and that its future lay in the development of better personnel with more adequate facilities to provide improved care of patients and the raising of its standards and effectiveness. During this year a Surgical Execu-
9
CHRONOLOGICAL
HISTORY
tive Committee was formed, which brought together General Surgery and the subdepartments of Orthopedics, Urology, and Neurosurgery. Thus each surgical department had representation in the affairs of the Hospital. During the year, Dr. Arlie V. Bock was appointed Henry K. Oliver Professor of Hygiene of Harvard University, the duties of which included responsibility for the health of the student body. Dr. Bock felt that the facilities of the Stillman Infirmary in Cambridge were inadequate to provide care of the students with serious illness, so he made arrangements between Harvard University and the Massachusetts General Hospital for their care. The University agreed to pay for the care of students in wards at the rate of $15.00 a week. If students desired rooms in the Baker Memorial or the Phillips House, they were expected to pay the difference between this rate and the usual charge for these rooms. This arrangement, with the necessary adjustment for rates, still continues in effect, although because of the close association of the Harvard Medical School with the Peter Bent Brigham Hospital, most of the students are now cared for in that institution. During 1935, a somewhat parallel arrangement was made with the Massachusetts Department of Public Health, which had requested that patients from state tuberculosis sanatoria requiring surgery be admitted to the Massachusetts General. This was because what is now known as thoracic surgery had been begun around 1908 at the Massachusetts General by Dr. Samuel W. Robinson and continued successively by Dr. Wyman Whittemore, Dr. E. P. Richardson, and Dr. Edward D. Churchill. Arrangements were made for the patients to be admitted to the Baker Memorial. The state was to pay for their care, and a fee of $25.00 per operation was to be paid the surgeon. During the many years that this arrangement continued, other surgeons developed skill in thoracic surgery, and finally the staffs of other hospitals and of the State Sanatoria became competent to perform these operations. A new accounting system, which had been recommended by Dr. Bigelow, was established during this year. This rearrangement made possible a more accurate report of the operation of the various departments and formed a basis for the development of a budget system which was adopted a few years later. The Food Store, including the purchase of food, was placed under the direction of the Dietitian, a start toward the ultimate concentration IO
1935 of responsibility for the purchase, preparation, and serving of food under the Dietary Department. Before this, the responsibility had been divided among the Administration, the Dietary Department, and the Nursing Department. Pay cafeterias were beginning to make their appearance in hospitals. At the Massachusetts General Hospital, arrangements had existed for the serving of meals to staff members and to guests in a rather desultory manner, but now a regular pay cafeteria was established in a basement room in the Phillips House, formerly used as a lunchroom for nurses and guests. This was the beginning of the present extensive and successful cafeterias that now exist in the Hospital. The Massachusetts General Hospital Training School for Nurses has been particularly successful in attracting women of ability and vision as its leaders and teachers, many of whom have greatly influenced nursing in the United States. The year 1935 marked the retirement of Miss Annabelle McCrae, a graduate of the Massachusetts General Hospital School for Nurses in 1895 and the McLean Hospital in 1903, who taught the "Principles and Practices of Nursing" to student nurses for thirty-three years. Probably no other nurse has ever equaled this record. In 1925, Miss McCrae published Procedures in Nursing, a book in two volumes, which has been used by countless nursing schools for the practical instruction of nurses. In 1934 she was awarded the Saunders Medal for distinguished service in nursing. In 1935 there were 323 student nurses in the Training School; in addition there were 221 graduate nurses serving in the various departments in the Hospital, making a total of 544 student and graduate nurses. While some of the graduate nurses had their own living accommodations outside the Hospital, many of the graduates were housed and all of the students lived in quarters provided by the Hospital, scattered in ten separate buildings. This housing was unsatisfactory and inadequate, and studies were begun to see how it could be improved. The American Red Cross for several years had been urging the training of Red Cross Volunteer Aides in hospitals, with the intention of instructing, during a given number of hours, women who because of this instruction would be able to provide first aid outside the hospitals and who would be willing to serve as volunteers to help with the work within the hospitals. Strange to say, this work was resisted by many hospitals, probably because of fear that such volunteers would disrupt the even tenor of nursing procedures and that they would be II
CHRONOLOGICAL
HISTORY
more of a nuisance than a help. Largely due to the insistence of Miss Betty Dumaine, a former nurse who was one of the Trustees, Miss Sally Johnson, Superintendent of the School of Nursing, agreed to undertake the training of these volunteers, thereby making the Massachusetts General the first hospital in Boston to do this. The wisdom of this decision was shown later by the important part these volunteers played during the war years. Social service at the Massachusetts General Hospital has always been considered an adjunct to the surgical and medical care of patients, and it was the responsibility of physicians to call upon the Social Service Department for its assistance. It was never considered as a part of the administration of the Hospital dealing with admitting or discharging patients or with the setting of rates for their care. Since the Department had always been careful not to intrude itself upon the clinical departments, it was with pleasure that they received invitations from the Orthopedic Fracture Clinic, the Diabetic Clinic, the Peripheral Circulatory Clinic, and the Department of Neurology to attend ward rounds with the physicians connected with these services. They were also invited to attend the Medical Discharge Conferences. In this way the Social Service Department was able to comprehend the medical problems of these patients and to assist and advise the doctors in the disposition of these patients after discharge. The physical changes in the Hospital this year were minor. The open corridor that ran from the enclosed part of the Cross or Brick Corridor, which ended at the West end of the Domestic Building, to the Baker Memorial Hospital was enclosed. Doctors, nurses, and others who had to cross this open corridor during the winter months, protected only by the roof and on the north side by a galvanized iron partition, appreciated this long-needed improvement. The writer can remember, while serving as a "Pup" on the South Surgical Service, wheeling a still partly anesthetized patient across this open bridge in a snowstorm. There were no complications and the patient recovered. The east end of the attic of the Bulfinch Building had been fitted up for medical offices and laboratories some years before, and in 1935 similar arrangements were made for the Surgical Department in the west end of the attic. In this day of almost individual plumbing, it is interesting to note that washbowls were placed in six rooms in Ward E. When it is remembered that Ward E was originally built for the purpose of providing the ultimate in asepsis for surgery, one wonders how the surgeons carried on the necessary technique with the meager lavatory facilities provided in the original ward. I 2
1936
1936 Plans for the White Building. Salary cuts partially restored. Phillips House and Baker Memorial. Some statistics. Celebrations. The first dental intern. Departmental changes. Staff changes.
>~pHis year was marked by signs of economic change, reflecting the country's beginning recovery from the Depression. The bequest of Mrs. Harriet J. Bradbury, made in 1930, to be used for a building of major importance for the care of the sick, had lain idle because of the Depression. As business conditions were now improving, the Trustees felt that they should carry out Mrs. Bradbury's wishes, and a committee was appointed for that purpose. During the year, plans were developed for a central building which would bring together wards at that time scattered in small pavilions. Certain basic principles were adopted: namely, to place all surgical patients in the George Robert White Memorial Building (as it was to be named, in memory of Mrs. Bradbury's brother) and all adult medical patients in the Bulfinch Building; to develop self-contained units, of open wards and single rooms, so as to correct the system of transferring patients from the open "upper wards" to the single rooms of the "lower ward" buildings, and vice versa. In December, Dr. Ralph B. Seem was appointed to assist in the details of planning and construction of the White Building. It had been necessary in 1932 to adopt a salary cut across the board of 5 to 10 per cent, according to various wage levels. This had been accepted graciously by all Hospital employees, and the Trustees were now pleased to be able to authorize a 50 per cent restoration during the year. The cost of living was going up, and so was the cost of operating the Hospital; consequently the Baker Memorial rates, which had been lowered during the Depression, were now restored to their original schedule ($4.50, $5.50, and $6.50 per day). Because prolonged illness sometimes forced patients to remain in the Baker over a period of several months, it was felt that the limitation of $150 for the total
13
CHRONOLOGICAL
HISTORY
professional fee was not fair to the doctors having charge of such cases. It was therefore agreed that the limitation on professional fees should cover a period of only three months, and after that additional charges might be made according to the length of stay involved. During the Depression, the number of patients in the Phillips House had been greatly reduced, but with the return of better conditions, all of the beds (102) were reopened in 1936. The Baker, with 242 available beds, averaged 195 patients daily, thus showing a steady though rather slow rise in the number of patients. The class barriers represented by the Phillips House, Baker Memorial, and the General Hospital were broken down by the adoption of a policy whereby Phillips House patients, in the event that Phillips House was full, might be cared for in the Baker Memorial until rooms were vacated in the Phillips House. This same policy was extended in later years, to allow Phillips House patients or Baker Memorial patients to be admitted to the General Hospital. In other words, it was the intention of the Hospital to take care of the needs of the sick regardless of their economic or social condition. For many years it had been the policy of the Hospital to staff the General Hospital wards almost exclusively with student nurses, using the senior students as head nurses. Graduates were used almost exclusively in the Phillips House, and the Baker Memorial had a mixture of graduate and student nurses. Study of this situation led the Trustees to approve of the suggested policy of reducing the number of students in the nursing school and replacing them on the hospital wards and floors by graduate nurses in a ratio of three graduates to four students. This was done in order to give the students better education and supervision, and ultimately to give the patients better care. In its report for 1936, the General Executive Committee noted that since 1910 there had been a 35 per cent increase in patients but a 66 per cent increase in personnel, and that this latter rise was due in part to the expansion of resident service in the Medical and Surgical Departments extended later to specialties. This larger number of residents and interns was the result of the greater complexities of diagnoses and treatment, the development of special departments, and, in part, a change in the type of cases coming to the Massachusetts General. For instance, in 1906 there had been 200 cases of typhoid fever, while in 1936 there were 10. The summer flood of typhoid patients had been replaced by patients with other conditions, often requiring more time for diagnosis and more varied treatment. In 1906, there had been listed 1,922 major surgical operations; in 1936 there were 5,640. Analysis of H
1936 the types of operation reflected not only the progress surgery had made during this period but the changes the Hospital had made in meeting the needs of the community. In 1906 the majority of operations had been for appendicitis and for hernia. In 1935, the actual number of operations for these conditions had remained practically the same in spite of a fourfold increase in the total number of surgical procedures. The increase in the total was in the more complicated operations for goiter, brain tumor, for cancer in all parts of the body, and in chest operations. The Massachusetts General Hospital's annual Ether Day celebration on October 16 further demonstrated the advances of medicine and the changes in hospital care. Dr. Paul D. White presented a most interesting study of the treatment of heart disease at the Massachusetts General from 1821 to 1936. He contrasted not only the changes and improvements in the medical and surgical care, but also noted the increase in the amount and cost of equipment used. This was graphically shown at a "Come and See; Go and Tell" party given for the Community Fund, where there was exhibited the equipment for 1900, consisting of the most simple furniture — a bed, tables, and chairs, costing $54.35 — and the equipment used in 1936, including oxygen tents, adjustable beds, and other bedroom furniture, costing approximately $350. It might be well to note that although it cost far more to care for cardiac patients in 1936 than it had in 1900, it was also possible to cure more of them. On Ether Day evening, the House Pupils' Alumni Association dinner, held at the Harvard Club, was attended by 1 5 2 members. There were six speakers, each representing in his reminiscences a decade of House Pupils. Another celebration held during 1936 had marked the twenty-fifth anniversary of the Genito-Urinary Department, or Urological Service, as it is now designated. At the dinner, held at the Harvard Club on March 28, the principal speaker was Dr. Hugh Cabot, who had been largely responsible for the establishment of the Service and who had served from 1 9 1 1 to 1919 as its first Chief. The Dental Service, which had grown in importance since its establishment in 1868, took another step forward with the authorization in 1936 of the first dental intern. The Dental Service, which during its long career had been tossed about between the Harvard Dental School and the Hospital, had at last come to rest in the OutPatient Department in 1919 when the Dental School moved to new quarters on Longwood Avenue, and had at that time acquired a Den15
CHRONOLOGICAL HISTORY
tal Surgeon and a Dental Assistant Surgeon and a Dental Intern. This authorization of an intern was on an experimental basis, with the stipulation that the intern should live out and should receive only his meals. However, the experiment was a success, and by 1950 there were two regular dental interns and a resident. The Ladies' Visiting Committee had contributed for many years the major portion of the salaries of the Occupational Therapist and a portion of certain salaries in the Social Service Department. In 1936, convinced of the usefulness of the positions involved, the Trustees relieved the Ladies' Visiting Committee of that responsibility. Thus what started as an experimental project became, as has often happened, an accepted responsibility of the Hospital. The man often creates the position, and when the man departs the position often disappears, too. A good example of this is the position of Chief of the Medical Out-Patient Department, which was first established in 1920 and then had been abolished in 1929. The need for a strong hand to direct the Medical Department was so obvious and the ability of Dr. William B. Breed was so apparent that in 1936 he was appointed Chief of the Medical Out-Patient Department. A resurgence of this department was the immediate result. During this year, the General Executive Committee, after a careful study, recommended that the two separate divisions of the Surgical Service be continued. Dr. Arthur W. Allen was appointed Chief of the East Surgical, Dr. Edward D. Churchill continuing as Chief of the West Surgical. It is also worth mentioning that in 1936 Dr. H. K. Beecher was appointed Anesthetist, because it is under his direction that the Anesthesia Department of the Hospital has made such startling advances. In the same year, Dr. Edward Benedict established an Endoscopy Clinic, one of the few clinics of this sort in the country. Having served for eleven years as chairman of the General Executive Committee, Dr. J. H. Means asked in 1936 to be relieved, and Dr. E. D. Churchill was elected to the position. This committee, which had been formed in 1912 to promote cooperation among the Trustees, Staff, and Administration, had been successful from the start, and under Dr. Means' chairmanship (1925-1936) had become a very important factor in the formation of policies, the developing of teaching and research, and the operation of the hospital. There were other changes in the staff, too. Dr. E. Lawrence Oliver, Chief of Dermatology and Syphilis since 1929, resigned, and was appointed to the Board of Consultation. He had been a member of the 16
1937 staff since 1911. Dr. C. Guy Lane, who had been on the staff since 19x9, was appointed to take Dr. Oliver's place. Mrs. Mary Bartlett Noyes, a good friend of the hospital, died. She was the great-granddaughter of the Reverend John Bartlett, who as Chaplain of the Boston Alms House wrote the letter urging the erection of better Hospital facilities for the insane and the sick poor, thus making the first effective step toward the founding of the Massachusetts General Hospital. Mr. Joseph A. Tomasello, a Trustee appointed by the Governor in 1935, died in February, 1936.
1937 Plans for White Building. Health Clinic. V.O. Clinic. State arthritics. Blue Cross. Million-volt X-ray. Unit record system. General Executive Committee reorganized. Sleeper report on Nursing Service and School.
TN THE chapter on "The Physical Plant of the General Hospital" Dr. Washburn noted that "the growth of a modern hospital in bricks and mortar is necessarily the story of tearing down and building and tearing down and building again," 1 a counterpart of the process of metabolism in the human body. Of all the buildings erected between 1821 and 1900 only the Bulfinch Building has escaped this fateful process, and even the Bulfinch has been completely remodeled inside. The year 1937 saw the sacrifice of many buildings in order that better facilities might be provided. Early in the year the plans for the George Robert White Memorial Building were completed. The central location selected necessitated the destruction of a number of existing buildings (see map, p. 148) and a serious disruption of the operation of the Hospital was inevitable. On March 1 began the moving of patients, the rearrangements of services, and the tearing down of buildings that was to continue throughout the year. First came the demolition of the Gay Ward (1884), the original Out-Patient Department; the Bigelow Surgical
17
CHRONOLOGICAL
HISTORY
Amphitheatre (1867); the old Accident Room and Recovery Room, then occupied by the X-ray Department; and the House Officers' Flat above them (1878). The Surgical Building, built in 1901, outgrown but still in excellent condition, was next. A temporary operating building was erected to provide for General Hospital surgery. Excavation, the sinking of caissons, and driving of piles continued until the end of the year. Since the opening of the Baker Memorial in 1930, nurses, residents, and interns had occupied several of the floors. The growing demand of patients forced the Hospital to provide other quarters for the nurses and also for employees displaced from the old Gay Ward, in newly purchased houses on Parkman Street. Employee health presented another problem. A hospital should set an example in the field of preventive medicine and obviously should provide the very best facilities for preserving the health of its employees. The staff had always met every request of the administration for the care of the employees, in the Out-Patient Department clinics and on the wards. Residents held sick calls for nurses and employees in the Emergency Ward and often visited the dormitories, but nevertheless there had never been satisfactory continuity of care. Dr. Robert S. Palmer was asked to study this situation, and, after consultation with Colonel Frederick F. Russell of the Harvard School of Public Health, it was decided to establish a Health Clinic under the direction of Dr. Palmer, assisted by Dr. Neil Crone, Dr. Myles P. Baker, and Dr. Thomas V. Urmy. The clinic was to be housed in the Female Medical Department and was to be open for all employees from 8 to 10 A.M. weekdays. This was the beginning of a hospital service that has become so important that we wonder how the Hospital ever got along without it. The ancient taboo which held that the Department of Public Health should never intrude on the clinical field of medicine was gradually being replaced with the more sensible attitude that public health departments, doctors, and hospitals were all interested in the prevention of disease and in providing the best possible care of patients. The appointment of Dr. Thomas Parran as Surgeon General of the United States Public Health Department marked the beginning of a determined effort to control and possibly to eradicate venereal disease. To this end, the Federal and State Departments of Public Health established and supported venereal disease clinics in many hospitals. One of these was established at the Massachusett General Hospital in the Male and Female Urological Department and in the Syphilis sec18
1937 tion of the skin service. The combined Public Health Departments paid the hospital 75 cents per patient visit. They also employed and paid competent doctors to instruct practicing physicians, residents, and interns in the proper care of these diseases. Also a public health nurse was employed to follow up cases outside the hospital. This was very important in order to insure that patients with infectious conditions continued treatments. The hospital paid the nurse but was reimbursed by the Department of Public Health. It was the policy of the United States Public Health Service to require continuity of service at these clinics and, to obtain this, modest salaries were paid to the Out-Patient physicians in charge of these venereal disease clinics. Heretofore all professional services in the Out-Patient Department had been given without charge. Under the prodding of Dr. Robert B. Osgood, formerly Chief of the Orthopedic Service at the Hospital, assisted by others, the State Department of Health had become impressed by the prevalence of crippling arthritis and interested in trying to improve the care with the hope of achieving the prevention of this condition. Largely through his efforts, the Massachusetts Legislature was convinced that rather than to build a special isolated hospital, it was wiser to associate this project with a general hospital, thus providing the opportunity of consultation with other departments of medicine and the use of elaborate laboratories already at hand. The Massachusetts General Hospital had been carrying on under the direction of Dr. Walter Bauer a study of arthritic patients for eight years and, impressed by the work done here, the Legislature appropriated $30,000 to be used for the care and examination of not more than twenty arthritic patients at one time in the hospital wards. This study, which has done much to advance the treatment of this disease and to improve the welfare of such patients, was wisely carried on by the Legislature from year to year until the opening of the Lemuel Shattuck Hospital in Forest Hills in October 1954· The Massachusetts Hospital Service Corporation, now known as the Blue Cross, was established in August, 1937. It was one of the first state-wide service corporations. The contract at the Massachusetts General Hospital was signed on August 20, and the first "Blue Cross" patient was admitted to the Phillips House on September 3. This is not the time or place to detail the history of Blue Cross. Suffice to say that the prepayment plan for hospital care developed by Blue Cross fulfilled a long-felt need of the people, that it has been of inestimable benefit to them and of great financial aid to hospitals, and 19
CHRONOLOGICAL HISTORY
has become so integrated with our hospital system that now it is inconceivable to think of their ever being separated. The same is true for the prepayment plan for meeting professional fees developed later by Blue Shield. The doubt that had been expressed by the Trustees when they consented to collaborate with the Community Fund two years before had been dispelled, and the Trustees noted "with appreciation the splendid results achieved by the Community Federation, with a special gratitude to all who had had their gifts designated to the Massachusetts General Hospital."2 The practice by the Hospital of collaborating with other institutions was shown by the facts that during this year studies were going on with the Massachusetts Institute of Technology on radioactive iodine, with the Huntington Memorial Hospital on thyroid hormones, and at the Harvard Medical School and the University of Leeds, England, on pernicious anemia. Moreover, a community of interest growing for some years between the X-ray Department of the Massachusetts General Hospital and the Physics Department of the Massachusetts Institute of Technology resulted in a plan for Massachusetts Institute of Technology to build a new model high-voltage energy machine, to be installed in a lead-shielded room in the White Building. Massachusetts Institute of Technology was to provide the engineering know-how and the Massachusetts General Hospital was to operate the apparatus and appraise the results in the treatment of cancer. At the Massachusetts General Hospital, patients' records have always been carefully kept, but with the growth of the Hospital a situation had developed in which the same patient could have five separate records: an Out-Patient record, a Baker Memorial record, a Phillips House record, and an Eye and Ear Infirmary record, in addition to his General Hospital record. After serious study the Record Committee recommended the adoption of a unit record system, whereby the record of each individual patient in all departments of the Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary would be collected in one folder under a unit number and that all subsequent admissions in any department would be chronologically included. This was approved by the Trustees and Managers and the unit record system was started on January 1, 1937. During the year the General Executive Committee was reorganized, to consist of the Medical Chief and one other from the Medical
20
1937 Service, the two Surgical Chiefs, the Pathologist, the Roentgenologist, and the Director, thus recognizing the growing importance of the Laboratory Services. A Surgical Executive Committee had been established in 1 9 1 1 . The Medical Executive Committee, which had been formed at the same time and which had lapsed, was revived, to include the Chief of the Medical Service and the Heads of the Department of Dermatology, Children's Medical, Neurology, and Psychiatry and the Director. These General, Medical, and Surgical Executive Committees play a very important part in the happy relationship that exists among the Trustees, Staff, and Administration and in the formation of policies affecting the operation of the Hospital. The Nursing School was having problems. Advances in medicine necessitated instruction of nurses in medical subjects as well as the usual instruction in nursing procedures. This upset the former division of students' time between classrooms and ward service. Some felt that the educational functions of the school were being encroached upon by the demands of nursing service to patients. It was finally decided to release Miss Ruth Sleeper, Assistant Principal of the school, from her routine duties to make a study and to present recommendations for remedying this situation. Within the last ten years a number of schools of nursing had been established as departments within a college or university. At the end of five years they gave a degree of Bachelor of Science and a Diploma of Nursing. In hospital schools only a Diploma of Nursing was awarded after three years. The primary object of any school is education, but in nursing didactic education must be supplemented by practical experience. It is obvious that collegiate schools, by reason of their longer period of study, can give superior instruction; on the other hand they may emphasize this to the detriment of the vocational aspect. Hospital schools conversely may be tempted to misuse a student's time, with overmuch practical training in some subjects in order to meet its need for nursing service to patients. The object of Miss Sleeper's study was to develop, insofar as possible, in the Massachusetts General Hospital School a proper balance between nursing education and nursing service. On July 7 Miss Sally Johnson, Principal of the Nursing School and Superintendent of Nursing Service, presented to the Advisory Committee of the Nursing School the first results of Miss Sleeper's studies. It was a comprehensive and far-reaching report and from it arose important changes, begun in the following year, in the School and in nursing service. For the school it recommended the development of a 2 I
CHRONOLOGICAL
HISTORY
better educational program with greater emphasis on ward teaching. For nursing service it recommended replacing student service on wards with more graduate nurses and other personnel. As both of these recommendations involved sizable financial expenditures for additional supervisors, teachers, and ward nurses, the report was referred to the Advisory Committee and the hospital Trustees for further consideration. Although the student library in Walcott House was obviously too small, since no other quarters were available it was decided that it could be made more adequate by the employment of a fulltime librarian. Miss Maxine Bailey was first employed on a voluntary basis, then on a special grant to the library and the work of cataloging the books and rearranging the library began. Another immediate improvement stemming from Miss Sleeper's report was an arrangement whereby nurses graduating from the Massachusetts General Hospital Training School who had had two years of college could obtain from Simmons College, at the end of one year of study, the degree of Bachelor of Science. This made the Massachusetts General Hospital graduates eligible for teaching positions in nursing schools. The Dietary Department reported that the cafeteria was increasingly popular and that a satisfactory meal could be bought on a check for 28 cents. Sixteen students had graduated from and eighteen had entered the Hospital School for Dietitions. A statement regarding a reduction in the amount of "edible garbage" from the wards and floors through a careful inspection and weighing was received with considerable amusement, but by "edible garbage" was meant food which had been served to a patient or had been taken by an employee, and then wasted. It still takes constant care and supervision to prevent this waste. The installation of the cafeteria system, where people pay for all food taken, now provides automatic control of "edible garbage." With wages and prices constantly going up, it was necessary to devise ways of producing higher income for the Hospital. To this end, a charge of $15 for anesthesia given by nurses in the Phillips House was established, with the understanding that Dr. Beecher and other medical anesthetists could charge a higher fee, which fee, however, would be credited to the Department of Anesthesia to establish an anesthesia fund. Ward charges at the Massachusetts General Hospital were increased from $17.50 to $24.00 a week and Baker Memorial rates were increased by 25 cents a day per room. During the year the Hospital received a letter from the American 22
1937 Medical Association, requesting them to adopt the policy of appointing to the Staff only members of the American Medical Association. The Trustees voted "that in view of the fact that out of 231 members of the Staff only nine are nonmembers of the American Medical Association, and these nine for good reasons, the Trustees feel that the favorable attitude of the Hospital toward the policy outlined by the House of Delegates is clearly demonstrated; that nevertheless they also feel that the Hospital must and should retain full powers in the appointment of its staff and that they authorize the Director to embody these conclusions in his reply to the Association." 3 During the year Dr. Frederic A. Washburn, the Director Emeritus, was requested to write the history of the Hospital from 1900 to 1935. A small experimental laboratory started in this year by Dr. Robert W. Schwab, with his apparatus tucked into a closet in one of the rooms used by the Social Service Department in the Bulfinch Building, was destined to grow later into an elaborate Electroencephalography Laboratory. The Assistant Director, Dr. Albert G. Engelbach, resigned on February 19, to become Director of the Cambridge Hospital (now the Mount Auburn Hospital). Dr. Gerald F. Houser, formerly of the Boston State Hospital, was appointed Assistant Director on March 1. Two doctors resigned and were appointed to the Board of Consultation: Dr. Benjamin H. Ragle, member of the Medical Staff since 19x7, on February 3, and Dr. William David Smith, member of the Medical Staff since 1916, on January 22. The Annual Report noted the following deaths: Dr. Robert B. Greenough, a member of the Surgical Staff from 1909 to 1932, and a member of the Board of Consultation since 1932, on February 16; Dr. William M. Conant, a member of the Surgical Staff from 1891 to 1914, a member of the Board of Consultation from 1914 to 1929, and an Honorary Surgeon since 1929, on February 18; Dr. Daniel Fiske Jones, a member of the Surgical Staff from 1903 to 1929, and of the Board of Consultation since 1929, on September 1 1 ; Dr. Harry P. Towle, a member of the Dermatological Staff from 1903 to 1925, and of the Board of Consultation from 1925 to 1936, and an Honorary Physician since 1936, on October 7; Mrs. Henry B. Sprague, for thirtyfive years a member of the Ladies' Visiting Committee; Mr. Alf C. Lootz, Superintendent of Works since 1922, on February 2 1 ; Mr. Ira Decker, for thirty-two years a faithful employee of the Hospital as a painter, on December 29.
23
CHRONOLOGICAL
HISTORY
I938 Cornerstone of the White Building. Nursing. North End Diet Kitchen. Laboratories. Hospital Research Council. Appointment system in Out-Patient Department. Residents and resident quarters. Social Service. Hospital finances.
'"pHE Trustees noted in their report that "during the year 1938 there had been rising in the middle of the hospital grounds the skeleton and shell of the new George Robert White Memorial Building. As a monument it already commands attention though its life has still to begin." 1 The last pile for the foundation was driven on December 31, 1937, and the excavation work was completed by January 14, 1938. During the winter of 1937-38 operations on the White Building were suspended. A sizable pond collected in the excavation, leaving only a few iron rods projecting from the caissons showing. One morning a wooden fisherman complete with pole and line appeared on one of the caissons. The next morning he was joined by a rainbow collection of live ducks: purple, green, red, blue, brown, and white. What breed could these be? Speculation ran rife and it was anybody's guess. The ducks paddled contentedly in their pond for about two weeks, then disappeared as suddenly as they had appeared. Cautious detective work finally solved the mystery, by working backwards. The night of the disappearance coincided with the "Change Day" of a certain surgical service. The pièce de résistance of the Change Day dinner was roast duck. Ergo, the ducks belonged to that service. The varied colors — oh, those were stains from the Pathological Laboratory, methylene blue, carbol fuchsin, and other dyes, liberally applied before release in the pond. It was a good joke which occasioned much comment, speculation, and enjoyment. On May 1, the water was pumped from the excavation and the Sawyer Construction Company went to work. The erection of the steel frame was begun on August 1, and on November 15, workmen 24
1938 triumphantly hoisted a flag on the final section. The outside brick work, which was begun on the lower stories even before the steel frame was finished, was completed on December 16. The cornerstone was laid with appropriate ceremonies on December 23, 1938. Warmed by "salamanders," work was continued inside the building during the winter. The power demands that would be made by the White Building necessitated consideration as to whether it were wiser to enlarge, at considerable expense, the existing powerhouse which had served for forty years or to contract with the Edison Company to provide steam. A contract with the Edison Company was agreed upon, and to avoid power failure it was stipulated that supply must be connected with both the North and South power plants. The final results of the study (see 1937) made by Miss Sleeper on the reorganization of the Nursing School were placed before the Trustees late in the year. It was adopted in principle by the Trustees, although it was recognized that it would take several years to attain the objectives. As all desired to make a start, $24,000 was authorized to provide additional teachers, more graduate nurses, additional ward helpers, a night operating graduate nurse, and a supervisor for ward teaching. The hours of duty for students were to be reduced and teaching was to be placed on a junior-college grade. The school was to be an amalgamation of vocational training and academic instruction. Since in addition to the nursing students, there were 182 graduates from 69 different schools, it was decided to hold classes for these graduates in order to try to provide some uniformity in procedures. During the year a joint commission on the cost of nursing service was established by the American Hospital Association, the American Nurses Association, and the National League of Nurses' Education. Fourteen hospitals were to be studied, and the Massachusetts General Hospital was included. Miss Maxine Bailey's work in the Nurses' Library had produced such satisfactory results that the library budget was increased and she was appointed Librarian. In 1938, in order to reduce overhead expenses, the corporation of the North End Diet Kitchen was dissolved and its charter was surrendered to the Massachusetts General Hospital. In 1923, at the request of the directors of the corporation, the Kitchen, which since 1874 had served food to the needy as a specialized charity of the City of Boston, had become affiliated with the Hospital and had begun operations as a Diet Clinic in the Out-Patient Department. At that 25
CHRONOLOGICAL
HISTORY
time a Hospital dietitian had been put in charge of the Kitchen. Permission was received from the courts in February 1938 to turn over the invested funds of the North End Diet Kitchen to the Hospital, which ever since then has continued to use them for the purpose of teaching diets to patients and of giving special food orders to enable the sick and needy to follow their prescribed diets. The founding of the American Dietetic Society took place in the same year as the appointment of the first dietitian to the Phillips House, in 1917. The growth of this society coincided with the advance in diets and dietary care at the Massachusetts General Hospital. During 1938, over two million meals were served, often with 1800 persons being served daily. The "take it and like it" days were past. The importance of food for sick people and the necessity of presenting food so that it would be eaten had become well recognized. The new pay cafeteria had proven a great success, a victory for the principle of free choice. A study of laboratory relationships recommended by the General Executive Committee in 1937 resulted in the establishment of three separate groups of laboratories: (1) clinical laboratories, doing routine work for the services and charging patients according to a schedule for this work — this income supported the laboratories only in part; (2) research laboratories, to the support of which the Hospital was to contribute quarters, maintenance, and service, but salaries of all personnel, equipment, and supplies were to come from other sources; (3) a special group where both clinical and research work was carried on, so closely associated that they could not be separated, where it was necessary to provide mixed support. This action had become necessary because the numerous laboratories of the Hospital had evolved either to meet clinical demands or by reason of personal interest and initiative of individuals, in the fields of clinical work or of basic research. Procedures which began as pure research were often adopted by clinical services to such an extent as to become routine. It was obvious under such conditions that they should be transferred from research to clinical laboratories. In order to coordinate the many clinical laboratories which were scattered throughout the Hospital and to instruct house officers in proper laboratory technique, Dr. Francis T. Hunter, who had been in charge of the Phillips House and Baker Memorial laboratories, was appointed Clinical Pathologist. Research was growing at such a pace, involving so many persons and such a variety of investigation, that it seemed wise to devise some 26
1938 arrangement for the exchange of information and to prevent unnecessary duplication of work. In June, the General Executive Committee authorized the formation of a Hospital Research Council "to keep all investigators in the Hospital constantly informed of the activities of their colleagues — a clearing house and censor of all reports prior to publication." 2 Dr. H. K. Beecher was chosen as secretary and monthly meetings were to be held. The number of clinical meetings had increased to such an extent that they began to interfere with each other, and so the General Executive Committee brought about a reorganization of these teaching activities whereby all clinical meetings were concentrated on Thursday: Surgical grand rounds at 9 o'clock; Neurological Staff Conference from 9:30 to ix; Medical grand rounds at 1 1 , and the Clinicopathological Conference at 12. The old distinctive pattern of the East and West Surgical was gradually breaking down and had now reached the point at which members of the staff often served part of their time on the East Service and part on the West, much to the advantage of Residents and House Officers, who benefited by the varied techniques and methods of the staff members. Crowding at certain hours, delays in seeing patients who needed prompt attention, and uncertainty on the part of the patient as when to come again had always plagued the Out-Patient Department. Hoping to relieve this situation, an appointment system for return visits was begun in the Medical Division. Also a resident and assistant resident were assigned to make a quick examination of all new patients or old patients who returned with new complaints, to sort them according to their needs for immediate attention or later appointments, and to act accordingly. The Staff Clinic, which had been started in the previous year, had grown rapidly, listing 1801 visits with all Hospital groups attending. All food handlers were examined before being employed and typhoid immunization was advised and offered to all employees. The Resident Staff was gradually growing larger and the problem of quarters was increased by inclusion in the Staff of a number of married men. The Trustees voted on March 25 "that all Residents, Assistant Residents and House Officers shall be provided, if possible with quarters and shall be required to live in while on duty. If quarters cannot be provided by the Hospital a monthly allowance for commutation of quarters will be allowed." 3 In order to provide rooms for house officers and residents, the nine-bed wards in the Baker Memorial
27
CHRONOLOGICAL HISTORY
were vacated, the patients being moved to four-bed rooms in the same building. Thirty-three years had changed not only the conjugal condition of the resident staff but also the attitude of hospital authorities in regard to the appointment of married house officers. In 1905 Dr. Clarence E. Ordway, who had been married for several years, had, by special dispensation, been appointed to the West Surgical Service. All the other house officers were bachelors. When the writer, then the South Surgical "Pup," innocently petitioned the Trutees for permission to be married during his service, he shook the Hospital to its foundations. After a lengthy judicial consideration of the circumstances, permission was granted, subject to exact stipulations intended to insure full performance of duties. Now married house officers are commonplace. Because of the administrative demands in Social Service on Miss Ida Cannon, it became necessary to appoint Miss Josephine Barbour as an administrative assistant, and Mrs. Eunice W. Wilson as supervisor of social work. A real step forward was achieved when the medical staff agreed that social-service information recorded on a separate sheet could be included in the medical records. It had been customary for nurses and doctors in following up the results of treatment on patients to turn to the Social Service Department to do this work. These demands had now become so great as to hamper social work and it became necessary to restrict this "follow-up" work and to try to transfer it to the Record Room and other departments and at the same time to regulate clerical work and other expenses. During this year the Boston Council for Social Agencies began a study on convalescent care in Boston which was to continue for nearly three years. After eight years of operation, the Baker Memorial Hospital had in 1938 at last achieved a profit of $11,000. The daily average number of patients during the year was 206, proving that it was necessary to have an occupancy of above 200 patients in order to absorb overhead, thus vindicating Dr. Washburn's insistence on "at least 300 beds." Anesthesia in the General Hospital had been improved to such an extent that it was decided to expand the service to include both the Phillips House and the Baker Memorial. During the year 91 volunteers from the Junior League and Red Cross Hospital Aides gave over 19,126 hours of service. The hospital has benefited throughout its long existence from a varied and extensive service by volunteers. The spirit of voluntary service supplements and
28
1938 aids the service of those who have entered hospital work as a vocation. Apart from the physical aid that such service brings to the Hospital, volunteers were welcome for the unselfish and spiritual bond through which their service tied the hospital to the community. When the Social Security Act was passed in 1935, hospitals were not included, although the American Hospital Association had been given to understand that they would be covered in that part dealing with the Old Age Assistance. In 1938 the Association began an effort to have hospitals included, by amendments to the original act. They asked their members to support this movement, and the Trustees decided to do so. It was not until 1943, however, that Congress passed such an amendment. At the Annual Meeting, the Treasurer, Mr. Ketchum, submitted the following interesting comparison of Hospital finances: In 1 9 0 1 , the hospital spent about $134,000 for food and supplies of all sorts. In 1 9 3 5 , it spent for that purpose about $806,000, a little over six times the amount in 1 9 0 1 . In 1 9 0 1 , the hospital spent about $65,000 for all salaries and wages. In 1 9 3 5 it spent for that purpose about $1,324,000, about twenty times the amount in 1 9 0 1 . In 1 9 0 1 the total receipts from patients were about $67,000. In 1 9 3 5 they were about $1,493,000 or about twenty-two times the amount in 1 9 0 1 . . . During this period, the Hospital received total principal gifts of over 1 7 million dollars. These made an enormous change in the financial position of the Hospital because in 1 9 0 1 the total funds of the Hospital were under $3,000,000. During the period, several million dollars were invested in hospital lands and buildings . . . The total of these deficits for the whole period from 1 9 0 1 to 1 9 3 5 inclusive was over $2,000,000. This had to be paid for from the Hospital's unrestricted funds. 4
It was decided that the Corporation should be enlarged, so at the Annual Meeting seven new members were elected. Furthermore, it was voted that amendments could be made to the rules of the Trustees, the majority of the full board being present and voting in the affirmative. During this year, Dr. George Gilbert Smith was appointed Chief of Urology, replacing Dr. J. D. Barney, who, reaching the age limit, was appointed to the Board of Consultation. Mr. William Endicott was appointed President of the Corporation. Dr. Lincoln Davis, a member of the Surgical Staff since 1903, Chief of the East Surgical Service from 1929 to 1932, and member of the Board of Consultation since 1932, was appointed Trustee. Miss Anna G. Griffen, R.N., was appointed Assistant Superintendent of Nurses, Baker Memorial. The following deaths took place during 1938: Dr. James J. Minot,
29
CHRONOLOGICAL HISTORY member of the Medical Staff since 1886, Board of Consultation 1 9 1 3 1929, Honorary Physician 1929-1938, died on April 30; Mr. Andrew J. Peters, Trustee 1 9 3 1 - 1 9 3 5 , and Member of the Corporation 1 9 3 5 1938, died on June 26; Mr. Nathaniel T. Kidder, Trustee since 1910 and President of the Corporation since 1931, died on July 13; Miss Gertrude M. Gates, Chief Nurse at Baker Memorial from 1930 to 1938, died on September 12. Dr. Luney V. Ragsdale, Assistant Director 1 9 3 1 - 1 9 3 8 , resigned to become Director of the Butterworth Hospital, Grand Rapids, Michigan. Four physicians resigned and were appointed to the Board of Consultation: Dr. J. Dellinger Barney, Member of the Surgical Staff since 1906 and Chief of Urology 1920-1938; Dr. Harry F. Hartwell, member of the Hospital Staff since 1904; Dr. William B. Robbins, member of the Medical Staff since 1913; and Dr. Channing C. Simmons, member of the Surgical Staff since 1904.
I939 The Chapel. Dedication of White Building. Resident training. Neurosurgery. Syphilis Clinic. Dr. Washburn's history published.
Τ Ν THE Annual Report for 1939, the Trustees told of the plans for a chapel: During this year, while the White Building was under construction, Bishop Lawrence, meeting with the Trustees, called attention to the fact that while medical skill in healing had grown enormously and the hospital structure had increased in size and scientific equipment, there had been no provision for a place where doctor, patient, nurse or visitor could withdraw with his hopes, his fears, his sorrows or his impulse for thanksgiving, and where, in silence and solitude, his spirit could gain consolation and strength. He suggested the building of a Chapel conveniently incorporated in the hospital structure and offered to raise the necessary funds for this purpose, the new Chapel to be used by those of any creed. The Trustees gladly accepted his offer. He, alone, raised for this Chapel over fifty thousand dollars from about eight hundred different donors, and hopes that a modest additional sum may be obtained for endowment. The plans for the Chapel have been made with great care and the actual building will soon begin. This work was done by Bishop Lawrence in his ninetieth year. 1
30
1939 On October 16, the ninety-third anniversary of Ether Day, the George Robert White Memorial Building was dedicated. Following the Trustees' luncheon, which was attended by over 600 people, dedicatory exercises were held in a tent on the lawn. Dr. Frederick A. Coller, West Surgical 1914, Professor of Surgery at the University of Michigan Medical School, gave the address. Although it was a keen October day, heaters within the tent made it comfortable for the 2000 people who attended and who afterwards roamed through the new building. "By the terms of Mrs. Bradbury's will, not over two and a half million dollars could be used from the White Fund ( over four million dollars) for the erection of this building. The total cost of the building was approximately $2,546,000, the excess being paid from the general and special funds," 2 reported the Director. Occupation of the new building began on October 19 and was completed on January 22, 1940. A meeting of the House Pupil Alumni Association, held in the evening of Ether Day at the Harvard Club of Boston, was attended by 224 members. It was a most successful gathering, with informal addresses, reminiscences, and a poem by "Fritz" Irving. Miss Muriel McLatchie, medical artist, designed a flag which, together with the national flag, is flown at the front of the White Building each Friday when the Trustees meet and on other special occasions. Mr. Macomber, President of the Trustees, somewhere found a coat of arms of the old Province House, which he presented to the Hospital. It is now displayed in the lobby of the White Building. In memory of Dr. Richard C. Cabot, who had done so much for and who had been connected in so many ways with the hospital, particularly in relation to the Social Service Department, the Cabot Room was established in the former Treadwell Library Committee room, and furnished with many of Dr. Cabot's personal belongings. The problem of quarters for the resident staff was partially solved by remodeling the second and third floors of the Baker after the removal of the General Hospital patients to the White Building and the Bulfinch. Further resident problems resulted from the requirements for accreditation set up by various national examining boards in specialties which had led the General Executive Committee in 1955 to appoint a subcommittee to undertake, in collaboration with the Harvard Medical School, a reorganization of resident training to make it easier for the residents to conform to the exacting requirements of the boards. The results of this investigation, including a complete discus31
CHRONOLOGICAL
HISTORY
sion of the problem and detailed plans of procedures to be adopted by the Hospital, were drafted by Dr. E. D. Churchill and submitted to the Trustees for approval. With their acceptance late in the year they were put into effect in all departments. The story of resident training at the Massachusetts General Hospital during this era will be presented in a separate chapter. Here it is only necessary to quote the General Executive Committee's statement: In General Surgery and its sub-divisions, the curricula for both interns and residents are designed to train specialists in some field of surgery and are closely interwoven. The typical training is for a period of five years. In the Department of Medicine the changes are somewhat less striking. The present distinctions between house officers and residents have been maintained. The period of service as house officer has, however, been lengthened from one and a half to two years and a further contact with the medical sub-specialties has been established. At the end of the two years it is believed that students will be well qualified to embark upon the practice of medicine without the necessity of further formal training. For those men who wish, or are selected, to become specialists in internal medicine, or one of its related specialties, residencies are available. The period of service as resident is for three years and does not differ materially from that which has been in operation for several years.3
Dr. Samuel J. Mixter had been a pioneer at the hospital in brain and spinal surgery. His work was being carried on by his son, Dr. W. Jason Mixter. Growth in this type of surgery had by 1939 become so extensive that it was decided to establish Neurosurgery as a subservice under Surgery and Dr. Jason Mixter was appointed Chief. Syphilis, a protean disease, had always been a stumbling block in medical organization. In 1913 a Syphilis Department, known as the South Medical, was set off from Dermatology, operating as a separate department; it was returned to Dermatology in 1929. In the belief that the diagnosis and treatment of syphilis was more properly a part of medicine than of dermatology, a Syphilis Clinic, patterned after the organization of the Tumor Clinic, was set up under the direction of Dr. Francis R. Dieuaide, who was appointed Physician in Medicine and Chief of the Syphilis Clinic. A Children's Medical Executive Committee was formed, and the length of service of residents was increased from nine months to one year. The Nursing School received full accreditation, having met all the requirements for a nursing school set up by the National League of Nursing Education. The effects of the European War were being felt, and the director
32
1939 requested permission to purchase certain supplies, such as gauze, sheets, et cetera, for at least six months in advance, not only to avoid price increases but also to be assured of delivery. The director submitted the first budget to the Trustees, a plan which has been annually continued. Dr. F. A. Washburn's The Massachusetts General Hospital. Its Development 1900-1935 was published this year. Dr. Washburn and Miss Helen Boyer, who assisted him, produced a most interesting and instructive history of the Hospital and its many activities. The Hospital this year received a substantial sum of money to be used for research, the legacy of Miss Grace Edwards, who had been a patient for many years in the Phillips House. The following deaths occurred in 1939: the Vice-President of the Corporation, Mr. Francis H. Appleton, Trustee 1902-1919, on April 5; Dr. Richard C. Cabot, member of the Medical Staff since 1894, Chief of the West Medical Service 1912-1921, Chairman of the Social Service Advisory Committee 1919-1939, Board of Consultation 19211938, Honorary Physician 1938-1939, on May 8; Dr. Algernon Coolidge, member of the Staff since 1886, Chief of Laryngological Department 1911-1920, Trustee 1921-1939, on August 16; Dr. George W. W. Brewster, member of the Surgical Staff since 1893, Board of Consultation 1927-1936, Honorary Surgeon 1936-1939, on September 26. Dr. Gerardo M. Balboni, Associate Physician, a member of the Medical Staff since 1913, resigned on June 23 and was appointed to the Board of Consultation. The following appointments were made: Mr. Henry R. Guild, Treasurer of the Corporation, on February 1, and Trustee on September 15; Dr. W. T. Sherman Thorndike (West Surgical 1919), Assistant Director, on February 1; Dr. Arthur L. Watkins, Head of Physiotherapy, on October 1.
33
CHRONOLOGICAL HISTORY
I 9 4 O
The 6th General Hospital. Selective Service. Physical changes. Anesthesia laboratory established. Physiotherapy Department. Convalescent Ward. Archives. Salaries for full-time heads of departments. School of Nursing. Psychiatrist-in-Chief and Director of McLean added to General Executive Committee. Ether stamp.
TTITLER'S continued acts of aggression finally led to a declaration of war by Britain and France on September 3, 1939. Although the United States proclaimed neutrality, the war clouds gathered as in World War I and the country began to prepare for what seemed the inevitable calamity of another war. The Trustees wrote, On March 20th., advice was received from the Surgeon General, James C. Magee, U.S.A., asking the Massachusetts General Hospital to organize the 6th General Hospital, to be an affiliated unit of the United States Army Medical Corps, such unit to be called into service in case of war or similar serious situations. After approval by the General Executive Committee and the Trustees, Dr. Thomas R. Goethals was chosen to act as organizing officer and later recommended to be commanding officer of the unit. Representatives of the Medical and Surgical Services were chosen to act as Chiefs of each of these sections and, with Dr. Goethals, completed a roster which was approved by the General Executive Committee. These men were then formally examined and recommended for commissions. To date, twenty six officers have been commissioned and assigned to this unit and there remain twenty nine staff men to be acted upon. Meanwhile Miss Johnson has enrolled eighty five nurses of the Red Cross to be specifically set aside for service with the 6th General Hospital. In addition to the men enrolled in the 6th General Hospital, approximately fifty men have joined the Medical Reserve Corps of the Army or Navy or are assigned to other units. 1 During the year, nine were called to active duty and were granted leaves of absence, to be restored to their former positions on the staff when released from service. A "Selective Service Act" became effective September 16, 1940, and its impact upon the Hospital was immediate. Members of the
34
1940 Staff, residents, interns, and all male employees were subject to the draft. The effect on residents and interns was particularly disturbing. Over twenty of them immediately received questionnaires from their local boards. In replying they asked (and the Director, for the Hospital, filed an officiai request) that induction into service be deferred until after the completion of existing appointments, even though some of these appointments ran for several years. Decision rested entirely with each local board. Most of the boards appreciated the situation and placed the men in Class II-Α for six months, as belonging to a group necessary for maintaining the health of the civilian population. Much confusion, many changes in directives were to follow before final clarification was established by the Procurement and Assignment Service. A part of the Defense Program carried on by the Hospital was the training of Red Cross Nurses' Aides. This had begun in a small way in 1935, but under the stimulation of the war, 60 Aides enrolled, who by contributing their time and work in the wards were of material assistance in meeting the personnel shortages which immediately developed. Many physical changes and readjustments were made during 1940; it was a year of change. Moving the surgical patients to the White Building vacated the entire western wing of the Bulfinch, allowing a rearrangement of the Medical Services and the transfer of medical patients who had been temporarily housed in the Baker Memorial. When the Baker was built, old Wards C and D, which had provided single rooms for medical and surgical ward patients, were demolished, and two floors of the Baker were allotted for their use. A third floor of the Baker was occupied by the Psychiatric Service. The growing popularity of the Baker Memorial now made it imperative to move these patients, and they were distributed: medical and psychiatric cases to the Bulfinch and surgical to the White Building. Completion of these changes increased the bed capacity of the General Hospital from 455 to 466; of the Baker Memorial from 242 to 284. The Phillips House remained at 102, so that the total number of beds became 852. The Children's Medical Service, which had occupied the second and third floors of the central section of the Bulfinch Building, was moved early in January, 1940, to more commodious quarters in old Ward E, which was remodeled for their accommodation. The balcony behind the portico pillars was removed and the rooms on the second floor which had served successively as resident
35
CHRONOLOGICAL
HISTORY
BULFINCH BUILDING
1939
Second Floor
W.M.-3I MALE
E Me leal Bui. 6 Staff Roomr
BULFINCH BUILDING 1939
Renaming of the Bulfinch wards (1939). The old designations are given in capital letters.
36
1940 physicians' quarters, Trustees' Room, Treadwell Library, and Children's Medical Ward 12, were remodeled to serve as a Memorial Medical Staff Room and a classroom. Children's Ward 10 was changed into offices and laboratories for the Psychiatric Service. A mantelpiece which formerly graced the old Treadwell Library and which had been taken by Dr. Algernon Coolidge to 198 Reacon Street in 1925, when the space was made into a ward for children, was given back by Mrs. Coolidge and now is reinstalled in its original location. The Metabolism and Cardiac Laboratories were moved from the basement and placed on the ground floor of the West Wing, a much more convenient location for the many patients going to them. The "Rrain-Wave Laboratory," which started in a closet across the hall, moved to the top floor into new quarters suitable to house a fine machine for encephalography, the gift of Dr. Alfred L. Loomis of New York. The numbering of wards in the Rulfinch Ruilding had long ceased to follow any definite order. The removal of the Surgical Services to the White Ruilding and the remodeling of the Rulfinch Ruilding for Medical Services offered a good opportunity for the adoption of a more rational system of numbering. For historical purposes and to satisfy the nostalgic interest of many generations of House Pupils the equivalents of the old and the new order are here recorded. Old
New
East Surgical: Wards 2 7 and 2 8 West Surgical: Wards 2 3 and 29 Research Ward 4: on first floor West Medical: Wards 1 6 and 3 1 East Medical: Wards 30 and 7 Children's Medical: Ward 1 2 Children's Medical: Ward 1 0
West Medical: Bulfinch 1 and 2 Bulfinch 3: single rooms for isolation Research Ward 4: no change East Medical: Bulfinch 5 and 6 Psychiatric: Bulfinch 7 and 8 Medical Staff Room Psychiatric offices and laboratories
The outward calm of the Rulfinch remains unchanged. Inwardly life flows as vigorously as ever in slightly different channels. This year marked the establishment on White 4 of the first research laboratory in anesthesia in the world, as far as can be ascertained. From it was destined to come greater knowledge of the action of anesthetics, narcotics, and the mechanism of sleep. Ry rearranging the old Emergency Ward in the basement of the Moseley Memorial Ruilding, adequate rest rooms and locker rooms were at last obtained for employees and a new employees' entrance
37
CHRONOLOGICAL
HISTORY
provided. Likewise, in the basement of the Phillips House adequate lockers and a rest room for graduate and private duty nurses was established to meet the long-felt want. Physiotherapy has long been recognized as an important therapeutic agent but has been strangely neglected. The Hospital had operated an active Physiotherapy Department from 1904 to 1917, when it was closed because of World War I. Recognizing the importance of this work, the Trustees voted to establish a Physiotherapy Department, and on October 1, 1939, Dr. Arthur L. Watkins began his duties as head of this Department. At that time Dr. Watkins began visiting the best existing units in other hospitals and in 1940 was engaged in planning a rearrangement of the second floor of the Domestic Building for the use of this Department. All physical therapy treatments were to be concentrated here under medical supervision. Occupational Therapy, which is closely allied to Physical Therapy, was to have quarters on the same floor so that the two departments could work together. Some time before, Dr. Marius Smith-Petersen had suggested that "a convalescent ward be established for orthopedic patients who frequently need long periods of physical therapy and training exercises following operation." Believing that similar cases must exist on surgical and medical wards, the Trustees authorized the establishment of a Convalescent Ward, and Ward I was opened as such for all services on October first. No definite time limit of stay was set but only relatively simple nursing care was provided. During his study of the records of the Treasurer and Secretary and of other papers connected with the Hospital, from which he collected information for the history of the Massachusetts General Hospital from 1900 to 1935, Dr. Washburn, the Director Emeritus, became convinced of the necessity of a proper storage place for these files and a continuing supervision to keep them in order. With the consent of the Trustees, Dr. Arlie V. Bock, the president of the Massachusetts General Hospital House Pupils' Alumni Association, and a committee of members appointed by him addressed a letter to the alumni inviting contributions for the establishment of a Department of Archives. The Trustees assigned the office formerly occupied by the Director and the Trustees' Room in the Moseley Memorial Building for this purpose, and Miss Helen Boyer was appointed Archivist. Archives has developed into a depository of documents, photographs, and records of absorbing interest. All graduates are invited and encouraged to visit
3«
194° these rooms when they return to the Hospital and to donate pictures, papers, or any memorabilia that are interesting or of value. The extent and cost of research in the Hospital finally reached a point in 1940 where it became necessary definitely to separate these costs from those directly connected with the operation of the Hospital for the care of patients. This was a major undertaking, and although great progress has been made, it still remains a moot question as to whether complete separation has been achieved. The accounting department also worked out a plan separating the dietary costs of the General Hospital, the Baker Memorial, and the Phillips House. The burdens of administration of clinical departments, of directing the teaching of undergraduates and graduates, had now reached a point where the Trustees felt that they should enunciate a policy whereby full time salaried heads of subdepartments, such as Orthopedics, Urology, Neurosurgery, Neurology, and Dermatology, should be appointed as rapidly as finances of the hospital would allow. Inasmuch as all of these heads would undoubtedly be members of the faculty of the Harvard Medical School and teaching was an important part of their duties at the hospital, the Trustees felt that the Medical School should pay at least one-half of their salaries. This year was important in the Nursing Department for further putting into effect the reorganization plan submitted by Miss Sleeper in 1939. The name of the school, which from 1873 to 1940 had been designated as the "Massachusetts General Hospital Training-School for Nurses," was now changed to the "Massachusetts General Hospital School of Nursing." The library of the school, formerly housed in Walcott House, was now moved to the old accounting room in the Moseley Building and was named the "Palmer-Davis Library" in honor of two graduates of the class of 1878, and a full-time librarian was employed. The time consumed in the administration of intravenous solutions had now become so great that a full-time intravenous-therapy nurse was employed to relieve residents and house officers of this duty; by 1955 the number of these nurses had grown to four. The Out-Patient Department added a reviewing officer, whose job was to review financially all old patients attending the clinics in order to determine whether they were still suitable patients for care in the Out-Patient Department. Of 3346 such patients studied between October 7 and December 21, 204 (or 6.1 per cent) were found to be ineligible for out-patient care.
39
CHRONOLOGICAL HISTORY
Dr. Kenneth J. Tillotson, Psychiatrist-in-Chief of the McLean Hospital, was appointed to the General Executive Committee and Dr. W. Franklin Wood, Director of McLean Hospital, was invited to attend Board meetings. During the year the United States Postal Department issued a stamp "commemorating the discovery of ether by Dr. Crawford W. Long." This prompted the Trustees to address a letter to Senator David I. Walsh of Massachusetts, pointing out that although Dr. Long had undoubtedly used ether for surgical anesthesia before 1846, the demonstration by Dr. W. T. G. Morton at the Massachusetts General Hospital on October 16 was usually accepted as the date which made known to the world the usefulness of ether to produce surgical anesthesia. In 1940 Mr. S. W. Fessenden was appointed as Vice-President of the Corporation, on January 19, and Mr. Ralph Lowell elected Trustee, November 15. The following resigned and were appointed to the Board of Consultation: Dr. V. H. Kazanjian, a member of the Staff since 1922, surgeon for plastic operations, 1930-1940, on February 21; Dr. Richard H. Miller, member of the Surgical Staff since 1912, Visiting Surgeon 1935-1940, on April 18; Dr. Loretta J. Cummins, member of the Staff since 1916, Dermatologist 1928-1940. There were six deaths: Dr. Herman F. Vickery, member of the Medical Staff since 1882, Visiting Physician 1898-1914, Board of Consultation 1914-1929, Honorary Physician 1929-1940, on February 22; Dr. Oscar Richardson, Assistant Pathologist, a member of the Staff since 1897, on August 29; Dr. Hans Zinsser, Trustee 1932-1940, on September 4; Dr. Torr W. Harmer, member of the Surgical Staff since 1908, Assistant Surgeon 1935-1940, on October 2; Dr. Ernest Amory Codman, member of the Surgical Staff since 1900, Board of Consultation 1929-1939, Honorary Surgeon 1939-1940, on November 23; Dr. John T. Bowen, member of the Staff since 1889, Chief of the Dermatological Department 1 9 1 1 1913, Board of Consultation 1913-1929, Honorary Physician since 1929, on December 31.
40
1941
1941 Pearl Harbor. Defense organization. The draft. Procurement and assignment. Action of General Executive Committee. Vincent Memorial Hospital. Hall-Mercer Hospital. Chapel dedicated. Ten years of Baker Memorial. Ο.Ρ.Ό, and V.D. program. O S R D contract. Personnel Director. Volunteers. The General Store. Salaries and rates. School of Medical Illustration. Dr. Holmes retires. Dorr Professor of Anesthesiology-
f - p H E Massachusetts General Hospital has served this country not only in peace but also in war. The year 1941 marks the fifth time in its history that the Massachusetts General Hospital has been affected b y war. Construction of the hospital was delayed by the W a r of 1812, so that the Bulfinch Building, for which subscriptions were started in 1811, was not completed and opened until 1821. Members of the Staff served in the Civil War, Spanish-American War, and in the Philippine campaigns. In World W a r I, 238 Staff members and graduates served in Base Hospital No. 6 and other units of the Army and Navy, and 228 graduates of the School of Nursing served in the Red Cross and Army Nurse Corps. Now in 1941 a second world war found many of the Staff already in active service, while the 6th General Hospital, organized in the previous year, at the request of the Surgeon General of the United States Army, staffed entirely by Massachusetts General Hospital personnel, stood ready for call to duty. The Director noted: For over two years we have watched the approach of war, considering involvement to be inevitable but hoping that in some mysterious way we could escape. During these years we have taken precautionary measures but in a leisurely and uncertain manner. The 6th General Hospital has been recruited, air raid schools have been attended, and members of the Staff have served on various defense and research committees. On Sunday, December 7 at Pearl Harbor, the expected happened with unexpected suddenness. The effect upon the country and upon the Massachusetts General Hospital was instantaneous. By Wednesday night a defense organization against fire and sabotage, which could be called to duty
41
CHRONOLOGICAL HISTORY
at any time, day or night, had been set up under the direction of Dr. W. T. S. Thorndike and suitable equipment for defense against incendiary bombs was in place on every roof. His previous attendance at Air Defense courses at the Massachusetts Institute of Technology was very helpful. A hospital must operate during blackouts and so, after an experimental blackout which disclosed many unexpected danger spots, blackout curtains and blue lights have been installed and other precautionary measures have been taken so that operating, telephone and utility rooms, kitchens, areas around head nurses' desks, and other vital places can be kept lighted and the hospital carry on during blackout periods. This work was placed in charge of Dr. G. F. Houser, whose experience with the Harvard Red Cross Hospital in England proved of great value. Dr. Houser was granted leave of absence as Assistant Director November 1, 1940. After assisting in planning and assembling the material for the Hospital, he sailed about March first. In England he supervised the erection of the pre-fabricated units and when he returned on September third the Hospital was ready to open. In the event that our hospital would suddenly be called upon to care for a large number of civilian casualties, a staff organization under the direction of Dr. E. D. Churchill has been set up whereby such casualties, after being sorted at a central "Triage," will be classified as "Slightly injured," "Seriously injured," "Burns," "Shock or resuscitation," or "Immediate operation," and distributed to places prepared to care for such conditions, to be treated by staff teams assigned for each category. Additional sterile supplies, plasma, beds, blankets, and necessary equipment have been collected and are daily being increased. It is difficult to know just what emergencies we will have to meet but we are trying to carry out the motto that, "An emergency prepared for ceases to be an emergency." The Selective Service Act was intended to operate in an impartial democratic manner on all persons within certain age groups and to make volunteering unnecessary, although retaining this method for those who wished to use it. No groups were excused or favored, excepting the clergy. All draftees entered as privates. The effect of this law was to place the procurement of doctors for the Army and Navy upon a volunteer basis because Draft Boards, seeing the absurdity of enrolling doctors as privates, deferred them indefinitely. The Army and Navy, following their tables of organization, were never able, up to the declaration of war, to obtain the quotas desired. Various methods of stimulating voluntary applications for commission have been tried: appeals to the profession and to patriotism, threats, and now, finally, upon the suggestion of the American Medical Association and other National medical and hospital organizations, a Procurement and Assignment Service was organized by Presidential order, and operated to supply adequate personnel to the Army and Navy and other government agencies, while simultaneously guarding the needs of medical schools, hospitals, civilian communities, and industry. It is a large job but at least it offers an intelligent approach through the collecting of information regarding each physician's place in his community, instead of the former haphazard method of volunteering or induction for active duty regardless of the community situation. Hospitals are being asked to prepare lists of their
42
1941 staffs, dividing them into available and non-available, this latter group containing members who are "essential" for the operation of the hospital, those over age, women physicians, and those known to have disqualifying disabilities. How far staff members can be reduced safely cannot yet be stated. Adjustments are already being made to change the old Resident Staff organization to a new one where a small number of Residents will try to direct and teach a large and constantly changing body of interns for one year. Ninety-two members of the medical staff have received commissions in the Army and Navy Medical Corps and have been called to active duty. The 6th General Hospital, recruited entirely from Massachusetts General Hospital personnel, now has fifty members of the Staff enrolled and one hundred eleven graduates of the School of Nursing, of whom twenty-five are now on the Hospital Staff. Thirteen house officers or residents are already in service and it is expected that others will receive commissions and may leave soon. In addition, fifty-eight alumni have been recorded as being in service, of whom four are with the Canadian forces, four are or have been with the American Hospital in Great Britain and four are either in the Pan American or T.W.A. Medical Corps. Some fifty-three hospital employees have joined the armed forces either voluntarily or through the draft. It is probable that we shall have to carry on with fifty per cent of the regular staff, composed largely of men over forty-five years of age, those with disqualifying physical defects, women physicians, and a few selected members of the younger staff retained on National Research Council projects. The Resident Staff will be reduced to one-third of its former size and in general no Resident will be retained for more than two years after finishing the one-year allowed internship.1
The General Executive Committee reported: [The General Executive Committee] representing as it does a cross section of the professional activity of the Hospital and constituting a link between a large general staff and its Board of Trustees, concerns itself largely with maintaining a nice balance between academic, scientific growth and the intelligent care of patients in a large community. In peace time such a task is never a simple one. In times of war it is decidedly difficult and complex — and such it has been during the past year. In an attempt to maintain this balance while at the same time preparing for war, the Committee's main objective has been to lower the standards of medical service as little as is humanly possible, and at the same time to provide the Government with necessary personnel . . . Because graduates of medical schools have been restricted by the Army of the United States to one year internships, the various departments in this hospital have complied — so that all applicants for intern positions who took the examinations in October did so with the understanding that beginning in April 1942 their term of service is to be twelve, instead of the usual twenty-four months. Such a change has involved long hours of study by this committee and has caused a definite upheaval in teaching and visiting schedules. It will necessitate closer supervision of interns, and, being made at a time when our staff will very likely be cut to one-half its peace
43
CHRONOLOGICAL
HISTORY
time size, will call for longer hours of service from the remaining members — the "Home Guard." Our out-patient clinics will also have to be manned by skeleton crews, working longer hours. However, plans have been made to accommodate to changing conditions, and some are now in operation. Even when the 6th General Hospital is called, an event to cause real depletion, the staff will be ready to carry on with the necessary work of the Hospital.2 Wartime restrictions by the Boston Traffic Commissioner placing a one-hour limit on parking in the street resulted in many of the staff receiving parking tickets; little could be done about it because the Hospital could only provide 270 parking places for the 450 persons to whom permits had been issued. After prolonged negotiations an agreement was reached whereby the Hospital agreed to limit the issuance of hospital "stickers" to the Staff and essential personnel and the Commissioner agreed to instruct traffic officers to refrain from tagging cars so marked. T h e Vincent Memorial Hospital had been since 1890 a well known Boston charity, supported from endowment and by the Vincent Club. Devoted to the care of women patients, the hospital had found it increasingly difficult to carry on satisfactorily as an isolated institution. Laboratories, X-ray, pathology, and other departments are necessary for the execution of modern methods of diagnosis and treatment. They are expensive and only justifiable in hospitals large enough to spread the overhead among many patients. After careful study an agreement was drawn up whereby the Massachusetts General Hospital agreed to erect a new building on its grounds, the lower three floors to be designated as the Vincent Memorial Hospital, to be paid for by Vincent, and the upper three floors to be equipped as memorial children's wards, according to the generous bequest of Mrs. A. Lawrence Hopkins. Satisfactory plans were accordingly drawn and a request for a priority rating made to the proper authorities in Washington. This was refused. A temporary arrangement was worked out, however, whereby twelve beds on each of the west wings of White 7 and White 8 were designated as "Vincent Memorial beds during the period of the war emergency." These beds were to be supported from Vincent funds. For many years the Surgical Services had hoped to set up a Gynecological Service. This consolidation of the Vincent Memorial and the Massachusetts General Hospital made it possible for Dr. Joe V. Meigs, Chief Surgeon at the Vincent Memorial Hospital and Surgeon at the Massachusetts General Hospital, to be made head of a new Gynecological Service.
44
1941 The Hall-Mercer Hospital, resulting from the bequest under the will of Reverend Alexander G. Mercer, was formally created in July 1941 and the following officers appointed: Phillips Ketchum, President; Sydney P. Clark, Vice-President; Francis C. Gray, Assistant Treasurer; Edgar H. Ertel, Secretary and Treasurer; Reginald Gray, Assistant Secretary; C. Sidney Burwell, M.D., Malcolm Lloyd, Jr., and Alfred N. Richards, Ph.D., Directors. Lauren H. Smith, M.D., and Nathaniel W. Faxon, M.D., were appointed administrators. For the present the Directors decided to provide for the care and study of psychoneurotic patients and entered into an agreement with the Massachusetts General Hospital and the Pennsylvania Hospital to provide such care and study in their psychiatric wards and through their psychiatric staffs. On December first the Massachusetts General Hospital Division of the Hall-Mercer Hospital was opened in the Bulfinch Building. The Chapel, made possible by Bishop William Lawrence, opened its doors on April 6, 1941. With its simple architecture, subdued atmosphere, the lovely rose window, and the feeling of the all-pervading presence of God, the Chapel provided the spiritual help that Bishop Lawrence desired, for those who come and go as well as for those who are actively on duty in the Hospital. All rejoiced that the bishop lived to see the Chapel a reality. Ten years had elapsed since the Baker Memorial had opened. Under the direction of Dr. Haven Emerson, through the kindness of the Commonwealth Fund of New York, a study of these first ten years was made and published. There was no doubt that the Baker Memorial had been successful. During those early years of operation, while it was getting under way, there had been an annual deficit, one half of which, for the first three years, was paid by the Rosenwald Fund of Chicago. Naturally the Depression complicated the early years, so that it was not until 1938 that the Baker was able to operate without a deficit. At first the staff was uncertain as to whether the new arrangement, whereby medical and surgical professional fees were limited by a fixed schedule and collected by the hospital for the doctor, was to prove satisfactory or not. As time had gone on it has become clear that the principles upon which the Baker Memorial was founded were sound and advantageous to patients, doctors, and the Hospital. Ward I, which was set up as a convalescent ward, had now been operating for a little over a year. Five hundred and seventy-seven patients had been treated, with a total of 6,658 days of treatment and an average stay of seventeen days. The basic formula was that the amount of nursing on this ward should be less than half of the nursing
45
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HISTORY
on an "acute" ward and that the cost of care in this ward should not exceed $3.00 a day. Eliminating administration or overhead charges, the cost this year was $2.70 a day, which represented the actual patient-day expense of operating the ward. In the Out-Patient Department, a grant from the United States Public Health, Genito-Infectious Disease Program, financed physical changes in the Urological Out-Patient Department and in the South Medical Clinics and the rearrangement of their laboratories. It was also decided to open, on November 4, an evening clinic for the care of patients with syphilis in order to avoid loss of time during working hours. The National Research Council made a grant, the first Office of Scientific Research and Development contract, to Dr. Champ Lyons for the study of the chemotherapy of contaminated wounds, and certain beds of White 12 were set aside for this study. The Children's Cardiac Service and the Children's Mission published a joint five-year report in the New England Journal of Medicine in April. This careful study of sixty children with heart disease was concerned with the medical and social problems involved in the longterm care of this condition. The relative value of supervised home care, life in a foster home, institutional care, the reaction of the individual child in these situations, the inner family relationships complicated by a crippled child needing special attention, and similar problems were all evaluated. The result was a better understanding and better care for children with chronic heart disease. In 1941, there were approximately 1500 paid employees on the Massachusetts General Hospital payrolls. Department heads had to spend much time interviewing applicants, time better devoted to other departmental duties. Agencies were confused by simultaneous requests, and candidates for different positions got mixed up. Departments competed with each other. Little selection according to qualification was possible. To remedy these difficulties a Personnel Department was established and Mrs. Lois D. McCoy was appointed Personnel Director on October 22. The handling of volunteers, with their growing numbers, finally resulted in the appointment of Mrs. David Worcester, who had previously acted as a full-time paid head of volunteers in the Out-Patient Department, as Chief of Volunteers for the Massachusetts General Hospital and the Massachusetts Eye and Ear Infirmary. When Mrs. Worcester resigned on December 1, at her recommendation the position was divided and Miss Eleanor Greenwood was appointed Chief
46
1941 of Volunteers responsible for their procurement and assignment and Miss Grace Ferrier was appointed as Assistant in charge of the OutPatient volunteers. The number of volunteers had now grown to 401, giving 31,790 hours of service, which is the equivalent of 4,000 eighthour days or the services of deven additional workers for every day of the year. For many years the Ladies' Visiting Committee had talked of establishing a canteen, and finally on March 4 "The General Store" was opened in the old cashier's cage in the Moseley Building, under the direction of Mrs. R. K. Crouch. By December 3 1 all indebtedness had been paid off, stock valued at over $1,000 was behind the counter, and there was a cash balance of $97.66. Everyone wondered how we ever got along without the Store. Recognizing the hardship which was produced by the rise of the cost of living, the Trustees increased wages of all employees earning less than $1,000 and made necessary adjustments in others. Ward rates were raised from $3.50 to $4.00 a day and 10 per cent was added to all room rates in the Baker Memorial and Phillips House; admittance to the Out-Patient Department was raised to 75 cents. Several years before it had been agreed that an additional Baker Memorial professional fee could be charged for services extending more than three months. This was reduced in 1941 to two months as a more equitable period. Miss Muriel McLatchie, who had acted as medical artist for several years, in 1941 announced after Trustee approval the establishment of a School of Medical Illustration. This school has continued to the present day, one of the very few in the world, a small but important contribution to medical illustration. On February 1, 1941, Dr. George W. Holmes, Roentgenologist since 1917, was promoted to the Board of Consultation. Recognizing the value of his counsel, a special arrangement was made by which he would continue as an active consultant on salary, available for consultation both to the department and to private patients in the Phillips House and Baker Memorial. Under Dr. Holmes' direction the Roentgenological Department grew from a small unit until by 1941 it occupied the entire second floor of the White Building, nearly half of the first floor of the Baker Memorial, and a group of several rooms on the first floor of the Phillips House. He was the first roentgenologist to develop a resident service, which due to his wise teaching has graduated a group of men who direct most of the outstanding X-ray departments in the United
47
CHRONOLOGICAL HISTORY
States. Altogether 35 men have graduated from these residencies under his tutelage. On October second, this group and other friends gathered at the Harvard Club and after a dinner in honor of Dr. Holmes, presented to the Hospital a portrait of him (by Charles Hopkinson) which now hangs in the X-ray Seminar Room in the White Building. Dr. Aubrey O. Hampton, for many years in charge of the Baker X-ray Department, succeeded Dr. Holmes. Dr. Fritz Lipmann was appointed a research fellow in Surgery July 1, 1941, on the recommendation of Dr. E. D. Churchill and Dr. Oliver Cope. Later appointed Research Chemist of the Massachusetts General Hospital, Dr. Lipmann, as recipient of the Nobel Prize in Chemistry (1953) brought great renown to the institution. Dr. Henry K. Beecher was this year appointed Dorr Professor of Anesthesiology by the Harvard Medical School. Dr. Norman C. Baker died suddenly on July 31, 1941. Dr. Baker came to the Hospital in 1927 to have charge of the Hospital for People of Moderate Means, now the Baker Memorial. Shortly after plans for the erection of this building were under way, he was made First Assistant Director, which position he held with consummate skill until his death. He was Acting Director from December 3, 1934, to July 1935. Dr. Morgan J. Rhees, who had been an Assistant Director in charge of the Baker Memorial for most of the eleven years in which he held an administrative position, accepted the position of Director of the Pratt Diagnostic Clinic and Director of the medical extension aspect of the Bingham Associates, his resignation to take effect on March 31. Dr. Rhees died suddenly on August 25. Dr. Ralph B. Seem died on May 12. Dr. Seem joined the Staff as Assistant Director in December 1936, to take charge of the detailed planning of the George Robert White Building. This work he supervised with meticulous care and skill. In 1939 he had the first of a series of attacks of malignant endocarditis, which after a long period of hospitalization caused his death. Mr. William Endicott, President of the Corporation since 1939, Trustee from 1917 to 1935, and Chairman of the Board of Trustees from 1928 to 1935, died on August 25. Mrs. Frederick T. Lord, a member of the Ladies' Visiting Committee since 1923, died on July 14; Dr. F. T. Lord, a member of the Medical Staff since 1903 and of the Board of Consultation from 1934 to 1941, died on November 4. Dr. Gerald Blake, a member of the Board of Consultation who had been on the Medical Staff from 1913 to 1941, died on July 28. On February 21, Dr. James C. White was appointed Chief of Neurosurgery, to replace Dr. W. Jason Mixter, who retired and was
48
1942 promoted to the Board of Consultation. Dr. T. Stewart Hamilton was appointed Assistant Director on April 1, and Dr. John E. Gorrell as Assistant Director on November 28. On July 31, Miss Agnes J. Trull, executive assistant, retired after eighteen years of efficient service at the Phillips House. Mrs. Constance Braman was appointed in her place. On November 1, Miss Carrie L. Williams resigned as Librarian of the Treadwell Library; Miss Eleanore A. Lewis was appointed as the new librarian as of January 1, 1942. Dr. John D. Stewart, Assistant Surgeon, resigned on September 15 to become Surgeon in Chief of the E. J. Meyer Memorial Hospital, Buffalo, New York.
1 9 4
2
Cocoanut Grove disaster. Effect of War on Staff, House Staff, Nurses and Personnel. 6th General Hospital activated. Huntington Hospital. Blood Bank. The "M.G.H. News." air raids and bombs, the Hospital developed during this year a program of Civilian Defense. Staff, nurses, administrators, Social Service, and all departmental personnel were instructed in their duties, a manual of organization and action was distributed, and practice drills were held. The importance of this preliminary planning was well exemplified when a civilian disaster, the fire at the Cocoanut Grove, a Boston night club, on November 28, 1942, put the organization to an acid test. A detailed account of how the Massachusetts General Hospital met this situation was published in the December 26 issue of the Journal of the American Medical Association. Later a full volume of the Annals of Surgery, June 1943, devoted to the medical, surgical, psychiatric, and social aspects of the disaster, was published. The treatment of severe burns detailed in this study was adopted by the Armed Forces. The following letter was sent by the Trustees to benefactors, supporters, and contributors to the Hospital: ANTICIPATING
Because of your interest in the Hospital, we are sending you this report of our part in the Cocoanut Grove disaster. The Cocoanut Grove fire started about 10:15 P.M. Saturday, November 28, 1942. The first patients arrived at the Emergency Ward of the Hospital at 10:30 P.M. Shortly thereafter the Hospital was notified of the disaster and
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HISTORY
asked to be ready for a large number of patients. The hospital's organization set up under Civilian Defense for the handling of war casualties was immediately put into operation. The House Staff and nurses on duty were called to the Emergency Ward; Teams for Burns and Resuscitation were summoned; members of the visiting staff, nurses off duty, social workers, volunteers, orderlies and others were notified. By 1 1 : 1 5 P.M. nearly the entire organization had been assembled; volunteers continued to arrive during the night. The Emergency Ward was immediately cleared of all other patients, but it was soon realized that its facilities would be overtaxed, and the sixth floor of the White Building, containing forty beds, was evacuated. Thirty surgical patients were removed to other beds in the Hospital. Between 10:30 and 12:45 A.M., 114 casualties were received. Of these 75 were either dead on arrival or died within a few minutes after admission. The 39 living patients, showed, besides burns of varying degrees, the effects of cold, exposure, fright, shock and partial asphyxia. Clothing was dripping wet, exposed surfaces grimy and blackened. The majority were quiet and cooperative. Some were comatose, others were greatly agitated, requiring restraint. In some this was due to hysteria; in others to cerebral anoxia (lack of oxygen supply to the brain). There was little or no evidence of intoxication. There were no fractures and only slight trauma of soft parts. Wet clothing was immediately removed; burned surfaces covered with sterile towels and the patients wrapped in blankets. Morphine was given subcutaneously to all. Meanwhile, two members of the House Staff had been stationed at the entrance of the Hospital to determine whether those admitted were living or dead. Those pronounced dead were carried directly to an emergency morgue established in the large brick corridor; the bodies covered with sheets and the area screened off. Some of the dead showed no burns; others burns of varying degrees, but death evidently had come from asphyxia in most cases. Many showed the cherry red color indicative of carbon monoxide asphyxia. A few were severely burned; one almost beyond recognition. Identification of the dead was started at once and all but two of the men were identified by 5:00 A.M. Identification of the women was very difficult on account of the lack of identifying data in their clothing. Many were identified only by direct inspection by relatives or friends. Preliminary treatment having been given to the living in the Emergency Ward, they were moved to White 6. By 1:30 A.M. all the living, 39 in number, had been put to bed in this ward. Burns had been dressed, shock was being treated, and asphyxia cases given oxygen therapy. The Emergency Ward was cleared and ready for more admissions. Thirty of the thirty-nine patients had surface burns of clinical significance and many showed evidence of damage to the respiratory tract. In some this was very severe. In some cases it developed twenty-four hours later. In one case artificial respiration was required for the first six hours. The patient recovered. Seven cases required tracheotomy and in one or two tracheal intubation was performed. The surface burns were treated by a single method. There was no cleansing or debridement. The burned surfaces were covered with gauze impreg-
50
1942 nated with boric petrolatum and a voluminous dressing applied with elastic pressure bandages. Splints of folded newspaper were used for forearms and hands. Eyes were examined by Staff and Residents from the Massachusetts Eye and Ear Infirmary and appropriate treatments instituted in seven cases. Blood plasma from the Hospital blood bank was administered to all patients in shock. By 1:00 A.M. all patients in shock were receiving plasma. Salt solution and glucose solution had been previously administered intravenously and was continued thereafter for long periods in many cases. In the first twenty-four hours 120 units of frozen plasma were used; in seven days a total of 141 units. In addition 16 whole blood transfusions were given where there was reduced oxygen capacity. Teams of interns and nurses under the direction of surgeons, residents and the chief anesthetist were assigned to individual patients and to groups, and were in constant attendance. There were twenty trained nurses on eight-hour duty on this ward, or sixty each twenty-four hours. Oxygen therapy directly by catheter or in tents was given in appropriate cases, carbon dioxide 5% to 7% in oxygen was given to three patients, showing evidence of carbon monoxide poisoning. Sterile suction tubes for intratracheal intubation were used in several cases. In addition to the more intricate treatment, routine intravenous medication, blood pressure determinations, blood tests, etc. were carried out. Sulfadiazine was given intravenously by 2:00 A.M. Sunday to all patients, including those without burns, and its administration was continued thereafter in appropriate amounts. All patients, having been serum tested, were given antitetanic serum, except Army and Navy personnel and those with serious pulmonary lesions. By 3:00 A.M. Sunday a list of all the living, with names and addresses, was made and given to the police and press. During the first week seven patients died. These were all cases showing severe respiratory tract damage from inhalation of flame or fumes. No cases of true bacterial pneumonia developed. All the patients were segregated and isolated on the sixth floor of the White Building. Admission to the ward was strictly limited with a doorkeeper in constant attendance. Besides professional staff and attendants only immediate relatives, clergy, family doctors and officials on errands of importance were admitted and all were masked and gowned. The East solarium was converted into a dressing-station where all dressings were done under aseptic precautions. X-ray examinations of the chest were carried on in the South solarium on the same floor. All patients were so examined by 10:30 A.M. on Sunday. The clinical laboratories were manned immediately on the night of the disaster and were kept busy continually thereafter. Hematocrit and serum protein determinations to guide the administration of fluids and plasma were available that night. Determinations of oxygen and carbon dioxide content of blood, oxygen capacity, non-protein nitrogen, prothrombin time, blood chloride, phosphorus, sodium, and other tests including various bacteriological examinations were also made. The pathological laboratory was called into action making tissue examinations and later in performing autopsies. Invaluable service was rendered by members of the Social Service Department. They helped in various places where needed. Their skill and
51
CHRONOLOGICAL HISTORY training in dealing with people emotionally disturbed fitted them for the trying tasks of interviewing distracted relatives and friends of patients and in answering innumerable telephone calls. They also helped in the identification of the living and the dead. The services of volunteers from the Ladies' Visiting Committee and the War Service Committee proved of great value. They were persons of poise and they knew the Hospital. Medical students assigned to the Hospital rendered valiant aid that night and thereafter. A group of Harvard under-graduates who had been doing volunteer work as orderlies for six months, some of whom were on duty that night and others who came in afterwards, rendered splendid service. They also knew the Hospital. The Red Cross rendered invaluable service in the emergency. The motor corps brought casualties to the Hospital. The Nurses' Aides were of immediate assistance that night and the next day large numbers replaced and relieved regular nurses on duty in other parts of the Hospital. The Red Cross Canteen, in connection with the hospital dietary department, served coffee and sandwiches during that night, which was a great help in sustaining energy and morale of workers and giving comfort to relatives and friends. Many private nurses from the Baker Memorial and Phillips House contributed their services during off duty time. The Massachusetts Women's Defense Corps sent volunteers who aided in identification and were also of great help with the Blood Bank. Over one hundred outside nurses from the following institutions volunteered and were put to work: McLean Hospital, New England Deaconess Hospital, Children's Hospital, Cambridge Hospital (now the Mt. Auburn Hospital), Emerson Hospital in Concord, Free Hospital for Women, the Faulkner Hospital, Chelsea Naval Hospital, State Department of Public Health, Quincy Women's Defense Corps, O.C.D., Community Health Association, John Hancock Life Insurance Company, Boston University Graduate School of Nursing, Simmons College students and Red Cross Nurses. T h e regular staff of the Hospital, administrative, medical, surgical, and special nurses, orderlies, technicians, telephone operators, dietitians, porters, maids, and maintenance personnel labored long hours at night and Sunday without stint in unsparing efforts for each to do his part. In conclusion it may be said that the Hospital organization met the emergency adequately and well. Much credit should be accorded to the Civilian Defense organization for having made the Hospital "catastrophe minded" beforehand. There was no shortage of supplies or equipment of any kind. Of course, some minor faults and difficulties were developed by the situation, which will serve a useful lesson in preparing for any future emergency. "An emergency anticipated and prepared for ceases to be an emergency!" 1
Many Cocoanut Grove patients were saved because there were adequate supplies of fresh blood and frozen plasma in the Hospital
52
1942 Blood Bank. The Blood Bank had been established under the direction of Dr. Lamar Soutter earlier in the year, after many years of procuring blood "on the hoof" for transfusions. On December 18 the Trustees voted that no charges should be made to Cocoanut Grove patients, from November 28 to December 13. Thereafter cost of care was assumed in part by the Red Cross, in part by patients themselves, and in part from other sources, including the Massachusetts General Hospital. During this year, the Hospital, like everything else, was profoundly affected by the war. Of the professional staff of 312, 124 had entered military service, including Chiefs of the Surgical, Neurosurgical, and Obstetrical Services and the Radiologist and Pathologist. The loss of these active, vigorous men had been partially compensated by return to the Hospital service of members of the retired staff and Board of Consultation. The 6th General Hospital, the Massachusetts General Hospital unit, was activated on May 1 5 and ordered to Camp Blanding, Florida. The carefully planned and recently inaugurated organization of the resident staff, with two-year internships and graduated residencies up to four years, was completely disrupted. The government ruled that after April 1942 all graduates of medical schools would be granted only one year for internship in a civilian hospital. When the one-year internship plan was promulgated it was understood that a six months' period of leeway between graduation and the initiation of the internship would be permitted. Directives promptly abolished this, so that all internships had to start on the day of graduation. Early in 1942 medical schools, in order to provide the additional doctors needed to meet the quotas established by the armed services and to care for civilian needs as well, shortened the school year to nine months, graduating classes on March 1, June 1, September 1, and December 1. Since internships were to begin on the day of graduation and were to be for one year there was an immediate conflict between the twelvemonth internship and the nine-month graduation, resulting in hospitals being expected to take double the number of interns during the last three months of each period. This produced much confusion and was unfair to both interns and hospitals. Moreover, this meant in the civilian hospitals a complete shift from a group of men who had been trained in hospital procedure for nine months to an entirely inexpe-
53
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HISTORY
rienced crew. The year 1942 was spent in efforts to reconcile this impossible situation. The need for some stable continuing group of experienced men was so apparent that Procurement and Assignment Service, the agency through which all voluntary enlistments in the medical services were cleared, advised draft boards that hospitals should be allowed to retain some interns as residents with more than one year's experience. By including those ineligible for military service, the hospital was able to retain approximately 50 per cent of the resident staff. At the end of the year there were twenty-nine residents and assistant residents, whereas a year before there had been forty-seven. To make up for the loss of residents, the number of internships in medicine was increased from eight to sixteen and in surgery from six to twenty-eight. To supervise and train this large group of interns in one year placed a heavy responsibility on residents and staff. How quickly conditions can change! In 1934 the hospital had shortened the working hours of nurses on wards and floors in order to spread the work and so help nurses who because of the Depression were out of work. Now, with the departure of many nurses to the armed services and to war plants, began a shortage of nurses that continues to this day, a shortage that has resulted in the loss of the use of many hospital beds through many years. It has also brought about the addition of attendants, hospital aides, and volunteers to act as auxiliaries to graduate-nurse service. "It is an ill wind that blows no good," and the addition of these auxiliaries has resulted in the development of "teamwork" under supervision of graduate nurses and has relieved them of much work that could be done adequately by nonprofessional persons. At the Massachusetts General Hospital, out of an authorized total of 588 graduate nurses, orderlies, and ward helpers there was a shortage of 188, or 32 per cent. Private-duty nurses, Red Cross Aides, and volunteers came to the rescue and for a while postponed the inevitable closing of wards and floors. Of the staff of graduate nurses, aggregating slightly over 300 in all departments of the Hospital, 79 entered military service, many from the administrative group. Of the 120 nurses finally enrolled in the 6th General Hospital, 71 were Massachusetts General Hospital alumnae. Seventy-six nonprofessional employees entered military service and many others left the Hospital employ to enter defense jobs. The turnover in hospital personnel reached such appalling proportions
54
1942 (271 per cent in kitchen jobs) that it is hard to see how the Hospital could have met the labor situation without the newly established Personnel Department. When the wartime plight of the Massachusetts General became known, the number of volunteers rose to 971, giving a total of 112,325 hours of service. They worked in every department of the Hospital except maintenance. Every war produces "conscientious objectors" to military service. A number of such, under the direction of Mr. Rufus Jones of Philadelphia and the Society of Friends, came to the Hospital. They acted as orderlies and as porters and served as volunteers in research experiments. They were a very helpful but queer group. Government priorities and restrictions in supplies also complicated hospital operations. Rationing of sugar allowed the hospital only 85 per cent of its usual supply, of coffee only 60 per cent. Great difficulty was experienced in getting adequate supplies of meat, butter, canned goods, and oils. Pharmaceutical supplies were unpredictable. At one time no clinical thermometers were available, the Army, according to rumor, having ordered four million. The cost of living rose 19 per cent during 1941 and 1942; hospital salaries 15 per cent and supplies 7/2 per cent; the operating deficit went up to $945,621 and the net deficit to $92,689. In establishing wage scales for employees, it had been the custom of most hospitals to estimate the value of the meals allowed each person and add a cash payment sufficient to bring the wages to the desired level. Since employees often ate meals outside the Hospital, they felt that in effect they were paying a double price for these outside meals. The Trustees felt that there was some justice in this and after an Employees' Cafeteria had been opened on May 20, 1942, the meal allowance was abolished and a cash equivalent added to the existing cash wage. Employees were much more contented and food waste was reduced. Everyone benefited. On December 8, 1941, Harvard University and the Massachusetts General Hospital had announced the conclusion of an agreement by which the main phases of the work in cancer treatment and research then being carried on by the Collis P. Huntington Memorial Hospital, a small hospital at the corner of Huntington Avenue and Shattuck Street, caring exclusively for patients with malignant diseases, would be transferred to the Massachusetts General Hospital on January 1, 1942. To care for in-patients, fourteen beds were added, mostly in the
55
CHRONOLOGICAL HISTORY
surgical wards, and all ambulatory or out-patients were transferred to the care of the Massachusetts General Hospital Tumor Clinic. The third floor of the Domestic Building, formerly the hospital kitchen, was remodeled for laboratories and an animal room, to accommodate the John Collins Warren Laboratories of the Huntington, this work to be continued under the direction of Dr. Joseph C. Aub. During the year the transfer of patients, with their voluminous records, of laboratory equipment, and of experimental animals was effected. On June 26, the Trustees voted to authorize a bulletin for a trial period of six months on a cost basis of $2,000 a year, provided this proposal met with the approval of the staff. With this lukewarm recommendation, the Massachusetts General Hospital News was launched, the first number appearing in October. The News was to serve as a medium for the publication of official notices and memoranda, to provide short articles of interest about the activities of the Hospital, and especially to publish such information as was permissible about the activities of the staff, graduates, nurses, and other personnel in the armed services. It was to be sent free to all active members of the staff both here and in service, to Trustees, the Ladies' Visiting Committee, and a limited mailing list. From graduates and others a subscription fee of one dollar was requested. Under the editorial direction of Miss Helen Boyer, the News was an immediate success and during the war years carried cheer to the Massachusetts General Hospital family all over the world. This was not the first time the Hospital had tried its hand at publication. From 1913 to 1917 a Massachusetts General Hospital Bulletin was published but was discontinued because of World War I; revived in 1919, it lapsed again in 1926, reappeared in 1928 only to succumb to the Depression in 1932. Bulletins were the responsibility of the administration and a voluntary editorial board. A paid editor, who also serves as Archivist, seems to be the main reason for the continued success of the News. Dr. Elliott G. Brackett, member of the Orthopedic Staff since 1907, Board of Consultation 1919-1931, Honorary Surgeon 1931-1942, died on December 30, 1942. Mr. William S. Ripley, Purchasing Agent for many years and connected with the Hospital since 1906, died on December 23. Dr. Leroy M. S. Miner, member of the Dental Service since 1910, and Chief of Dental Services 1924 to 1942, resigned on April 13 and
56
1943 was appointed to the Board of Consultation. Mrs. Alice C. Burnell and Mrs. Helen S. Warton succeeded Mrs. Crouch in the "General Store."
Effect of War. Volunteers. L.V.C. War Service. Cadet Nurse Corps. Workmen's Compensation Act. Food rationing. A.H.A. emblem. 6th G.H. at Casablanca. Case records. Portraits.
HE outstanding feature of the past year, the second war year," J- the Director noted, has been the struggle to maintain the usual quality and quantity of hospital service to this community in spite of decreasing professional and non-professional personnel, rising wages, fluctuating governmental regulations and restrictions on supplies. Coincidentally, there has been an increasing demand for hospital admissions to the General Hospital, Baker Memorial and Phillips House and waiting lists have been frequent. The Convalescent Ward was closed in February; the eighth floor of the Phillips House has been closed most of the year and other floors have been closed temporarily, all because of lack of nurses.1
Staff, personnel, and resident and intern problems continued throughout the year. The Visiting Staff, from a peacetime strength of 312, through subtraction and temporary additions stabilized itself at about 230, which seemed to be the irreducible minimum for the efficient running of the General Hospital. Of the entire 230 the Hospital requested deferment for only 19, all of whom occupied such important positions that it was felt that without them the work of the Hospital could not be carried on. The remainder consisted of those ineligible for military service, women, and many oldsters returned to service from retirement. In addition to their hospital service, many served on Selective Service and Induction Boards, Civilian Defense, National Council, and other wartime committees. Military service and defense jobs produced acute shortages in personnel of the dietary department, housekeeping, and nonprofessional
57
CHRONOLOGICAL
HISTORY
nursing service. Although wages were raised to offset the increased cost of living, the Hospital could not compete with industry, especially those industries engaged in war work. Only the response to Hospital needs by volunteers made it possible for the Hospital to carry on. A total of 1248 volunteers gave 148,577 hours of service, or the equivalent of 50 people working 8 hours a day. Volunteers worked in the kitchen, at dishwashing, sweeping floors, making beds, washing walls, in the central supply room, in fact, in every department of the Hospital. Appeals were made to the Red Cross and to the Hospital Volunteer Service Bureau for volunteers. The majority of those who responded were from church and college groups or from fraternal and industrial organizations, but there were many individual volunteers also. Seven evening groups, each working once a week, did practically all the evening orderly work. A group of women from "America's middle class" came to help with ward housekeeping. Of twenty-eight authorized maids often only eight would report for duty, and it was this group of volunteer women who kept the wards and floors clean; this in addition to their own home work or job. Realizing that it could not adequately compensate these loyal volunteers, the Hospital tried to show its appreciation by granting meals to all giving four hours of service and by token payments to cover transportation and other expenses that they incurred. On Ether Day, 1943, the Ladies' Visiting Committee presented a stand of flags — a Hospital flag and an American flag — to be placed in the Trustees' Room. This Committee also inaugurated "War Service," a volunteer messenger service with a delivery twice daily, known as the "Red-Basket Service," assignments to push patients to and from wards, to check clothes, and so on, which relieved nurses, ward maids, and others of many steps. The General Store, despite difficulty in obtaining stock, continued to function efficiently. In recognition of all this serious effort, the Trustees gave a luncheon and lawn party, designated as "Volunteers' Day," on May 24, to all volunteers who had worked in the Hospital during the previous twelve months. Held on the Bulfinch lawn, it was a great success, attended by over 500 persons. Efforts to reconcile the irreconcilable combination of a twelvemonth internship and a nine-month graduation date continued through 1943. By reason of the understanding and cooperation of most of the draft boards, by making additional appointments during the overlapping last three-month period of the internships, with two men
58
1943 doing the work of one, by adjusting promotions to the unpredictable enlistment whims of individuals, the Hospital and its services managed to muddle through. Finally, in the autumn of 1943, the Office of Procurement and Assignment announced that one-year internships would end on December 31, and a new arrangement that came to be known as the "9-9-9 Plan" would begin on January 1, 1944. At long last a sensible workable training program had been evolved (see 1944). Research during the year, with minor exceptions, was on OSRD contracts having a direct contribution to the war effort. Trauma, shock, the healing of wounds, the treatment of burns, survival at sea for castaways, neurocirculatory asthenia, and the criteria for selection of air pilots were some of the problems studied. On June 15, 1943, Congress voted in the United States Cadet Nurse Corps. This was to mean a larger number of young women attracted into the field of nursing, financial assistance to hospitals in order to help with the cost of educating the Cadet Nurses, an acceleration in the programs of nursing schools, and a guarantee of a supply of nurses throughout the war period. (Details of the program are given on p. 327·) At the Massachusetts General Hospital, this program raised the number of students from 309 in 1941 to 450 in 1944. Although the war ended before the full effect of the Cadet Corps was felt, it helped during the war by bringing in more students and by providing more graduates during the postwar period. To provide quarters for the added students, a house at 23 Parkman Street was purchased and renovated to accommodate thirty-three nurses. As a rule hospitals have been free from labor union troubles, but because of the high wages earned by mechanics in defense work, the maintenance department men became restless and petitioned the State Labor Relations Board for the right to form a collective bargaining unit. Following the provision of this law, such a unit was formed, and a satisfactory compromise on wages, overtime, vacations, holidays, et cetera, was made between the Hospital and the men. In subsequent years the union lapsed, was revived, and lapsed again. Throughout these rather trying periods there was no threat of a strike and negotiations between the Trustees, Administrator, and the representatives of the union were carried on in a friendly spirit. An attempt to enlarge the union to cover all Hospital employees was overwhelmingly defeated. When the Workmen's Compensation Act was passed, hospitals
59
CHRONOLOGICAL HISTORY
were not included but the Massachusetts General Hospital had voluntarily followed the rules laid down for industry. In 1943 hospitals were brought under the Act and given the choice of contracting with an insurance company or becoming self-insurers. After a trial of company insurance which was unsatisfactory, the Trustees decided to register the Hospital as self-insured and posted the required bond with state authorities. A provision for the care of industrial accident cases had been made in the Baker Memorial when it opened, but the number of these patients had increased to such an extent that this year the original eighteen beds had to be raised to twenty-eight. Rationing of food began in March with the establishment of a ration bank account at the First National Bank, under the rules of the Office of Price Administration. The Chief Dietitian, Miss Marion D. Floyd, wrote, "The ever changing picture of food supplies with the complication of rationing procedures presented daily problems. The Government agencies were cooperative and understanding of the needs of the hospital in the many transactions necessary and in assigning us surplus commodities. One remembers, however, the scarcity of meat; then potatoes; the restriction of ice cream mix and how margarine had to be substituted for butter and carefully labeled. Milk and cream shortage, the fish strike and various temporary and permanent shortages affecting the daily menus. Often the labor situation affected the menu plan as much as did the food supply." 2 Yet on the whole both patients and personnel received adequate food and fared very well. The importance of hospitals in preserving the health of the community and their place in Civilian Defense was officially recognized, and to relieve those working in hospitals from being considered as "slackers" the American Hospital Association devised an emblem to be issued to employees, which the Massachusetts General Hospital adopted and supplied to all personnel. The News carried cheer to Massachusetts General Hospital graduates in the armed services throughout the world. Letters to the News and other items often brought Massachusetts General Hospital graduates together by apprising them of their proximity to each other. The circulation was over 3,000. Even the Trustees, who had to pay the cost ($2,693), thought it worth while and in addition assumed the salary of the Archivist, formerly paid by the Alumni Association. Fred Coller (West Surgical 1914) once said, "The alumni of the Massachusetts General Hospital belong to the finest club in the
60
1943 world." Many alumni scattered around the globe found "Massachusetts General Hospital" a password to gracious reception, respect, and comradeships professional and social. The 6th General Hospital left Camp Blanding on January 20, 1943 and arrived in Casablanca, Morocco, Africa on February 19, 1943, the first intimation of this being a letter to the News dated February 25. During the year reports of awards to Massachusetts General Hospital Alumni of Citations, Bronze Stars, Legion of Merit, Distinguished Service Medal, Croix de Guerre, et cetera, were received and duly published in the News. The Case Records, based on the weekly Clinico-Pathological Conference, published in the New England Journal of Medicine, were adopted by the Army as one means of postgraduate education for doctors in service, on the recommendation of Colonel Walter Bauer, Medical Consultant to the 8th Service Command. During the year over 900 Army and Navy hospitals throughout the world received copies of the Journal each week. Some army hospitals, through a grant from the Rockefeller Foundation, received protocol, lantern slides of x-rays, kodachromes of specimens, and microphotographs to be used in teaching programs. Thus the Massachusetts General Hospital taught around the world. Medical education in Europe had been disrupted by war. Also medical education in the United States had advanced. As a result of these two factors, doctors from South America desiring postgraduate courses in medicine, who had formerly gone to Europe, now began to come to the United States. During 1943 ten doctors from South America were appointed as Graduate Fellows at the Massachusetts General Hospital. Portraits of famous men help to connect the man and the deed. On June 18, portraits of Dr. James Jackson, Dr. Reginald Fitz, Dr. Frederick C. Shattuck, and Dr. Frederick T. Lord, gifts from benefactors of this Hospital, were unveiled in the Medical Staff Room. Also a portrait of Dr. Herbert B. Howard, administrator from 1897 to 1908, the gift of Mrs. Howard, was placed in the White Building corridor near the Trustees' Room. Mr. E. Thayer Bigelow donated two fine tapestries, to be hung in the Chapel, in memory of his mother, Susan Thayer Bigelow. The Trustees' minutes record that because of a severe snowstorm on January 29, 1943, no Trustees appeared for the meeting, only Mr. Reginald Gray, the secretary, being present. Mr. Sewall H. Fessenden, Trustee since 1919, Vice-President of
61
CHRONOLOGICAL
HISTORY
the Corporation from 1940 to 1942 and President in 1942, died on April 27, 1943; Mr. John Abbott, the Hospital's attorney for thirty-five years, died in September; Dr. George Adams Leland, member of the Surgical Staff since 1912, Visiting Surgeon since 1935, died on September 22; Mr. Edward Field, who had worked in the Orthopedic Shop since 1910, died on October 16; Dr. Harry F. Hartwell, member of the Surgical and Pathological Staff since 1899 and a member of the Board of Consultation since 1938, died on December 7. Mr. Joseph Godsoe, Apothecary since 1909, who had been associated with the Hospital for nearly fifty years, retired on December x. Dr. Kurt H. Thoma was appointed Chief of the Dental Service on February 19, and Mr. Lloyd D. Brace was appointed Trustee on June 25.
I 9 4 4
Penicillin. Closed beds. 9-9-9 Plan. Personnel problems. OSRD. Volunteers and Volunteer Day. Cash salaries. Cafeterias. Institute of Pastoral Care. Metric system. Physical Medicine.
and other antibiotics are now (1959) commonplace but 1944 may be remembered by a few older men as making the transition from "B.P." ("before penicillin") to "A.P." ("after penicillin"), so great has been the therapeutic effect of these compounds. During the year the Massachusetts General Hospital received supplies of this new product, to be cautiously tried. The demand for it was great but it was admirably allotted under the direction of a committee headed by Dr. Chester Keefer of the Massachusetts Memorial Hospital. In May Miss A. B. Mangiaracine in the Mosher Laboratory of the Eye and Ear Infirmary produced penicillin for ophthalmic use, a notable achievement for a small laboratory. A partial picture of the problems of the hospital during this year is presented by the following extracts from the Trustees' and Director's reports. " P ENiciLLiN
During the past year the difficulties arising out of the war, which have been with us now for over three years, were greatly intensified. T h e strug-
62
1944 gle to maintain the high quality of service which the Massachusetts General Hospital has always given to the community has been constant in the face of increased demands for hospital care and the shortage of nurses and other personnel. The nursing situation became so grave for a time that early in the Fall it became necessary to close one floor in the White Building, one in the Phillips House and one in the Baker Memorial, making a total of 99 beds out of service. Fortunately, by reorganizing and with the aid of volunteers, we have been able to reopen these for awhile, but in view of the ever increasing demands of our Government for nurses to care for our wounded men in service, the situation may well become desperate in the near future, not only for the Massachusetts General Hospital but, also, for other hospitals. How to meet this crisis and maintain the fairly adequate medical care required by a community such as ours is the problem which most deeply concerns us. The hospital is greatly indebted to the large body of men and women, who, in these difficult periods of great emergency, have offered their services and have given of themselves without stint for the cause. These include not only the regular staff personnel and nonprofessional personnel, but also the Red Cross nurses, the student nurses, the volunteers, the Gray Ladies and Nurses' Aides, and the many friends of the Massachusetts General Hospital who have given us enthusiastic and loyal support. Further to encourage general-duty graduate nurses, the Trustees have voted that hereafter they shall be paid in cash only, at the basic rate of $150.00 per month instead of on the old cash plus maintenance basis. This matter was long considered by the Trustees and was decided upon only after giving reasonable notice to other neighboring hospitals which might be affected by this new policy. 1 On January 1, 1944, the " 9 - 9 - 9 Plan" for resident training in hospitals, promulgated by the Office of Procurement and Assignment, became effective. This plan was arranged to provide resident and intern service in hospitals and to supply to the armed services a large number of partially trained medical officers, needed to fill the lower grades, and a smaller group of officers competent to fill the more exacting positions in all the specialties. The senior staff, instead of deploring the shrinkage in size and lessened experience of the house staff, adopted as their watchword "Let us do the best w e can with what we've got." This was the spirit of the entire Hospital. At the Medical School, all students except the few unfit for active service went on active duty in the Army or Navy on July 1. "Over their warlike uniforms, while in the hospital they wore the long white coat of peacetime medicine," the General Executive Committee report said of them.2 The Director's Report further described the Hospital in wartime.
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CHRONOLOGICAL HISTORY
This is the third war year. 142 members of the active medical staff are in service; 148 residents and interns have entered military service during, or immediately following the completion of their hospital appointments; 143 nurses have left the hospital to enter the Army or Navy Nurse Corps; and 1 6 1 employees from various departments have either volunteered or have been drafted. The hospital has, accordingly, contributed 594 persons to the armed forces, or nearly one third of its normal personnel of 1800. An Honor Roll tablet bearing the names of staff members, nurses and employees in the services, has been erected in the lobby of the White Building. Three have been killed in action: Dr. Theodore P. Robie, a graduate of the East Surgical Service in 1943; Mr. Leonard Feingold who was an employee of the pharmacy, and Mr. Joseph Comeau, formerly employed as an orderly in the Baker Memorial . . . Throughout the year there has been great difficulty in obtaining adequate personnel. All departments have operated with fewer employees than were authorized and necessary to maintain proper standards. Part-time workers and volunteers have helped to meet this deficiency. Mounting casualties toward the year's end brought requests for more nurses for the Army and Navy than could be supplied by graduations from the Cadet Nurse Corps. If there is a further reduction of our nursing staff, we shall have to choose again between closing wards or accepting lower standards of nursing care than we believe desirable or safe. Because of graduation, vacations, and other factors, an acute shortage both of graduate and student nurses necessitated the closing of White-9 from October 1 to 30, of Baker-10 from October 1 to November 1, and Phillips House 7 from July to October. Research Ward 4, which usually is closed only for July and August, was not reopened until November 1. At present the Phillips House is operating with about half the usual number of special and floor-duty nurses. Special nurses have substituted for floor nurses and have pulled us through several critical nights. The assignment of a large number of student nurses to duty in the Baker Memorial has to some extent made up for the loss of graduate nurses. Mr. MacNair has accomplished wonders in maintaining an adequate staff of orderlies. Although greatly curtailed, some research goes on, most on OSRD projects. Several of these have been completed but study of anti-malarial drugs, shock, metabolic aspects of convalescence, neurocirculatory asthenia, (soldier's heart or effort syndrome) continues. In conducting these projects we have been aided by about thirty volunteers from the American Friends Service Committee. These men, when not actively participating in the experiments, work in various departments of the hospital and have been of great assistance. By arrangement with the Federal Parole Board we have also been able to obtain the assignment of paroled Federal prisoners who have been of material assistance in the kitchen, as orderlies, and in other departments. Without volunteers we should have had to curtail much of our work. During the year 1,936 different persons contributed 126,347 hours of volunteer service, the equivalent of 69 persons working an eight-hour day for every day of the year. If these had been paid workers, it would have cost
64
1944 the hospital $81,848 which gives some idea of the value of volunteer service both in manpower and in dollars. Volunteers run errands, make beds, and help on the wards, sweep, clean, make dressings, mend gloves, stretch gauze (4,900 lbs.), act as clerks and secretaries, etc. Certain groups deserve special mention — 90 male orderlies serving under the leadership of Mr. Osborne R. Perry, a volunteer who has personally given over 2,000 hours of service, have performed outstanding work especially during the evening period. Paid men cleaners are practically non-existent and the hospital was getting disgracefully dirty. This condition has been greatly improved by a group of fifty business men under the direction of Mr. Howard Haywood. They have served as cleaners, washing walls, scrubbing and polishing floors, and tidying up in general. Since cleanliness is of first importance in a hospital, the value of their work cannot be over-estimated. Volunteers serve in wards, kitchens, Occupational Therapy, Blood Bank, Social Service, Out-Patient Department, and practically in all hospital departments. Miss Greenwood, as Director of Volunteers, has had a busy year. A Volunteer's Manual has been compiled. She directed a one-day institute for volunteers at the New England Hospital Assembly in March, read a paper at the convention of the American Hospital Association in Cleveland, gave radio broadcasts, and conducted her office at the hospital. Volunteer Day, held on June 22 in the Bulfinch Yard, was an attempt to introduce the 1,600 hospital employees to the 1,900 volunteers and to acquaint each group with the contributions of the other. About 500 volunteers were present while 1,000 of the hospital personnel went on parade for them. The Coast Guard Band played and Governor Saltonstall spoke. The inspiration that came from this demonstration was more than words can describe. It reached both the personnel and the volunteers. They stood on common ground, working together, helping each other with the maintenance of the standards of the institution. From the point of view of human relations, this was an outstanding one in the history of volunteer service and the hospital, and, one might say, the community, and will be remembered for a long time to come.3 Traditionally, in the past, hospital employees lived on hospital grounds, in hospital buildings, and received hospital meals as part of their compensation. In 1942 the Hospital decided to follow the lead of a few other hospitals, and adopted the policy of eliminating maintenance and paying only cash salaries. At first this was applied only to nonprofessional employees, but it proved so satisfactory to them that on November 1, 1944, all graduate nurses were given the choice of receiving cash salaries alone or cash and maintenance. With few exceptions they elected the cash salary. Consequently, ever since then they have paid for their meals in the Hospital dining room and, if they live in Hospital rooms, pay rent. This policy of cash salaries now embraces nearly all Hospital personnel. The few who still receive cash
65
CHRONOLOGICAL HISTORY
and maintenance remain on that basis because of exceptional circumstances. Before the Hospital could adopt a cash payment of wages and salaries, it was necessary to establish pay cafeterias so that Hospital personnel, doctors, nurses, and employees could eat at the Hospital if they wished. Accommodations outside the Hospital were utterly inadequate. The first pay cafeteria was opened in the Phillips House basement for the use of Staff members and office personnel (see 1935). In 1940 this was moved to the White Building. In 1942 the employees' cafeteria was put on a pay basis. In November 1944 the nurses' cafeteria was similarly changed. Graduate nurses paid for meals; student nurses received credit books on the basis of $28.00 a month. Everyone seemed to be pleased with this method. The opportunity to select, from a liberal assortment of food, is a great improvement over fixed menus. The individual difference in food selection is so great that in the counter lines there are seldom two trays with the same assortment. Waste is greatly reduced. After 1944 only Assistant Directors living at the Hospital, the resident and intern staff, the faculty of the Nursing School, dietitians, student dietitians, and dietary employees received meals as partial compensation. In November 1943, the Trustees had voted that the Hospital should provide lodging as well as board for students in the Training School for Dietitians. Accordingly, 27 Commonwealth Avenue, the gift of the late Robert F. Herrick, was renovated, and on July 1, 1944, students moved in. Alterations were completed and a formal opening with a tea in honor of Mrs. Herrick was held on January 26, 1945. "During this period of wartime rationing and shortages of this and that," the Director reported, it is a pleasure to be able to state that at no time have either patients or employees of the hospital been denied adequate and satisfactory food. Moreover, the local representatives of the War Production Board, of the Office of Price Administration, and of the Ration Board have been most helpful in every way. Through the Massachusetts Department of Public Welfare, surplus government foods, amounting in value to $21,400, have been assigned to the hospital. Critical shortages have occurred and more may be expected but a forward buying policy and the interest and cooperation of dealers and hospital departments, both working to conserve supplies, have so far enabled us to get along.4
The informal arrangement between the Massachusetts General Hospital for the instruction of ministers and theological students in
66
1944 the care of the sick, now in its tenth year, was replaced by an Institute of Pastoral Care, with Reverend Rollin J. Fairbanks as Executive Director. Two summer courses were given, in May and June. The application of a Negro girl to the School of Nursing led the Trustees to establish the policy "to accept applicants to the School of Nursing without qualification as to race, creed or color." Scientists and doctors in the United States were rapidly changing from the old apothecary system of weights and measures to the more accurate and widespread metric system. To change from an established custom to a new one in an institution the size of the Massachusetts General Hospital, involving many persons, is a serious undertaking, but after due consideration, the General Executive Committee voted on October x, to adopt the metric system for all purposes. To allow for adjustment in the Pharmacy, for instruction of nurses and doctors, for the compilation of conversion tables, which were skillfully prepared by Dr. Butler, the effective date was set for May 1, 1945· Physical Therapy and Occupational Therapy were combined in this year to form the Department of Physical Medicine, a term more in keeping with the newer concept of such activities by the Council of the American Medical Association. The seventy-fifth Anniversary celebration of the Ladies' Visiting Committee was held in May, but the festivities were somewhat upset by an unexpected miniature blizzard. In June the General Executive Committee was given power to appoint Graduate Assistants, Clinical Fellows, and Research Fellows. The Trustees, however, continued to appoint all staff members who would treat patients. In September, word was received that the 6th General Hospital had moved from Africa to Italy. Dr. Edward P. Richardson, member of the Surgical Staff since 1906, Chief of the West Surgical Service, 1925-1931, Honorary Surgeon since 1931, died on January 26, 1944; Dr. William B. Breed, member of the Medical Staff since 1919, Physician since 1936, died on August 21; Dr. Richard F. O'Neil, member of the Surgical and Urological Staff since 1896, and of the Board of Consultation since 1934, died on November 30; Mrs. Richard P. Strong, a member of the Ladies' Visiting Committee since 1923, died in May. Mr. Bartholomew A. Brickley was appointed General Counsel for the Hospital on February 2.
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CHRONOLOGICAL HISTORY
I 94 5 V.E. and V.J. Days. Return of doctors and nurses. Deficit. Resident Staff increased. Staff readjustment. Arrangement with Radcliffe. Appointment of King Committee. Volunteer Day. Service pins. Metric system adopted. Personnel policies. Vincent-Burnham Building begun.
>np HE beginning of the year brought little hope for a speedy ending of the war, but V-E Day came on May 8 and V-J Day on August 14. The 6th General Hospital operated in Rome from June 19 to December 22, 1944. Following a period during the winter months of inaction and reorganization, on May i, 1945, it was moved to Bologna, functioning there until August 10, 1945. On September 15, 1945, the 6th General Hospital was formally inactivated at Leghorn, Italy, forty months to the day following its entry into service at Camp Blanding, Florida, on May 15, 1942. Of the 644 persons who entered service from the hospital seven lost their lives. Many others received wounds or suffered illness. These men and women gave in many instances four years of their lives in honorable service to their country and to the world. The Hospital had looked forward hopefully for the end of the war, with the expectation that nurses and employees would return to their former positions and duties. By December 31, of the 142 members of the Staff who entered military service, 50 had returned to hospital duty; but of the 174 nurses, only 3 had returned, and of the 172 employees, only 29 had returned. The dislocating effects of war are shown by a review of 100 Massachusetts General Hospital nurses who served with the 6th General Hospital: of these, 40 married, 20 decided to go to college under the "G.I. Bill," 15 remained in service, 12 agreed to return to the Massachusetts General Hospital, 4 were sick, and 8 had made no decision. Throughout the year the shortage of nurses continued, necessitating the closing of floors and wards in the Phillips House, Baker Memorial, and General Hospital. For several months 88 beds were closed,
68
1945 and the year ended with 32 beds still out of commission. This reduction in beds caused a loss of approximately 5000 patient days, which naturally affected income. It also built up a large admission waiting list. Although all room rates were increased during the year, the evil effect of inflation forced expenses up faster than receipts from increased rates, so that it was necessary to again raise room rates and Out-Patient Department charges. The resulting operating deficit of over $1,000,000 was the largest in the history of the Hospital and depleted the General Fund to a dangerous low. The prewar resident staff numbered 85. By direction of the Procurement and Assignment Service it was reduced to 64 and the period of training shortened. Recognizing the educational deficiencies that had resulted from this reduction and believing that many former residents would want further training, the Trustees voted "that the resident staff may be increased to xoo, the additional residencies being added in order to meet the needs of men who had been unable to complete their medical training by reason of induction into the armed forces; to provide board and room as a service to the community; and to give first choice to those who had held appointments here and, next, to a selected group of others with excellent credentials, if all places were not filled by the first group." 1 Most of the returning residents received a small stipend under the "G.I. Bill of Rights" and in some instances the Hospital received a small reimbursement. However, this decision of the Trustees to increase the resident staff by 36 persons, in the interest of their education and for better medicine, represented a real financial contribution by the Hospital. In 1948 the Director estimated that for a resident staff of 67 with 21 interns (a total of 88), $45,000 would be paid in salaries to the residents (these salaries ranging from $500 to $1,200), and, allowing $900 a year for board and room, $79,200 would be paid for maintenance, a total of $124,200. Therefore each resident or intern represented a contribution to education by the Hospital of $1,411. In return patients got excellent care from these active and inquiring young men. The hospital policy of not reappointing doctors to the Active Staff beyond the age of sixty was suspended during the war. That the Hospital was able in large measure to carry out its obligation during the war was due to the willingness of the remaining staff to make the necessary extra effort, aided by the return to active service of many of those who had retired. Drs. George Gilbert Smith, James B. Ayer, and C. Guy Lane were continued as Chiefs of their respective services,
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CHRONOLOGICAL HISTORY
although over the retiring age. When Dr. J. C. White was called to full duty in the Navy, Dr. W. Jason Mixter returned as Acting Chief of Neurosurgery. Dr. George W. Holmes likewise returned to act as Chief of Radiology when Dr. Hampton left. Drs. R. H. Vose, J. D. Barney, Andrew P. Cornwall, and Willard S. Parker returned to their former services. Dr. Harold Giddings devoted much time and effort in keeping the Surgical Out-Patient Department going. With the ending of the war and the return of former active staff members, many changes became necessary. Dr. Holmes in Radiology and Dr. G. G. Smith in Urology asked to be relieved of their duties. Dr. Laurence L. Robbins was appointed Acting Chief of Radiology, becoming Chief on February 1, 1946. Dr. Fletcher Colby succeeded Dr. Smith. Drs. Ayer and Lane were asked to continue in their services until successors could be chosen. Dr. E. D. Churchill returned in mid-December. During his absence Dr. Leland McKittrick served as Acting Chief of the West Surgical Service and as a member of the General Executive Committee. Dr. T. B. Mallory returned to begin the new year, relieving Dr. Benjamin Castleman, who had ably served as Acting Pathologist during his absence. Dr. Francis Hunter also returned to resume his duty as Clinical Pathologist, which work Dr. Wyman Richardson had ably carried on during his absence. Although further enrollment in the Cadet Nursing Corps ceased with the ending of war, the Corps had to continue until all students then enrolled had graduated: that is, until the fall of 1948. By then, of the 678 young women who joined the Corps, 538, or 80 per cent, had graduated or were still in the school. Marriage accounted for most of those who had left. One hundred seventy-three served their final six months in government hospitals, a noteworthy war contribution of the Massachusetts General Hospital. From the beginning of the Massachusetts General Hospital School of Nursing, its graduates by reason of ability and training had risen to positions of prominence as teachers and administrators in other hospitals. With increasing emphasis being laid upon academic education and the development of collegiate schools of nursing, Massachusetts General Hospital graduates without an academic degree were placed at a disadvantage. So with the ending of the arrangement with Simmons College in 1934, the Hospital had sought to establish affiliation with some other college. After many disappointments, a plan for a coordinated program leading to an academic degree from Radcliffe
70
1945 College and a diploma from the Massachusetts General Hospital School of Nursing was worked out, ratified in September 1945 by the Boards of both institutions, and approved by the State Boards of Registration of Massachusetts and New York. Students could now choose the three-year course leading to a diploma or the five-and-ahalf-year course leading to a diploma and a degree. The General Executive Committee foresaw the coming of many social changes and, recognizing the need for future planning, in 1945 appointed a committee consisting of Dr. Donald S. King, Chairman, Dr. Leland S. McKittrick, Dr. Allan M. Butler, Dr. Langdon Parsons, and Dr. Carroll B. Larson to study these problems. This committee appointed as the "Committee on Staff Reorganization and Office Building" but commonly called the "King Committee" after many months of study presented a report in the next year on hospital organization which profoundly influenced the future of the Hospital ( see pages 75 and 92 ). Volunteer Day was held on June 14. The United States Coast Guard Band played. Dr. Joe V. Meigs outlined the history of the Vincent Hospital, and then members of the Vincent Club executed the intricate maneuvers of their famous Drill. Dr. Meigs introduced twenty-one doctors from twelve foreign countries, assembled under their respective national flags, who were at the Massachusetts General Hospital as residents or fellows or taking graduate courses. On Ether Day, President Macomber of the Corporation presented pins reproducing the seal of the Hospital and bearing a star for each ten years of service. Two hundred and forty-one employees received pins; two of them were gold, the equivalent of five stars, denoting fifty years of service, and were given to Mr. Eric Frankson, storekeeper, and Mr. Robert Henderson, orderly. Although the change to the metric system from the apothecary system had been planned to take place on May 1, the necessary changes in the Pharmacy and the compilation of a table of approximate equivalents delayed adoption until August 22, 1945. The Dietary Department, by arrangement with Pathology, introduced a system of regularly testing the sterilization of dishes and utensils in all units. Employees were instructed in proper sanitation procedures. Rationing had ended, but supplies, especially of meat, continued to be short. The development of physical medicine, its importance in the treatment of casualties and in rehabilitation, was one of the outstanding features of the war. This resulted in a demand for trained physical
71
CHRONOLOGICAL HISTORY
and occupational therapists. In conjunction with the three approved physical-therapy schools and one occupational-therapy school in Boston, the Department of Physical Medicine trained 270 physical therapists, about half of whom entered service, receiving commissions; four members of the Staff entered the Army, two to head departments of physical therapy. Three occupational therapists left to enter service. An important development in this department was the inauguration of a three-year program for physicians intending to specialize in physical medicine, supported by the Baruch Committee on Physical Medicine, and developed with the Department of Physiology of the Harvard Medical School. Dr. C. S. Wise was appointed in February as its first research fellow. Believing that a common personnel practice should be developed for Boston hospitals, the Boston Hospital Council, in conjunction with three hospitals, of which the Massachusetts General Hospital was one, engaged Mr. Royal Parkinson to survey these hospitals and develop policies. As a result the Massachusetts General Hospital published two booklets on personnel practices, one for distribution to old and new employees and one for department heads. The erection of the Vincent-Burnham Building, planned in 1941, on the site of Ward G, had been delayed by wartime restrictions on building materials. With the removal of these restrictions soon after V-J Day, the Ward G patients were transferred to Ward I on November 15 and the Sewing Room from the Ward G basement to the Moseley basement. Excavation began on December 1. Dr. Hugh Williams died on February 22, having been connected with the Hospital as an active surgeon from 1898 to 1929 and thereafter as a member of the Consulting Staff. He generously bequeathed his house at 301 Beacon Street to the hospital to be used as a residence for an Assistant Director. His lovely desk was donated to the Treadwell Library. Dr. David L. Edsall, a member of the Medical Staff since 1921, Chief of Medical Services 1921-1923, Board of Consultation 19231939, and Honorary Physician since 1939, died on August 12; Dr. Hugh Cabot, member of the Surgical Staff since 1903, and Chief of Urology 1911-1919, died on August 14; Dr. Walter B. Cannon, Consulting Physiologist for many years at the General and McLean Hospitals, died on October 1. He was the brother of Miss Ida M. Cannon, Chief of Social Service. Dr. George G. Smith, Chief of Urology 1938-1945, resigned on February 23, and was appointed to the Board of Consultation; Dr.
72
1946 Helene Deutsch, Associate Psychiatrist 1937-1945, resigned on February 21 and was appointed to the Board of Consultation; Dr. Harold G. Giddings, Assistant in Surgery 1942-1945, Associate Visiting Surgeon 1945-1946, resigned on the same date and was appointed to the Board of Consultation. Dr. John E. Gorrell, Assistant Director since 1941, resigned on September 4. Dr. Gerald F. Houser, Assistant Director 1937-1941, First Assistant Director 1941-1945, resigned on December 31 to become Director of the Faulkner Hospital in Brookline, Massachusetts. Miss Ida M. Cannon, Chief of Social Service since 1908, resigned on August 24. Miss Eleanor Greenwood, Director of Volunteer Service, resigned. Mr. Eric Frankson, Storekeeper since 1895, retired on September 7. The governor of Massachusetts appointed Dr. Roy J. Heffernan and Mr. Samuel J. Tomasello to the Board of Trustees in February, 1945; Dr. Fletcher H. Colby was appointed Chief of Urology on February 23; Miss Eleanor Wilson was appointed Director of Volunteer Service; Miss Josephine C. Barbour was appointed Chief of Social Service on August 24; Mr. George S. Weld was appointed Assistant Treasurer.
I 9 4 6
Ether Centenary. Reception to veterans. Nurse shortage. Report of King Committee. D. A. Crockett and fund-raising. Storrow House and Eldredge House. Nursing Auxiliary Service. Section of Nervous Diseases. Resignation of Bishop Sherrill. F. C. Gray elected Chairman. Miss Johnson resigns. Dr. Smith-Petersen.
>npHE outstanding event of the year was the celebration of the cen^ tenary of the first public demonstration of the use of ether as an anesthetic, by a three-day series of symposia on scientific subjects. This program had been planned by a committee of Trustees and staff with Dr. James Howard Means as chairman. On October 14, 15, and 16 a distinguished group of men and women presented a wide range of subjects, dealing with surgery, medicine, degenerative joint disease, anesthesia, war wounds, and the social and financial problems of
73
CHRONOLOGICAL HISTORY
hospitals. The exercises were held in a large tent on the Bulfinch lawn and were attended by nearly 2,000 persons. The ceremonies were climaxed by a meeting which filled Sanders Theatre in Cambridge and overflowed into Memorial Hall, where the proceedings were heard over a loudspeaker. The Right Reverend Henry K. Sherrill, Chairman of the Board of Trustees, presided. Speeches were given by Dr. Henry K. Beecher, Dorr Professor of Anesthesia, Harvard Medical School; Dr. Raymond B. Fosdick, President of the Rockefeller Foundation; Dr. Evarts A. Graham, Professor of Surgery at Washington University; and Dr. Karl T. Compton, President of the Massachusetts Institute of Technology. The House Pupils' Alumni Association dinner, held at the Copley Plaza Hotel on the evening of October 14, a theater party, and a schedule of teas and luncheons added much social happiness to this fitting and impressive anniversary of America's outstanding contribution to medical science. In addition to the exercises at the Hospital, the American Dental Association, under the auspices of the Massachusetts Dental Society, held a dinner at the Hotel Statler on October 15, to commemorate "the First Public Demonstration of Surgical Anesthesia by William T. G. Morton, a Dentist of Boston." Dr. Kurt H. Thoma, Chief of the Dental Service at the Hospital, and Chairman of the Morton Celebration Committee, presented the Morton Plaque to the Massachusetts Dental Society. On May 23 a reception was held for all returned veterans on the Bulfinch lawn. The weather was perfect and the many uniforms, the finery of the ladies, and the music of the Army Band lent color and lightness to this otherwise solemn and moving occasion. Each period of war brings its turmoil and each postwar period its problems of readjustment. After V-J Day, on August 14, 1945, everyone hoped for a speedy return to normal. This hope was not fulfilled. True it was that a full complement of physicians had been attained and that the enlarged quota of residents had remedied some of the deficiencies in training caused by war. However, there was still a definite shortage of nurses, technicians, attendants, ward helpers, and housekeeping and domestic personnel as well as men in maintenance and other departments. Because of this, over eighty beds remained closed. The shortage of nurses was most serious. It was nationwide and had assumed the status of a vicious circle. There were not enough graduate nurses who offered themselves for floor duty. Consequently these duties had to be performed by student nurses. In turn the stu-
74
1946 dents had to give a larger proportion of time to the care of patients than had been proved advisable in addition to their studies and were therefore overworked and unhappy. As a result, fewer girls entered nursing schools: 51,000 in 1945, 24,300 in 1946. An attempt to enroll more graduate nurses by increasing pay and shortening hours met with only meager success. Replacing Red Cross Volunteer Aides with paid "Hospital Aides" given "on-the-job training" helped only a little. The Director noted that "presumably, in time this economic-social condition with its problems of salaries, hours of labor for graduates, work, play and educational periods for students will adjust itself and the present materialistic attitude will be modified by a recrudescence of the spirit of service which furnished the spiritual motive power leading to the development of the modern nurse." The situation was further complicated by another factor which placed additional duties on the nursing service. The introduction of antibiotics, while of tremendous value in the treatment of disease, paradoxically produced a problem in nursing. The use of penicillin had increased to such an extent that it took the equivalent full time of eleven nurses to give the intramuscular injections daily ordered by the staff. After a year of study, the committee appointed in 1945 with Dr. Donald S. King as chairman made its recommendations on staff reorganization, noting five points. 1. The professional staff of the Massachusetts General Hospital should, as in the past, consist of full- and part-time doctors. 2. The part-time staff should be limited to those who would contribute to the development of the Hospital by teaching or by clinical laboratory investigation. [This was to eliminate "dead wood" and assured a working staff.] 3. Facilities, that is, an office building, should be provided which would make it easier for the members of the active professional staff to work together in private practice as well as in hospital activities . . . 4. Some form of staff organization should be developed around the men in the proposed office building which would give office patients the same benefits of group care as are now enjoyed by patients in the Baker Memorial . . . [This recommendation resulted in the formation of the Massachusetts General Hospital Staff Associates] . . . 5. Such an office building and clinic would be feasible only if the staff were provided with more private beds . . Λ The General Executive Committee noted that "decisions on its recommendations regarding staff appointments, the proposed office building and the general future policies of the hospital are yet to be made but the members of this committee express appreciation and
75
CHRONOLOGICAL HISTORY
gratitude to the King Committee for their patient and painstaking effort in accomplishing a difficult assignment." On March 22 an ad hoc committee (Drs. J. H. Means, E. D. Churchill, and Stanley Cobb) was appointed to confer with the Harvard Medical School to choose successors to Dr. Ayer in Neurology and Dr. Lane in Dermatology and to improve the organization of Dermatology at both the school and hospital. On the recommendation of this committee, Dr. Charles S. Kubik was appointed Chief of Neurology in 1946 and a study of dermatological problems was begun. The Massachusetts General Hospital from its very beginning has enjoyed the loyal support of many people who have ever generously responded to its appeals. Each appeal was a separate and unconnected effort to provide a new building or additions to old, or to defray the annual deficit resulting from the charitable contribution of the hospital, by reason of free care and reduced rates to those unable to pay the regular charges. Moreover with the rapid extension of research and the annual need for money to support it, and the conviction of the Trustees that research was an essential and imperative part of the Hospital's responsibility, it was decided to accept fund-raising as a continuing function. On February 21 the Trustees voted to consider the appointment "of someone to collect and coordinate the data necessary to present clearly and cogently the Hospital's need for additional funds." 2 Meanwhile the General Executive Committee had been thinking along this same line and recommended the appointment of Drs. Walter Bauer, Oliver Cope, R. W. Rawson, and F. D. Moore to work with a Trustees' Committee to raise funds. To this end, Mr. David C. Crockett was appointed (beginning May 1, 1946) as Administrative Assistant to the Trustees, his duties to be the raising of the funds for research and other activities of the Hospital. His success in this field, as evidenced by the Research Building, the Warren Building, the phenomenal support of research, and the growth of endowment funds, has amply demonstrated the wisdom of this move. During the war, mechanics, carpenters, and electricians working in war plants received wages far in excess of what the Hospital was able to pay, yet most of the maintenance employees remained loyal to the Hospital. This year the Associated Hospital Employees' Union again requested higher wages, which, after careful consideration, the Trustees granted, believing that their request was justified. Rising costs and resulting operating deficits forced an increase in charges in the General Hospital, Baker Memorial, Phillips House, and
76
1946 in the Out-Patient Department on February 1, 1946, and January 1, 1947· The cornerstone of the Burnham Memorial Hospital for children was laid with appropriate ceremony on May 23 and that of the Vincent Memorial Hospital on May 28. The Director reported, "During the year two pieces of property were left to the hospital. The Storrow Estate in Lincoln, Massachusetts, consisting of a large house, a stable, including a dwelling house, and considerable land. The hospital intends to use this property for a convalescent home as soon as it can be staffed. It is planned that Mrs. Cressida P. Eldredge's house at 44 Chestnut Street, Boston, with a few alterations will make an attractive home for about twenty graduate floor duty nurses." 3 The name of the North End Diet Kitchen was changed to North End Nutrition Clinic as more nearly representing its present function. The Ladies' Visiting Committee's War Service, a voluntary service, was changed to a Nursing Auxiliary Service in 1946 and was then carried on as a combined paid and volunteer service. The difficulty of understanding, diagnosing, and treating diseases of the complex human nervous system is evidenced by the development of Neurology, Neurosurgery, and Psychiatry, each acting as a separate department. In order to unite these services in a common objective, a Section on Nervous Diseases was created. Each was to remain autonomous as regards budget and general policies but was to share laboratories and coordinate reseach under Dr. Charles Kubik, Dr. James C. White, and Dr. Stanley Cobb. In 1941 Dr. Theodore L. Terry of the Massachusetts Eye and Ear Infirmary Staff began the study of a rare but disabling condition known as "persistent tunica vasculosa lentis occurring in premature infants," now spoken of as retrolental fibroplasia, which he continued until his death in 1946. Since this involved only premature babies, Dr. Terry sought information by the study of animals, such as baby opossums or pigs, which when born had to go through further development of a type which in the human was carried on in the uterus. One hot Saturday in August 1946, he acquired a pregnant sow, in the first stages of labor, and urged her up the stairs to the animal room in the Massachusetts General Hospital Pathology Building. Delivery of a multitude of piglets took place, but unfortunately the mother died. Now here was a dilemma. The sow weighed 300 pounds or more, too heavy for Dr. Terry to carry downstairs. The temperature was 90 o . It was Saturday afternoon. He appealed to the Director of the Massa-
77
CHRONOLOGICAL HISTORY
chusetts General Hospital. The Director appealed to Tony, general factotum of the maintenance department. Tony rose to the occasion. His crew being summoned, in some way they eased the carcass down the stairs, a really formidable task, placed it in a truck, and deposited the remains at the Brighton abattoir. Dr. Terry and the Director heaved sighs of relief. The following note in the September 1946 number of the News is interesting because of the prominence of one of the major participants during later years: "Dr. Paul D. White and Dr. Robert L. King, a prominent Seattle surgeon, are planning to send an expedition to the North Pacific very soon to study the heart beat of a whale. Dr. White has taken the heart beats of other great mammals and his interest in the whale began several years ago." In 1957 Dr. White was again unsuccessfully pursuing whales. In September 1946 Bishop Henry Knox Sherrill was chosen Presiding Bishop of the Protestant Episcopal Church of America and as this required residence outside the state, he tendered his resignation. Bishop Sherrill's association with the Hospital began in May 1917 when he became chaplain of Base Hospital No. 6. In 1928 he was elected a Trustee; and from 1934 served as Chairman of the Board. Mr. Francis C. Gray was elected to succeed him as Chairman. On December 13, 1946, Dr. Lincoln Davis retired from the Board, after serving as a Trustee since 1938. For forty-five years he has been associated with the hospital as house officer, surgeon, Chief of the East Surgical Service, and Trustee. Francis W. Hatch and John E. Lawrence were elected Trustees to fill these vacancies. On February 1, 1947, Miss Sally Johnson resigned as Superintendent of Nurses and Principal of the Nursing School, after twentyfive years of service, and was succeeded by Miss Ruth Sleeper, her assistant for many years. During the summer of 1946 Dr. Marius Ν. Smith-Petersen, Chief of Orthopedics since 1929, returned to his Norwegian homeland to receive from the King of Norway the Royal Order of St. Olav and the degree of Doctor honoris causa from the University of Oslo. He also performed major hip operations on a number of patients, demonstrating the orthoplastic technique which he had developed for the relief of hip disease. The honors accorded him were well deserved. It was a real case of "home boy makes good." Dr. Smith-Petersen, who had been on the Orthopedic Staff since 1917, resigned on June 14, and was appointed to the Board of Consultation. Other resignations and retirements during 1946 were those of Dr. Edward L. Young, member of the Surgical Staff since 1912, Visiting
78
1947 Surgeon since 1937, who retired on January 1 1 and was appointed to the Board of Consultation; Dr. Aubrey O. Hampton, member of the Staff since 1927, Radiologist since 1941, who resigned on February 21; Dr. Reginald H. Smithwick, Associate Visiting Surgeon since 1941, who resigned and was appointed to the Board of Consultation on February 21; Dr. James B. Ayer, member of the Staff since 1911 and Chief of Neurology since 1926, who resigned and was appointed to the Board of Consultation on June 30; Dr. George Clymer, member of the Staff since 1912, Neurologist since 1923, who retired and was appointed to the Board of Consultation; Dr. Russell F. Sheldon, Anesthetist since 1936, who retired and was appointed to the Board of Consultation; Dr. Raymond S. Titus, Obstetrician since 1931, who retired and was appointed to the Board of Consultation; Miss Ruth Sinclair, R.N., Executive Assistant since 1932, who resigned; Miss Elspeth Campbell, R.N., Supervisor of the Out-Patient Department since 1918, who retired; Robert O. Henderson, an orderly for fifty-two years in the General Hospital and Phillips House, who resigned on September 30. Miss Eleanor Wilson, Director of Volunteer Service, resigned. Dr. T. Stewart Hamilton, Assistant Director since 1941, resigned on June 15 to become Director of the Newton-Wellesley Hospital. The following appointments were made: Dr. Laurence L. Robbins as Chief of Radiology Service, February 21; Dr. Joseph S. Lichty as Assistant Director on June 10; Dr. George W. Van Gorder as Acting Chief of the Orthopedic Service on June 21; Dr. Charles S. Kubik as Chief of the Neurological Service on June 30; Dr. Joseph S. Barr as Chief of the Orthopedic Service on November 29; Mrs. Dorothy M. Courtney as Chief of the Volunteer Service on December 1; Ruth Sleeper, R.N., as Superintendent of Nurses and Principal of the Nursing School.
194
7
Vincent-Burnham Building opened. Comptroller appointed. Deficits. Welfare patients. Corporation dinner. General Research and Scientific Advisory Committees. Clinical Assistants. HE building housing the Vincent Memorial Hospital and the Burnham Memorial Hospital for Children was begun on December 1,
79
CHRONOLOGICAL
HISTORY
1945. Under normal conditions it would have been finished and occupied early in 1947. But delays in delivery of material, a reduced output per workman, the five-day week, and so forth, slowed construction. Dedicative exercises were finally held on November 25, 1947, for the Vincent Memorial Hospital. Offices for Dr. Meigs, Chief of the Vincent Staff, and Dr. Butler, Chief of the Children's Medical Service, were provided on the first floor, together with suitable clinical and research laboratories for the Vincent. The Hospital pharmacy occupied most of the basement and was connected with the Out-Patient Department pharmacy. Laboratories for the Children's Medical Service occupied the remainder of the basement. There were two floors for Vincent patients and three for children. Patients were admitted to Vincent floors 2 and 3 on January 2 and 5, 1948, and to Burnham 4 and 5 on January 8. Shortage of personnel postponed the opening of Burnham 6, the private floor for children. Because of rising construction costs and delays, the estimated cost of $923,000 had risen to a final cost of $1,402,589, imposing a real financial hardship upon the Trustees of both the Vincent Memorial Hospital and the Massachusetts General Hospital. Thanks to Dr. Kurt H. Thoma, retiring Chief of the Dental Service, rooms in the Out-Patient Department were renovated and brought up to date in arrangement and equipment. The family of Dr. Robert S. Hurlbut, a graduate of the East Surgical Service in 1939, who died in service, furnished a charming memorial room on White 4 primarily for the use of the Resident Staff and Medical students. In May, Mr. E. Russell Greenhood was appointed Comptroller. His duties were to relieve the Director of the details of budget making, to review and revise accounting procedures, to adjust charges, allot collections, and in general supervise and improve the financial accounting of the Hospital. Because of the generous amount of free care given to ward patients, the Massachusetts General Hospital had accepted an annual operating deficit which up to 1940 had been largely met from Treasurer's income, leaving only a small net deficit to be taken from General Funds. The prewar and war inflation of the past eight years had disrupted this and had created a serious financial problem for the hospital. Salaries, wages, and the cost of supplies increased with such rapidity that rates which when established in January were expected to produce adequate income were found by December to have been
80
1947 grossly inadequate, and alarming deficits resulted. This year the Director reported on how these economic changes affected the Hospital. Supplies
Total
Income
1947 1941
Salaries and Wages $3,084,167 1,587.533
$1,927,926 1,263,499
$5,012,093 2,851,032
$3,928,429 1,922,917
Operating Deficit $1,083,664 928,115
Increase
$1,496,634
$ 664,427
$2,161,061
$2,005,512
$ 155,549
94
53
76
104
Increase (percentage)
According to the Massachusetts Department of Labor and Industries, between 1941 and 1947 wages rose 94 per cent, the cost of commodities applicable to hospitals 7 1 per cent. Thus it would appear that the Hospital had kept pace with the general rise in wages, but had, by economy, been able to keep well below the rise in the cost of supplies. In spite of this, the operating deficit increased to $1,083,664. Against this the Treasurer was able to supply from all sources $839,721, leaving a net deficit of $243,943, which had to be taken from capital. During these seven years the cumulative operating deficit was $7,178,167, and the net deficit, after all income from the Treasurer had been deducted, was $1,272,501. This had to be met by withdrawal from the General Fund, which became dangerously depleted. That the Hospital was conscious of the need of increased revenue during this period is shown by the changes in room rates, which doubled or more than doubled in this period. Even so, costs rose faster than could be offset by increased rates, so deficits continued to be too high for comfort. Daily Rates at the Massachusetts General Hospital 1939 1945 1946 1947
Phillips House $ 8.50-16.00 $ 9.00-16.00 $11.00-18.00 $13.00-21.00
Baker Memorial $4.50- 5.50- 6.00 $5.25- 6.25- 7.25 $7.00- 8.00- 9.00 $9.00-10.00-11.00
General Hospital $4.00 $5.00 $6.00 $8.00
O.P.D. $ .75 $ .75 $1.00 $1.50
For several years the Boston Hospital Council had presented to the Committee on Welfare of the General Court the hardship imposed on hospitals by the failure of the Welfare Departments of the state, cities, and towns to pay the full cost of care of patients whom they sent to the Hospital and for whom they were legally responsible. The state 81
CHRONOLOGICAL HISTORY
paid only $6.00, whereas the average cost was over $14.00. Likewise the Industrial Accident Board paid only $6.00 plus an allowance of $3.00 for extras. The total cost to the Massachusetts General Hospital for the care of these patients over and above that paid by these responsible parties was approximately $207,000 for 1947. Each year the Welfare Committee of the Massachusetts Legislature sympathetically listened, approved in principle, and referred the matter to the Ways and Means Committee, which accepted the recommendation of the Welfare Committee that Welfare should pay the full cost of hospital care, but promptly amended it to read "but not more than $6.00" (or $8.00, or whatever amount they decided upon). While they increased the amount each year or so, it fell further and further behind the rising cost of care. It was brought out in the legislative hearings that most hospitals charged ward patients less than the cost of care. Welfare departments objected, rightfully, to paying more for their patients than was asked of others. After thorough study, the Trustees finally on October 3 1 , 1947, formally adopted the principle of setting charges for patient care in the General Hospital at cost, this to apply to all patients, welfare and others, to be determined from a review of the previous six months of operation. This was a courageous action for the Trustees to take, which brought out the iniquity of the situation by which welfare boards misused the charitable funds of hospitals by paying only a part of the cost of care for their beneficiaries. The Massachusetts General Hospital was one of the first hospitals in Boston to accept this principle, which is now widely accepted. Forced to face up to the situation, the Industrial Accident Board the next year accepted the principle of reimbursing the Hospital for the actual cost of care. It was not until 1953-54, however, that the Massachusetts Hospital Association mobilized all the hospitals of the state and finally obtained the passage of an act that provided, beginning January 1, 1955, that welfare boards should pay the full cost of care of hospitalized welfare patients. It had taken nearly twenty years to rectify this unjust situation. Blue Cross had been caught by rising hospital charges and was forced to undergo a drastic revision of contracts. During this period of readjustment it was necessary for the Hospital to accept a 10 per cent deduction on all Blue Cross payments. This deduction was later paid in full. All of these factors combined to create almost a financial crisis for the Massachusetts General Hospital. To meet this, the Trustees ap-
82
1947 pealed to the public, who responded generously, subscribing $700,000 of the $1,000,000 needed. In order to acquaint members of the Corporation with what was going on in the hospital and to tell them about some of its problems, on the invitation of President John R. Macomber, a dinner was held at The Country Club in Brookline on December second. It was so successful that dinners were continued each year up to 1956, when the annual dinner was replaced by a luncheon at the dedication of the Warren Building on December 3. Frank Hatch's poems were the high points of each dinner and were enjoyed by all. Two samples are given below. "THE TRUSTEES' DILEMMA" or "M.G.H. Ado about Nothing" or "What's the Matter with Harvard Football" A Ballard cynical, on Matters Clinical By Francis W. Hatch (On the occasion of the meeting of the Corporation of the Massachusetts General Hospital. December 5, 1949.) Consider the fate of the layman trustee who got his degree, a simple "A.B", with the help of a " C " and the fear of an " E " , a modest soul who dodged on the run courses exacting like "Chemistry I," he feels inferior, desperately when chatting with stalwarts from M.I.T.; he knows a little of Shelley and Kipling, (he read "The Brushwood Boy" as a stripling). yet should you ask him, he knows to the fraction Where G.E. sold in the closing transaction He shoots in the nineties on Clyde Park turf, He dunks his torso in Manchester surf; but science, NO, science go hang leave that field to the slide-rule gang. His knowledge of medicine, bless his heart, ranks in depth with a raspberry tart. He knows none but these when his symptoms demand aid, Aspirin, Phenolax, Iodine, Band Aid! and here we find him, lost in a daze trying to cut through the technical haze of what is discussed by clinicians and others he finds by mere chance are his M.G.H. brothers, this talk about isotopes, antibiotics, hormones and sedatives good for neurotics,
83
CHRONOLOGICAL
HISTORY
of Cortisone, miracle drug for Arthritis, a new unpronounceable cure for Nephritis! he learns that a doctor in far-away Sydney has found how to make a mechanical kidney centrifugal action, it works like a rotor, (to "A.B." it sounds like a new outboard motor). a doctor in Hartford will take you apart, and right on the table shake hands with your heart; a plan they've developed, old age to foil by draining your blood, like changing your oil. a new anesthesia with strength so it's said to keep you well under 'till all bills are paid! then the docs say, oh so pathetically, "there's so little left to do synthetically," we've synthesized drugs as a matter of course by building a lab in the rump of a horse. We've synthesized this and synthesized that it's the age of synthetics, paste that in your hat. Small wonder, then, that "A.B. Trustee" speculates what his role should be, lost in the maze of the test-tube era he feels so alone, yes queerer and queerer, 'til suddenly tinkles a faint little bell deep in his brain in the loneliest cell, "see here, just remember not one of these guys, no matter how M.I.T. — totally wise can synthesize the thing called dough the stuff that makes the hospital go, (unless he holds a secret yen for rest and peace in a Federal pen) "That's it" shouts Mr. "A.B. Trustee" something important remains for me, as surely as I'm in the land of living, scientists cannot synthesize giving; by helping to keep the place afloat I'm pulling an oar that counts in the boat; that New Research Building will certainly count, too, but architects drawings, at best they amount to hopes on paper, no more no less 'til someone raises the water cress that crinkly stuff with portraits of Presidents so dear to the hearts of Boston residents. And so good people at last we see emancipation of "A.B. Trustee" he thinks of Aunt Celia, her residue trust fund, he tells her quite frankly that this is a "must fund," he shows Uncle Joe how he can raise ructions by giving quite painlessly thanks to deductions.
1947 a treasurer friend who has had a good year he tackles and leaves with a bug in his ear the M.G.H. bug whose buzz won't be stilled a virus quite toxic which only is killed by one anti toxin a check in the mail to Henry R. Guild, here's a cure without fail, and if I should read the omens aright that's one of the reasons we're all here tonightl WE'RE STILL IN A QUANDRY, THAT LAUNDRY, THAT LAUNDRY. A hydromatic ballad (The metre shifts as you drive) by Francis Whiting Hatch (For the occasion of the annual dinner of the Members of the Corporation of the Massachusetts General Hospital, December 4, 1950.) Muse, pray guide the pencil in my hand, Guide it in its trek across the page, Give it the power to form the telling word, To strike a blow, as in another age Edward [sic] Markham lifted with his verse The burden from the serf, and you recall How Dr. Holmes espoused Old Ironsides and saved her from oblivion for all; Dana helped the hand before the mast, Kipling saved the Tommy from oppression, Yes, Muse, I pray for strength and your support, While I review, once more, an old obsession. We talk about it, sigh about it, walk about it, And then forget it in perennial quandry, The riddle of a century unsolved, What are we going to do about the Laundry? The problem has been ours across the years, Back to the Gold Rush days, and two years more, While annually we lave it with our tears, And things go on precisely as before, In eighteen hundred A.D. forty seven, With soapstone sinks, and copper kettles gleaming, The Laundry first exhaled its noxious breath, And entered on a century of steaming. One tenth the patients then, ten times today, One tenth the sheets, the towels and the gear That we must wash and iron, starch and dry, All in the same old laundry, year on year. If you can't take it, stick to Dante's art, He'll paint you hell in words of a classic bard,
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CHRONOLOGICAL HISTORY But if you have courage, call and we'll make a date, To visit Inferno, down on the Esplanade! In summer heat, when out on city streets, You're taxed to draw the least sustaining breath, Virgil described our laundry thus to Dante, "My son here may be torment but not death" (Classical scholars present please will note "tormento, ma non morte" quote, unquote) Drums in a whirl Sheets in a tangle Steam in a hiss Breath of a mangle Tongue goes dry Throat goes parch Vapor swirl Fragrant with starch Rub a dub dub Fight your way out We've still got the tub, Without any doubt W e built the Baker W e built the White The Phillips House And chromium-bright The Research Lab Is mounting on high The Nurses Home Is a gleam in the eye But who will slay Our dragon of quandry Who'll benefact Our Chippendale laundry? Oh relic and type Of our ancestors' worth Which has long kept our uniforms clean, First flower in our wilderness Star in our night It's high time you're removed From the scene! Envoie A monument to Harkness, the Harvard Houses stand, A son of Yale extending the monumental hand. The beauty of the Esplanade which you'll enjoy tomorrow, Forever keeps the memory green of Boston's James J. Storrow. And Rockefeller's Williamsburg will treasure, first and last, The wisdom for the future in the lesson of the past. Oh Heaven, where's our angel, where walks the kindly feller,
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1947 Who'll do his benefacting in the M.G.H.'s cellar? There in the swirling soapsuds, w e l l wash his sins away And starch his memory fresh and clean, a dozen times a day; So if at Christmas, once again, you find you're in a quandry, How in the name of humanity, would you like to give a laundry?
The activities of Ward 4, the Huntington Memorial Laboratory, the numerous OSRD contracts, and the growing interest of the public in research, led the General Executive Committee and the Trustees to consider the proper place of research in the Hospital. They decided that a hospital such as the Massachusetts General could and should embrace research as a major function and that it should be carefully integrated with the other functions of care of patients and teaching. They believed that future progress in preventive and therapeutic medicine would come from a combination of basic and clinical research. Already at the Hospital a multitude of projects were under way. In order to avoid duplication of effort, to control application for grants, and to coordinate research, a General Research Committee of Trustees and Staff was appointed, consisting of Francis C. Gray, Phillips Ketchum, and Ralph Lowell, Trustees, Drs. Walter Bauer (Chairman), Henry K. Beecher, Allan M. Butler, Edward D. Churchill, Stanley Cobb, Oliver Cope, Tracy B. Mallory, J. Howard Means, Francis D. Moore, and Rulon W. Rawson, of the Staff, and Dr. Nathaniel W. Faxon for the Administration. All applications for grants-in-aid had to have its approval, and monthly meetings were held to hear reports on research proposed and in progress. To assist this committee in the formulation of policies concerning research, the Trustees appointed a Scientific Advisory Committee, consisting of Dr. Karl T. Compton, President of Massachusetts Institute of Technology, Dr. Carl F. Cori, Professor of Biochemistry at Washington University, Dr. Herbert S. Gasser, Director of the Rockefeller Institute for Medical Research, and Dr. Eugene M. Landis, Professor of Physiology at Harvard Medical School. This committee met on December 12 and 13, 1947, and prepared a helpful report for the Trustees. The war was over: now came the opportunity for the victors to show magnanimity to the defeated. Medicine in Central Europe had collapsed, and many hospitals had been destroyed. America and the Massachusetts General Hospital responded. From our staff, Dr. Paul D. White and Dr. Joseph C. Aub went as members of a group of fourteen doctors on a three-months' teaching mission to Czechoslo-
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HISTORY
vakia to help rehabilitate the medical situation there. In December, Miss Lucy Morse went there to demonstrate our methods of occupational therapy. Even though the war had ended, the unselfish contribution of the volunteers continued, under the direction of Mrs. Dorothy M. Courtney. The title Graduate Assistant, which had been used to designate doctors who had received adequate resident training, but who could not be appointed to a regular staff position because there were no vacancies, who nevertheless could be used to supplement the work of both regular and resident staff, was changed to that of Clinical Assistant as more truly expressing their position. The shortage of nurses continued. During the year more adjustments in salaries and working hours were made in an effort to attract more nurses, but it was felt that only a comprehensive study and revision of all factors would bring results and so the Trustees' Committee on the General Hospital School of Nursing was asked to study salary schedules, hours of work, evening, night, and week-end assignments, divided hours, and other conditions which caused dissatisfaction. A "training on the job" program for hospital aides demonstrated that the work on an "acute" surgical ward could be carried on by graduate nurses assisted by hospital aides, provided that 50 per cent of the staff be nurses. A radical step then, it is now considered routine. From 1884 to 1947 ward housekeeping was the responsibility of nursing. In June, for the General Hospital and Baker Memorial it was transferred to the Housekeeping Department under the direction of Mr. T. Parker Clarke. Certain changes were made in the Radcliffe program, necessitated by alteration in the Harvard Summer School schedules. Also the threeyear hospital course was divided into two periods, the first, of twentyeight months, to be a period of education, during which instruction of the student was the primary objective, and a second period of eight months to be a practical internship, during which the student should develop the skill requisite to a graduate nurse. To this she would give full time and be paid a stipend. On December 14, Dr. Arthur M. Greenwood, Honorary Physician, a member of the Staff since 1921, and of the Board of Consultation since 1937, died. The following doctors retired and were appointed to the Board of Consultation on February 21: Dr. Charles A. McDonald, member of
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1948 the Staff since 1916, Associate Neurologist since 1918; Dr. A. William Reggio, member of the Surgical Staff since 1916, Visiting Surgeon since 1941; Dr. Richard S. Eustis, member of the Staff since 1914, Physician to the Children's Medical Service since 1932; Dr. Edward S. O'Keefe, member of the Staff since 1917, Physician to the Children's Medical Service since 1936. Others retiring and appointed to the Board of Consultation during the year were Dr. Arthur W. Allen, member of the Surgical Service since 1916, Chief of the East Surgical Service since 1936, who retired on April 2; Dr. C. Guy Lane, member of the Dermatological Staff since 1919, Chief of Dermatology since 1936; Dr. Kurt H. Thoma, Oral Surgeon and Chief of the Dental Service since 1943; Dr. Horace K. Sowles, member of the Surgical Staff since 1920, Visiting Surgeon since 1940. Mr. Charles E. Spear, Assistant Treasurer since 1929, retired on April 18; Miss Alvira B. Stevens, Executive Assistant from 1919 to 1921, Assistant to Director in charge of Phillips House since 1921, resigned on January 10; Miss Katherine J. Donovan, Matron and Housekeeper for forty years, resigned. Dr. James A. Halsted, member of the Staff since 1935, resigned on December 12 as Assistant Physician to become Chief of the Medical Services at Faulkner Hospital, Brookline, Massachusetts. Mr. Francis W. Hatch and Mr. John E. Lawrence were appointed Trustees on January 10. Miss E. Louise Seymour was appointed Record Librarian on January 1; Miss Agnes V. Dunn, R.N., was appointed Assistant to Director in charge of Phillips House on May 1; Dr. G. Marshall Crawford was appointed Acting Chief of the Dermatological Service on July 1.
I 9 4 8 Policies of Medical School and affiliated hospitals. G. E. C. reorganized. Surgical Services combined. Dermatology. Executive Secretary for Research Committee. More of the King Report. Physical changes. Seventy-fifth anniversary of Nursing School. Lowell Lectures.
>t*his was a year of reorganization and planning for the future. Rela^ tions with Harvard, reorganization of the General Executive Com-
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mittee, the "King Committee" report, new laboratories, and the extension and control of research, kept the Trustees, Staff, and Administration in constant ferment. At the request of President Conant of Harvard, a study was made concerning the status of men working at the Hospital on Medical School salaries or, at the other extreme, men who had only Hospital salaries, but did teaching for the Medical School. This resulted in the adoption of a "Statement of General Policies of Harvard Medical School and Affiliated Hospitals" and a "System of Appointments and Titles in the Harvard Medical School," which divided the teachers into three types, according to the amount of time spent in teaching and the percentage of salary paid by each institution. ( This is outlined more fully in Chapter 5, p. 249. ) Clarification of these relationships was a relief to all concerned. The General Executive Committee was again reorganized, with the Chief of the Psychiatric Service being added and with one medical and one surgical representative elected from the staff, and the Psychiatrist-in-Chief of the McLean Hospital serving as a liaison member. Members of the Staff down to the grade of Assistant in Medicine or Surgery could vote. The resulting committee was as follows: Chief of Medicine, Dr. J. H. Means; Chief of Surgery, Dr. E. D. Churchill; Pathologist, Dr. Tracy B. Mallory; Radiologist, Dr. L. L. Robbins; Chief of Psychiatry, Dr. Stanley Cobb; elected medical member, Dr. Wyman Richardson; elected surgical member, Dr. Leland S. McKittrick; the Director, Dr. N. W. Faxon. Choice of new chiefs of service, formerly recommended by vote of the whole staff, would hereafter be by special ad hoc committees reporting through the General Executive Committee to the Trustees, which committees might also recommend changes in policy. This change in policy regarding the appointment of chiefs was brought about by the situation in Surgery. Dr. A. W. Allen, Chief of the East Surgical Service, reached the retiring age and the problem then arose as to whether the Surgical Service should remain divided into two services or be united under one Chief. Upon recommendation of an ad hoc committee, on March 26 the following vote was passed. The Trustees reaffirm their belief that the care of the patient is and must remain the primary function of the Massachusetts General Hospital, but that teaching and research are and must always be essential functions of the Staff in promoting the welfare and care of the patient. The contributions of the part-time unsalaried staff to all three of these functions is of great importance. This group contains many men of great skill and experience. Their interest in and service to the Hospital must be
90
1948 maintained, and the development of able men in all grades must be assured through continuing for them participation in Hospital policy. The Trustees believe that the foregoing can best be achieved under the guidance of Dr. Edward D. Churchill, and have accordingly created the position of Chief of the General Surgical Services and have appointed Dr. Churchill as that Chief. 1
Another important change was the reorganization of the Dermatology Service and the appointment of Dr. Chester N. Frazier as fulltime Chief at the Hospital and as Wigglesworth Professor of Dermatology at the Harvard Medical School on July 1, 1948. This was the result of a careful study by a joint ad hoc committee of the Hospital and Medical School, appointed in 1946, and was made possible by a grant from the Rockefeller Foundation. It was planned to relate skin diseases to disorders of other tissues and organs instead of treating them as local conditions, and so not only improve an old specialty but increase its integration with general medicine. As a first step the South Medical Clinic for Syphilis was rejoined to Dermatology. The work of the General Research Committee, established the year before under the chairmanship of Dr. Walter Bauer, had increased to such an extent that it was necessary to appoint Dr. Paul C. Zamecnik as a salaried executive secretary. The position of top research appointees, who up to this time had led a precarious existence, dependent upon so called "soft money," was also settled, at least for a period, by the decision of the Trustees to place them on permanent tenure, so long as funds were available. A growing realization of the association of research with medical progress, the impetus given by OSRD during the war, and the impact of national societies such as those for cancer and polio stimulated doctors and scientists to greater activity, and the public to provide more funds. In 1948 the Massachusetts General Hospital received half a million dollars for research. This expenditure demonstrated the extent and importance of research at the Hospital. Knowledge may be gained from research as to diagnosis, cause, prevention and speedier cure of disease. In this way disease may be "outflanked" and the necessity of ever increasing the number of hospital beds ended. The Massachusetts General Hospital began this year a campaign to complete a fund of $2,500,000 to build a new research building in which the laboratories, scattered throughout many buildings, could be concentrated and expanded. On the clinical side, Dr. Perry Culver succeeded Dr. Robert Palmer in the Staff Clinic, which, with a record of 17,907 visits in 1948, is an example of preventive and curative medicine and demonstrates an
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interest in the welfare of its personnel of which the Hospital may be proud. The "King Report" had been debated at length for two years, by the General Executive Committee, by the Staff in meetings and in the dining room and corridors. The report recommended that all active members of the Staff should function actively in at least one of the following directions: (1) care of ward patients, (2) teaching, (3) research. This made it necessary for the Chief of each service to decide how many physicians he needed on his staff in the various grades and to prepare a roster. The pending reorganization of the surgical services and the possibility of an office building made this difficult. Another problem was the status of Pathology, Radiology, and Anesthesia, which came to be designated as "supporting departments." The staffs of these departments were all on full-time salaries. What should be their relationship to private patients and to "third-party" patients as regarded professional fees? The matter of professional fees for patients in the General Hospital paid by third parties (that is, insurance companies for industrial accident cases, other forms of sickness insurance, and Blue Shield) was settled by having the Hospital collect these in the name of the attending physician, placing these in a fund, to be disposed of according to the direction of the staff involved, with Trustee approval. Although this has been settled amicably and satisfactorily at the Massachusetts General Hospital, the discussion still rages in the American Medical Association and across the United States. In the heat of argument and the effect on personal finance, the welfare of the patient has often been forgotten. Physical changes at the Hospital were many in 1948 and, although individually small, in the aggregate made an impressive total. Ward E, from which the Children's Medical had recently departed, moving to the new Burnham floors, was remodeled to prepare laboratories for dermatological research. The Blood Bank moved from the basement of Moseley to the old Pharmacy on the first floor of the Domestic Building. Aided by a grant from the Hyams Trust, a major part of the fourth, fifth, and sixth floors of the Domestic Building were remodeled as laboratories for bacteriology, allergy, and cancer research. Dr. Fritz Lipmann's laboratory for the study of enzymes was moved from White 4 to larger and better quarters on the third floor of the Bulfinch and a new neuropathological laboratory for Dr. L. R. Morrison was added nearby. A new diet kitchen with up-to-date equipment appeared in Ward 4. The Marion Lawrence Memorial Room, fitted up by the Ladies' Visiting Committee, was opened on October 7 for the
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1948 convenience of the 563 volunteers who continued to give their services to the Hospital. The quarters in Wolcott for Miss Sleeper, Director of the School of Nursing, were improved. Storrow House in Lincoln, for convalescent patients (see 1946) was opened on August 8 with appropriate ceremonies and placed under the direction of Miss Elizabeth Welsh. Eldredge House at 44 Chestnut Street was opened on September 9 and provided attractive quarters for eighteen graduate nurses, who were to pay a reasonable rental. The field of dietectics had grown faster than dietitians could be trained. In this program as well as in others, the hospital had less appeal than formerly. Just as nurses had to assign less important functional duties to aides, having less training, so dietitians had to accept "diet aides," so that dietitians could give more time to supervision and to the instruction of patients on diets. In the Nutrition Clinic alone, instruction was given to over twenty-eight patients daily. The School of Nursing celebrated its seventy-fifth anniversary. Opened on November 1, 1873, the School had graduated 3,745 nurses, who had entered all branches of nursing practice, civilian and military, throughout the United States and abroad. Miss Sleeper noted: "Exercises to mark the closing of this era in the School's history were held on June xi in conjunction with Graduation and Alumnae Day. Miss Mary Wheelwright, daughter of Mrs. Sarah Cabot Wheelwright, one of the founders, attended the anniversary meeting and spoke informally of her mother's work to establish the School." 2 The affiliation with the Boston Visiting Nurse Association for the instruction of student nurses in district public health and home visiting was given up. Hereafter, only graduate nurses specializing in public health would receive training by the Association. An additional instructor in public health was added to the School faculty. The Lowell Institute was founded in 1837 by the will of John Lowell, Jr., who left $250,000 (half of his fortune) for that purpose. ( At that time this was the second largest amount of money left in the United States for educational purposes.) He gave instructions that none of this money should be put into bricks and mortar and that 10 per cent of the income should be added to the principal each year in the hope that the fund might grow. This will states: As the prosperity of my native land, New England, which is sterile and unproductive, must depend hereafter, as it has heretofore depended, first on the moral qualities and secondly on the intelligence and information of
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its inhabitants, I am desirous of trying to contribute towards this second object also; and I wish courses of lectures to be established on physics and chemistry with their application to the arts, also on botany, zoology, geology and mineralogy connected with their particular utility demand. After the establishment of these courses of lectures should disposable funds remain or in process of time be accumulated in the hands of the Trustees; for there is a provision in my will touching a gradual accumulation of said funds; the said Trustees may appoint courses of lectures to be delivered on the literature and eloquence of our language and even those of foreign nations if he see fit, he may also from time to time establish lectures on any subject that in his opinion the wants and taste of the age may demand and he may abolish those already established replacing them b y others that he thinks more useful. 3
Mr. Ralph Lowell, being a Trustee of the Massachusetts General Hospital, followed the suggestion of his ancestor to use his judgment in the selection of topics for lectures, and in 1948 chose the problems of the modern hospital as an appropriate subject. These problems were discussed in the following lectures: The Evolution of the Hospital, by Dr. Edward D. Churchill; The Relief of Suffering, by Dr. Henry K. Beecher; Human Nature and the Understanding of Disease, by Dr. Stanley Cobb; The Care of the Patient, by Dr. Leland S. McKittrick; The Education of the Doctor, by Dr. Oliver Cope; How Medicine Grows and Its Relation to Science, by Dr. Eugene M. Landis; Unsolved Problems, by Dr. Joseph C. Aub; The Place of the Hospital in the Social Order, by Dr. Nathaniel W. Faxon. These lectures were later collected and published in a book entitled The Hospital in Contemporary Life * The administration at last succumbed to the growing custom and demand, so a coffee hour in the Cafeteria was finally established in August. Dr. Richard P. Strong, Consultant in Tropical Medicine since 1915, member of the Board of Consultation 1941-1942, and Honorary Physician since 1942, died on July 4; Miss Annabelle McCrae, R.N., a graduate in 1895 of the School of Nursing and a member of the teaching staff of the School from 1902 to 1935, died on February 1; Miss Doris Knights, R.N., Chief Nurse of the 6th General Hospital and Executive Assistant for periods during 1932-1947, died on January 2. Dr. Francis M. Rackemann retired February 20, 1948, and was appointed to the Board of Consultation; he had been a member of the Medical Staff since 1917, Physician since 1929, Head of the Allergy Clinic since 1919. Dr. Paul D. White, member of the Medical Staff since 1911, Physician 1928-1948, and Head of the Cardiac Clinic,
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1949 retired to become Executive Director of the National Heart Institute; he was appointed to the Board of Consultation. Dr. W. T. Sherman Thorndike, Assistant Director 1939-1946, First Assistant Director since 1946, resigned to become Director of the Germantown Dispensary and Hospital, Germantown, Pennsylvania. Dr. Francis D. Moore, Assistant Surgeon 1945-1948, resigned to become Surgeon in Chief, Peter Bent Brigham Hospital, Boston. Dr. Langdon Parsons, Visiting Surgeon 1945-1948, resigned to become Head of the Gynecological Service, Massachusetts Memorial Hospital, Boston. Dr. Walter S. Burrage was appointed Head of the Allergy Clinic. Dr. David Weisberger was appointed Chief of the Dental Service.
Dr. Faxon retires. Credit Office. Research. New services and units. Nursing School. Ten-year program. Bay State Clinic. Mallinckrodt Ward. Richardson lectureship.
/-jpHE 136th Annual Report of the Trustees noted: This year brought the retirement of the hospital's fourteenth Director, Nathaniel Wales Faxon, M.D. Dr. Faxon's service at the Massachusetts General Hospital began in 1905 as a House Officer. In 1 9 1 9 he was appointed Assistant Director under Dr. Washburn. In 1922 he accepted the Directorship of the Strong Memorial Hospital in Rochester, New York. In 1935 he returned and served as our Director for 14 years. Dr. Faxon's successor, Dr. Dean A. Clark, assumed office on October ist.; a graduate of Princeton, a Rhodes Scholar at Oxford and a graduate of Johns Hopkins Medical School, Dr. Clark has had broad experience in teaching and in the United States Public Health Service. Prior to coming to the Massachusetts General Hospital he was Medical Director of the Health Insurance Plan of Greater New York. He had also held positions of Associate Professor of Public Health Practice at Columbia University and Lecturer in Medical Economics at the University of California School of Public Health.1 On October 17, a farewell party with bagpipe music was tendered to Dr. Faxon in the Hospital dining rooms, followed by more formal
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well-wishes in the Moseley Auditorium. To prevent the occasion from being too solemn, Frank Hatch, Poet Laureate of the Trustees, read one of his inimitable poems and Dean C. S. Burwell submitted the following parody on Newman Levy's poem about McNally and Rand, recalling the days before the war, "When our toughest job was to sit and think/shall France be purple and Britain pink": "Remember those days," Nathaniel said, "When the annual balance was black, not red? When the staff was small and there wasn't any Crockett Putting his hand in other people's pocket?" "Those days," said Trustee Francis Gray, "Like dinosaurs are passed away. We have rising costs and heavy taxin', But thanks to Nathaniel W. Faxon, The M.G.H. future is bright, not dark." "You said it brother," said Dean A. Clark.2 Although the year 1948 showed a reduction in the annual deficit to a reasonable figure, it was obvious that the pattern of increasing salaries and the rising cost of supplies would continue. Reluctantly all admission charges were increased and every effort made to reduce operating costs. Doctors' bills and hospital bills have always been hard to collect, and hospital "accounts receivable" tend to increase steadily. Although the Hospital had tried to develop a follow-up collection system, it was not very successful until a Credit Office, under the full-time direction of Miss Frances M. Hernán, formerly Chief Accountant, was established in December. Because of her association for many years with the Retail Credit Association, of which she was later (in 1954) president, Miss Hernán was particularly suited for this job, and the operation of the Credit Office since its establishment has been eminently successful in keeping "accounts receivable" at a minimum. The heavy loss resulting from the failure of welfare boards and other agencies to reimburse the hospital for the care of patients for which they were legally responsible approached $300,000. A letter was sent to all welfare boards, stating that due to the financial situation, the Hospital would require, prior to admission of all public-assistance cases (except emergency cases), authorization from the responsible welfare board for full payment of hospital charges. Since no other hospital had the courage to take this stand, it was a bold step, which, however, clearly showed the iniquity of the situation and probably helped to hasten remedial legislation. A hospital is often compared to a stool with three legs; the care of
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1949 patients, teaching, and research. At the Massachusetts General Hospital, the patient leg and the teaching leg grew faster than the research leg, but the war stimulus to research produced a rapid growth of this third leg. Evidence of this growth and the present magnitude of research at the Massachusetts General Hospital is shown by a 1949 budget of $1,288,000, all money from outside sources, and the construction of the new Research Building at the corner of Blossom and Allen Streets at a cost of over $2,000,000. The importance and extent of research had been evidenced by the creation of the General Research and Scientific Advisory Committee and was further shown by inclusion in the Annual Report of a special section for the Research Committee. During the month of December, with the permission of the Community Fund, a drive was held to provide funds for the completion of the new Research Building. Formal requests for funds were preceded by a dinner to members of the Corporation, through the courtesy of Mr. John R. Macomber, President of the Corporation. At the year's end, sufficient funds having been collected, the contract was let and ground broken with a special ceremony on December 30, 1949. Razing of the old Lodge on Blossom Street, which housed the Nurses' Science Laboratory for many years, to make way for the Research Building made it necessary to add two new science laboratories to the classrooms and nursing practice laboratory in the Domestic Building. Next, the Resident Physicians' House, erected in 1891 by Dr. Herbert B. Howard, was moved from its site at the corner of Allen and Blossom Streets to a new position on Blossom Street. In spite of a January thaw the moving of this brick building was accomplished without damage, a tribute to the skill of the movers. When the agreement for the affiliation of the Vincent Memorial Hospital with the Massachusetts General Hospital was made, it was agreed that additional operating rooms would be added to White 3, to be used mainly but not exclusively for Vincent patients. In 1949, two operating rooms were placed on White 3 over the southern X-ray wing with a direct connecting corridor to Vincent 3. An observation gallery serving both operating rooms, the gift of Mr. S. H. Fessenden's family, enhanced the use of these for teaching. At the same time, offices and laboratories for the rapidly growing Anesthesia Department were built above these connecting with White 3A. Later, offices and laboratories were added on the White 4 level. Physical changes also included improvements in "suction equipment" and a remodeling of the nurse's station in the Baker Memorial.
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A generous contribution from Mrs. Theodore Brown brought about the construction of an X-ray laboratory, over the Emergency Ward, for the study of cardiovascular problems, a joint project of Cardiology and Radiology. Expansion of hospital service included the establishment of a "Bone Bank" in January and a Blood Iodine Laboratory in October. The Occupational Medical Clinic, which had functioned from 1913 to 1917 and again from 1917 to 1928, was reopened under the direction of Dr. Harriet L. Hardy. A dispensary was opened in the Out-Patient Department on February 10 to handle minor injuries and infections, to sort out patients whose admission interview did not disclose the need for a proper clinic, to give certain intramuscular medication requiring the attention of a physician or nurse, and to dismiss the patient with inconsequential symptoms. Since a dispensary visit can be completed more quickly than a clinic visit, the fee was set at $1.00 instead of the customary $2.25 Out-Patient Department charge. It was staifed by a medical and a surgical assistant resident. During the year many steps were taken to facilitate the work of the nursing service. Responsibility for oxygen equipment was transferred to the recently created Inhalation Therapy Unit under the direction of the Anesthesia Department; an exchange system for intravenous equipment at Central Supply was arranged; all floors were equipped with autoclaves, a Suction Room was established in Baker, and other minor changes were made. On January 1 a new salary schedule for nurses was introduced, the weekly hour schedule reduced to forty hours, with overtime pay for day staff nurses up to forty-six hours and full holiday time granted without loss of pay to all. In May the Harmon voluntary contributory retirement plan was offered to nurses after three years of employment. In the fall, sick-leave allowance was made more liberal. These were significant and costly steps, which, however, were warranted in order to assure a return to the quality and quantity of nursing service needed by the Hospital. The number of nurses increased and the turnover lessened enough to justify these changes. For these and other reasons, recruitment for the school was so successful that the number of diploma students was limited to 325, the maximum number which could be taught and housed with existing facilities. Moreover the loss of students from various reasons was reduced from 23 per cent to 1 1 per cent. Lessened hours with reduced fatigue, less tension with better and happier living apparently brought 98
1949 better health so that days lost from illness dropped from 7.5 to 2.3 days per year. A new plan for an affiliation with Simmons College was adopted whereby Simmons students would join with students in the RadcliffeMassachusetts General Hospital coordinated program (see 1945), a joint program of mutual value to all. Acting upon the request of President Conant, an ad hoc committee was created to formulate a written plan outlining proposed joint activities with Harvard Medical School and the general development of the Hospital during the next ten years. This involved (a) long-term objectives in research, education, patient care, and community service; (b) long-range departmental planning and also planning for interdepartmental coordination; (c) a review of all teaching positions, especially University and Hospital full-time positions; (d) future construction plans; (e) the budget, salaries, facilities, and endowment for the next ten years. The scope of this project showed the close relationship between the Hospital and the Medical School and the heavy responsibility the Hospital carried for medical education at all levels. Planning was begun for collaboration with the Bay State Medical Rehabilitation Clinic by establishing a rehabilitation center at the Hospital and arrangements were also started for the organization of a complete health-care service for families in the Hospital area, in collaboration with the Harvard Medical School and the Community Fund. A concrete example of the close and friendly collaboration of the Massachusetts General Hospital and the Eye and Ear Infirmary was the loaning of the fifth floor of the Baker Memorial to care for Eye and Ear patients during alterations in the Infirmary. On March 4, with simple ceremonies, the following tablet was placed on the wall of Ward 4, the original research unit of the Hospital. M A L L I N C K R O D T — W A R D IV This ward in which certain patients can be made the subject of prolonged study both to their own benefit and that of others was opened November 4th 1 9 2 5 . The impetus given to clinical investigation by David Linn Edsall had much to do with its founding. On March 21st 1949, in gratitude for his many benefactions to this ward, it was named for Edward Mallinckrodt Jr.
Three generations of Richardsons had served on the Massachusetts General Hospital Staff. In 1949 the sons of Dr. E. P. Richardson, for-
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mer Chief of Surgery, established by a gift of $300, later endowed by a further gift of $10,000, the Edward Pierson Richardson lectureship (see Appendix A). At the same time they presented an oil portrait of their father which was hung in the Bigelow Amphitheatre on White 3A. Dr. Franklin S. Newell, Obstetrician 1914-1929, Board of Consultation 1929-1941, Honorary Physician since 1941, died on March 3, 1949; Dr. Harold G. Giddings, Supervisor of the Surgical Out-Patient Department 1942-1945, Board of Consultation since 1945, died on May 28; Dr. Charles L. Scudder, member of the Surgical Staff since 1891, Chief of the East Surgical Service 1914-1920, Board of Consultation 1920-1931, Honorary Surgeon since 1931, died on August 19; Dr. Frederic A. Washburn, Resident Physician and Director 1903-1934, Director Emeritus since 1934, died on August 20; Dr. Raymond S. Titus, Obstetrician 1930-1946, Board of Consultation since 1946, died on December 25. Dr. Ferdinand Haase, Jr., resigned on October 29 to become Director of the Nathan Littauer Hospital, Gloversville, New York. He had been Assistant Director since 1943. Three members of the Staff retired and were appointed to the Board of Consultation on February 18: Dr. Arlie V. Bock, member of the Medical Staff since 1919, Physician since 1928, and Dr. George Van Gorder, member of the Orthopedic Service since 1929, Visiting Orthopedic Surgeon since 1937, Acting Chief of the Orthopedic Service, and Dr. Ethel M. Rockwood, Dermatologist and member of the Dermatological Service since 1928. Dr. Rulon W. Rawson, Associate Physician, resigned to become a member of the Staff of the Memorial Hospital, New York. Dr. Wyman Richardson, member of the Medical Staff since 1925, Physician since 1939, resigned and was appointed to the Board of Consultation on March 4. Dr. Ellsworth T. Neumann was appointed Assistant Director on July 1; Dr. Dean A. Clark was appointed General Director on October 1. Mrs. Constance Braman, R.N., was appointed Assistant to Director, Phillips House, on February 18, and Miss Dorothy Perkins, R.N., was appointed Assistant Director of Nursing, Baker Memorial, on September 1.
IOO
1950
19 50 Research Building begun. Korean War. Trustees' actions. Loan Fund and Credit Union. Social Security. Bay State Clinic. Baker Memorial schedule. Nursing Service. Community relations consultant.
had been broken for the Research Building on December 30, 1949. The Trustees noted that the cornerstone had been laid on November 24, 1950, on the occasion of the fourth meeting of the Scientific Advisory Committee. The building stood completed to the extent that equipment was being installed. Lack of funds and space made it necessary to omit facilities for Pathology, which had originally been included. Funds were to be raised and plans drawn for a new Pathology Building. The Korean war began on June 25 when North Koreans crossed the 38th parallel to invade South Korea. Immediately the hospital set up an Emergency Defense Committee, under the direction of Dr. Horatio Rogers, which submitted an excellent and comprehensive report, which, after approval by the State Civil Defense Authority, was published for public use. In October a rehearsal of "Operation Strategic" was successfully carried out and received considerable publicity. Again it was shown that plans must be practiced to be effective. After a careful study of the relative merits of a new heating plant and the steam service provided by the Boston Edison Company, a ten-year contract with the Edison Company was signed. Ether Day was celebrated by the awarding of pins for years of service to the Hospital, and in the evening an "old timers' night" for those who had served twenty years or more was held in the Nurses' Cafeteria. The Corporation dinner, again through the courtesy of Mr. J. R. Macomber, was held at the Algonquin Club and was as usual a pleasant and informal party enjoyed by all. The Director wrote: F I ROUND
Four actions were taken by the Trustees to strengthen the organizational and financial base of the Hospital. The first of these was a vote approving in principle, the use of the hospital's general funds for education
101
CHRONOLOGICAL HISTORY and research in any instance where such use might be thought advisable. Secondly, the Trustees provided life tenure at the hospital for all staff members holding permanent full-time appointments at Harvard Medical School. The next event was of importance to all the hospital's functions, but particularly those of education and research, namely, the preparation and approval of a ten-year program of development, including not only contemplated construction but also future endowment needs and proposed organizational changes and improvements. This program was completed in June and submitted along with similar programs from other hospitals associated with the Medical School, to President Conant of Harvard. Finally, the Trustees agreed to participate in the Harvard retirement plan for all staff members holding joint appointments with the Medical School and eligible under the broadened Harvard plan, so that the Hospital will now contribute to the plan with respect to all salaries paid by the hospital to joint appointees. These moves, taken together, should, it is believed, go far toward assuring the academic standing and financial security of the full-time staff and thus attracting to the institution the highest type of talent for scientific advance. Efforts along similar lines with respect to all employees of the Hospital, both professional and nonprofessional, were also made. First, in June, upon recommendation of the Staff, the Trustees established a loan fund for house officers. This fund was made up from fees paid by third parties for physicians' services to ward patients and deposited with the Hospital by the visiting staff . . . In response to numerous requests from employees a Credit Union was established, in which employees might deposit their savings and from which they could obtain small loans at reasonable interest rates. In December, by vote of the Trustees supported by more than a twothirds vote among the employees, the hospital decided to enter the Federal Old Age and Survivors Insurance program. Employees of sixty-five years of age and over became eligible to retire under this program starting July 1 , 1952. Participation in this Social Security retirement plan was voluntary for all existing employees but became compulsory for all new employees, professional as well as nonprofessional, coming on the payroll after January 1, 1 9 5 1 . Plans for a more comprehensive retirement program for employees not holding permanent joint appointments with Harvard were still under consideration by the Board . . . Efforts continued during 1950 toward strengthening the role of the hospital in the community. The most important event in this regard was an agreement reached by the Trustees with the Bay State Medical Rehabilitation Clinic. By this agreement, the Bay State Clinic, an entirely independent non-profit corporation, would renovate and occupy old Ward I with a rehabilitation Center open to patients from all over the community regardless of their age or financial status. While the conduct of the center would be entirely under the direction of the Board of the Bay State Rehabilitation Clinic, its staff would be appointed jointly by the Clinic and the hospital, the Clinic would reimburse the hospital for the cost of maintaining the Clinic's quarters, and the Clinic would have full access, at cost, to the
I02
1950 hospital's diagnostic and therapeutic facilities and to its medical staff for consultation. By this arrangement the Bay State Clinic would not be required to duplicate much expensive equipment already available in the hospital, and the hospital would have immediately at hand the increasingly important services of experts in the techniques of rehabilitation for the use of the patients in its wards, semi-private and private rooms, and out-patient department. At the same time, the Clinic remained a separate enterprise based on the entire community, so that patients of other hospitals and of physicians not associated with the Massachusetts General Hospital could be readily referred to it for treatment.1 For over twenty years inflationary trends in the United States had reduced the purchasing power of the dollar, which made the original Baker Memorial fee ceiling of $ 1 5 0 unrealistic. To remedy this inequity it was first raised to $200, then to $250. This year a further attempt to adjust matters resulted in the adoption of a flexible fee schedule ranging from $200 to $400, the total charge to be adjusted to the patient's financial status. In its report for 1950 the General Executive Committee reviewed its establishment in 1912, its development, and changes in its membership, together with its important decisions and accomplishments. The Director of Nursing wrote in her report: Because of the generous cooperation of Mrs. Constance Braman and the Phillips House Nursing Staff, and the appointment of Mrs. Margaret Matthie as Assistant Director of the Nursing Service in the Out-Patient Department, it was possible this year to plan jointly for all hospital divisions, and to provide for a free exchange of ideas, equipment, services and at times personnel. This greatly facilitated nursing care, and often permitted the admission of more patients. Through the cooperation of the private nurses in the Phillips House who came into that division as staff nurses, it was possible to keep all floors in that division open in June when resignations in the nursing personnel were numerous and patient admissions high. Through the acceptance of more than their share of evening and night assignments, staff nurses in both the Baker Memorial and the General Hospital tided those units over periods when students were too young for such experiences and when the number of graduate nurses employed was low. During periods when the patient census was high, Baker patients used the facilities of the Phillips House operating room. Evening and night operations for the Phillips House were performed during the summer months at the Baker. More patients from the Baker were cared for temporarily in the General Hospital. Some nurses who could be spared were reassigned to the division with the greatest need. 2 Assistance was obtained from the United States Public Health Service for a study of the "head nurse's function," with the hope of
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CHRONOLOGICAL HISTORY
relieving these nurses of some of the responsibility which had gradually been forced upon them. Efforts to recruit graduate nurses met with some response following publicity in local newspapers and on one radio station. About this time, Mrs. Elizabeth Weiss was appointed as Community Relations Consultant and, under her leadership, nurses were gathered in small groups to discuss their problems and to make recommendations. From these meetings there resulted a team plan for nursing care, whereby a graduate nurse acted as a leader for auxiliary workers, a plan which has gradually grown to be generally accepted in nursing service. In order to keep pace with the rising cost of living, salaries and wages for nurses, ward helpers, maids, porters, ward clerks, orderlies, and aides were raised during the year. While it was recognized that these increases might bring few if any additional workers, it was hoped that this voluntary recognition of the rising cost of living would assist in the retention of the good, experienced workers. There was no doubt that the relationship with personnel had been greatly improved through the participation in the Social Security plan. Interest in nursing as a profession seemed to be increasing, since the number of acceptable applicants for the school outnumbered possible admissions by nearly 5 to 1 and the enrollment of the school increased 15 per cent during the year. The coordinated program with Radcliffe College had been slow in developing, but this year there was proof of greater interest, since eleven students entered in September. It was necessary to reopen 23 Parkman Street for graduate and student nurses, and arrangements were made to give twenty-five others a housing allowance. The teaching program started in 1948 had proved very satisfactory, although the necessity of repeating classes in order to deal with small groups of students was rather hard on the faculty. Naturally the nursing faculty felt that a few more classrooms and better facilities in the library would be helpful. The school again received its annual accreditation from the National Nursing Accrediting Service. The Ladies' Visiting Committee joined the American Hospital Association Hospital Auxiliary. Dr. George R. Minot, member of the Medical Staff since 1913, Board of Consultation 1930-1949, Honorary Physician since 1949, died on February 25; Dr. L. Raymond Morrison, Neuropathologist since 1945, died on August 12.
104
1951 Three doctors retired and were appointed to the Board of Consultation: Dr. Dwight L. Siscoe, member of the Medical Staff since 1924, Associate Physician since 1929, on February 17; Dr. Donald S. King, member of the Medical Staff since 1924, Physician 1945-1950; Dr. F. Chester Durant, member of the Dental Staff since 1915, Dental Surgeon since 1924. Dr. Joseph S. Lichty resigned on July 15 to become Director of Moses H. Cone Memorial Hospital, Greensboro, North Carolina. He had been Assistant Director since 1946. Dr. Jacob E. Finesinger, Psychiatrist since 1938, resigned to become Professor of Psychiatry at the University of Maryland; Dr. Carroll B. Larson, Assistant Orthopedic Surgeon since 1946, resigned on September 1 to become Professor of Orthopedic Surgery, University of Iowa; Dr. Fiorindo A. Simeone, Assistant Surgeon since 1945, resigned to become Professor of Surgery, Western Reserve University. Dr. Leon R. Lezer was appointed Assistant Director on July 7, the appointment to become effective on April 14, 1951. Miss Louise Hatch was appointed Director of the Dietary Department and the School of Dietetics.
Research Building opened. Clinical and Research Fellows. Salaries to interns. Adequacy of Nursing School. Effects of inflation. Dr. Means retires.
(( j τ is a pleasure to report," the Trustees stated, that during 1 9 5 1 the Hospital has not only maintained the high standards in each of the three-fold functions—care of the sick, teaching and research— but has made significant advances in each of these fields. In addition a good start has been made towards realizing the goals set forth in the Ten Year Plan. Improvements in our ability to care for the sick have been many. The enlargement and remodeling of Mallinckrodt Ward 4 (adding seven beds and a recreation room) represents one of these. It is believed that the establishment of a means by which the full and
IOS
CHRONOLOGICAL HISTORY
part time staff may center all their activities at the hospital is highly desirable. The Massachusetts General Hospital Staff Association . . . may be the answer to this need . . . Towards this end a joint Staff and Trustees Committee was appointed. With a working fund appropriated and Mr. E. Michael White as Full Time Director of Organization much progress has already been made.1 The Bay State Medical Rehabilitation Clinic was opened on June 4 in quarters provided by extensive remodeling of old Ward I (see 1950). It was planned to have the Department of Physical Medicine, which had recently been expanded to include beds in Baker Memorial and Phillips House, collaborate with the Bay State Clinic. The new Research Building at the corner of Allen and Blossom Streets was formally opened on May 16 with appropriate ceremonies. Speakers were Mr. Francis C. Gray, Chairman of the Board, Dr. George P. Berry, Dean of the Harvard Medical School, Dr. James R. Killian, Jr., President of Massachusetts Institute of Technology, Dr. W. Palmer Dearing, Deputy Surgeon General, United States Public Health Service, Dr. Dean A. Clark, General Director, and Sir Charles Harington, Director of Medical Research, Institute of Hampstead, England who delivered the first Richardson Lecture. The Committee on Research reported, "The new Research Building, opened this year, highlighted two points; one the necessity of choosing suitable titles for a number of non-clinical investigators as well as assuring them of tenure consistent with their positions and second, the obtaining of adequate compensation for the indirect or overhead costs of conducting research at the hospital." 2 The growth in the extent and importance of research is shown by the number of pages on the subject in the Annual Reports: in 1941 — four pages; in 1951 — seventeen pages. In 1957 grants of over $2,000,000 were received for research. On October 26 and 27, the Hospital sponsored a two-day symposium, to which representatives of pharmaceutical companies, scientists, and clinicians were invited, to study the problem of the clinical evaluation of new drugs. A new Cardiovascular Research Laboratory was established in the Research Building, under Dr. Ivan Frantz. "More than ever before," reported the General Executive Committee, "the mounting responsibility of our hospital to the community and to the profession is reflected in the increasing number of physicians and research workers from home and abroad who come each year for work and instruction within these walls." 3 A table followed, showing
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1951 the magnitude of this obligation, a four-fold increase in ten years: in 1941, there had been 27 clinical and research fellows, 12 in medicine, 5 in surgery, and 10 in other departments; in 1951, there were a total of 95 fellows, 37 in medicine, 9 in surgery, and 49 in other departments. Out of an appropriation from the Professional Services Fund, by vote of the Staff, whose services provided this fund, salaries were paid for the first time to interns, and resident salaries were increased. After five years of study on the instability in the employment of graduate nurses and other nursing personnel, the Nursing Service decided to accept this instability as continuing indefinitely, to try to create an effective staff in spite of change, and to develop an in-service program that would operate efficiently in spite of constant change of personnel. With the cooperation of the United States Public Health Service a two-year study of "head nurse power and how to use it" had been undertaken and the report of this study encouraged the Hospital definitely to adopt a plan which had been previously tried as an experiment. A head nurse carried a heavy load. She was responsible for the discipline and order of her ward or floor, for the exact carrying out of doctors' orders, for the practice of proper nursing services and techniques and for the assignment and teaching of graduate nurses, students and other nursing aides. This matter of assignment and teaching involved eight groups or categories, ( 1 ) first-year student nurses in the Massachusetts General Hospital diploma course, (2) second-year students in this course, (3) third-year students in this course, (4) Radcliffe and Simmons students in the nursing collegiate course, ( 5 ) Boston University graduate nurses taking advanced practice courses, (6) Boston University graduate nurses taking their Master's degree, (7) McLean-affiliated male nurses, (8) students of practical nursing. In addition there were nursing aides, secretaries, volunteers, and salaried staff nurses to be accounted for. To assign each person to an appropriate function, to assist and guide them all, and to produce a well-integrated and happy staff proved too much for a head nurse to carry alone on a large floor. The solution adopted was a "team plan," which spread responsibility to graduate nurses working under the head nurse. Instead of each graduate being assigned to care for three or four patients with aides and other helpers allotted indiscriminately, each
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graduate was made the leader of a team of students, aides, and helpers, and made responsible for the care of eight or ten patients. The graduate nurse as team leader was also responsible for teaching her group. All were of course subject to direction by the head nurse. This plan worked well; it relieved the head nurse of minor details and gave patients a continuity of care by a responsible team thus giving them a feeling of security. The erection of a new nurses' home in the Bulfinch yard, made possible by the Noyes Bequest, was authorized. Miss Sleeper reported that the revised Nursing School curriculum of twenty-eight months' instruction with an eight-month internship had proved highly successful. Also, by arrangement with the Household Nursing Association, student attendants were to be given clinical training in the Baker Memorial. In 1947 the Advisory Committee and the faculty of the School of Nursing had accepted two principles: first, that the three-year course must be educationally sound and the graduates prepared for the responsibilities they would meet, and second, that the Massachusetts General Hospital School should, within the limits of its facilities, participate in other programs for the preparation of nurses. It now seemed appropriate to take stock of the School's progress. The first class to complete the reorganized three-year program was graduated in September 1951. Measured by enrollment and student interest, the program might be said to have achieved its goal. Enrollment had grown to 374, compared to 260 in December 1948. That the students found satisfactions in the programs seemed to be indicated by the fact that 8 χ per cent of the graduates of this first class remained to work in the Hospital. To test the quality of instruction the "Graduate Nurse Qualifying Test," a written, standardized examination, was given to this class on completion of the twenty-eighth month of the educational period, and again at the thirty-sixth month, when the internship was completed. There were no poor results for either period, so that it was felt that the course was educationally sound. Participation in other programs in 1951 included the RadcliffeMassachusetts General Hospital Course, and the Simmons College School of Nursing, and on the graduate levels, Simmons College, Boston University, and McGill University. A second instructor in Public Health was appointed to make up for the loss in 1948 of the affiliation with the Boston Visiting Nurse Association. 108
1951 The Social Service Department noted a marked increase in the number of patients referred for long-range complicated social adjustments, which require continuing comprehensive case work over months and sometimes years. The Alcohol Clinic had also added responsibilities which required a full-time worker. The impact of the Korean war, with the resulting inflation, produced an increased cost of supplies, the necessity of large wage increases, and the raising of Hospital rates twice, reaching $16 a day in the General Hospital. Closed beds and the reduction of the average stay of patients from 16 days to 13 days resulted in a loss of nearly 40,000 days' care, and a serious drop in Hospital income, in spite of increased rates. The death of Dr. Tracy B. Mallory, for twenty-five years Chief of the Department of Pathology, occurred on November 1 1 . Over a hundred physicians received training in pathology under his direction. He introduced the house officership and residency in the department. From a complement of four staff doctors, one resident, two technicians, and one secretary, he saw it grow to include eight staff men, seven residents, six fellows, and about thirty technicians and secretaries. He developed a close association between the Pathology Department and the Clinical Services by conducting morning reviews of pathological specimens, attended by the resident staff and interested physicians, and by having a member of the department attend service and special clinic meetings. "This year," reported the Trustees, "saw the retirement, after 40 years of active service to the hospital, of Dr. James Howard Means. As Chief of the Medical Services for the last 28 years, Dr. Means contributed very greatly in establishing the high professional standing of these services. His modesty, generosity and understanding endeared him to all of his colleagues." 4 As Jackson Professor of Clinical Medicine, 1923-1951, he was an active member of the Harvard Medical School Faculty, interested in bringing Hospital and school into closer cooperation. Dr. Walter Bauer, long an associate, succeeded him. Mr. David C. Crockett, formerly Administrative Assistant to the Board of Trustees, was appointed Associate Director for Resources and Development and Dr. Robert L. Berg as Assistant to the Director for Research and Education. Dr. Raymond D. Adams was appointed Chief of the Neurological Service upon the retirement of Dr. Charles S. Kubik after twenty-four years of service, the last five years as Chief of Neurology. Besides Dr. Tracy B. Mallory, the Hospital lost three more Staff
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CHRONOLOGICAL HISTORY
members by death during 1951: Dr. William B. Robbins, member of the Medical Staff since 19x3, Physician 1928-1938, member of the Board of Consultation 1938-1948, Honorary Physician 1948-1951, on January 16; Dr. F. Chester Durant, member of the Dental Department since 1915, Board of Consultation 1950-1951, on March 7; Dr. G. Marshall Crawford, member of the Dermatology Staff since 1935, Acting Chief of Dermatology 1947-1948, Dermatologist 1948-1951, on October 19. Dr. Jacob H. Swartz, member of the Dermatology Department since 1923, Dermatologist since 1937, resigned and was appointed to the Board of Consultation; Dr. James H. Townsend, member of the Medical Staff since 1927, resigned and was appointed to the Board of Consultation on June 1; Dr. Arthur Bates Lyon, Associate Physician to the Children's Medical Service 1935-1951, resigned on February 23; Dr. Ernest M. Daland, member of the Surgical Staff since 1921, Visiting Surgeon 1941-1951, retired and was appointed to the Board of Consultation on July 1; Dr. Frederick J. Lynch, Assistant Obstetrician since 1936, resigned; Dr. Somers H. Sturgis, Assistant Surgeon 19411950, resigned on January 1, to become Professor of Gynecology, Harvard Medical School, and Chief of Gynecological Service, Peter Bent Brigham Hospital; Dr. Augustus S. Rose, Associate Neurologist, resigned on February 7 to accept the Professorship of Neurology at the University of Southern California; on July 2, Dr. Bertram H. Selverstone resigned as Assistant in Neurosurgery and was appointed Clinical Associate in Neurosurgery. Mr. Lawrence Martin was appointed Comptroller on September 7, and on October 16, Dr. Wyland F. Leadbetter resigned as Associate Urologist and was appointed a Clinical Associate.
I952 Statistics. Pathology. Bacteriology. Cytological Laboratory. Improved care of patients. Nursing School. Dietary Department. Physical changes. Service pins to doctors. r i p HIS year, the hospital was honored by the appointment of Dr. Dean A. Clark, General Director, to serve on the "President's Commission on the Health Needs of the Nation." I IO
1952 The following items are taken from the Director's report. In 1952 the Massachusetts General Hospital admitted 20,799 Pa~ tients to its beds, including those of the affiliated Vincent Memorial, Hall-Mercer and Huntington Hospitals, providing 235,225 patient days of bed care. Through the use of endowment income, and generous gifts from the United Community Services and individuals, it was possible for the equivalent of 42,000 of these patient days of care to be provided free of charge. In the combined Out-Patient Department, the Massachusetts General Hospital admitted 5,986 new patients, with 108,496 subsequent visits, and the Eye and Ear Infirmary 8,321 new patients, with 54,875 subsequent visits, making a total of 14,307 new patients, with 163,371 subsequent visits. The total visits to the Out-Patient Department numbered 177,657, and the daily average 588. These services were furnished in the face of a severe shortage of nurses and other personnel. It would not have been possible without the work of the 465 volunteers, who performed 42,938 hours of work. Including medical staff, nurses, employees, students, fellows, and volunteers, nearly 4,000 people took part in the care of patients, education, and research at the Massachusetts General Hospital. Public Welfare Agencies still were failing to pay the full cost of care for recipients of public assistance admitted, the underpayment to the Massachusetts General Hospital for 1952 being $180,726. After many years of effort, it could now be said that the cost of research was at last separated from the cost of patient care. In working this out it had been found that many research projects were not paying for the indirect costs of operation, which then fell upon the Hospital. To correct this the Hospital sponsored a meeting of representatives of granting agencies and found an unexpected area of agreement between agencies and research workers. Strangely enough, it was found that many scientists who advised these agencies did not understand the nature of the true indirect costs of research and needed to be reoriented. In order to help meet the shortage of pathologists — over one hundred hospitals were now seeking full-time pathologists — the Trustees approved a four-year residency program, which included, in addition to pathologic anatomy, rotation through the various clinical pathological laboratories. Also an affiliation with the Worcester Memorial Hospital was made whereby each resident would spend a four-month period there. Much needed space for research was allotted in Domestic 4. Ill
CHRONOLOGICAL HISTORY
With the retirement of Dr. Louis Dienes, who had been the Hospital Bacteriologist for twenty-two years, Dr. Thomas F. Paine, Jr., was appointed in his place and the department of Pathology and Bacteriology was made into two separate entities. Plans were begun for a new pathology building. Dr. Meigs noted in the Vincent Memorial Hospital report the increasing use of cytological diagnosis for early cancer of the cervix and the continued activities of the enlarged Vincent Laboratory. At the request of the Surgeon General, United States Army, to reconstitute the 6th General Hospital, plans were formulated to set up a skeleton organization that would provide key personnel in case of activation. On the advice of the Scientific Advisory Committee it was decided to reduce the amount of so-called "war research," which, since it obligated the uncovering of specific information useful to the Armed Forces, curtailed the freedom of the investigator to pursue those topics most appealing to him. The year before, it was reported, again on the advice of the Scientific Advisory Committee, a Therapeutic Trials Panel, composed of clinicians, a pharmacologist, and a statistician, had been formed to advise on the clinical testing of new drugs. Three projects intended to improve the care of patients were now under way: ( 1 ) reorganization of the Out-Patient Department into an Ambulatory Clinic with comprehensive unified and personal service for all patients; (2) through an appropriate staff organization the extension of ambulatory care to patients of all income groups; (3) development of a Family Health Service for the people in the immediate neighborhood so that they might receive complete preventive, as well as curative, medicine at the Hospital or at home. Visiting hours, which had previously been rigidly restricted, were gradually liberalized in all units. In 1952, an unlimited number of adult visitors was permitted on adult wards in the Baker Memorial and General Hospital, and daily visiting for parents, with restricted hours, to children on Burnham floors. Although only 8,4x4 patients, which included those in the General Hospital, Out-Patient Department, and Phillips House, were listed as being referred to and cared for by Social Service, due to the increased number of medico-social rounds on most major services, there was felt to be, through this conference discussion method, practically a 100 per cent social review of patients on the wards, numbering over
112
1952 ιο,οοο. The use of case aides had been helpful and had led to many aides having gone on to become graduate social service workers. Miss Barbour's report contains the following: This year a bequest of slightly over $3,000 came to us from a former patient, Miss Ulmia Des Jardins. The records show that as a single, lonely seamstress, living in a small housekeeping room, she came as a patient to the Hospital and Social Service in 1 9 1 8 and was last known in 1924. Her complaints and illness were not of a major nature but were difficult for her in her loneliness. Both doctors and social worker gave devoted, but what seems today like minor services—furnishing medicine, encouragement, friendliness, a brief period of convalescent care and final arrangements for an adequate retirement plan. She died in 1942, leaving the residue of her estate to Social Service. 1
During the year 470 student and graduate nurses received instruction at the Hospital. Graduate instruction included refresher courses at the Phillips House and training of team leaders at the Baker Memorial Hospital. Graduates from McGill and Boston Universities were given experience in nursing service administration, head nursing, and operating-room control. Undergraduate instruction was given to 227 attendants and students from affiliated schools. Each year, it was noted, brings an increasing number of new students and graduate nurses to the wards and clinics to be oriented and taught the Massachusetts General Hospital methods of patient care. The student quota of the school was filled, with resignations far below the national level. The curriculum was undergoing constant study for improvement. Tuition had to be increased from $200 to $300. Meal tickets were given up. Students could now eat all they could hold. To promote efficiency, administration of operating rooms in the Phillips House and Baker Memorial was combined under the supervision of Miss Helen Coghlan. The Central Supply Room was rearranged and new labor-saving machines installed. The former isolation of the Phillips House nursing service had been abandoned, and now nurses were freely exchanged between all units to meet the greatest need. Due to a shortage of trained obstetrical nursing personnel, it was necessary to discontinue the Obstetrical Service in the Baker Memorial and Phillips House on September 1. The former Ladies' Advisory Committee to the Massachusetts General Hospital School of Nursing adopted a new plan of organization,
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which was approved by the Trustees, and became "The Advisory Council to the School of Nursing of the Massachusetts General Hospital." Under Miss Hatch's able direction the administration and organization of the Dietary Department had been gradually improved. Menu planning and cost control through purchasing resulted in a saving of $28,000 in meat buying alone. Combinations of a staff dietitian, dietetic intern, and diet aide functioning as a team produced better patient coverage in the Baker Memorial. Special diets, totaling 319 daily, formed nearly half of the daily meals, and 1,714 discharge diets were provided for patients, almost 1 for every 10 patients leaving the hospital, which shows the important role of proper food in medical care. The Treadwell Librarian regretfully reported an increase in the number of journals and books stolen from the Library. The Warren Library was redecorated in 1952 and a volunteer cart service for Phillips House patients inaugurated, allowing three visits a week to all floors. Each year between 50,000 and 60,000 volumes are circulated. The cornerstone of a new nurses' residence, to be known as the John Bartlett Memorial Nurses' Home, was laid on December 8, 1952. Alterations to old Ward 4, now the Mallinckrodt Ward, were completed. A seventh floor was added to the Vincent-Burnham Building, to be used for the study of child psychology and as a psychiatric clinic for children. This had been made possible by a gift in 1950 from the Hyams Trust. Additional lead protection was installed in the X-ray Department and a new incinerator, costing $41,318, was built. The parking problem was eased somewhat by arrangements made with the Metropolitan District Commission for the joint use of the new parking space, accommodating 200 cars, on Charles Street under the overpass, by the Massachusetts General Hospital, the Eye and Ear Infirmary, and the Suffolk County Jail. The custom of awarding service pins on Ether Day, begun in 1945, was this year extended to include doctors who had served twenty-five or more continuous years on the active Staff; sixteen physicians received the twenty-five-year pins and Dr. Joe V. Meigs one for thirty years' service. Awards to employees, which previously began after ten years of service, were this year started at five years. Thereafter each ten years of service entitled an employee to a new pin with an additional star. Dr. Richard H. Miller, member of the Surgical Staff since 1912,
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1953 Visiting Surgeon 1935-1940, member of the Board of Consultation since 1940, died on June 3; Dr. Lincoln Davis, member of the Surgical Staff since 1903, Board of Consultation 1932-1938, Trustee 1938-1946, Honorary Surgeon since 1946, died on July 19; Dr. Henry D. Lloyd, Dermatologist 1928-1929, member of the Board of Consultation 19291947, Honorary Physician since 1947, died on November 3; Dr. Charles E. Wells, Assistant Director 1914-1928, Assistant in Dermatology 1935-1945, died on November 13. Dr. James J. McCort, Associate Radiologist since 1947, resigned to go to the Santa Clara County Hospital, San Jose, California. Dr. Maurice Fremont-Smith, member of the Medical Staff since 1920, Physician 1951-1952, retired on July 1 and was appointed to the Board of Consultation; Dr. William A. Rogers, member of the Orthopedic Staff since 1924, Visiting Orthopedic Surgeon since 1937, retired on December 1 and was appointed to the Board of Consultation. Dr. Lamar Soutter, member of the Surgical Staff since 1941, resigned on November 1 to join the staff of the Massachusetts Memorial Hospital, and was appointed as Clinical Associate. Dr. Charles L. Clay was appointed Assistant Director, with permanent tenure; two more Assistant Directors were appointed: Mr. Henry J. Murphy in May, and Mr. Edmund J. Mattos in August. Dr. Ellsworth T. Neumann, Assistant Director since 1949, was appointed Executive Officer. Dr. Paul C. M. Zamecnik was appointed Hospital Full Time as Associate Professor of Medicine, Harvard Medical School, and Dr. Nathan B. Talbot was appointed Hospital Full Time as Associate Professor of Pediatrics, Harvard Medical School.
Nobel Prize to Dr. Lipmann. Basic Research. Physical changes. Private patients to O.P.D. Consultants. Married students. Hospital Dispatch Service. Supervisor for all operating rooms. Bartlett Hall dedicated. Social service index. Coordinating Committee.
HE Nobel Prize for 1953 was awarded to Dr. Fritz Albert Lipmann, Biochemist of the Hospital (1941) and Professor of Bio-
"5
CHRONOLOGICAL HISTORY
logical Chemistry at the Harvard Medical School (1944), "for his discovery of co-enzyme A and its significance in the intermediary metabolism." For some years the Hospital had recognized in theory and practice the desirability of conducting basic research, and of attracting to its staff men adequately trained to undertake intricate laboratory work. In 1953, there were more than a score of trained research workers, who might or might not possess M.D. degrees, who were devoting their entire time to laboratory investigation at the Massachusetts General Hospital. These men were contributing essential "know-how" in complex situations where those with clinical training alone would be unable to handle the problem. The physician undertaking work in a new field thus had expert advice available to him in almost all basic science fields. The transfer of these investigators from the academic arena to the hospital was jeopardizing to a degree their future scientific careers, since they lacked then a close relationship with other members of their own field and thus might not be considered for some vacant academic post. Furthermore, since the Massachusetts General Hospital had adopted along with Harvard University the policy of not providing a succession of temporary appointments for longer than eleven years, at the end of this time the investigator must seek another position, which was often difficult to find. It was a large problem, involving sympathetic study by university, hospital, and the investigators themselves. To provide financial stability for basic science investigators, the Trustees began to collect an endowment sufficient to guarantee salaries for a few permanent positions. Research Funds for 1953 totaled $2,815,556. The Vincent Hospital and the Vincent Memorial Laboratories were busy with the problem of diseases of women, especially as they pertain to surgical methods, endocrinological studies, cancer treatment and research. In particular, a plan was being developed to allow clinical selection of patients for surgery or radiation in cancer of the cervix, according to which procedure would offer the greatest advantage. Plans for the new Pathology Building were advanced. The Lawrence Memorial Hospital in Medford was added to the group of suburban hospitals furnished pathological service. Dr. Benjamin Castleman was appointed Chief of Pathology. A gift of $136,000 from Mr. Edward Mallinckrodt, Jr., provided an
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1953 adequate endowment of Mallinckrodt-Ward 4 and an anonymous donation, through Bishop Henry K. Sherrill, assured the completion of the much needed Pathology Building. A new front entrance and vestibule to the White Building, conforming to state regulations, was installed, the Out-Patient Department extensively renovated and redecorated, the parking area increased by the demolition of six tenement houses on North Anderson Street and, regretfully, the razing of the old Market House. The unique cupola was given to Trustee Francis W. Hatch, who planned to preserve it on his property in Castine, Maine. Three houses on Parkman Street were demolished, Fruit Street from North Grove to Blossom Streets, which had been acquired from the City of Boston, was closed, the pavement torn up, the North Anderson Street gate moved south to Parkman Street and all of the ground thus released landscaped and added to the yard (see Plot Plan 1956). Planning for the Urban Redevelopment of the West End was going slowly forward, a project which when accomplished should benefit the Hospital greatly. As originally planned, White 6 was for East and West Surgical men patients and White 7 for women patients. This was now changed so that White 6 served both men and women West Surgical patients and White 7 both men and women East Surgical patients. This reduced the number of doctors on each floor and eliminated much confusion. Parking space made available by the Metropolitan District Commission in 1952 and assigned for the use of the Massachusetts General Hospital and the Massachusetts Eye and Ear Infirmary allowed the Hospital to stop the temporary use of the lawn in front of the Bulfinch Building for parking and, through the generosity of Mr. John R. Macomber, to restore the yard with new trees, shrubs, and grass to its former beauty. To provide experience in the care of new-born infants, now that the Obstetrical Service had been suspended, an additional internship in Children's Medical was established and an affiliation arranged with the Boston Lying-in Hospital for pediatric intern rotation there; also a prenatal and postnatal clinic in the Out-Patient Department was established in collaboration with the Lying-in, whereby mothers were to be delivered in the Lying-in and the children, once they left the Lying-in, cared for in the Out-Patient Department. A reorganization of the Out-Patient Department was begun, under the leadership of Mr. E. Michael White, Assistant Director.
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Private ambulatory patients were admitted for the first time to the Hand Clinic and the Occupational Medical Clinic and arrangements made for health examinations of company executives with several industrial firms. The importance of considering the referring physician as a member of the team, of treating him with courtesy and respect and of keeping him informed about his patient was emphasized. Provision for the care of ambulatory private patients was now considered a necessity. The development of plans for an office building, of arrangements with the Massachusetts General Hospital Staff Associates, now being organized, and the fact that there were now sixty staff members who were permitted to see a limited number of patients in their hospital offices testified to this need. It was obvious that the Hospital must solve the problem of providing as adequate care for the ambulatory patient, whether paying or charity, as it now did for all classes of the community as in-patients. In order to make use of Staff members who, though retiring because of age, were still sound in mind and body, the new positions of Consulting Visiting Physician and Consulting Visiting Surgeon were created. This seemed to be a good way to make use of seasoned teachers, appointing them from year to year and giving them special assignments. Accordingly Dr. Leland S. McKittrick was appointed Consulting Visiting Surgeon on March 18. Likewise the Chief of any service was authorized to ask any member of the Board of Consultation to take part in General Hospital activities in connection with teaching that would not interfere with the assigned activities of regular Staff members. The Advisory Council of the Massachusetts General Hospital School of Nursing recommended to the Trustees that a study be made to identify the cost of additional nursing time involved in caring for patients who were subject to special research projects, so that the costs might be included in the research project and ultimately reflected in the nursing budget. During the year the Nursing Department put into effect a new marriage policy, allowing students to marry after the first six months and remain in the school. Although numerous students took advantage of this new policy, the majority of married students left the school to establish homes away from Boston. Believing that immaturity has often caused failure of the preclinical nursing student, a plan of allowing selected students to resign and 118
1953 then re-enter after a rest period was adopted. Ten such students reentered and did well. Miss Sleeper noted: Unlike students in other fields of study, the student in the three year diploma program in nursing must pay for her education in part by tuition fees and also in large part through a working scholarship. She has no choice of the type of work she will do for her self-help, or where she will do this work, for it is combined with, and is indistinguishable from the nursing practice which is a part of her required educational program. This system by which a student nurse pays for her education is both an advantage and a disadvantage to the student. To many students, the opportunity to earn a large proportion of the charges for their education is a decisive factor in the choice of nursing and in the choice of the three year school. Although the cost to the Massachusetts General Hospital student for the entire three years is only $300.00 for tuition, and approximately $200.00 for uniforms, books, and fees, and although the payment of this is spaced over the first two years, many students now enrolled find these costs difficult to meet. Seventeen $100.00 scholarships have been given this year, almost all of which have been used to pay tuition. Personal needs of many students consequently are not met. This year the graduating class of 1 9 5 3 54 presented to the School a sum of $300.00 for scholarships for enrolled students. The money was given as an expression of appreciation for scholarship aid given to members of their class. 1 The balancing of the educational needs of the student and the school and the everyday nursing service needs of the Hospital required constant vigilance and ingenuity. The "Auxiliary Service" of the Nursing Service, which replaced the War Errand Service, was discontinued and its workers transferred to the Hospital Dispatch Service to serve all nursing units and all Hospital departments. In February, Miss Coghlan, as an Assistant Director of Nurses, was placed in charge of all operating rooms — General Hospital, Baker Memorial, and Phillips House. Nursing service for all nurses and personnel was placed on a forty-hour basis and a new pay schedule adopted to provide increases at the end of six and eighteen months. Morale was improved by these changes. Bartlett Hall, the new nurses' residence, was opened with appropriate ceremonies on April 29, providing quarters for 155 graduate and student nurses. More than half of the funds for the construction of the building came from a bequest in the will of the late Mary Bartlett Noyes. The balance was contributed by many hundreds of friends of the Hospital, including a gift from the Hyams Trust in memory of
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Isabel F. Hyams and Sarah A. Hyams to be used to furnish the living and social rooms on the first floor. Continuity of social care is important. While a hospital social worker's assignment may be a ward, her active work may be scattered through numerous clinics and wards, if she is to follow the care of her patients. This is time-consuming but pays off, since the social worker may be the one continuity person in the patient's multiple contacts in his medical care. The 1953 report pointed out that because the Social Service index registered on one card all members of families currently or previously under care here, although limited to patients and families known to Social Service, it does represent an index to many families for whose health this Hospital has been responsible. To be able to see the interrelated experiences of illness in families is important in the treatment of many patients. In this respect the Hospital is the "family doctor." In 1951 the Ladies' Visiting Committee appointed a committee to consider the advisability of the formation of a hospital auxiliary. The committee recommended, instead of the conventional woman's auxiliary, the formation of a coordinating framework into which existing volunteer groups would fit. On this recommendation, approved by the Trustees, a Coordinating Committee was established on January 30, 1952, with membership consisting of the Chairman and one other representative of each of the following groups, each group maintaining its own identity and functions: the Ladies' Visiting Committee of the Massachusetts General Hospital, the Massachusetts General Hospital Staff Wives' Hospital Committee, the Distaff Club, the Advisory Council to the Massachusetts General Hospital School of Nursing, the Board of Managers of the Vincent Memorial Hospital, the Ladies' Visiting Committee of the Massachusetts Eye and Ear Infirmary, and the Ladies' Committee of the Bay State Medical Rehabilitation Clinic (see Chapter 7). Mrs. Augustus Thorndike was elected chairman, with the understanding that the chairmanship should be rotated each year among the member organizations. It was agreed that the General Director, Dr. Dean A. Clark, should preside at meetings. In 1953, a consolidated report for the Massachusetts General Hospital members namely, the Ladies' Visiting Committee, the Staff Wives' Committee, and the Distaff Club was presented. This year the Warren Triennial Prize was awarded in the form of a lectureship to Dr. René J. Dubos of the Rockefeller Institute of Medical Research, who gave a series of five lectures on "Biochemical I 20
1953 Aspects of Infection" in the newly-opened auditorium of the Boston Museum of Science. Dr. Arthur W. Allen, a member of the Board of Consultation, former Chief of the East Surgical Service, was appointed a Trustee by Governor Christian A. Herter. During the year, Dr. Ellsworth T. Neumann was appointed Administrator of the Hospital, and Mr. E. Michael White and Mr. Frederick D. Foster were appointed Assistant Directors. Dr. E. Lawrence Oliver, member of the Dermatological Staff since 1911, Chief of Dermatology 1927-1936, Board of Consultation 19361946, Honorary Physician since 1946, died on June 12; Dr. Marius Ν. Smith-Petersen, member of the Orthopedic service since 1917, Chief of the Orthopedic Service 1929-1946, Board of Consultation since 1946, died on June 16; Dr. George Clymer, member of the Neurological Staff since 1912, Neurologist 1923-1946, Board of Consultation since 1946, died on August 4; Dr. Channing C. Simmons, member of the Surgical Staff since 1904, Visiting Surgeon 1927-1938, Board of Consultation 1938-1947, Honorary Surgeon since 1947, died on August 15· Three doctors retired and were appointed to the Board of Consultation: Dr. Eli C. Romberg, Associate Physician to the Children's Medical Service since 1924; Dr. F. Dennette Adams, member of the Medical Staff since 1925, Physician since 1939; Dr. Joseph Garland, member of the Children's Medical Service since 1924. Dr. Leland S. McKittrick, member of the Surgical Staff since 1923, Visiting Surgeon since 1945, Acting Chief of the Surgical Staff 1942-1945, retired and was appointed Consulting Visiting Surgeon. Dr. Thomas F. Paine, Jr., Chief of Bacteriology since 1952, resigned, to become Associate Professor of Bacteriology and of Medicine at the University of Michigan Medical School.
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I 9 5 4 General Executive Committee comments. High occupancy. OntPatient Department renamed. Massachusetts General Staff Associates. Family Health Program. Problems of Nursing School. Changes in Nursing Service. New Pathology Building. Cancer Society grant. Dr. Meigs resigns. Appointments.
f j p H E General Executive Committee observed: There is concern always that the natural balance between these three elements [care of the patient, teaching, and research] be preserved since their mutual interdependence in a teaching hospital has long been recognized. Nevertheless there have been periods in the history of the Hospital when, for various reasons, emphasis on one area has temporarily disrupted the equilibrium in total development. Certainly the years following World War II saw a great resurgence in research activity, which was reflected in new research construction and in the acquisition of funds and personnel for activities related to research. The past year, 1954, may well be recorded as one in which another shift of emphasis took place, for it marked the beginning of several important undertakings in patient care and professional practice. The Massachusetts General Hospital Staff Associates was launched, the Family Health Program came into being, and significant changes took place in the newly named Clinics of the Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary [formerly the Out-Patient Department]. It is gratifying to be able to report that while these undertakings related to patient care were evolving, concurrent progress was made in relation to teaching and research. 1 Some of the artificial barriers which traditionally separated clinic (Out-Patient D e p a r t m e n t ) and private (office or ambulatory) patients w e r e broken d o w n b y the admission of private patients to the A m p u tee, Occupational Medicine, Child Psychiatry, and Hand clinics, w h e r e they could n o w be seen b y groups of specialists whose joint opinion was needed f o r the solution of the medical problem at hand. Just as the administrative, teaching, and clinical demands in the General Hospital had made it necessary to appoint full-time salaried members of the Staff, the changes in the Out-Patient Department or 122
1954 Clinic made it necessary to do so there, and Dr. John D. Stoeckle was given the first full-time clinical appointment in the Clinics in the Hospital's history. He later became Director of the Medical Clinic. To relieve Chiefs of Services of the load of administrative detail, the General Executive Committee proposed to "draw on a larger segment of the professional staff to serve on the committees and the study units appointed yearly. This policy not only distributes the administrative load more equitably, but also offers an opportunity for more of the professional staff to acquaint themselves with the Hospital's many problems and to aid in their solution and in the institution of future policy." 2 Not only was there improvement in patient care, as noted by the General Executive Committee, but the Trustees were able to report that "during the fiscal year ending on October 1, 1953 the Hospital operated financially better than at any time for many years." The explanation was high occupancy. This fortunate situation allowed the Hospital to meet, for this year at least, an increased cost of operation caused by the adoption of a forty-hour week for all employees. They further noted that studies were constantly being made of how to improve the operation of the Out-Patient Department and "how to amalgamate the Massachusetts General Hospital staff, including both visiting and full-time men, into a smooth-working, efficient group." 3 The development of the Massachusetts General Hospital Associates and plans for a doctors' building were steps in this direction. On June 25, 1954, the Massachusetts General Staff Associates and the Trustees, after two years of negotiations, came to an agreement and adopted articles of organization, constitution, and by-laws that were satisfactory to both parties. Later in the year an Executive Committee was chosen, consisting of Drs. Marshall K. Bartlett, Howard Ulfelder, Joseph S. Barr, Edward F. Bland, Chester M. Jones, Daniel S. Ellis, and Stanley Wyman, representing the Associates, and Mr. Ralph Lowell, Mr. Phillips Ketchum, and Mr. Francis C. Gray the Trustees, with Dr. Dean A. Clark, the General Director, as a member ex officio. During 1949 the Children's Medical Service began a modest program of visiting to the homes of children who had been patients of the Hospital, either in the wards or the Out-Patient Department, believing that with fuller knowledge of home conditions they could render better care of these children. The success and advantages of this program undoubtedly encouraged the Staff and Trustees to in-
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CHRONOLOGICAL HISTORY stitute the more comprehensive Family Health Program which was started in 1954. The Director commented, The Family Health Program will serve a group of families in the neighborhood of the Hospital, acting as family physician for those who enroll. Medical and nursing care will be provided at home, in the Clinics, or in the Hospital. The enrolled families will be asked to pay as much of the cost as they can. The principle objective of this new service is to furnish its families the most up-to-date, comprehensive medical care, both preventive and therapeutic, that medical science now knows how to provide. The interest of die Rockefeller Foundation is to give an opportunity to Harvard Medical students to participate in such a comprehensive scheme of medical care. It is planned to invite fifteen first-year and fifteen third-year students to work in the Family Health Service and to follow, during their entire medical school career, the one or two families assigned to them. This arrangement, it is felt, will give the students an idea of the personal and environmental, as well as the medical problems of patients and thus better prepare them to be practicing physicians. A staff internist and a staff pediatrician, assistant residents in both medicine and pediatrics, will supply supervision as well as direct service to patients. Closely associated will be public health nursing through the Visiting Nurse Association, and any other special medical and allied services that may be required in any case. 4 Miss Sleeper noted that four problems confronted the School of Nursing: ( 1 ) how to provide more and better education; (2) how to educate nurses so they might assume new and greater responsibilities; (3) how to provide more nursing service to the Hospital; (4) how to combat the increasing costs of nursing education in the school. The first problem could be met, she felt, only by constantly improving teaching methods and by better facilities and equipment. This had been done. The second required the nurse to be equally adept with the sick patient or the patient in the process of rehabilitation. She had become a full member of the health team. She should be able to teach the patient in sickness and in health, to teach the auxiliary worker, and to know the community resources. And yet the curriculum must be guarded lest it prepare administrators instead of nurses. The third required a careful balancing of the needs for nursing service in the Hospital, by which the student would pay for part of her education, with the educational requirements, by which she would become a nurse competent to meet the demands of her calling. The Hospital tried to do this by increasing the number of permanent grad-
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1954 uate evening and night nurses and the provision of more paid auxiliary workers, thus lightening the service load on the students. A survey of nursing-school cost in 1930 showed the School as a distinct financial asset. In 1948 it had been estimated that the cost per student was somewhat below the value of her contribution in fees and service. In 1953, there was no doubt but that the cost per student was in excess of her contribution. But the value of the School must still be apparent, not only because of the services that the students gave as they learned, but more especially because of the graduates it produced for employment. Thus of 100 students who graduated in 1954, a majority returned to work in some unit of the Hospital; 65 per cent of the March section did so. In 1954, number 30 Blossom Street was renovated for affiliating students and licensed practical nurses and 1 7 Parkman Street for graduate nurses. Eldredge House, a residence for graduate nurses, was closed, its double rooms not being well adapted to the changing hour schedules of graduate nurses. Many administrative functions, including hiring and firing of personnel, were transferred to the Assistant Directors of Nursing Service in the major buildings and Head Nurses made responsible for nonnurse-personnel schedules. Each unit was becoming more self-contained. The Central Supply Room was placed in charge of a man experienced in industrial management. A program for staff development was being formulated, through proper introduction of group teaching, in-service education and opportunity for advancement. Miss Ruth M. Farrisey was appointed as Executive Officer and Assistant Director of Nurses in the Out-Patient Department, and Miss Mary Quinlan Assistant Director of Nursing Service in the VincentBurnham Building. On the research front, there were both gains and losses. For Pathology, the highlight for 1954 was the breaking of ground on November 8 for its new home. The family and friends of Mr. Edwin S. Webster, a former Trustee, established the Edwin S. Webster Laboratory, to be set up in the new building and to be devoted to the study of tissue ultrastructure, making use of the electron microscope, tissue diffraction, and other related techniques, under the direction of Dr. David Spiro of the Massachusetts Institute of Technology. The report of the John Collins Warren Medical Laboratory of the 125
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Huntington Memorial Hospital contained many and varied accounts of cancer studies. While the Warren Laboratory dealt mainly with basic research, clinical research was furthered by a grant to the Harvard Medical School of money from the American Cancer Society to be used in a group attack upon the problem of cancer of the cervix. Dr. and Mrs. John B. Graham of the Vincent Laboratories were to serve as the administrators of this study; the selection of patients to be treated by surgery or radiation and the compilation of results would be their responsibility. The Free Hospital for Women, the Peter Bent Brigham Hospital, the Pondville Hospital, and the Vincent Memorial Hospital of Greater Boston were to be united in this important undertaking. In 1954, too, Mrs. Ruth M. Graham received an honorary degree of Doctor of Science from the Women's Medical College of Philadelphia. The acceptance by Dr. Ivan Frantz of a professorship at the University of Minnesota was both a serious loss and a source of pride to the Hospital and left the position of Head of the Cardiovascular Research Laboratories as yet unfilled. In October, Dr. Mahlon B. Hoagland took over the reins as Assistant to the Director for Research and Education, replacing Dr. Robert L. Berg. Dr. Joe V. Meigs resigned, effective July 1, 1955, from his triple position as Chief of Staff of the Vincent Memorial Hospital, a position held since 1929, Chief of the Gynecological Service of the Massachusetts General Hospital, and Clinical Professor of Gynecology at Harvard Medical School, each held since 1942. He was appointed, effective upon his retirement, as Consulting Visiting Gynecologist at the Vincent Memorial Hospital and Consulting Visiting Surgeon at the Massachusetts General Hospital. Dr. Howard Ulfelder, for thirteen years an associate of Dr. Meigs, was appointed Chief of Staff. In any institution as large as the Massachusetts General Hospital, with its many activities and interests, many changes are made and many events take place that for purpose of record are best grouped together as "other items of interest." The committees of the Ladies' Visiting Committee continued their activities, and through the General Store contributed over $4,000 for the benefit of Hospital improvement. The Staff Wives' Committee furnished hospitality to foreign visitors, and the Distaff Club conducted teas and other parties. Social Service reported that the problem of meeting chronic and terminal care, especially from the standpoint of cost but also of finding
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1954 facilities, especially for the medically indigent family, ordinarily selfmaintaining, was still unmet. The yard was renovated in 1954 and a new tennis court was provided. Not only had the new Pathology Building been started, but the fourth floor of the Bulfinch was rearranged for laboratories and offices for Doctors Jones and Albright, and offices provided on the first floor for Dr. Bauer. The construction of a new Metropolitan Transit Authority station, near the Boston Museum of Science, was to make it easier for people living north of Boston to reach the Hospital. The West End Housing Redevelopment Plan, which would eventually improve the area surrounding the Hospital, was slowly progressing in 1954. Further improvements were made in the Store and in purchasing of food. Automatic vending machines in the clinic area replaced the former lunch counter. The Dietary Manual was revised, with forty-six pages of new copy. Work was begun on rearranging material of Tier 3 in the Treadwell Library; the Phillips House established its own library. Several important appointments were made during this year. On July 1 Dr. Erich Lindemann was appointed Chief of the Psychiatric Service and Professor of Psychiatry at Harvard, and on September 1 Dr. Wyland F. Leadbetter was appointed as Chief of the Urological Service. On July 1, Harvard appointed Dr. Raymond D. Adams, Chief of the Neurology Service, as Bullard Professor of Neuropathology. The appointment of Drs. Lindemann and Adams to these professorships, providing as it did substantial financial support, emphasizes the intimate and mutual dependence of Hospital and School. Distinction was given the Hospital during the year by the service of Dr. Orjan T. G. Ouchterlony, Professor of Bacteriology at Göteborg, Sweden, as Acting Chief of Bacteriology. Dr. Joe V. Meigs, Chief of Gynecology and Chief of Staff of the Vincent Memorial Hospital represented the Massachusetts General Hospital and gave the principal address at the 100th anniversary of the Touro Infirmary in New Orleans. Several members of the Staff were given leaves of absence to undertake important outside assignments. Dr. Edward D. Churchill went to Lebanon and Syria at the invitation of the Department of State under the International Educational Exchange Program. Dr. Walter Bauer lectured in Argentina. Dr. Dean A. Clark assisted in a health survey of Alaska, conducted by the University of Pittsburgh School of
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Public Health under contract with the United States Department of the Interior. The Hospital lost the following doctors by death during 1954: Dr. Eli C. Romberg, Associate Physician to the Children's Medical Service, 1935-1953, Board of Consultation 1953-1954; on February 28; Dr. C. Guy Lane, member of the Dermatological Staff since 1919, Chief of Dermatology 1936-1948, Board of Consultation since 1948, on March 12; Dr. Armin Klein, member of the Orthopedic Staff since 1920, Visiting Orthopedic Surgeon 1937-1954, Board of Consultation 1954, on April 3; Dr. Ira T. Nathanson, member of the Surgical Staff since 1941, Associate Visiting Surgeon since 1946, on May 3; Dr. John W. Cummin, member of the Surgical Staff since 1897, Chief of the Surgical Out-Patient Department 1919-1930; Honorary Surgeon since 1941, on July 16; Dr. Francis T. Hunter, member of the staff since 1927, Associate Physician since 1936, Clinical Pathologist since 1937, on September 7. Three doctors retired and were appointed to the Board of Consultation: Dr. Stanley Cobb, member of the Neurological Staff since 1919, Chief of Psychiatry since 1934; Dr. Charles S. Kubik, member of the Neurological Staff since 1927, Chief of Neurology 1946-1951, Consultant in Neuropathology since 1951; Dr. Judson A. Smith, member of the Obstetrical Staff since 1929, Obstetrician since 1941. Dr. Chester M. Jones, member of the Medical Staff since 1920, Physician since 1928, retired and was appointed Consulting Visiting Physician. Dr. Leon R. Lezer, Assistant Director since 1950, resigned to become Assistant Professor of Preventive Medicine at the University of Vermont. Dr. John W. Raker, Assistant in Surgery since 1949, resigned to become Chief of Surgery, Pennsylvania Hospital, Philadelphia. Dr. Henry H. Brewster resigned to become Assistant Professor of Psychiatry at Western Reserve University; he had been Assistant Psychiatrist since 1949. Miss Mary R. Wolf was appointed Director of Volunteers; Dr. Carl A. Binger was appointed Consultant in Psychiatry; Dr. Oscar Hirsch was appointed Consultant in Neurosurgery, and Mr. Joseph W. Degan was appointed Assistant Director.
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POSTSCRIPT
Postscript The original intent was for this history to cover the years 19351950, during nearly all of which period the writer was the Director, but so many important activities of the Hospital starting in that period came to fruition in the next five years that it was decided to cover the twenty years from 1935 to 1955. When 1955 was reached it was found that three events occurred, two in 1955 and one in 1956, which seemed so important that a postscript, as it were, describing them should be added to the history. The first of these was the handling of the polio epidemic during 1955, the second the celebration of the fiftieth anniversary of the founding of Medical Social Service on October 20-22, 1955, and the third was the dedication of the Warren Building on December 3, 1956· THE POLIO EPIDEMIC OF I955
Emergencies are common in hospitals. Usually these involve only individuals but sometimes emergencies rise to heroic proportions involving a large number of people. The Cocoanut Grove Disaster in 1942 was one of these unusual occurrences. From the standpoint of the Hospital this was primarily a surgical emergency, since the victims suffered from burns and shock. From this experience developed a treatment of burns that was widely adopted during World War II. The polio epidemic, which began early in 1955, became a slowly developing emergency as the number of cases rose rapidly during the summer months. This might be designated as a medical emergency, since it was combated mainly by the medical services with but few surgical procedures during the acute stages of the disease. In both instances the Staff, nurses, and Administration of the Hospital rose to the occasion with skill and a devotion beyond the ordinary call of duty and handled the situation in a satisfactory manner. The Massachusetts General Hospital had for years accepted responsibility for the care of polio patients. As the epidemic developed, all the facilities for the care of such patients in the Boston area rapidly became filled to capacity. It soon became apparent that the Hospital
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must adopt unusual measures if it was to meet, in its traditional manner, the responsibility for this unanticipated load of seriously ill citizens of the state. Whole floors in the Baker and the White Building were made available and a portion of the Burnham was set apart to care for children. The Medical, Neurological, Anesthesia, and Physiotherapy services organized polio teams, who were on constant duty on these floors, to treat these patients more effectively. A total of 428 patients — 376 adults and 52 children — was admitted with polio in some form. Particularly difficult was the management of the 73 adults and 8 children who were at one time or another in respirators. The large number of respirator cases created an emergency which was met by setting aside White 9, equipping it with the respirators and special electrical wiring (this was all done in twentyfour hours), organizing teams of Staff, residents, and nurses to provide twenty-four hour service, and establishing contagious-disease techniques for visitors. White 9 at the height of the epidemic presented a sight never to be forgotten by those who served there or who visited it. There were 27 deaths, all among adults. Doctors, nurses, Hospital personnel in all departments gave unstintingly of their time and strength. Volunteers flocked to help, nurses from the Phillips House and Baker Memorial as well as from other hospitals. Members of the Ladies' Visiting Committee and lay volunteers from all walks of life relieved the weary Hospital workers in so far as could be done. Although the acute emergency ended late in 1955, on January 1, 1956, there remained 30 patients in respirators. Some recovered, some were moved to the Lemuel Shattuck Hospital and to the Wellesley unit of the Children's Medical Center. Recovery from polio is a slow process, often requiring many returns to the hospital for surgical action or medical complications. On March 12, there were still 2 patients on White 9, which had been converted into a Rehabilitation Ward. h o s p i t a l s o c i a l service 1 9 5 5 :
THE
YEAR o f
jubilee
Fifty years before, the late Dr. Richard C. Cabot with the aid of Miss Ida Cannon had begun a new form of patient and family aid, known as hospital social service. Dr. Cabot's first report in 1905, entitled "Social Service Permitted," is indicative of the reception accorded the new venture. For nine years Dr. Cabot, Miss Cannon, and a Social Service Supervisory Committee raised the necessary funds and directed the operation of hospital social service as a separate
130
POSTSCRIPT
entity within the Massachusetts General Hospital. In 1914 the Trustees recognized it as a part of the Hospital by appointing Miss Cannon as Chief of Social Service, but financial responsibility was not accepted until 1919. This time Dr. Cabot's report referred to Social Service as "Formerly a Territory, Now a State." During these fifty years hospital social service has spread so that no hospital of any size in the United States is without such a department and the example demonstrated here has been followed in many foreign countries. Believing that this contribution to the benefit of humanity was worthy of recognition, the Trustees appointed a committee under the chairmanship of Dr. J. Howard Means to prepare a program for the recognition of the "Fiftieth Anniversary of Social Service." The half-century celebration held on October 21, 22, and 23, 1955, was attended by over six hundred persons. The exercises began with an Alumnae Day and a historical review. This was followed by workshops and meetings, at which current practices in service, teaching, research, and administration were presented and evaluated. Graduates of the Massachusetts General Hospital Social Service in Hawaii sent such a profusion of orchids that no event and no individual went underrated. The Trustees gave a dinner to the Social Service Department and its guests at the Harvard Club where Professor Elliott Dunlap Smith of Yale University gave the address. At the closing exercises Miss Harriet Bartlett, who had contributed much to the educational development of Social Service, gave a brilliant paper on the challenge of the next fifty years. The Anniversary was a fitting tribute to the pioneers of social service, to the spirit of the Massachusetts General Hospital and to the resulting contribution to the world. THE WAEBEN BUILDING
The Warren Building of the Massachusetts General Hospital was so named "as a tribute to the members of the Warren family for their contributions to the medicine and surgery of the new world." The names and contributions of six members of this family are suitably recorded on a series of tablets placed on the wall of the waiting room. The opening of the Warren Building took place at a luncheon and dedicatory exercises held on December 3, 1956. Dr. Wilder Graves Penfield, Director of the Montreal Neurological Institute, was the principal speaker. Mr. Francis C. Gray, Chairman of the Board of
131
CHRONOLOGICAL
HISTORY
Trustees, Dr. Edward D. Churchill, Chief of the Surgical Services, Dr. Dean A. Clark, General Director, and Dr. George Packer Berry, Dean of the Harvard Medical School, also gave short addresses. Because this building had originally been planned to provide better quarters for the Pathological Department, in order to appropriately celebrate the accomplishment of this long-felt need, special exercises for the dedication of the Tracy Burr Mallory Library were held on December 2, 1956. Originally outlined in 1951 as a five-story building for the Pathology Department, plans were revised in 1955 to provide space for other laboratories and for several floors of offices to accommodate members of the Massachusetts General Hospital Associates. "The Trustees considered the activities to be housed in this building to be of such great importance that they made a momentous decision: for the first time in the Hospital's 135 year history, to borrow funds for a capital purpose if necessary." 1 A full account of the facilities provided appears in the section on "The Research Building and the Warren Building." Suffice to record here that it contains three floors for the Pathology Department, including the Webster Laboratory, three floors for the laboratories of special departments, with the Mixter Laboratories on the fourth floor for Neurosurgical Research, five floors primarily for offices of a number of the Massachusetts General Hospital Staff Associates, and a twelfth floor for the eventual use of Baker Memorial patients to replace rooms cut off by the junction of the Warren Building with the Baker Memorial. The Mixter Laboratories, funds for which were supplied by the Department of Neurosurgery, the Mixter family, and friends, were dedicated on October 16, 1957.
Summary The foregoing pages have chronicled the happenings in each particular year, but a summary of the more important events may give a clearer picture of the development of the Hospital during this period. The number of available beds grew from 728 in 1935 to 878 in 1955, an increase of 150 beds. The number of patients admitted to all units in 1935 was 14,792, and in 1955, 22,673, an increase of nearly 132
SUMMARY
8000 persons. Patient days rose 47,000 days, from 223,000 to 270,000 (Table 2, Appendix). In the year 1955, 22,673 patients were cared for in the General Hospital, Baker Memorial, and Phillips House, a daily average of 741 persons, staying approximately 12 days apiece, which made a total of 270,602 days of patient care. Each weekday an average of 391 patients came to the Out-Patient Department, making 117,361 visits during the year; 6,939 were new patients. To the Emergency Ward came 25,027 patients, with troubles ranging from minor ills to the most serious accidents. Altogether, in one year the Massachusetts General Hospital cared for 53,739 persons, which is the same number as the entire population of the town of Brookline, Massachusetts. The cost per day for all in-patients rose from $8.58 in 1935 to $26.88 in 1955, and for out-patient visits from 93 cents to $5.80. The Active Staff — that is, doctors caring for patients in the General Hospital, Baker Memorial, Phillips House, and the Out-Patient Department — grew from 258 to 359, a jump of 101. To this must be added an Associate Staff of 59, who had occasional patients in the Baker Memorial and Phillips House, plus a group of 37 clinical assistants, who assisted the Active Staff, mostly in special clinics. Altogether, this amounts to 453 doctors who were connected with the care of patients at the Massachusetts General Hospital in 1955 (Table 3, Appendix). The House Staff of residents, assistant residents, and interns grew from 67 to 146. These men are learning as well as serving, under the direction of the Active Staff. They are the future physicians and surgeons and spend from three to five years in the various grades (Table 4, Appendix). In 1955 there were 122 clinical and research fellows, contrasted with 15 in 1933, engaged in research and special post-graduate study. Research fellows are restricted to laboratory activities, but clinical fellows may combine laboratory studies with direct application to patient care (Table 5, Appendix). Nurses and nonmedical technical personnel, plus those who work in the Dietary Department, Housekeeping, Maintenance, and other service departments, increased from 946 in 1935 to 2,762 in 1955. The total number of persons on the Hospital payroll grew from 1,167 to 3,106 and the payroll from $1,324,343 to $6,549,956. Eight new departments were added during this period: Gynecology, Neurosurgery, Endoscopy, Bacteriology, Physical Medicine, Research Chemistry, Infectious Diseases, and the Blood Bank. Five major buildings were erected: the George Robert White 133
CHRONOLOGICAL HISTORY
Memorial Building, opened in 1939; the Vincent Memorial Hospital and the Burnham Wards for Children in the Vincent-Burnham Building, opened in 1948; the Research Building, opened in 1951; Bartlett Hall, a new nurses' residence, opened in 1953, and the Warren Building, opened in 1956. The Chapel was dedicated on April 26, 1941. In addition to these new buildings, the Bulfinch was remodeled for medical patients. Quarters for the Department of Physical Medicine were provided by rearranging the second floor of the Domestic Building, while on the third floor new laboratories were built for the John Collins Warren Laboratory, and the fourth, fifth, and sixth floors were made over to provide laboratories for Bacteriology and a new Department of Infectious Diseases. Ward 4 was renovated and renamed the "Mallinckrodt Ward" in 1949. A seventh floor was added to the Vincent-Burnham Building for Child Psychiatry in 1952 and the OutPatient Department was redecorated in 1953. Numbers 17, 19, 21, and 23 Parkman Street and 30 Blossom Street were rebuilt to provide rooms for graduate and student nurses, 27 Parkman Street for male employees, and 25 Parkman Street for the overflowing Resident Staff. Herrick House at 27 Commonwealth Avenue was opened in 1945 for student dietitians, Eldredge House at 44 Chestnut Street for graduate nurses in 1948, and 301 Beacon Street in 1946 for the accommodation of an Assistant Director. Storrow House in Lincoln was opened as a convalescent home in 1948. The Hospital plant in 1955 consisted of fourteen major buildings and four smaller ones on the enlarged Hospital grounds, together with eleven outlying buildings, and finally, Storrow House in Lincoln. Some of the other things accomplished during the last two decades are noted here in more or less chronological order, not according to their importance. A unit record system was adopted in 1936 and the metric system of weights and measures in 1945. A Health Officer was appointed in 1936, followed by a Staff Health Clinic in 1938. The Blood Bank began to function in 1942. The first issue of the Massachusetts General Hospital News appeared in September 1942, and Dr. F. A. Washburn's history of the Hospital from 1900 to 1935 was published in 1939. In 1938 the North End Diet Kitchen was merged with the Massachusetts General Hospital. In 1941, the Vincent Memorial Hospital
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SUMMARY
entered into an affiliation with the Hospital, and during the same year the Massachusetts General Hospital Division of the Hall-Mercer Hospital was opened. Through an agreement with Harvard University, the Huntington Memorial Hospital and the John Collins Warren Laboratories were transferred to the Massachusetts General Hospital in 1942. World War II began for the United States on December 7, 1941. The Defense Organization set up by the Hospital immediately thereafter provided the mechanism for the successful handling of the Cocoanut Grove Disaster of November 28, 1942. The Sixth General Hospital was recruited during 1940 and activated for service in May 1942. A "War Service" was initiated by the Ladies' Visiting Committee. The Institute of Pastoral Care was established at the Hospital in 1944 by the Federation of Churches. The Ether Centenary in October 1946, with its accompanying three-day exercises, the series of Lowell Lectures by members of the Staff in 1948, the Volunteer Days in 1944 and 1945, and the Veterans' Reception Day in 1946 were unusual educational and social events. In 1948 the School of Nursing celebrated its seventy-fifth anniversary. Since its founding in 1873, 3,754 nurses had been graduated. During the period 1938-1947 the Nursing School was reorganized; the number of teachers was increased, the curriculum was revised so that twenty-eight months were devoted to education, followed by an eight months internship; hours of student service were decreased, and better classrooms and laboratories were provided. Nursing service was modified with shorter hours of work, increased salaries, retirement plans, and postgraduate classes. Three memorial rooms, the Richard C. Cabot Room, the Marion Lee Lawrence Room, and the Hurlbut Memorial Room, were established and furnished. The appointment of Mr. David C. Crockett as Administrative Assistant to the Trustees and Mr. E. Russell Greenhood as Comptroller in 1947 improved the administrative organization. The King Committee presented in 1946 a report embodying a careful study and appraisal of staff organization and membership with definite recommendations. A "Statement of General Policies of the Harvard Medical School and of Affiliated Hospitals," issued in 1948, clarified the relationships of the Harvard Medical School and the Hospital. In 1949 a plan for the general development of the Hospital during
135
CHRONOLOGICAL
HISTORY
the next ten years was prepared, including a statement of the longterm objectives in patient care, education, research, and community services. To systematize the activities of the Ladies' Visiting Committee, the Staff Wives' Committee, and the Distaff Club, a Coordinating Committee was formed in 1953. The Massachuetts General Staff Associates was organized in 1954, a Family Health Program was initiated, and private patients were admitted to some of the Out-Patient Department special clinics. The polio epidemic of 1955, involving 428 patients, was successfully handled. Probably the most outstanding feature of these years was the expansion of research. A Research Council was established in 1938, which was replaced by the General Council on Research in 1947, together with a Scientific Advisory Committee. These guided the development of the extensive facilities which have been provided and the varied research activities therein. Beginning in 1946 research expenses and income were separated from hospital operating cost and income. The research budget for 1935 was $50,000; for 1955 it was approximately $2,000,000 (see p. 239). Medically, progress was made in the understanding and treatment of arthritis; in thyroid disease through the use of radioactive iodine; in bone disease and myasthenia gravis. The Cardiac Service achieved national fame. The development of encephalography assisted in the diagnosis of epilepsy and brain tumors. Surgery of the parathyroids, thymus, lungs, esophagus, and the peripheral vascular system was advanced and postoperative embolism controlled. The operations of arthroplasty of the hip, sympathectomy for malignant hypertension, and removal of intervetebral discs for back pain were developed here. A rational treatment of burns, locally and systemically, with an improved technique of skin grafting, was also developed. Control of many infectious diseases developed during this period, to which members of the staff contributed through research and the clinical use of sulfonilimides, penicillin, streptomycin and other antibiotics. Bricks and mortar and the buildings they form represent the tangible expression of the thinking and planning of the builders. From 1821 to 1947 the Trustees of the Massachusetts General Hospital were engrossed in the provision of accommodation for the better care of patients, and this need dominated the physical expansion of the Hospital, beginning with the Bulfinch Building and ending with the erection of the White Building in 1939 and the Vincent-Burnham in 1947. 136
SUMMARY
In many of the buildings of this period facilities for teaching in the shape of amphitheaters, classrooms, and teaching laboratories were provided, for the instruction of medical students, nurses, dietitians, social workers, and other groups. Around the turn of the century laboratories for research, of which Ward 4 was a notable example, began to appear here and there in the various buildings, a trend culminating in the erection of the Research Building in 1950 and the Warren Building in 1956. Although the physical plant of the Hospital has grown from a single building to more than twenty five, each designed and equipped for its particular function, the original objectives of the Hospital remain unchanged today except as they have been expanded to meet the broader concepts of modern medical care. These objectives are to furnish the best possible care of the sick, to provide for the training and teaching of future doctors, nurses, and other professional workers in the health field, to advance through research the development of new knowledge and better methods for alleviating and preventing disease, to extend the Hospital's service to the community and to assist the disabled and handicapped person to self-independence through rehabilitation. In terminating this chronological history of the Massachusetts General Hospital for the years 1935 to 1955, with the addition of certain events in succeeding years, the writer is moved to say that the Massachusetts General Hospital may well be proud of its one hundred and thirty-six years of service. Its personality, the amalgamation of a long succession of trustees, doctors, nurses, and faithful employees, each of whom has contributed something of himself, has kept it young in spirit, though it is old in years. Its past is one of achievement, its present one of action, its future one of vision, determination, and hope.
137
PART
II
"Care of the Sick, Teaching, and ^Research"
I
zA ^Record of Structural Qrowth and 'Development INTRODUCTION
HE Massachusetts General Hospital is a nonprofit corporation, which operates the McLean Hospital in Waverley and the General Hospital in Boston under the direction of a single Board of Trustees. On February 25, 1811, the General Court of the Commonwealth of Massachusetts passed an "Act to incorporate certain persons by the name of the Massachusetts General Hospital" for the maintenance of a General Hospital for sick and insane persons. The War of 1812 delayed further action until 1816, when a house-to-house canvass raised approximately $100,000, half of it for an asylum for the insane and half of it for a general hospital for the sick. The Trustees decided that the two institutions should be separate. Feeling that the need for the asylum was more urgent, they purchased in December 1816 the Joy (or Barrell) estate on Cobble Hill, Charlestown. Using the colonial dwelling built for Joseph Barrell in 1872 as an administrative building, they erected two three-story brick buildings in 1817 and admitted the first patient on October 6, 1818. In 1826, in honor of a large gift, the asylum was officially named "The McLean Asylum for the Insane," by which name it was known until 1892, when it was changed to "The McLean Hospital." The location in Charlestown (later Somerville) becoming unsuitable for hospital purposes, land was purchased in Waverley in 1875, new buildings erected, and on October 1, 1895 the McLean Hospital, offering accommodations for 180 patients, was opened on this new site. In 1817 the Trustees purchased a tract of land on Allen Street, Boston, on which they proposed to erect a general hospital. The central building, designed by Charles Bulfinch, was begun in 1818, and the first patient was admitted on September 3, 1821.
T
141
" C A R E OF T H E SICK, TEACHING, AND R E S E A R C H "
Starting with four acres of land and one building in 1821 the General Hospital in Boston in 1955 occupied thirteen acres, all added to the original site, with fourteen major buildings. In addition there are four houses used as residences for nurses, dietitians, and the administration, and Storrow House, a convalescent home, in Lincoln. The General Hospital was founded for the care of the sick. Accepting this as its primary function, the Hospital has consistently endeavored to provide more and better facilities for this purpose: first through gradually increasing the number of beds from 93 to 878; second by providing better buildings and equipment, and lastly by making its services available to all classes of the community: the poor, the well-to-do, and those of moderate means. Next came the assumption by the Hospital of its responsibility as a teaching institution. This started in its early years with its association with the Harvard Medical School, an association which became firmly fixed in 1846 by the erection of the Medical School adjoining the Hospital grounds. This alliance has continued and become increasingly intimate during the succeeding years. Postgraduate teaching, including that of interns and residents, naturally followed as a part of its responsibility for medical education. Further educational responsibilities were assumed with the establishment of the Massachusetts General Training School for Nurses in 1896, followed by the provision of practical training for medical social workers, hospital dietitians, nurse anesthetists, and laboratory technicians. The third hospital function, namely that of advancing medical knowledge through research, has been the last to be realized. From a small beginning in the last century it has achieved adequate support and recognition only within recent years. To provide satisfactory accommodations two buildings devoted almost exclusively to research have been built. The nearly one hundred and fifty years of the General Hospital's history since its opening in 1821 may be divided into epochs of approximately twenty-five years each. During each epoch a new phase of hospital activities developed, marked at some point in that period by some striking event or accomplishment. The natural population growth of Boston between 1825 and 1850 forced the Hospital to increase its accommodations, through the addition of two wings to the Bulfinch Building. Interest and experimentation in chemistry produced the historic public demonstration of ether as an anesthetic in 1846. This was followed by an immediate increase in the number of surgical operations performed each year.
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STRUCTURAL GROWTH AND DEVELOPMENT
The next period, 1850-1875, chronicles the struggle to overcome hospital gangrene and other surgical infections, which in those days were supposed to come from "miasms" arising from marshes, poor drains, or contaminated buildings. Doctors had noted that the wounded soldiers of the Civil War had less infection when housed in small isolated units, and this discovery led the Massachusetts General Hospital to the construction of the pavilion wards (1873-1875). The first of these wards were built to be used for a period of ten years, then ( since, as it was believed at that time they would be impregnated with disease) to be torn down and replaced. The establishment of the germ theory of disease by Pasteur and Koch, followed by the development of antisepsis by Lister between 1865 and 1875 and the concept of asepsis and sterilization by steam in 1890, paved the way for the control of surgical infections. To provide suitable facilities for the practice of these new principles, the Bradley Ward E, with single rooms and a separate operating unit, was erected in 1888, to be used only for aseptic abdominal surgery. The Bigelow Surgical Building followed in 1901. With pain and sepsis overcome, surgery was now free to advance. During its first seventy-five years the Hospital had grown in a more or less haphazard manner. When needed, more beds were provided up to 1907 in the conventional type of pavilion wards. Around 1900 the Trustees became aware of the need of a more orderly development and adopted a plan whereby future buildings would be placed around the periphery of a quadrangle in front of the Bulfinch Building and another quadrangle which would be developed later towards Charles Street, a plan which has been followed during the last fifty years. The knowledge of how to control infection, together with improved engineering in building construction, new materials, and elevators for vertical transportation, made multistoried buildings possible and, since land was getting scarce, desirable. It has been during these last two epochs that the Phillips House (1917) for the well-to-do and the Baker Memorial ( 1930 ) for those of moderate means were built, followed by the erection of the White Building ( 1939 ) and the VincentBurnham Building (1947). A record of the structural growth and enlargement of the General Hospital in Boston, of the acquisition of the land and the erection of the buildings which have provided the physical means by which the Hospital has been able to perform its functions, follows in detail.
143
" C A B E OF T H E SICK, TEACHING, AND R E S E A R C H " A YEAR-BY-YEAR ACCOUNT, 1 8 1 7 - I 9 5 5
The Land On October 6, 1817, the Trustees of the Massachusetts General Hospital purchased four acres of land on Allen Street, Boston, on which they proposed to erect a general hospital. "Each Trustee approved of the site on Allen Street. The Committee was-authorized
144
;
Γ
-
-
;
1876
From Bulfinch Steps
1956
1857
From Longfellow Bridge
1957
1895
Across Biilfinch Lawn
1955
1905
From corner of Parkman St.
1955
STRUCTURAL GROWTH AND D E V E L O P M E N T
to buy it at not over $20,000, provided the title be good and the street now laid through the same be discontinued." 1 The title was finally cleared, the street was closed, and the land purchased for $23,000. Plans submitted by Mr. Charles Bulfinch were accepted, the cornerstone was laid on July 4, 1818, the central section and the East Wing were completed, and the first patient was admitted on September 3,
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" C A R E OF T H E SICK, TEACHING, AND R E S E A R C H "
1821. The West Wing and the colonnade for the Central Section were finished in 1823. The General Hospital in Boston and the Bulfinch Building were launched on their eventful careers. Around the property a wooden fence was built, which with the passage of years fell into such disrepair that a neighbor of the Hospital
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STRUCTURAL GROWTH AND DEVELOPMENT
remarked, "Your institution always reminds me of a fine looking man disfigured by a rusty coat and a 'shocking bad hat.' " 2 Nothing was done about it, however, until 1856, when a new fence was built. During the period 1821 to 1855, the East and West Wings of the Bulfinch Building were extended and the Touro Ward (Old Brick)
147
"CARE OF THE SICK, TEACHING, AND RESEARCH"
for "offensive diseases" was built (see Plot Plan 1823). 1856 In 1856 the City of Boston proposed to build a seawall and fill in the flats lying between the Hospital grounds and the Harbor Commissioner's Line, in order to extend Charles Street, but this proposal was not accepted by the Trustees. However, by January 19, 148
STRUCTURAL GROWTH AND D E V E L O P M E N T
1859, an agreement had been reached, the wall was built and the flats were filled in, covering over the wharves and changing the shoreline, thus incidentally adding a considerable area to the Hospital grounds. During excavation for the White Building in 1938, one of these old wharves, with stone facing, caplog, and chafing piles, was 149
"CARE OF THE SICK, TEACHING, AND RESEARCH"
uncovered, about six feet under ground surface. A cement wall was built around it and it can now be seen from the doctors' dining room in the angle between the east and south wings of the White Building (Plot Plan 1873). 1881 Reference to a map, dated 1862, hanging in the Archives Room shows that there was a considerable plot of land lying west of Charles Street extension which was known as the Hospital Wharf. On May 20, 1881, the Treasurer was authorized to convey to the City of Boston "all land owned by the Hospital lying westerly of Charles Street in said City, between Craigie's Bridge and West Boston Bridge, to be used solely for the purpose of a Public Park," 3 for the sum of $62,000, this being the amount at which the land was valued for taxation by the city assessors in the year 1880. This sale was concluded in the spring of 1883. Between 1858 and 1884, Wards A, B, C, and D were built, as well as the Bigelow Amphitheatre and Operating Rooms, the Lodge, the Thayer Nurses' Home, the Gay Ward for Out-Patients, and a powerhouse. 1888 In 1888 the Massachusetts Charitable Eye and Ear Infirmary purchased the plot of land that it now occupies at the corner of Charles and Fruit Streets. In this same year the Hospital acquired the building at 30 Blossom Street, which was later remodeled and is still used as a nurses' residence. 1898 In 1898 the Hospital decided to acquire the plot of land lying between the Harvard Dental School and the Infirmary, having Fruit Street as the southern boundary, the Infirmary and part of Charles Street to the west, the fence enclosing the Hospital grounds to the north, and the Dental School to the east. Purchase was approved and executed. Part of this land was occupied by tenants in one-story buildings, which after being vacated were torn down. The present Out-Patient Building and the Connecting Building, built in 1903 and 1927 respectively, now cover most of this land. Many buildings were erected during the nineteen years between 1888 and 1907: Ward E, the Resident Physician's House, Ward F, the Pathology Building, a new powerhouse, an addition to the Thayer Nurses' Home, the Domestic Building, Ward G, the Out-Patient Building and Ward I (Plot Plan 1901). 1908 The Trustees' Report for 1908 states: "Three lots of land on Fruit Street in Boston, with the houses thereon, adjoining the
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STRUCTURAL GROWTH AND DEVELOPMENT
grounds of the General Hospital, have been bought during the year. This purchase completed the ownership by the Corporation of the land bounded by Blossom Street, Fruit Street, the old yard of the Hospital, and the Parkman land and buildings on Fruit Street Place. All the old buildings upon this property, thirty in number, have been torn down, the land graded and made a part of the Hospital yard, around which a brick wall with a gate at the foot of North Anderson Street has been built." This made a notable addition to the yard. The old wooden fence which separated the yard from these rather disreputable houses had a small gate at the end of one of the narrow alleys running between the houses, to which house officers were given keys, so that if coming from the Back Bay district they could enter there instead of having to go to the regular entrance at the Lodge on Blossom Street opposite McLean Street. 1909 In the Annual Report for 1909 the following purchase is recorded: "The real estate of the Corporation has been increased during the year by the purchase of certain land and buildings on Fruit Street. The Harvard Dental School having vacated during the year the building used by them at the foot of North Grove Street, this building and the land upon which it stands was acquired from the Corporation of Harvard University." When the Moseley Memorial Building was erected in 1916 the former Dental School was torn down and the land on which it stood now forms the entrance driveway to the Hospital. In his history of the Hospital Dr. Washburn noted: "By purchase and exchange a large tract bounded by Parkman, North Grove and Cambridge Streets was secured. When the last of the small buildings upon this area were razed shortly after the War [W.W. I], all that was left standing was the old Market House at the northeast corner of Cambridge and North Grove Streets and the old wooden building on the southeast corner of Parkman and North Grove Streets. The latter building has been used as the Cement Shop, a storehouse for X-ray records, and then as a paint shop. A little later to increase the parking area, the paint shop was moved to the Market House and the wooden building just mentioned torn down." 4 ìgio In this year the houses at 90 and 92 Charles Street were acquired to be renovated and used as residences for nurses. They are still so used. When Charles Street was widened in 1919 the fronts of these houses had to be remodeled and the small yards in front of them became sidewalks.
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" C A R E OF T H E SICK, TEACHING, AND R E S E A R C H "
1914 Number 8 North Grove Street was purchased in this year and demolished soon after, the date uncertain. 1916 The building and land at 4 North Grove Street, which also fronted on Cambridge Street, was acquired in 1916. The upper floors were remodeled as nurses' residences. The lower floor was used as a store by a Mr. and Mrs. Minichiello for many years. Between 1910 and 1920, Walcott House for nurses, the Moseley Building, and the Phillips House for private patients were built and Wards A and F combined in one unit. 1920 In 1920 numbers 56, 57, 58, and 59 Allen Street were purchased. Numbers 57 and 58, being in poor condition, were torn down in 1937; numbers 56 and 59 were used for storage until torn down around 1952. The cleared area is used for parking. 1921 Number 35 North Anderson Street was purchased this year. Renamed Lowell House, it was made over to provide small apartments for supervisors, head nurses, the housekeeper, and similar employees. It was torn down in 1953. This same year numbers 1, 2, 3, and 4 Spring Street Court were purchased, the dilapidated buildings demolished in 1937, and the land added to the Allen Street parking lot. In the same year 5 Kennard Street was purchased; it was demolished by 1952 (Plot Plan 1921). 1925 When Cambridge Street was widened in this year, forty feet were taken from the Hospital land, and it was necessary to cut that much from the old Market House and to move the house at 4 North Grove Street, which also faced Cambridge Street, back the same distance. 1926 Number 29 Parkman Street was purchased (demolished 1937)· 1928 Number 15 Parkman Street was purchased (demolished 1937)· By 1930 the Bulfinch Building had been thoroughly renovated and fireproofed, the Connecting Building between the Out-Patient Department and the Eye and Ear Infirmary completed, and the Baker Memorial erected. J 933 I n 1933, after extended negotiations with the City of Boston, the old City Stables at the corner of Fruit and North Grove Streets, from which the horse-drawn cleaning carts used to rumble forth each morning over the rough pavingstones, and the Ladder House of the Boston Fire Department facing on North Grove Street, together with the land as far as the North End Morgue, was purchased. After some repairing, the Stables were occupied on the second floor by the Car152
STRUCTURAL GROWTH AND DEVELOPMENT
penter and Electrical Shops, while the first floor was used for storage. The Ladder House at 10 North Grove Street was fixed up for the male nurses from McLean Hospital taking their courses at the General Hospital. Later it housed a group of conscientious objectors serving as orderlies and research volunteers during World War II, and at present is occupied by women residents. The Hospital now owned all of the land between North Grove Street and the Suffolk County Jail wall, excepting the central section containing the City Morgue (Plot Plan 1935). 1937 This year four houses on Parkman Street, numbers 17, 19, 21, and 27, were purchased. Numbers 17, 19, and 21, together with 30 Blossom Street, were renovated for nurses' residences and 27 was fixed up for the male employees who had been ousted from their quarters in the upper floors of the Gay Ward, or old Out-Patient Building, which was torn down to make room for the White Building. Numbers 15 and 29 were in such poor condition that they were torn down. A connecting corridor was built between numbers 17 Parkman and 30 Blossom Streets and openings were made with fire doors between the other buildings, so that all the nurses' residences were joined. 1941 Number 25 Parkman Street was purchased and remodeled for house officers. In 1941 it became necessary to rebuild the Jail wall. The entrance to the Jail yard had been by a right of way on the Hospital property to a gate just west of the Stables, a condition that was unsatisfactory to both parties. This was corrected by the Hospital ceding land on Cambridge Street to the Jail, leading to the placing of a new gate at the southeast corner of the Jail yard. At the same time the Hospital bought from the City of Boston the rest of its property between North Grove Street and the Jail, except for the Morgue building and a ten-foot strip of land surrounding it. 1943 Number 23 Parkman Street was purchased. The Hospital now owned all of the land and buildings on Parkman Street backing on Fruit Street. 1945 Numbers 57 and 59 Spring Street and 55Î2 Allen Street were purchased. Numbers 59 Spring Street and 55/2 Allen Street were torn down in 1953. Number 57 Spring Street was torn down either in 1952 or 1953. The land was added to the parking area. During the period between 1939 and 1950, the George Robert White Memorial Building, the Chapel, and the Vincent-Burnham Building were built and Herrick House for dietitians, Eldredge House for nurses, and Storrow House for convalescents were acquired by gift.
153
"CARE
OF
THE
SICK, T E A C H I N G ,
AND
RESEARCH"
1951 In 1951 Fruit Street from North Grove to Blossom Street was acquired from the city, with permission to close this section so as to add it to the Hospital yard. 1953 With the completion of Bartlett Hall in 1953, numbers 23 and 25 Parkman Street and Lowell House (35 North Anderson Street) were torn down, the sidewalks and street surface of Fruit Street were taken up and grassed, the North Anderson Gate was moved south as far as Parkman Street, and walls were built on Blossom and North Grove Streets, enclosing this area in the yard. The defaced Market House, which had been used as a paint shop since 1909, was finally demolished in 1953. The cupola, presumably designed by Bulfinch, with its striking weathervane, transferred from some other building at an unknown date, was given to Mr. Francis Hatch, one of the Trustees. In 1951 the Research Building was opened. In 1953 Bartlett Hall for nurses was built, and in 1956 the Warren Building for the Department of Pathology, laboratories, and doctors' offices were erected (Plot Plan 1956). 1956 During the years 1945 and 1956 all of the land and buildings from 20 to 36 North Anderson Street were purchased. Numbers 34 and 36 were torn down in 1952 and numbers 20, 22, 24, 26, 28, 30, and 32 in 1956. All of the land was added to the parking space. The wire fence which surrounded this lot was taken down in 1956 and the area was resurfaced. THE BAKER MEMORIAL HOSPITAL
The Baker Memorial, opened in 1930, was a new venture, intended to provide the same quality of care to persons in the middle-income group that had already been made available in the General Hospital to the poor, and in the Phillips House to the well-to-do. In 1939, Dr. Morgan J. Rhees, Assistant Director in Charge of the Baker Memorial, reviewed its origin and the first ten years of its operation. He said in part: T h e hope for a hospital for people of moderate means was expressed b y Dr. Washburn in his annual report as early as 1914. T h e project was made possible by the bequest of one million dollars for this purpose b y Mrs. Mary Richardson, received in 1925. As Dr. Washburn and the Trustees wished to build a fairly large unit for people of moderate means, both because this group of people is a large one in the community and because a large unit can be operated at a lower per capita cost than a smaller one, a campaign for additional funds was undertaken. About nine hundred thousand dollars
154
STRUCTURAL
GROWTH
AND
DEVELOPMENT
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d m -h"oo cd OOSCDÍ-^H^'^''J Bd. of Cons. 1952FRENCH, ARTHUR B., a. in M. 1951 FRENCH, ELIZABETH G., a. to C.M. 1954-1959 FREYMANN, JOHN G., a. in M. 1954FRIEDLICH, ALLAN L., JR., a. in M. 1952-1953, a.p. 1953-1957, assoc. p· 1958FROST, HAROLD M., a. in S. 1921-1922, a.s. to O.P.D. 1922-1926, a. in S. 1942-1945 GALL, EDWARD Α., a. path. 1937-1940 GALLUP, HENRY E., assoc. p. to C.M. 1942-1944, cons, in Ped. 1947GANT, JULIAN C., a. in M. 1935-1945 GANZ, ROBERT N., a.p. to C.M. 1953-1954, assoc. p. to C.M. 1954GARDELLA, JOSEPH W., a. in M. 1955GARLAND, JOSEPH, a.p. O.P.D. 1922-1923, v.p. to C.M. 1924-1926, p. to C.M. 1926-1953, Bd. of Cons. 1953GARRETT, JOHN W. D., a. an. 1942-1950, assoc. an. 1956GARREY, WALTER E., a. in S. 1936-1949, cl. assoc. in S. 1949GAULD, A. GORDON, a. obst. 1936-1945, assoc. obst. 1945GEISS, GEORGE W., a. in Phys. M. 1954-1956 GEORGE, HENRY L., JR., a. to C.M. 1932-1936 GEPHART, F. THOMAS, a. in S. 1950-1955, a.s. 1955-1959, assoc. v.s. 1959GERGELY, JOHN, a. biochem. M. 1953-1955, assoc. biochem. 1955GEVALT, FREDERICK C., a. in M. 1946-1947 GIBBONS, JOHN F., a. rad. 1952-1954 * GIDDINGS, HAROLD G., a. to S.O.P.D. 1909, a. in S. 1943-1945, assoc. v.s. 1945-1946, Bd. of Cons. 1946-1948 GILL, BENJAMIN F., a. in Psychiat. 1956-1957, a. psychiat 1957GILLESPIE, LUKE, a. obst. 1942GITLIN, DAVID, a. to C.M. 1955 GLENDY, MARGARET M., a. to C.M. 1935-1945 GLENDY, ROBERT EARLE, a. in M. 1935-1945 GLICKLICH, EARL Α., a. in D. 1946-1955, a.d. 1955GODFREY, ELBERT S., a. dn. s. 1938-1947 GOETHALS, THOMAS R., obst. 1929-1950, Bd. of Cons. 1952GOLDEN, THEODORE S., a. to C.M. 1950-1951, a.p. to C.M. 19511952, cl. assoc. to C.M. 1953GOLDMAN, HENRY M., periodontist 1946-1948 GOLDTHWAIT, JOEL E., cons. or. s. 1900-1903, or. 1903-1904, or. O.P.D. 1904-1908, v. or. s. 1908-1909, Bd. of Cons. 1922-1937, Hon. s. 1937GOODMAN, JOSEPH, a. in D. 1937-1941 GORDON, JOHN E., cons, in Prev. M. 1940GOVE, BURTON J., a. dn. s. 1944-1958
426
STAFF,
i935 -1 959
GRAHAM, JOHN B., a. in S. 1952-1955, a.s. 1955-1957» ci. assoc. S. 1957GRAHAM, JOHN R., a. in M. 1937-1953, ci. assoc. M. 1953GRAHAM, RUTH M. (MRS. JOHN B.), ci. cytol. Path. 1953-1956 GRAY, BASIL C., a. in D. 1950GRAYBIEL, ASHTON, a. in M. 1934-1946 * GREEN, ROBERT M., a. in S. 1909, a. obst. 1929-1941, cons, in Anat. 1948-1955 GREEN, THOMAS H., JR., a. in S. 1955-1958, a.s. 1959GREENE, J. EVARTS, a. in M. 1935-1955. a.p. 1955-1957» ci. assoc. in M. 1957β GREENOUGH, ROBERT B., s. O.P.D. 1900-1911, a.v.s. 1911-1916, v.s. 1916-1932, Bd. of Cons. 1932-1937 β GREENWOOD, ARTHUR M., a. dir. 1904-1906, a.d. 1921-1928, d. 1928-1937, Bd. of Cons. 1937-1947, Hon. P. 1947 GREGG, WARD I., a. in S. 1937-1942, a.s. 1942GREGORY, ELIZABETH Α., a. to C.M. 1949-1951 GREGORY, J. DELAFIELD, a. in biochem. 1949-1950, a. in biochem. res. 1950-1953, assoc. biochem. 1953-1957 GRIER, ROBERT S., a. in M. 1946-1950 GRIESEMER, ROBERT D., a. in D. 1953-1955, a.d. 1955GRILLO, HERMES C., a. in S. 1955GROGAN, MARGARET V., a.p. O.P.D. 1920-1923, p. O.P.D. 1923-1927, a.p. 1927-1944 GROGAN, RICHARD H., a. obst. 1948GROH, HERMAN, a. in D. 1932-1946 GROSS, JEROME, res. assoc. in M. 1951-1952, assoc. biol. in M. 1952GROVE-RASMUSSEN, MORTEN, a. dir. Bl. Bank 1951-1952, dir. Bl. Bank 1953" β GUILD, B. THURBER, a. in M. 1924-1926, a.p. O.P.D. 1926-1928, a.p. 1928-1943 GURALNICK, WALTER C., dn. s. 1951-1959, a. oral. s. 1959" GUSTAFSON, PAUL, a. obst. 1929-1947 HAANES, MERLE Α., a. in D. 1951-1953 HAGER, LOWELL P., a. biochem. in Res. Chem. 1954-1955 HALE, CLAYTON H., rad. 1943-1946 HALEY, FREDERICK Α., a. dn. s. 1931-1941 HALEY, WALLACE P., JR., a. in Psychiat. 1955-1958 HALL, THOMAS C., ci. a. in M. 1955-1956, a. in M. 1956HALL, VOLTA R., a. in Psychiat. 1944-1945, 1949-1950, a. psychiat. 1950HALLOWELL, PHILLIPS, a. in An. 1955-1956, a. an. 1956-1959, assoc. an. 1959HALSTED, JAMES Α., a. in M. 1934-1936, 1942-1945, a.p. 1946-1947 HAMLIN, EDWIN, JR., a. in S. 1938-1941, a.s. 1941-1951, assoc. v.s. 1951-1957, v.s. 1958HAMLIN, HANNIBAL, cl. assoc. in N.S. 1949-1957, a. in N.S. 1957β HAMPTON, AUBREY O., a. rad. 1927-1939, rad. 1939-1941, c. Rad. 1941-1945 427
APPENDIXES
HANELIN, JOSEPH, assoc. rad. 1948-1957, roent. McLean 1950-1957, rad. 1957, cl. assoc. rad. 1958HANSEN, ROBERT J., cons, in biomechan. 1957HARDY, HARRIET L., a. in M. 1943-1949, a.p. 1949-1951, assoc. p. 1951HARDY, IRAD B., a. in S. 1947-1952, cl. assoc. in S. 1952HARE, A. PAUL, assoc. sociol. 1956β HARMER, TORR W., a. in S. O.P.D. 1910-1911, a. in S. 1913-1916, a.s. O.P.D. 1916-1925, s. O.P.D. 1925-1930, c.S. O.P.D. i930-i935> a.s. 1935-1940 * HARTWELL, HARRY F., a. in Or. 1904-1911, a. surg. path. 1911-1916, surg. path. 1916-1938, Bd. of Cons. 1938-1943 HARWOOD, REED, a. in M. 1936-1941, a.p. 1941-1954, assoc. p. 1954HATHAWAY, J. SEABURY, a. in M. 1932-1936 HAVEN, GILMAN W., a. dn. s. 1949-1957 HAWES, LLOYD E., rad. 1942 HAYDEN, E. PARKER, a. in S. 1924-1927, a.s. O.P.D. 1927-1931, s. O.P.D. 1931-1935, a.s. 1935-1941, assoc. v.s. 1941-1955, v.s. 1955" 1956, Bd. of Cons. 1956HAYNES, RUTH C., a. in An. 1955-1956 HEELS, GEORGE E., a. obst. 1939-1949 HELMAN, MILTON E., a. in D. 1953-1955, a.d. 1955HEMPELMANN, LOUIS H., JR., cons, in biophysics 1948-1950 HENNEMAN, PHILIP H., a. in M. 1954-1958 * HERTZ, SAUL, a. in M. 1937-1947 HIGGINS, HAROLD L., p. to C.M. 1927-1932, c. C.M. 1932-1942 HILL, WILLIAM R., JR., a. in M. 1941-1942, a.p. 1942-1952, a. in D. 1940-1948, a.d. 1948HINCHEY, PAUL R., a. in S. 1939-1946 HINCKS, ELIZABETH M., a. psychol. Psychiat. 1938-1943, psychol. 1943-1951 HINDMAN, DANIEL H., a. obst. 1941HIRSCH, OSCAR, cons, in N.S. 1954HITCHCOCK, JAMES, a. in M. 1922-1923, a.p. O.P.D. 1923-1928, a.p. 1928-1938, a. in M. 1938-1939, 1944-1947 HOAGLAND, MAHLON B., assoc. biochem. M. 1955-1957, assoc. biochem. 1958HOBBS, WAYNE, a. in M. 1941-1942 HODGSON, JOHN S. a. in S. 1920-1921, a.s. O.P.D. 1921-1927, s. O.P.D. 1927-1931, a.v.s. 1931-1939, v.n.s. 1939~1943, Bd. of Cons. 1944HOFFMAN, JAY L., a. in Psychiat. 1952-1953, cl. assoc. in Psychiat. 1953HOLDER, RICHMOND, a. in Psychiat. 1951-1957, a. psychiat. 1957HOLLAND, DANIEL J., JR., a. dn. s. 1940-1948, a. oral s. 1948-1950, cl. assoc. in Dn. 1951* HOLMES, GEORGE W., a. rad. 1910-1917, rad. 1917-1935, c. Rad. 1935-1941, act. c. Rad. 1943-1945, Bd. of Cons. 1941-1947, Hon. P. 1947-1959 HOLMES, JOSEPH Α., a. in S. 1940-1949, cl. assoc. in S. 1949HOMANS, JOHN, JR., a. in M. 1947-
428
staff,
ι935-1959
HOPKINS, ANNE M., a. in M. 1943-1945 HOWARD, EDGARTON M., a. psychiat. 1936-1940 HOWARD, ERNEST B., a. in M. 1942-1948 HOWARD, PAUL M., assoc. psychiat. 1950-1955, psychiat. 1955HOWE, HENRY D., a. dn. s. 1946HOWE, HENRY F., a. in S. 1940-1947 HOZIER, JOHN B., a. in M. 1942-1944 * HUNTER, FRANCIS T., a. in M. 1927-1930, a.p. 1930-1937, assoc. p. 1937-1954, clin. path. I937"i954 HUNTINGTON, BENJAMIN L., a. in M. 1943-1956, a.p. 1956HURWITZ, DAVID, a. in M. 1943-1953 HURWITZ, JOSHUA J., a. in U. 1955HUSSEY, MARGARET B., a. in D. 1940HYATT, GILBERT T., a. in Or. 1935-1946 INGALLS, THEODORE H., a. to C.M. 1939-1945 INGERSOLL, FRANCIS M., a. in S. 1943-1951, a.s. 1951-1956, assoc. v.s. 1956IRWIN, JOHN W., a. in M. 1956ISSELBACHER, KURT J., a. in M. 1955-1958, a.p. 1958JACKSON, ARTHUR M., a. in S. 1944-1945 JACKSON, HOWARD B., a. in M. 1922-1923, a.p. O.P.D. 1923-1928, a.p. 1928-1950 JACKSON, WILLIAM P. U., a. in M. 1953 JACOBSON, BERNARD M., a.p. 1937-1953, a s s o c · P· i953-i957> P1958JEANLOZ, ROGER W., assoc. biol. ehem. M. 1951JEFFERIES, WILLIAM McK., a. in M. 1947 JESSNER, LUCIE N. a. in Psychiat. 1942-1944, a. psychiat. 1947-1949, assoc. psychiat. 1949-1951, psychiat. 1951-1954 JOHNSON, MARIANNE E., a.an. 1952-1953 JONES, CHESTER M., a. in M. 1920-1921, 1923-1925, assoc. p. 19251928, p. 1928-1954, cons. v.p. 1954-1957, Bd. of Cons. 1957* JONES, DANIEL F., s. O.P.D. 1903-1911, a.v.s. 1911-1917, v.s. 19171925, c. E.S. 1925-1929, Bd. of Cons. 1929-1937 JONES, H. WALTER, JR., a. in M. 1952JONES, MARY ELLEN, assoc. biochem. 1955-1957 JONES, STEPHEN G., a. in S. 1925-1931, a.s. O.P.D. 1931-1935, a. in S. 1935-1946, cl. assoc. in S. 1951* JONES, T. DUCKETT, res. f. 1925-1928, a. in M. 1931-1939, a.p. 1939-1949 JONES, WILLIAM N., a. in Or. 1951JOPLIN, ROBERT J., a. in Or. 1940-1947, a. or. s. 1947KAHN, DAVID, a. path. 1952-1954 KALIL, FREDERICK H., a. dn. s. 1948-1955 KALIL, TOUFIC H., rad. 1947KANE, LEWIS W., a. in M. 1945KAPLAN, NATHAN O., a res. chem. 1945-1948 KAPLAN, SAMUEL, a. to C.M. 1949-1951, a.p. to C.M. 1951-1953, a. in Psychiat. 1955-1956, a. psychiat. 1956-
429
APPENDIXES β KAPPIUS, MEINOLPH V., a. obst. 1932-1945 (W.W.II) KAUFMANN, GUSTAV. G., a. in M. 1946-1952 KAZANJIAN, VARAZTAD H., a. in L. 1922-1923, a.l. 1923-1928, a.s. L. O.P.D. 1928-1930, s. for plas. op. 1930-1940, v.s. 1935-1940, Bd. of Cons. 1940-1949, Hon. S. 1949KELLER, ELIZABETH Β., a. biochem. M. 1954-1958 KELLER, JOHN W., a. in M. 1955KELLEY, RITA M., a. in M. 1951-1956, a.p. 1956KELLEY, SYLVESTER Β., a. in U. 1933-1935, a.u. 1935-1941, assoc. v.u. 1941-1954, act. c. U. 1954-1955. v.u. 1955KELLOGG, FOSTER S., a. obst. 1929-1945 KELLY, JOHN F., podiatrist 1956KENDRICK, DORIS, a.p. to C.M. 1935-1944 KENNARD, HARRISON E., a. in S. 1938-1947 KENNEDY, EUGENE, a. in Biochem. Res. 1951 KERR, WALTER S., JR., a. in U. 1950-1951, a.u. 1951KERRIGAN, GERALD Α., a. to C.M. 1954-1955, a.p. to C.M. 1955-1956 KETCHUM, WILLIAM F., a.p. to C.M. 1953-1956 KEUPER, CHARLES S., a. in D. 1954KIEHL, KATHARINE, a. to C.M. 1950-1951 KING, DONALD S., a. in M. 1924-1926, a.p. O.P.D. 1926-1928, a.p. 1928-1936, assoc. p. 1936-1945, p. 1945-1950, Bd. of Cons. 19509 KING, RICHARD Β., a. in M. 1929-1937, a.p. 1937-1952, cl. assoc. in M. 1952-1953 KINSEY, DERA, a. in M. 1942-1946 KIRKWOOD, SAMUEL B., a. obst. 1938-1945, assoc. obst. 1945KITE, OWEN W., a. dn. s. 1951-1954, dn. s. 1954* KLEIN, ARMIN, a. or. O.P.D. 1920-1921, or. O.P.D. 1921-1929, a. or. 1929-1935, a. v. or. 1935-1937> v. or. 1937-1954. Bd. of Cons. 1954 KLEIN, DONALD C. assoc. psychol. 1955KLEMPERER, FRIEDRICH W., a. in M. 1943-1946 KRANES, ALFRED, a. in M. 1938-1940, a.p. 1940-1946, assoc. p. 19461952, p. 1952KRAYER, OTTO, cons, in Pharm. 1939KRUMBHAAR, G. DOUGLAS, a. obst. 1937-1947, assoc. obst. 1947-1957 KUBIK, CHARLES S., a. in Ν. & N. Path. 1927-1936, n. path. 1936-1942, a.n. 1937-1942, assoc. n. 1942-1946, c. N. 1946-1951, cons, in N.P. 1951-1954. Bd. of Cons. 1954KUNZ, LAWRENCE J., a. bact. 1952LAMONT, JOHN H., a. in Psychiat. 1955-1956, a psychiat. 1956-1957, assoc. psychiat. 1958* LANE, C. GUY, a.d. 1919-1928, d. 1928-1936, c. D. & Syph. 19361947, Bd. of Cons. 1947-1954 LARSON, CARROLL B., a. in Or. 1939-1946, a. or. 1946-1950, Bd. of Cons. 1950LAWRENCE, GLENN W., dent. O.P.D. 1920-1924, dn. s. 1924LAYTON, ROY W., a. in S. 1944-1945 LEADBETTER, WYLAND F., a. in U. 1939-1941, a.u. 1941-1945, assoc. v.u. 1945-1951. cl. assoc. in U. 1951-1954, c. of U. 1955-
430
STAFF,
I935-I959
LEAF, ALEXANDER, Res. & cl. assoc. 1951-1952, a. in M. 1952-1953, a.p. 1953-1957, assoc. p. 1957LeDONNE, JOHN E., a. in D. 1952LEE, ROGER I., p. O.P.D. 1908-1912, v.p. 1912-1920, act. c. W.M. 1920-1921, assoc. c. M. 1921-1923, Bd. of Cons. 1929-1951, Hon. P. 1951LEIDHOLT, JOHN D., a. in Or. 1954-1957 LEIGHTON, HERBERT, a. obst. 1948β LELAND, GEORGE ADAMS, JR., a. in S. 1915-1916, a.s. O.P.D. 19161919, s. O.P.D. 1919-1927, a.v.s. 1927-1929, assoc. s. 1929-1935, v.s. 1935-1943 LERMAN, JACOB, res. f. in M. 1929-1934, a. in M. 1934-1938, a.p. 1938-1945, assoc. p. 1945-1957. P· 1957LEVER, WALTER F., a. in D. 1942-1948, a.d. 1948-1955, assoc. d. 1955LEVINE, HARRY Β., a. in M. 1931-1952 LEVITAN, JULIUS J., a. dn. s. 1939LEWIS, EMERY O., rad. 1945-1946 LEWIS, JOSEPH L., a. to C.M. 1937-1951, a.p. to C.M. 1951-1955, cl. assoc. in C.M. 1956LINCOLN, ROBERT C., a. dn. s. 1956-1958, dn. s. 1959LINDEMANN, ERICH, a. in Psychiat. 1936-1938, assoc. psychiat. 19381945. psychiat. 1945-1954, c. Psychiat. 1954LINENTHAL, ARTHUR J., a. in M. 1944-1946, a. to C.M. 1946-1950, assoc. p. to C.M. 1950LINGLEY, JAMES R., a. roent. 1931-1939, roent. 1939-1942, rad. 19421946 LINTON, ROBERT R., a. in S. 1930-1935, a.s. 1935-1941, assoc. v.s. 1941-1945, v.s. 1945LIPMANN, FRITZ Α., res. f. in S. 1941-1942, res. ehem. 1942-1952, biochem. 1952-1957 LITTLEFIELD, JOHN W., a. in M. 1956β LLOYD, HENRY D., a. in M. 1915-1916, a. in Syph. O.P.D. 1916-1923, p. syph. O.P.D. 1923-1926, c. Syph. O.P.D. 1926-1929, Bd. of Cons. 1929-1948» Hon. P. 1948-1952 LOFTFIELD, ROBERT B., assoc. biochem. M. 1954LONG, ROBERT T., a. in Psychiat. 1955-1956, a. psychiat. 1956β LOOFBOUROW, DOROTHEA G., a. in M. 1944-1951 LOOMER, GWEN M., a. dn. s. 1937-1940 * LORD, FREDERICK T., p. O.P.D. 1903-1912, v.p. 1912-1934, Bd. of Cons. 1934-1941 LORENZ, JOHN J., a. in Phys. M. 1956 LORENZ, MARIA, a. in Psychiat. 1951-1956, a. psychiat. 1956LOWELL, J. DRENNAN, a. in Or. 1956LOWIS, SAMUEL, a. in N.S. 1943-1949, cl. assoc. in N.S. 1949LUDWIG, ALFRED O., a.p. 1941-1946 a. psychiat. 1946-1952, assoc. psychiat. 1952-1957 LUONGO, MICHAEL Α., a.v. path. 1951-1952, cons, in Forensic Path. 1952* LYNCH, FREDERICK J., a. obst. 1936-1950 4SI
APPENDIXES
LYON, ARTHUR Β., a. to C.M.O.P.D. 1921-1922, a.p. to C.M.O.P.D. 1922-1923, p. to C.M.O.P.D. 1923-1931, a.p. to C.M. 1931-1936, assoc. p. to C.M. 1936-1950 LYONS, CHAMP, a. in S. 1937-1940, a.s. 1940-1945 MABREY, ROY E., a. in S. 1935-1948, cl. assoc. in S. 1949-1958, a.s. 1959MacAUSLAND, WILLIAM R., JR., cl. a. in Or. 1954-1956, a. in Or. 1956MacMILLAN, JANE C., a. in Path. 1950 MACNAUGHTON, DOROTHY A.S., a. in Psychiat. 1945-1947 MACOMBER, DONALD, a.p. O.P.D. 1915-1919, a. in S. 1921-1922, a. obst. 1934-1942, 1944-1945 * MALLORY, TRACY B., c. Path. 1925-1951 MALOOF, FARAHE, a. in M. 1951MANN, WALTER, a. in Psychiat. 1956-1957, a. psychiat. 1957MARBLE, HENRY C., a.s. O.P.D. 1916-1925, s. O.P.D. 1925-1935, a.v.s. 1935-1941. v.s. 1941-1945, Bd. of Cons. i945"i955, Hon. S. 1955" MARCUS, SAUL M., a. in U. 1942-1954, a.u. 1954-1957 MARKS, GEORGE Α., a. in S. 1935-1947, cl. assoc. in S. 1951* MASON, NATHANIEL R., a. obst. 1929-1939 * MASON, ROBERT L., a. in S. 1935-1939 MASSELL, BENEDICT, a. in M. 1939-1947 MATARAZZO, JOSEPH D., assoc. psychol. 1955-1957 MATARAZZO, RUTH G., a. psychol. 1956-1957 MATOLTSY, ALEXANDER GEDEON, res. assoc. D. 1951-1955, assoc. biol. D. 1955-1957 MATZ, MYRON H., cl. a. in D. 1955, a. in D. 1956MAY, GEORGE E., a. obst. 1929MAZICK, SARAH J., a. in Psychiat. 1937-1939 McALLESTER, RALPH W., a. in M. 1923-1937 McARTHUR, JANET W., a. in M. 1944-1947, cl. a. to C.M. 1947-1949, a. in M. 1949-1950, a.p. 1950-1959; ( 195^-1957 assigned to Gyn.), assoc. p. 1959McCARTHY, PHILIP L., a. in D. 1953McCORT, JAMES J., assoc. rad. 1948-1952 McDERMOTT, WILLIAM V., JR., a. in S. 1951-1955, a.s. 1955-1957, assoc. v.s. 1957McDONALD, CHARLES Α., a. in N. 1916-1918, a.n. 1918-1939, assoc. n· 1939-1946, Bd. of Cons. 1946-1954, Hon. P. 1954McDONALD, FRANCIS C., assoc. p. to C.M. 1948-1957, cl. assoc. C.M. 1957McGINN, SYLVESTER, a. in M. 1935-1946, a.p. 1946-1952, cl. assoc. M. 1952McGOVERN, JOSEPH J. M., a. to C.M. 1954-1958, a.p. to C.M. 1958McKITTRICK, JOHN B., a. in S. 1946-1952, a.s. 1952McKITTRICK, LELAND S., a. in S. 1923-1925, a.s. O.P.D. 1925-1927, s. O.P.D. 1927-1929, a.v.s. 1929-1937, v.s. 1937-1942, (act. c. S. 19421945)> v.s. 1945-1953. cons. v.s. 1953-1959. Bd. of Cons. 1959McLEAN, JOHN D., a. podiatrist 1955-
432
STAFF, 1 9 3 5 - 1 9 5 9 MEANS, JAMES HOWARD, a.p. O.P.D. 1916, assoc. in M. 1916-1923, c.M. 1923-1951, Bd. of Cons. 1952-1956, Hon. P. 1956MEIGS, JOE V., a.s. O.P.D. 1922-1927, s. O.P.D. 1927-1935, a.v.s. 19351938, v.s. 1938-1955» c. Gyn. 1941-1955, cons. v.s. 1955-1958, Bd. of Cons. 1958MERRILL, OLIVER E., physicist 1937-1949, engineer in Rad. 1949MICHAELS, JOSEPH J., a. in Psychiat. 1936-1939 MICHELSEN, JOST, a. in N.S. 1938-1943, a.n.s. 1943-1949, cl. assoc. in N.S. 1949MILES, HENRY H. W., a. in Psychiat. 1949-1952 MILLER, BENJAMIN F., assoc. p. to C.M. 1949-1950 MILLER, R. BRETNEY, a. in M. 1938-1945 MILLER, CARROLL C., a. in S. 1940-1949, cl. assoc. S. 1949MILLER, LOVICK C., JR., a. psychol. 1952-1956, assoc. psychol. 19561957 ® MILLER, RICHARD H., a. in S. 1912-1914, a.s. O.P.D. 1914-1916, s. O.P.D. 1916-1919, c. S. O.P.D. 1919-1925, a.v.s. 1925-1929, assoc. s. 1929-1935, v.s. 1935-1940, Bd. of Cons. 1940-1952 MINER, LEROY M. S., dent. 1910-1924, oral s. & c. of Dn. 1924-1943, Bd. of Cons. 1943-1953, Hon. S. 1953MINER, RICHARD L., a. dn. s. 1950-1958, dn. s. 1958• MINOT, GEORGE R., a. in M. 1915-1918, assoc. in M. 1918-1924, p. to Sp. Cl. 1924-1930, Bd. of Cons. 1930-1949, Hon. P. 1949-1950 MINOT, JAMES J., p. O.P.D. 1876-1903, v.p. 1903-1913, Bd. of Cons. 1913-1929, Hon. P. 1929-1938 MINTZ, E. ROSS, a. in U. 1932-1935, a.u. 1935-1939 MIRABELLO, FRANK, a. in S. 1944-1946 MISKELL, LOUIS, a. dn. s. 1924-1940 MISRA, SHARAD CHANDRA, cons, in S., pro tem., Oct. 30, 1953-Apr. 7, 1954 MIXTER, CHARLES C., JR., a. in S. 1949β MIXTER, W. JASON, a. in S. 1909, a.s. O.P.D. 1911-1917, s. O.P.D. 1917-1919, a.v.s. 1919-1927, assoc. s. 1927-1929, v.s. 1929-1940, c. N.S. 1939-1941, Bd. of Cons. 1941-1953, Trustee 1947-1948, Hon. S. 1953-1958 MOLHOLM, HANS B., a. in Psychiat. 1934-1940 β MONKS, JOHN P., a. in M. 1931-1938, a.p. 1938-1955, assoc. p. 1956 MOORE, FRANCIS D., a. in S. 1944-1945, a.s. 1945-1948, Bd. of Cons. 1948MORELLI, DARIO, a. to C.M. 1943-1947 MORGAN, WINFIELD S., a. in Path. 1952-1953, a. path. 1953MORRIS, JOHN McL., a. in S. 1950-1952 MORRIS, LLOYD E., JR., a. in Path. 1945 β MORRISON, L. RAYMOND, n.p. 1946-1950 MOSTOFI, FATHOLLAH K., a. path. 1943-1945 MUELLER, HARRY L., a. to C.M. 1939-1942 MUELLER, H. PETER, a. rad. 1944-1949, a.v. rad. 1949-1952, cl. assoc. Rad. 1952-
433
APPENDIXES
MURPHY, HELENA M., a. in D. 1935-1944 * MURRAY, MICHAEL E., JR., a. in M. 1935-1941 MYERS, GORDON S., a. in M. 1950-1951, a.p. 1951-1956, assoc. p. 1956NADAS, ALEXANDER S., a.p. to C.M. 1954-1957, assoc. p. to C.M. 1958NARDI, GEORGE L., a. in S. 1952-1956, a.s. 1956NATHAN, LOUIS, a. in Or. 1935-1955, cl. assoc. in Or. 1955-1959 * NATHANSON, IRA T., a. in S. 1942-1946, a.s. 1946-1947, assoc. v.s. 1947-1954 NAUEN, ALICE C., a. to C.M. 1948-1950 NELSON, H. BRISTOL, a. obst. 1932-1952 NEMIAH, JOHN C., a. in Psychiat. 1951-1953, a. psychiat. 1953-1956, assoc. psychiat. 1956NEUSTADT, ELSE S., res. f. in Psychiat. 1939-1942, a. in Psychiat. 19421947 * NEWELL, FRANKLIN S., obst. 1914-1928, cons. obst. 1928-1929, Bd. of Cons. 1929-1942, Hon. P. 1942-1949 NEWELL, JOHN L., a. obst. 1937-1945, assoc. obst. 1945NORMAN, NILS, a. an. 1951-1952, 1954 (5 mos.) NORTON, PAUL L., a. in Or. 1935-1939, a. or. 1939-1946, assoc. v. or. 1946-1952, v. or. s. 1952NOSS, GEORGE M., a. dn. s. 1947-1958, cl. assoc. in Dn. 1959NOVELLI, G. DAVID, a. in biochem. 1949-1950, a. in biochem. res. 1950-1951, assoc. in biochem. res. 1951-1952, assoc. biochem. 19521953 O'KEEFE, EDWARD S., a. in M. 1917-1920, a.p. to C.M. O.P.D. 19201922, p. C.M. O.P.D. 1922-1927, p. to Sp. Cl. 1927-1929, a.p. C.M. 1929-1931, assoc. p. C.M. 1931-1936, p. C.M. 1936-1946, Bd. of Cons. 1946-1956, Hon. S. 1956OLIN, MERTON J., cl. a. to Dn. 1953-1954, a. dn. s. 1954* OLIVER, E. LAWRENCE, a. D. O.P.D. 1911-1923, assoc. d. 19231925, d. 1925-1927, c.D. 1927-1929, c. D. & Syph. 1929-1936, Bd. of Cons. 1936-1946, Hon. P. 1946-1953 * O'NEIL, RICHARD F., a.u. O.P.D. 1911, u. O.P.D. 1911-1925, assoc. u. 1925-1934, Bd. of Cons. 1934-1944 * OSGOOD, ROBERT B., a. or. O.P.D. 1904-1907, or. O.P.D. 1907-1911, a. v. or. 1911-1917, v. or. 1917-1919, c. Or. 1919-1922, Bd. of Cons. 1 93 1_1 944> Hon. S. 1944-1956 OUCHTERLONY, ORJAN T. C., v. bact. pro tem. 1954 PAINE, THOMAS F., JR., a.p. 1951-1953, 0. of Bact. 1952-1953 PALAZZO, WILLIAM L., assoc. rad. 1948 (5 mos.) PALMER, ROBERT S., res. f. in M. 1927-1928, a. in M. 1928-1937, (Health Officer i933~i944), a.p. 1937-1946, assoc. p. 1946-1950, p. 1950-1958, Bd. of Cons. 1958PAPAS, PRODROMOS Ν., a. in U. 1922-1924, a.s. U. O.P.D. 1924-1925, a.u. 1925-1937, a. in U. 1937-1946 PARKER, GEORGE D., a. dn. s. 1943-1945 β PARKER, WILLARD S., a.p. to C.M.O.P.D. 1912-1915, a.p. to O.P.D.
434
STAFF,
I935-I959
1915-1916, a. in M. 1922-1923, a.p. to O.P.D. 1923-1924, a.p. 19421945 PARSONS, LANGDON, a. in S. 1930-1939, a.s. 1939-1941, assoc. v.s. 1941-1945, v.s. 1945-1948, Bd. of Cons. 1948PATTERSON, JAMES F., cl. a. in D. 1954-1956, cl. assoc. in D. 19561957, a. in D. 1957PAVENSTEDT, ELEANOR, a. in Psychiat. 1934-1937 " PECK, MARTIN W., a. in N. 1926-1930, a. psychiat. 1940 PEEBLES, THOMAS C., a. to C.M. 1955-1957, a.p. to C.M. 1957PENDLETON, MURRAY E., a. to C.M. 1955-1957, a.p. to C.M. 1957PERLO, VINCENT P., a. in N. 1949-1953, a.n. 1953-1957, assoc. n. 1957PFEFFER, WILLIAM, JR., a.p. to C.M. 1953PHANEUF, LOUIS E., a. obst. 1940-1945 PHILLIPS, RUSSELL S., a. dn. s. 1934-1946 PIER, ARTHUR S„ Jr., a. in M. 1946-1953, a.p. 1953PITTMAN, HELEN S., a. in M. 1933-1937, a.p. 1938-1945, assoc. p. 1945-1958, p. 1958-1959, Bd. of Cons. 1959PITT-RIVERS, ROSALIND V., v. biochem. in Res. Chem. 1953 * PLACE, EDWIN H., cons, in Contag. Dis. 1915-1957 POINT, WALTER W. III., a. in M. 1951-1956, a.p. 1956POLANSKY, SYMON C., a. dn. s. 1937POLITANO, VICTOR Α., a.u. 1955-1957 PORTER, HUNTINGTON, a. in N. 1952-1955, a.n. 1955-1958 POULIN, FREDERICK K., a. dn. s. 1947PRATT, THEODORE C., a. in S. 1931-1946 PROUT, CURTIS, a. in M. 1945-1947 PUTNAM, MARIAN, a. in Psychiat. 1938-1942 QUARTON, GARDNER, a. in Psychiat. 1951-1953, a. psychiat. 19531955, assoc. psychiat. 1955QUINBY, JOHN T., a. in M. 1944-1956, a.p. 1956QUINBY, WILLIAM C., JR., a. in S. 1950-1956, a.s. 1956QUINN, MILTON J., a. in M. 1927-1938, a.p. 193&-1952 RACKEMANN, FRANCIS M., a. in M. 1917-1921, p. O.P.D. 1921-1924, c.M. O.P.D. 1925-1929, p. 1929-1947, Bd. of Cons. 1947-1957, Hon. P· 1957RAE, ROBERT G., a. dn. s. 1931-1936, dn. s. 1936β RAGLE, BENJAMIN H., a.p. O.P.D. 1917-1920, 1921-1928, a.p. 19281930, assoc. p. 1930-1937. Bd. of Cons. i937~ 1 956 RAK, I. PALEY, a. in Psychiat. 1942RAKER, JOHN W., a. in S. 1950-1954, a.s. 1957RAWSON, RULON W., a. in M. 1943-1945, a.p. 1945-1946, assoc. p. 1946-1948 RECORD, EUGENE, a. in Or. 1947-1952, a. or. 1952REED, CARLISLE, a. in M. 1929-1943 REEVES, JOHN D., a. rad. 1955-1957, assoc. rad. 1957REGGIO, A. WILLIAM, a.s. O.P.D. 1916-1925, s. O.P.D. 1925-1935, a.s. ΐθβδ-^θβθ» a.v.s. 1939-1941, v.s. 1942-1946, Bd. of Cons. 1946-1956, Hon. S. 1956-
435
APPENDIXES
REID, DUNCAN, a. obst. 1938-1948, Bd. of Cons. 1955REIDY, JOHN Α., a. in Or. 1938-1946, a. or. 1946REITH, HOWARD C., a. dn. s. 1937-1954 REYERSBACH, GERTRUD C., a. to C.M. 1946-1947, a.p. to C.M. 19471950, assoc. p. to C.M. 1950RHINELANDER, FREDERIC W., a. in Or. 1941-1947 RHODES, FRANK I., a. dn. s. 1929-1956, dn. s. 1956β RICHARDSON, EDWARD P., a.s. O.P.D. 1911-1912, s. O.P.D. 19121919, a.v.s. 1919-1922, c. Third S. Serv. 1922-1925, c. W.S. 1925-1931, Hon. S. 1931-1943 RICHARDSON, EDWARD P., JR., a. in Ν. & N.P. 1949-1950, a.n. & a. in N.P. 1951-1952 a.n. & a.n.p. 1953-1956, a.n. & assoc. n.p. 1957, a.n. & n.p. 1958, assoc. n. & n.p. 1959RICHARDSON, GEORGE S., a. in S. 1955* RICHARDSON, WYMAN, a. in M. 1925-1927, a.p. O.P.D. 1927-1928, a.p. 1928-1929, assoc. p. 1929-1939, p. 1939-1949. clin. path. 19421949, Bd. of Cons. 1949-1952 RING, JOSEPH Α., a. dn. s. 1910-1911, a. dent. 1911-1924, dn. s. 19241946 RISLEY, THOMAS S., a. in S. 1950-1951 ROBBINS, FREDERIC C., a. to C.M. 1951-1952 ROBBINS, LAURENCE L., rad. 1941-1946, c. of Rad. 1946ROBBINS, SAMUEL D., speech corrector, N. 1935-1945 β ROBBINS, WILLIAM B., a.p. O.P.D. 1913-1915, p. O.P.D. 1915-1925, assoc. p. 1925-1928, p. 1928-1938, Bd. of Cons. 1938-1948, Hon. P. 1948-1951 ROBERTS, HELEN, a. in Or. 1936-1937 * ROBERTS, SUMNER M., a. in Or. 1929-1933, or. O.P.D. 1933-1935, a. or. 1935-1937. a.v. or. 1937-1939 ROBINSON, CHARLES V., a. in Res. Biophys. 1949-1953 ROCHLIN, GREGORY N., a. in Psychiat. 1943 ROCK, JOHN, a. in S. 1921-1926, a. obst. 1929-1944, Bd. of Cons. 1944ROCKWOOD, ETHEL M., a. in D. & Syph. 1928-1936, a.d. 1936-1947, d. 1948-1949, Bd. of Cons. 1949-1957, Hon. P. 1958RODKEY, GRANT V., a. in S. 1952-1957, a.s. 1957ROGERS, HORATIO, a. in S. 1927-1931, a.s. O.P.D. 1931-1935, a.s. 1935-1941. assoc. v.s. 1942-1948, v.s. 1948-1957, Bd. of Cons. 1957ROGERS, WILLIAM Α., a. in Or. 1924-1929, a. or. 1929-1935, a.v. or. 1935-1937. v. or. 1937-1952, Bd. of Cons. 1952ROGERS, WILLIAM P., JR., a. in S. 1955-1957, a.s. 1958β ROMBERG, ELI C., a.p. to C.M.O.P.D. 1924, p. to C.M. O.P.D. 19241931, assoc. p. to C.M. i93i-i953> Bd. of Cons. I953"i954 ROPES, MARIAN W., a. in M. 1937-1942, a.p. 1943-1944, assoc. p. 1944ROSE, AUGUSTUS S., a. in N. 1937-1943, a.n. 1943-1948, assoc. n. 1948-1951 ROSENBLUM, GERSHEN, a. psychol. 1952 ROSS, RALPH S., a.p. to C.M. 1942-1946, assoc. p. to C.M. 1946-1949, p. to C.M. 1949-
436
STAFF,
I935-I959
ROUILLARD, FRANCIS, a. obst. 1932ROUNDS, CHARLES E., a. dn. s. 1950-1954, dn. s. 1954ROURKE, GRACE MARGARET, res. assoc. M. 1953ROWE, CARTER R., a. in Or. 1947-1951, a. or. s. 1 9 5 1 RURIN, SOLOMON H., a.p. to C.M. O.P.D. 1920-1923, p. to C.M.O.P.D. 1923-1931, assoc. p. to C.M. 1931-1944 RUDY, HAROLD Α., a. in U. 1955RUESCH, JÜRGEN, a. in Psychiat. 1940-1942 RUSSFIELD, AGNES S. BURT, a. in Path. 1954-1956, a. path. 1956RUTSTEIN, DAVID D., cons, in Prev. M. 1948, assoc. p. 1949RYAN, MILDRED, a. in D. 1930-1942, a.d. 1942ST. AUBIN, PAUL M. G., a. rad. 1955-1958, assoc. rad. 1959SANCHEZ, GUILLERMO C., cl. a. M. 1954-1957, a .M. 1957SANDS, KENNETH F., a. to C.M. 1950-1951, a.p. to C.M. 1952SARRIS, EPIROS P., a. in S. 1941-1948, cl. assoc. in S. 1949SASLOW, GEORGE, psychiat. 1955-1957 * SAWYER, ALPHA R., a. in U. 1920, a.u. O.P.D. 1920-1925, a.u. 19251936 SAWYER, CARL S., a. in D. 1945-1949 SCANNELL, JOHN G., a. in S. 1945-1951, a.s. 1951-1954, assoc. v.s. 1954SCEERY, ROBERT T., a. to C.M. 1953-1956, a.p. to C.M. 1957SCHATZKI, RICHARD, a. rad. 1935-1937, rad. 1937-1947, a. rad. 19471949, a.v. rad. 1949-1952, cl. assoc. in Rad. 1952SCHIER, W. WILSON, a. in M. 1947-1949 SCHMID, KARL, a. biochem. 1954-1955, assoc. biochem. 1955SCHULZ, MILFORD D., rad. 1942SCHWAB, ROBERT S., a. in N. 1936-1942, a.n. 1942-1947, assoc. n. 1947-1952, n. 1952SCOTT, JESSE F., assoc. biophysicist 1953SCOVILLE, WILLIAM B., a. in Psychiat. 1936 β SCUDDER, CHARLES L., s. O.P.D. 1891-1903, v.s. 1903-1914, c. E.S. 1914-1920, Bd. of Cons. 1920-1931, Hon. S. 1931-1949 SCULLY, ROBERT E., a. path. 1951-1956, assoc. path. 1956SEARS, JOHN B. a. in S. 1931-1938, 1942-1945. * SELLARDS, A. WATSON, a. in T.M. 1915-1928, cons, in T.M. 19281942 SELVERSTONE, BERTRAM H., a. in N.S. 1949-1951, clin, assoc. in N.S. 1951SELVERSTONE, BETTY F., a. to C.M. 1950-1952 SEWALL, WESTON, a.obst. 1937SEYFARTH, HERMANN B. F., a. dn. s. 1942-1946, grad a. in Dn. 19461947, a. dn. s. 1947-1956 SHANDS, HARLEY C., a. in Psychiat. 1948-1953 SHANGRAW, KEITH Α., a. dn. s. 1937SHATTUCK, GEORGE C., a.p. O.P.D. 1910-1912, a.v.p. 1912-1921, cons, in T.M. 1928SHAW, ROBERT S., a. in S. 1953-1958, a.s. 1958-, a. dir. Bl. Bank 1953-
437
APPENDIXES
SHEDDEN, WILLIAM M., a. in S. 1922-1927, a.s. O.P.D. 1927-1935, a. in S. 1935-1946 SHELDON, CHARLES P., a. obst. 1934, 1937-1945, assoc. obst. 1945SHELDON, RUSSELL F., a. an. 1925-1936, an. 1936-1946, Bd. of Cons. 1946-1959, Hon. P. 1959SHORT, CHARLES L., a. in M. 1933-1938, a.p. 1938-1946, assoc. p. 1946-1956, p. 1957SHRIBER, WILLIAM J., a. in M. 1951-1954, a. in Phys. M. 1951-1954 SIFNEOS, PETER E., a. in Psychiat. 1953-1955, a. psychiat. 1955-1956, assoc. psychiat. 1956— SILVER, LOUIS S., a. in M. 1927-1946 SIMEONE, FIORINDO Α., a. in U. 1941, a.u. 1942-1945, a.s. 1946-1950, Bd. of Cons. 1950β SIMMONS, CHANNING C., a.s. Path. 1904-1907, s. O.P.D. 1907-1916, a.v.s. 1916-1927, v.s. 1927-1938, Bd. of Cons. 1938-1948, Hon. S. 1948-1953 SIMMONS, FRED Α., JR., a. in S. 1938-1946, a.s. 1946-1954, assoc. v.s. 1954-1958 SISCOE, DWIGHT L., a. in M. 1924-1927, a.p. O.P.D. 1927-1929, assoc. p. 1929-1950, Bd. of Cons. 1950SISSON, WARREN R., p. to C.M. O.P.D. 1917-1923, assoc. p. to C.M. 1942-1945, cons, to C.M. 1947-1948, Bd. of Cons. 1948-1958, Hon. P. 1958SKIRBALL, LOUIS I., a.p. to C.M. 1949-1952 SLEEPER, EDWARD L., a. dn. s. 1950-1954, dn. s. 1954-1955 SLEMONS, MARION L., cl. assoc. C.M. 1952-1956, a.p. to C.M. 1956SMITH, CLEMENT Α., cons, to C.M. 1942-1943, 1946-1950, p. to C.M. i95i-i953> cons, to C.M. 1953* SMITH, C. MORTON, c. Syph. 1913-1926, sp. cons. p. in Syph. 19261938, Bd. of Cons. 1926-1937, Hon. P. 1937-1938 SMITH, EDWIN W., a. obst. 1930-1941 SMITH, GEORGE GILBERT, a.u. O.P.D. 1 9 1 0 - 1 9 1 1 , u. O.P.D. 1 9 1 1 1925, assoc. u. 1925, u. 1925-1935» v.u. 1935-1938, c.U. 1938-1945, Bd. of Cons. 1945-1954, Hon. S. 1954SMITH, JUDSON Α., a. obst. 1929-1941, obst. 1941-1954, Bd. of Cons. 1954SMITH, PATRICIA H., a. in M. 1938-1944, a. in Gyn. 1945-1946 (see Benedict, P.H.S.) SMITH, WILLIAM D., a. Syph. O.P.D. 1916-1921, p. O.P.D. 1921-1925, assoc. p. 1925-1928, p. 1928-1936, Bd. of Cons. 1936-1947, Hon. P. 1947SMITH, WILLIAM H., p. O.P.D. 1903-1912, v.p. 1912-1930, Bd. of Cons. 1930-1941, Hon. P. 1941— β SMITH-PETERSEN, MARIUS Ν. a. in S. 1917-1919, or O.P.D. 19191921, a.v. or. 1921-1929, c. Or. 1929-1946, Bd. of Cons. 1946-1953 SMITH-PETERSEN, MORTEN, a. in Or. 1953SMITHWICK, REGINALD H., a. in S. 1928-1931, a.s. O.P.D. 1 9 3 1 1935, a.s. 1935-1939, a.v.s. 1939-1941, assoc. v.s. 1941-1945, Bd. of Cons. 1945-
438
STAFF, I 9 3 5 - I 9 5 9 SNEDDON, ERNEST Α., a. in An. 1954 SNIFFEN, RONALD C., a. path. 1940-1948, a.v. path. 1948-1953, assoc. v. path. 1953SOARES, EDWARD L., a. dn. s. 1937-1952 SOHIER, WILLIAM D., JR., a. in M. 1954- a. to Gen. Dir. for Res. & Ed. 1957SOLOMON, HARRY C., a. in M. (Syph.) 1920-1923, a.p. Syph. O.P.D. 1923-1925, a.n. 1925-1939» assoc. η. 1939-1943. Bd. of Cons. 1943SOLOMON, PHILIP, a. in Psychiat. 1936 SOLOWAY, ALBERT H., a. ehem. in N.S. 1957SOODAK, MORRIS, a. biochem. M. 1951-1957 SOUTTER, LAMAR, a. in S. 1942-1946, a.s. 1946-1952, clin, assoc. S. 1952SOWLES, HORACE, a.s. O.P.D. 1920-1925, s. O.P.D. 1925-1935, a.v.s. 1935-1940. v.s. 1940-1947, Bd. of Cons. 1947SPANGLER, ARTHUR S., a. in D. 1950SPEARE, GEORGE S., a. in S. 1935-1949, cl. assoc. in S. 1949-1957, Bd. of Cons. 1957SPECTOR, LEONARD B., a. biochem. in M. 1954SPELLMAN, JOHN W., a. in S. 1930-1931, a.s. O.P.D. 1931-1935, a. in S. 1935-1948, cl. assoc. in S. 1949SPENCER, JACK, a.v. rad. 1937 SPIRO, DAVID, a. in Path. 1954-1956, a. path. 1956SPLAINE, RUSSELL L., a. in U. 1927-1929, a.u. 1929-1936 SPRAGUE, HOWARD S., a. in M. 1926-1927, a.p. O.P.D. 1927-1928, a.p. 1928-1938, assoc. p. 1938-1953, p. 1953-1956, Bd. of Cons. 1956SRERE, PAUL Α., a. in biochem. res. 1951-1953, a. biochem. 1953 STANBURY, JOHN B., a. in M. 1949-1950, a.p. 1950-1956, assoc. p. 1956STANTON, ALFRED H., psychiat. 1956-, c. psychiat. (McL) 1955STANTON, JOHN C., a. dn. s. 1935-1942, dn. s. 1942STAPLES, GEORGE Α., a. dn. s. 1935-1943 STAPLES, O. SHERWIN, a. in Or. 1939-1945 STAUFFER, RUTH E., a. in N. 1 9 5 1 STEARNS, HOWARD O., cons, physicist Rad. 1928-1937 STEBBINS, HENRY D., a. in M. 1936-1939, cl. assoc. in M. 1950STEWART, JOHN D„ a. in S. 1935-1939. a.s. i939"i94i STILLMAN, J. SYDNEY, a. in M. 1938-1949 STOECKLE, JOHN D., a.p. 1954STOKES, JOSEPH, III, a. in M. 1956STONE, BARTLETT H., a. obst. 1 9 5 1 STROCK, MOSES S., a. dn. s. 1924-1936, dn. s. 1936-1948 * STRONG, RICHARD P., c. T.M. 1915-1928, cons. T.M. 1928-1941, Bd. of Cons. 1941-1942, Hon. P. 1942-1948 STURGIS, GEORGE P., a. in M. 1935-1940, a.p. 1940STURGIS, SOMERS H., a. in S. 1935-1942, a.s. 1941-1950 SUBY, HOWARD I., a. in U. 1939-1941, a.u. 1941-1946, assoc. v.u. 1946SULLIVAN, CHARLES L., a. obst. 1944-
439
APPENDIXES
SULLIVAN, EUGENE R., a. in M. 1940-1948 SUTHERLAND, GEORGE F., a. in Psychiat. 1938-1940 SWAN, CHANNING S., a.u. 1928-1935, a.v.u. 1935-1938, a. in U. 19461954 SWAN, CHARLES L., a. in S. 1935-1938 SWAN, DANIEL M., a. in M. 1942-1945 SWARTZ, JACOB H„ a. in D. 1923-1926, a.d. 1926-1937, d. 1937-1951, Bd. of Cons. 1951SWARTZ, MORTON N., a. in M. 1956-1957, a.p. 1957SWEET, PAUL L., a. dn. s. 1954 SWEET, RICHARD H., a. in S. 1930-1935, a.s. 1935-1941, assoc. v.s. 1941-1946, v.s. 1946SWEET, WILLIAM H., a. in N.S. 1946-1947, a.n.s. 1947-1948, assoc. v.n.s. 1948-1956, v.n.s. 1956SWEETNAM, GEORGE H., a. dn. s. 1942-1956 SWINSON, MILDRED E„ a. psychol. 1951-1952 TAFT, EDGAR B., a. path. 1952-1957, assoc. path. 1957TALBOT, FRITZ B., p. in charge C.M. 1910-1911, c. C.M. 1911-1931, Bd. of Cons. 1932-1948, Hon. P. 1948TALBOT, NATHAN B., a.p. to C.M. 1941-1947, assoc. p. to C.M. 19471950, p. to C.M. 1950TALBOTT, JOHN H., a.p. 1937-1946 TALKOV, ROBERT H., a. in M. 1946-1955 TALLAND, GEORGE Α., a. psychol. 1954-1956, assoc. psychol. 19561957 TAYLOR, GRANTLEY W., a. in S. 1925-1931, a.s. O.P.D. 1931-1935, a.s. 1935-1939. a.v.s. 1939-1941, assoc. v.s. 1941-1946, v.s. 1946-1957, Bd. of Cons. 1957* TAYLOR, MARIANNA, a. in N. 1930-1937, a. psychiat. 1937-1945 TEBBE, DOROTHY K., a. to C.M. 1942-1944 TEFFT, RICHARD C., JR., a.p. C.M. 1925-1928, p. C.M. O.P.D. 19281931, assoc. p. to C.M. 1931-1957, Bd. of Cons. 1957TENNEY, BENJAMIN, JR., a. obst. 1930-1946, assoc. obst. 1946 THOMA, KURT H., oral s. & c. of Dn. 1943-1947, Bd. of Cons. 19471953, Hon. S. 1953THOMAS, D. VERNON, a. an. 1951 THOMAS, JACKSON M., a. psychiat. 1947, cl. assoc. in Psychiat. 19521955» a. in Psychiat. 1955THOMPSON, ERNEST D., a. in Or. 1935-1947 THOMPSON, JOHN W., a. in Psychiat. 1938-1940 THOMPSON, MILTON S., JR., a. in Or. 1936-1939 THOMPSON, RALPH D., a. dn. s. 1935-1956, cl. assoc. in Dn. 1956THOMPSON, RICHARD H., a. in S. 1941-1949, cl. assoc. in S. 1949THOMPSON, WILLIAM P., a. in M. 1936 THORNDIKE, AUGUSTUS, cons, in S. of Traum, cond. 1941-1955, cons, in S. 1955* THORNDIKE, W. T. SHERMAN, a. in S. 1922-1925, obst. 1929-1939, a. dir. 1939-1948 THORP, EDWARD G., a. in M. 1933-1940, a.p. 1940-1945
440
STAFF,
I935-I959
TILLEY, ROBERT, a. in D. i95i-i953, a.d. 1953TILLOTSON, KENNETH J., psychiat. 1934-1948 TIMBERLAKE, WILLIAM H., a. in N. 1952-1956, a.n. 1956-1958, assoc. η. 1958* TITUS, RAYMOND S., a. obst. 1930-1931, obst. 1931-1946, Bd. of Cons. 1946-1949 TODD, DONALD P., a. an. 1948-1953, assoc. an. 1953TOLL, KAREL van S., a. in N. 1955TOLMAN, MAURICE M., a. in D. & Syph. 1931-1938, a.d. 1938-1949, d. 1949TOMPKINS, JOHN BUTLER, a. in Psychiat. 1942-1947, gr. a. in M. 1944-1948, ci. a. in M. 1948-1949 •TORBERT, JAMES R., a. obst. 1935-1941, Bd. of Cons. 1941-1946, Hon. S. 1946-1955 * TOWLE, HARVEY P., a.d. O.P.D. 1903-1911, d. 1911-1925, Bd. of Cons. 1925-1936, Hon. P. 1936-1937 TOWNSEND, JAMES H., a. in M. 1927-1934, a.p. 1934-1937, assoc. p. 1937-1951, Bd. of Cons. 1 9 5 1 TRUMP, JOHN C., cons, in Physics 1948TUCCI, JOHN H., a. an. 1945-1950 TUDOR, FREDERIC, a. in M. 1938-1953, cl. assoc. in M. 1953TURTLE, WILLIAM J., a.p. to C.M. 1943-1947, assoc. p. to C.M. 19471953 TUTTLE, ELBERT P., JR., a. in M. 1955-1956 ULFELDER, HOWARD, a. in S. 1942-1946, a.s. 1946-1955, v.s. 1955c. of Gyn. 1955URMY, THOMAS V., a. in M. 1930-1937, a.p. 1937-1945 VANCE, ROBERT G., a.v. rad. 1926-1939, a. rad. 1939-1949, cl. assoc. R. 1949-1956 VAN DYKE, WILHELMINA, a. to C.M. 1945-1953, a.p. to C.M. 1953VAN GORDER, GEORGE W., a. or. s. 1929-1935, a.v. or. s. 1935-1937, v. or. s. 1937-1948, act. c. of Or. Serv. 1946-1949, Bd. of Cons. 19491958, Hon. S. 1958VAUGHAN, CLARENCE, a. dn. s. 1937-1940 VICKERY, AUSTIN L., JR., a. path. 1949-1956, assoc. path. 1956* VICKERY, HERMAN F., p. O.P.D. 1885-1898, v.p. 1898-1914, Bd. of Cons. 1914-1929, Hon. P. 1929-1939 VICTOR, MAURICE, a. in N. 1951-1952, a.n. 1952-1958, assoc. n. 1958VIETS, HENRY R., a. in N. & S. 1919-1920, a. in N. 1921-1923, a.n. 1923-1940, n · 1940-1951, Bd. of Cons. 1 9 5 1 VINCENT, BETH, a. in S. 1906-1907, s. O.P.D. 1 9 1 1 - 1 9 1 7 , a.v.s. 1 9 1 7 1927, v.s. 1927-1932, c. E.S. 1932-1935, Bd. of Con. 1935-1945, Hon. s. 1 9 4 5 -
VOLWILER, WADE, a. in M. 1945-1948 von FELSINGER, JOHN M., assoc. psychol. An. 1952-1955, assoc. psychol., Psychiat., 1955-1956, psychol. 1957VOSE, ROBERT H., temp. a.s. O.P.D. 1917-1919, a.s. O.P.D. 1919-1925, s. O.P.D. 1925-1931, a. in S. 1942-1945
441
APPENDIXES
WADDELL, WILLIAM R., a. in S. 1952-1955, a.s. 1955-1958, assoc. s. 1958WADDINGTON, EARL J., a. dn. s. 1945-1959, dn. s. 1959WAKSMAN, BYRON H., assoc. bact. N. 1953WALDFOGEL, SAMUEL, psychol. 1949-1952 WALLACE, RICHARD H., a. in S. 1931-1940, a.s. 1940-1941, assoc. v.s. 1941-1951, cl. assoc. in S. 1951-1957 WALLACE, WILLIAM McL., a.p. to C.M. 1949-1950, assoc. p. to C.M. 1950-1951 WALLIS J. KENDALL, a. in Psychiat. 1936-1941 * WALTON, GEORGE L., a. in N. 1883-1889, n. O.P.D. 1889-1907, Bd. of Cons. 1907-1929, Hon. P. 1929-1941 WANNING, PATRICIA, a. to C.M. 1946-1951 WARD, JOHN L., a.p. to C.M. 1936-1946 WARNER, FRANK Α., a. in M. 1954WARREN, RICHARD, a. in S. 1940-1941, a.s. 1941-1950, assoc, v.s. 1950-1954. B d · of Cons. 1954WARTHIN, THOMAS Α., a. in M. 1941-1953, a.p. 1953-1954 WATKINS, ARTHUR L., c. of Phys. Μ. 1944-, a. in M. 1940-1949, a.p. 1949WATSON, RICHARD H., a. to C.M. 1954-1959, a.p. to C.M. 1959WEBSTER, EDWARD W., physicist, Rad., 1954WEBSTER, RICHARD C., JR., a. in S. 1945-1949, cl. assoc. in S. 19491956 WEINBERGER, JEROME L., a. in Psychiat. 1953-1954, a. psychiat. 1955-1958, assoc. psychiat. 1958β WEINGER, MURRAY Α., a.u. 1935-1937, a. in U. 1937-1940 WEINSTEIN, LOUIS, a.p. to C.M. 1949-1950, assoc. p. to C.M. 1950WEISBERGER, DAVID, dn. s. 1942-1945, a. oral s. & stomatologist 19451948, oral s. & c. of Dn. 1948WEISMAN, AVERY D., a. in Psychiat. 1949-1952, a. psychiat. 1952-1956, assoc. psychiat. 1956WELCH, CLAUDE E., a. in S. 1937-1942, a.s. 1942-1946, assoc. v.s. 1946-1953, v.s. 1953* WELLS, CHARLES E., a.r.p. 1914-1915, 1917-1919, 1920-1928, a. in D. 1932-1946 WELLS, F. LYMAN, psychol. 1941-1949 WESSELHOEFT, CONRAD, con. in M. 1943β WETHERELL, BRYANT D., a. in Syph. 1919-1924, a.u. 1933-1940 WHEELER, EDWIN O., a. in M. 1950-1952, a.p. 1952WHEELER, ROY R., a. in M. 1925-1926, a.p. O.P.D. 1926-1927, p. to Sp. Cl. 1927-1929, a.p. 1929-1954 WHEELOCK, FRANK C., JR., a. in S. 1951-1955, a.s. 1955WHITE, CHARLES J., a.d. O.P.D. 1895-1903, d. O.P.D. 1903-1911, d. 1911-1925, c. D. 1925-1927, Bd. of Cons. 1927-1939, Hon. P. 1939WHITE, JAMES C., assoc. in S. 1928-1935, a.v.s. 1935-1939, v.n.s. 19391940, c. of N.S. 1 9 4 1 ' WHITE, LeMOYNE, a. in Psychiat. 1948-1950, a. psychiat. 1950-1954, assoc. psychiat. 1954-1958
442
STAFF,
I935-I959
WHITE, PAUL D., c. M. O.P.D. 1920-1925, p. to Sp. CI. 1921-1924, assoc. in M. 1924-1925, assoc. p. 1925-1928, p. 1928-1949, Bd. of Cons. 1 949 - 1 956, Hon. P. 1956WHITEHORN, JOHN C., assoc. psychiat. 1937-1938 WHITELAW, GEORGE P., a. in S. 1941-1945 WHITING, RICHARD G., a. in M. i939"i955, a.p. 1955WHITNEY, RAY L., assoc. psychiat. 1935, 1936-1939 • WHITTEMORE, WYMAN, a. in S. 1907-1908, a.s. O.P.D. 1911-1914, s. O.P.D. 1914-1919, a.v.s. 1919-1927, assoc. s. 1927-1929, v.s. 19291936, Bd. of Cons. 1936-1949, Hon. S. 1949-1957 WILKINS, EARLE W., JR., a. in S. 1953-1958, a.s. 1958WILLIAMS, CONGER, a. in M. 1943-1946, a.p. 1946-1949, assoc. p. 1949* WILLIAMS, HUGH, s. O.P.D. 1903-1911, a.v.s. 1911-1917, assoc. s. 1917-1919, v.s. 1919-1929, Bd. of Cons. 1929-1941, Hon. S. 1941-1945 WILLIAMS, VERNON P., a. psychiat. 1934-1936, a. in Psychiat. 19381945, a. psychiat. 1946WILLS, A. ALLISON, a. in Psychiat. 1936 WILSON, PHILLIP D., or. O.P.D. 1919-1925, a. or. 1925-1929, or. 19291934, Bd. of Cons. 1934-1956, Hon. S. 1956WILSON, RICHARD V., a. rad. 1953-1957, a. rad. 1957-1958 (6 mos.) WINSOR, ALLEN P., a. obst. 1929-1946, assoc. obst. 1946-1952 WOLFF, LOUIS, a. in M. 1926-1929, a.p. 1929-1937 WOLMAN, HAROLD M., a. in Psychiat. 1955-1957 WOOD, BENJAMIN S., a. in S. 1935-1943 WOODRUFF, LORANDE M., a. in U. 1949-1951, a.u. 1951WOODS, WILLIAM L., a. in Psychiat. 1941-1943 WYATT, FREDERICK, a. psychol. 1944-1946, psychol. 1946-1948 WYATT, GEORGE M., a. rad. 1942-1946 WYMAN, R. RONALD, a. dn. s. 1945WYMAN, STANLEY, rad. 1946YORK, RICHARD H., a. psychol. 1952 YOUNG, EDWARD L., a.u. O.P.D. 1912-1914, u. O.P.D. 1914-1919, s. O.P.D. 1919-1927, a.v.s. 1927-1937, v.s. 1937-1946, Bd. of Cons. 1946-1956, Hon. S. 1956β YOUNG, J. HERBERT, a.p. C.M. O.P.D. 1911-1913, p. C.M. O.P.D. 1913-1924, v.p. C.M. 1924-1926, p. to C.M. 1926-1944, Bd. of Cons. 1944-1946 YOUNG, ROBERT Α., psychol. 1935-1942 ZAMECNIK, PAUL C.M., a. in M. 1942-1948, a.p. 1948-1950, assoc. p. 1950-1956, p. 1956ZAUDY, ELEONORE C., a.p. to C.M. 1946-1958, assoc. p. to C.M. 1958ZETZEL, ELIZABETH R., cl. assoc. Psychiat. 1951-1952, a. psychiat. 1952-1956, assoc. psychiat. 1956-1958, psychiat. 1958ZUKOWSKI, HENRY J., a. an. 1948 (6 mos.)
443
APPENDIX
G
'Resident Staff of the ^Massachusetts Çeneral Hospital, 1935—1958 A complete list of Residents, Assistant Residents and Interns for the year 1955 would include 146 names. The following list includes only those who have held the position of Chief Resident or Resident in the various services. A list of all Residents, Assistant Residents and Interns for each year is published in the Annual Report for that year and a cumulative file is kept in Archives. Resident Physicians and Surgeons
1935
Alfred Kranes Kenneth L. Stout Robert S. Schwab E. Murray Burns Leo B. Burgin Benjamin Castleman
M. William H. Snyder D. Norman E. Freeman N. Monica Harnden Snyder Psychiat. Milton S. Thompson C.M. John S. Rhodes Path. J. Maurice Robinson John L. Shaw P.H.
S. S. An. Or. U. Rad.
1936 Alfred O. Ludwig Howard W. Berg Knox H. Finley David A. Young Robert P. Goodkind Edward A. Gall
M. Walter E. Garrey D. Champ Lyons Ν. Julia Arrowood Psychiat. Eugene J. Morrissey C.M. Stanley R. Lowrey Path. J. Maurice Robinson Thomas L. Shipman P.H.
S. S. An. Or. U. Rad.
1937 Neil L. Crone William M. Huber William L. Holt, Jr. Neil T. McDermott Joseph L. Lewis Harvey R. Morrison
M. D. N. Psychiat. C.M. Rad.
444
Edward A. Gall Claude E. Welch Roy B. Cohn Carl C. Corson John L. Shaw Richard R. Owens
Path. S. S. Or. U. P.H.
RESIDENT STAFF,
1938 M. Edwin Hamlin, Jr. D. Carrie E. Chapman N. Louis Goldstein Psychiat. Fred W. Ilfeld C.M. Norman Egei Path. Mark M. Exley S. Harvey R. Morrison J. Kenneth Keeley P.H.
John W. Zeller Walter P. Lever Arthur L. Watkins Sidney B. Maughs Theodore H. Ingalls David Weir J. Vernon Cantlon
A. Thornton Scott Leon F. Ray Raymond D. Adams Milton Rosenbaum George E. Gardner Hugh A. Stout S. Peter Sarris
I935-I958 S. An. Or. Or. Or. U. Rad.
1939 M. D. N. Psychiat. C.M. Path. S. Sam M. Talmadge
Ralph Adams Fiorindo A. Simeone J. Lawrence Campbell H. W. F. Grosselfinger Otto E. Aufranc Howard I. Suby Harvey G. Morrison P.H. & B.M.
S. S. An. Or. Or. U. Rad.
1940 M. D. N. Psychiat. C.M. Path. S.
Richard H. Thompson Spiros P. Sarris Henry L. Heyl J. Lawrence Campbell Parker C. Carson Hilbert S. Sabin Richard C. Batt
S. S. N.S. An. Or. U. Rad.
William W. Beckman Lewis Capland Burton M. Shinners Samuel P. Hunt Edmond Β. Sinclair Marshall De G. Ruffin Howard Ulfelder Eugene R. Sullivan Robert N. Buchanan, Jr. Richard B. Pippitt Bernard Bandler Albert W. Kitts Charles Derrick Howard Ulfelder
1941 M. Gordon A. Donaldson D. Edwin L. Cantlon N. William H. Sweet Psychiat. John W. D. Garrett C.M. Richard D. Nies Path. Walter C. Graham S. Arthur Willetts Otto S ahler Rad.
S. S. N.S. An. An. Or. U.
1942 William Parsons William E. Flood Sedgwick Mead Burness E. Moore Walter R. MacLaren Henry W. Edmonds Gordon A. Donaldson Charles B. Burbank
M. John B. McKittrick D. Donald N. Sweeny, Jr. N. Jack L. Ulmer Psychiat. Raymond M. P. Donaghy C.M. Howard L. Elliott Path. George A. Berkheimer S. Carl E. Horn S. John P. Gens Otto S ahler Rad.
445
S. S. N.S. N.S. An. Or. Or. U.
APPENDIXES Gordon S. Myers Carl S. Sawyer Russell L. Baker George Saslow Wilhelmina M. VanDyke Erna G. Anderson Bernard I. Maisel Donald N. Sweeny, Jr.
1943 M. D. N. Psychiat. C. M. C. M. Path. S.
Francis D. Moore Addison G. Brenizer A. Price Heusner Francis F. Foldes Chung-Chang T a h Neis W. Ahnlund Robert H. Hepburn Clayton H. Hale
S. S. N.S. An. Or. Or. U. Rad.
Janet W. McArthur Frederic B. Mayo Charles H. DuToit Wade Volwiler John J. D'Urso James Solomon James G. Miller Gertrud C. Reyersbach Catherine R. Michie
1944 M. M. M. M. D. N. Psychiat. C.M. Path.
Addison G. Brenizer Dean K. Crystal Nathan D. Munro J. Gordon Scannell Edward W. Shannon Alice M. Bandeian Robert E. Carroll Paulo F. Albuquerque James J. McCort
S. S. S. S. N.S. An. Or. U. Rad.
Wade Volwiler, Chief Res. Arthur S. Spangler George C. Cotzias Avery D. Weisman Elizabeth Conrad John D. Crawford John F. Tannheimer
1945 M. D. N. Psychiat. C.M. C.M. Path.
J. Gordon Scannel Dean K. Crystal Jesse E. Thompson John H. Tucci Grant V. Rodkey Alexander J. Mitchie Emery O. Lewis
S. S. N.S. An. Or. U. Rad.
1946 Robert L. Berg, Chief Res. M. Dean K. Crystal Clito R. Damiani D. Claud E. McGahey Abraham I. Perley D. Charles W. Robertson Huntington Porter N. J. Gordon Scannell James A. Meath N. Wooster P. Giddings Richmond Holder Psychiat. James M. Judd Cecil Muchatt Psychiat. David W. Compton John D. Crawford C.M. David W. Williams J. Peter Kulka Path. Howard A. Hoffman Benjamin Schneider Rad.
S. S. S. S. S. N.S. An. Or. U.
1947 Lewis K. Dahl, Chief Res. M. Abraham I. Perley D. Robert D. Griesemer D. Ralph H. Luikart, Jr. D. James A. Meath N. Gardner C. Quarton N.
J. Peter Kulka Thomas S. Risley Charles W. Robertson Charles G. Mixter, Jr. Bertram Selverstone Marshall R. Urist
446
Path. S. S. S. N.S. Or.
RESIDENT STAFF, LeMoyne White Mary L. Gannnon Harlan I. Firminger
Psychiat. N.P. Path.
1935~1958 Richard S. Rodgers Benjamin Schneider William C. Coles
U. Rad. Rad.
Diane Cross John L. Wilson Francis T. Gephart Ralph Hawkins David Gamsu Raymond F. Kuhlmann David W. Williams William H. Mathis
Path. S. S. N.S. N.S. Or. U. Rad.
1949 Charles H. DuToit, Chief Robert H. Fennell, Jr. Res. M. William V. McDermott Robert D. Griesemer D. William C. Quinby William H. Timberlake N. John W. Raker John C. Nemiah Psychiat. Robinson L. Bidwell, II Gardner C. Quarton Psychiat. Thornton Brown John D. Crawford C.M. Walter S. Kerr, Jr. William R. Eyler Rad.
Path. S. S. S. N.S. Or. U.
1948 John B. Stanbury, Chief Res. Abraham I. Perley Cully A. Cobb, Jr. James C. Skinner Archibald D. Leigh Charles U. Lowe John D. Crawford
M. D. N. Psychiat. Psychiat. C.M. C.M.
1950 Robert L. Berg, Chief Res. M. Roy W. Leeper D. Robert A. Fishman N. Earl G. Solomon Psychiat. Frederic M. Blodgett C.M. Roy V. Buttles Path. William C. Quinby S. William V. McDermott S.
Benson B. Roe John R. Newstedt Richard W. Garrity Thomas J. Quinn, Jr. Bedford F. Boylston Gordon L. Block, Jr. Richard B. Holmes Donald W. S. Stiff
1951 Isaac M. Taylor, Chief Res. M. George L. Nardi Charles S. Keuper D. William R. Waddell Raymond A. Adams N. Richard G. Nilges Laurence J. Barrows N. Louis Bakay Frank R. L. EglofiE Psychiat. Armand L. Bengle Frederic M. Blodgett C.M. Stanley T. Schölt Remedios Κ. Rosales N.P. Robert B. Higgins Winfield S. Morgan, III Path. Frederick W. O'Brien, Jr. Grant E. Colpitis Path. James A. Martin George Christman Dn.
S. S. N.S. An. Or. U. Rad. Rad. S. S. N.S. N.S. An. Or. U. Rad. Rad.
1952 Evan Calkins, Chief Res. John E. LeDonne
M. D.
Falls B. Hershey Robert B. Shaw
447
S. S.
APPENDIXES Laurence J. Barrows Rhett Talbert Peter E. Sifneos Gerald A. Kerrigan Remedios Κ. Rosales Lawrence J. Barrows Grant E. Colpitts
N. Manucher Javid N. John LaF. McClung Psychiat. Morten Smith-Petersen C.M. Lytle D. Atherton N.P. Clifford J. Straehley, Jr. N.P. John L. Sosman Path. Chiu-chen Wang George Christman Dn.
N.S. An. Or. U. U. Rad. Rad.
1953 Morton N. Swartz, Chief Res. M. Leon Reznick D. Rhett Talbert N. Freddy H. Frankel Psychiat. Robert B. Sloane Psychiat. Robert T. Sceery C.M. Stanley Berlow C.M. Lawrence J. Barrows N.P.
Richard B. Cohen Ernest S. Crawford William P. J. Peete Hermes C. Grillo Samuel Brendler Phillips Hallowell Joseph B. Tanner Thomas J. Mathieu Alexander S. MacMillan, Jr.
Path. S. S. S. N.S. An. Or. U. Rad.
1954 Frederick C. Goetz, Chief Res. M. Leon Reznick D. Clare K. Marshall N. Pierre M. Dreyfus N. Frederick E. Whiskin Psychiat. Stanley Berlow C.M. John O. Strom N.P. Gordon D. Lazerte Path. George S. Richardson S.
Ernest S. Crawford Hermes C. Grillo Robert W. Mackie Ernest A. Sneddon Joseph B. Tanner Thomas L. DeLorme Thomas J. Mathieu Frederick G. Shaffer Wilma J. Canada Martin B. Levene
S. S. N.S. An. Or. Or. U. U. Rad. Rad.
Hermes C. Grillo Richard C. Austin Bernard B. Stone James L. Vanderveen Thomas L. DeLorme Frederick G. Shaffer Frederick S. Tomchik Julio Toriello Justin R. Huppe
S. S. N.S. An. Or. U. Rad. Rad. Rad.
Raymond A. Justi Si-Chun Ming Richard C. Austin Paul S. Russell, Jr. Herbert B. Locksley
Path. Path. S. S. N.S.
1955 Richard A. Field, Chief Res. M. Setrag A. Zacarian D. Pierre M. Dreyfus N. Thomas C. Peebles C.M. John O. Strom N.P. Leonard Atkins Path. Charles R. Campbell Path. Si-Chun Ming Path. Robert C. Coe S. 1956 Lloyd Hollingsworth Smith, Jr., Chief Res. M. Alexander B. Timm, Jr. D. Henry deF. Webster N. Philip H. Leiderman Psychiat.
448
RESIDENT STAFF,
I935-I958
Richard B. Kearsley, Chief Norman W. Andrew Res. C.M. Melvin J. Glimcher Thomas J. Whitfield, 3rd., Demetrios A. Papadopoules Chief Res. C.M. Justin R. Huppe Benjamin D. Canias, Jr. Path. James A. Petersen Fleming McConnell Rad.
An. Or. U. Rad. Rad.
1957 Stephen Martin Krane, Chief Res. Ruth Κ. Freinkel Wayne M. Hebertson William E. Karnee Philip H. Leiderman Thomas J. Whitfield, III, Chief Res. Walter C. Cotter
John F. Burke Robb H. Rutledge Federico Mora Donald P. Pederson Frederick S. McAlpine Howard S. Cameron James F. Donovan C.M. Hermann Κ. Schueler N.P. Roy J. Barry Majic S. Potsaid Rad. M. D. N. N. Psychiat.
S. S. N.S. An. An. Or. Or. U. Rad.
1958 John H. Knowles, Chief Res. R. Neal Schneiderman William E. Karnes Egbert H. J. Mueller Gerhard Nellhaus, Chief Res. Clement A. Heibert William H. Hendren, III.
M. D. N. Psychiat. C.M. S. S.
449
Raymond N. Kjellberg Richard L. Rovit Alfred D. Surtess Robert P. Fornshell Douglas G. Tompkins Edward C. Parkhurst William R. Biade Robert S. Richards Richard C. Packert
N.S. N.S. An. Or. Or. U. Rad. Rad. Rad.
APPENDIX
H
çAdministration and Staff, ^hCcJ^ean Hospital, 1935—ig$g Administration — McLean Hospital Superintendent Emeritus
Director Emeritus
Frederic H. Packard, M.D. 1935- * W. Franklin Wood, M.D. 1957-1958 * W. Franklin Wood, M.D. Alfred H. Stanton, M.D.
Director Psychiatrist-in-Chief
1932-1956 1956-
Joseph T. Prekup, R.N., B.S.
Assistant to Director Assistant Director Administrator
1952-1954 1955-1957 1958-
Burton N. Sears, M.H.A. Henry J. Langevin, M.S., M.H.A. Willa F. Pasho, B.S.
Assistant Administrator
1958-
Administrative Assistant Executive Assistant Executive Assistant to Director Executive Assistant Executive Assistant ( administration )
19581953 1954-1955 1956
Chief Clerk Comptroller Steward Steward-Purchasing Agent Purchasing Agent Steward
1949-1951 19521948-1955 1956 19571935-1947
Thomas J. Burley Alexander Armour Alexander Dorey
1957-
Director of Personnel Alison J. Coolidge, M.A. Golda Edinburg, M.S.S.S. Martha M. Norton, M.S.W.
1943-1956
Vera Kilstein, M.A.
Director of Social Service Director of Psychiatric Social Work Supervisor of Psychiatric Social Work
450
19571957 19581958-
STAFF, MCLEAN HOSPITAL, Director of Music
Therapy
Homer Whitford, D. Mus. Director of Occupational Daniel A. Joy, R.N., O.T.R. Frances E. Wood, R.O.T. Elaine S. Pinkham, O.T.R. Supervisor of Physical Thomas A. Crapo, R.N. Supewisory
I935-I959
of Recreational
Ada A. Roth, B.S., Reg. P.T.
1947Therapy 1935-1956 1935-1948 1949Therapy 1957Therapy 1957-
School of Nursing and Nursing
Service
Kathleen H. Atto, R.N., M.A., Superintendent of Nurses and Principal of School of Nursing 1935-1942 (Leave of absence 1943-1944) Margaret C. Tibbetts, R.N., B.S., Assistant Principal of School of Nursing 1938-1940; Assistant Superintendent of Nurses 1941; Acting Superintendent of Nurses and Principal of School of Nursing 1942-1944; Director of School of Nursing and Nursing Service 1 9 4 5 Ann B. Connor, R.N., Assistant Director, Nursing Service 1947-1956; Executive Assistant (Admissions) 1957-1958 George B. Durham, R.N., A.A., Th.M., B.S., Assistant Director, Nursing Service 1952-1958 Leon I. Gintzig, R.N., B.S., Assistant Director, School of Nursing 1947-
1948
Harold Hayford, R.N., Assistant Director, Nursing Service 1946-1951 Eleanor R. Kinney, R.N., Assistant Principal, School of Nursing 1941 Daniel H. Lennox, R.N., B.S., Assistant Director, Nursing Service 1 9 5 7 Clara L. Maddocks, R.N., Assistant Superintendent of Nurses 1935-1940; Assistant to the Director 1 9 4 1 - 1 9 4 2 Mildred C. Makin, R.N., B.S., M.S., Assistant Director, School of Nursing 1949Robert J. Robertson, R.N., B.S., Assistant Director, Nursing Service 1958Gertrude N. Shea, R.N., B.S., Assistant Director, Nursing Service 1946 Horace C. Smith, R.N., Assistant Superintendent of Nurses 1936-1944; Assistant Director, Nursing Service 1945 Estella Sowa, R.N., Assistant Director, School of Nursing and Nursing Service 1946 Lois J. Walworth, R.N., A.B., Assistant Superintendent of Nurses (acting) 1942-1944; Principal, School of Nursing (acting) 1942-1944; Assistant Director, School of Nursing and Nursing Service 1945 451
APPENDIXES
Librarians Patients' Library Elizabeth W. Reed Isobel M. Collins Eleanor C. Bent, M.A. Judith R. Atwood, A.B.
1935-1937 1938-1947 1951 1952-1954
Ruth K. Church Arianne S. Kassuf Jean R. Schroeder Nannie H. Tuli
1955 1956-1957 1957-1958 1959-
Mary R. Strovink Jean R. Poor
Medical Records Librarian Medical Records Librarian
1956-1957 1959-
Hector Bossange, M.A.
Medical Librarian
1958-
Pharmacists Charles O. McCullom Carl A. MacDonald
1935-1939 1940-1944; 1946
Waldo Flint 1945 George R. Zager, M.S. 1947-
Staff of the McLean Hospital Abbreviations act. : acting an.: anesthetist anthr.: anthropologist assoc.: associate asst.: assistant attend.: attending biochem. : biochemist c.: chief cardiol.: cardiologist Chem.: Chemical Clin., clin.: Clinic, clinical cons.: consultant Diag.: Diagnostic dir. : director dn. s.: dental surgeon f.: fellow int.: internist Int. M.: Internal Medicine Lab: Laboratories M.: Medicine n.: neurologist
n.p.: neuropathologist N.P.: Neuropathology p.i.c.: psychiatrist-in-chief Phys. M.: Physical Medicine physiol.: physiologist Physiol.: Physiology psychiat.: psychiatrist Psychiat.: Psychiatry psychol.: psychologist r.: resident Res., res.: research roent. : roentgenologist s.: surgeon Sc., sc.: scientific Serv.: Services soc. anthr.: social anthropologist Soc. Anthr.: Social Anthropology sociol.: sociologist sr.: senior V., v.: visiting e : Deceased
* ABBOT, E. STANLEY, M.D., psychiat. cons. 1936-1957 ADAMS, ROBERT S., M.D., clin. asst. in Psychiat. 1957ADLER, MORRIS H., M.D., attend, psychiat. 1957A L L E N , NORMAN J., M.D., res. f. in N.P. 1955 A L T S C H U L E , MARK D., M.D., int.-cons. 1945-1946, dir. Int. M. and Res. in Clin. Physiol. 1947ANTHONISEN, NIELS L., M.D., sr. p. 1935-1936
452
STAFF, MCLEAN HOSPITAL,
I935-I959
AYER, JAMES Β., M.D., n.-cons. 1936BAIRD, PERRY C., JR., M.D., r.p. 1940, res. f. 1940-1941 BALL, ROBERT E., M.D., r. psychiat. 1958BARTLETT, GEORGE O., D.M.D., dn. s. 1935-1945 BEAMAN, G. BURNHAM, JR., M.D., r.p. 1935 BEUSCHER, RUTH B., M.D., r. in Psychiat. 1953-1954, asst. psychiat. 1955, clin. asst. in Psychiat. 1958— BEUSCHER, WILLIAM F., M.D., r. in Psychiat. 1953-1954, asst. psychiat. 1955 BISGROVE, JOHN G., M.D., asst. in Phys. M. 1958BOGOCH, SAMUEL, M.D., asst. r. in Psychiat. 1953, sc. res. asst. 1954, asst. biochem. 1955 BOWER, WILLIS H., M.D., r. psychiat. 1947, c. Women's Serv. 1948-1950, psychiat. 1951-1957, assoc. psychiat. 1958BROWN, F. HAROLD, M.D., an. (act.) 1957CAIN, ARTHUR J., M.D., asst. in Psychiat. 1954, asst. psychiat. 1955CALKINS, VIRGINIA B., M.D., clin. asst. 1954, clin. asst. in Med. 1955* CAMPBELL, C. MACFIE, M.D., psychiat.-cons. 1936-1942 * CANNON, WALTER B„ M.D., physiol.-cons. 1936-1944 CAPLAN, LLOYD M., M.D., r. psychiat. 1958CARTER, FRANKLIN, M.D., r.p. 1946-1947, sr. r. 1948 CHALPIN, GEORGE, M.D., clin. asst. in Psychiat. 1958CHAMBERLIN, DOROTHY B., M.D., asst. in Psychiat. 1952-1953, asst. psychiat. 1954 CHASEN, MIGNON C., M.D., clin. asst. in Psychiat. 1957, asst. attend, psychiat. 1958CHITTICK, RUPERT Α., M.D., sr. p. 1936-1939, c. Women's Serv. 19401943 CHRIST, JACOB, M.D., clin. asst. in Psychiat. 1956-1957, asst. psychiat. 1958CLARK, JOHN G., JR., M.D., asst. in Psychiat. 1955, r. psychiat. 19561957, clin. asst. in Psychiat. 1958CLINE, HERBERT S., M.D., clin. asst. in Psychiat. 1957, asst. attend. psychiat. 1958β CLYMER, GEORGE, M.D., n.-cons. 1936-1954 COBB, STANLEY, M.D., psychiat.-cons. 1936COLES, MARTIN R., M.D., r. psychiat. 1956-1957 COSER, ROSE L., Ph.D., assoc. sociol. 1958CROWELL, WILLIAM M., M.D., asst. in Psychiat. 1952-1953, asst. psychiat. 1954 CUMMER, FREDERICK H., JR., M.D., r.p. 1947-1948, sr. r. 1949-1950 CUTLER, RICHARD E., M.D., clin. asst. in Psychiat. 1958DANIELS, EDWARD M., M.D., psychiat. 1956-1957, assoc. psychiat. 1958DANIELS, HADASSAH, M.D., asst. attend, psychiat. 1958d'AUTREMONT, CHESTER, M.D., asst. attend, psychiat. 1958DAVIDSON, EDWIN M., M.D., clin. asst. in Psychiat. 1958DAVIS, HALLOWELL, M.D., physiol.-cons. 1939-1944
453
APPENDIXES
DAVIS, PAULINE, M.A., res. f. 1939-1941 DAWES, DANIEL C., M.D., sr. p. 1938-1944 DAWSON, CHARLES B., M.S., asst. psychol. 1958de MARNEFFE, FRANCIS L.A., M.D., asst. in Psychiat. 1953, asst. psychiat. 1954, assoc. psychiat. 1955-1957, asst. psychiat. 1958DONAGHY, R.M. PEARDON, M.D., r.p. 1940 DREYFUS, PIERRE M., M.D., res. f. in N.P. 1957β DRINKER, CECIL K., M.D., clin, physiol.-cons. 1943-1947 DWYER, JOHN J., M.D., r. psychiat. 1956-1957, clin. f. in Psychiat. 1958EICHORN, MARY, M.D., asst. psychiat. 1950-1951 ELDRED, STANLEY H., M.D., assoc. psychiat. 1958FLEMING, ROBERT E., M.D., res. f. 1936-1938 FOLCH-PI, JORDI, M.D., dir. Sc. Res. 1944GAITONDE, MUDLAGIRI K., Ph.D., asst. biochem. 1958GARDNER, GEORGE E., Ph.D., M.D., psychol. 1935-1942 GATES, PHILLIP H., M.D., r.p. 1941-1944 GAUTHIER, JACQUELINE, M.D., r. psychiat. 1957GOLDEN, LEWIS Α., M.D., r.p. 1935 GURD, BARBARA C., M.D., r. psychiat. 1958GUY, WILLIAM Η., M.A., asst. psychol. 1948-1949 HALL, THOMAS C., M.D., clin. asst. in M. 1956HALL, WILLIAM Α., M.D., clin. asst. in M. 1958HALLENBECK, DORR F., JR., M.D., r.p. 1946, sr. r. 1947-1949, psychiat. 1950-1952, asst. psychiat. 1958HANELIN, JOSEPH, M.D., roent. 1950-1956 HARTY, JOHN E., M.D., r.p. 1938-1939 HAUSER, GEORGE P., Ph.D., asst. biochem. 1958HAVEN, GILMAN W., D.D.S., dn. s. 1946HAYCOX, JAMES Α., M.D., asst. psychiat. 1955HERSEY, FRANCIS C., M.D., asst. attend, psychiat. 1958HESS, HELEN H., M.D., sc. res. f. 1952-1953, sc. res. asst. 1954, asst. η ·Ρ· 1955-1957, assoc. n.p. 1958HOGARTY, JOHN, M.A., asst. psychol. 1951-1952 HOLLISTER, NATHANIEL R., M.D., r.p. 1940 HORWITZ, WILLIAM H., M.D., r.p. 1949, asst. in Psychiat. 1950-1951, asst. psychiat. 1952, Clin. p. 1953 HOWARD, PAUL M., r.p. 1937-1939, sr. p. 1940-1943, c. Men's Serv. 1944-1946, c. Women's Serv. 1947, act. c. psychiat. 1948-1949, c. of Serv. (act.) 1950-1955, assoc. p.i.c. 195&JACKSON, LEE, M.D., r. psychiat. 1957JESSNER, LUCIE N., M.D., r.p. 1938-1939 JOSSMAN, PAUL B., M.D., sr. p. 1946, c. Men's Serv. 1947 KAHANA, EDA M., M.D., r. psychiat. 1956, clin. f. in Psychiat. 1958KAHNE, MERTON J., M.D., psychiat. 1956-1957, assoc. psychiat. 1958KAUFMAN, M. RALPH, M.D., res. f. 1937-1939 KERSHAW, BEATRICE R., M.D., r.p. 1938-1939, sr. p. 1940 KRAUS, P. STEFAN, M.D., assoc. attend, psychiat. 1958LAMONT, JOHN HOPKINS, M.D., sr. r. 1949, assoc. psychiat. 1950-1952 ¡LAZARUS, HERBERT R., M.D., r. psychiat. 1958-
454
STAFF, MCLEAN HOSPITAL,
1935-1959
LeBARON, FRANCIS N., Ph.D., sc. res. f. 1952, sc. res. asst. 1953-1954, asst. biochem. 1955-1957, assoc. biochem. 1958LEES, MARJORIE B., Ph.D., sc. res. f. 1952-1953, sc. res. asst. 1954, asst. biochem. 1955-1957, assoc. biochem. 1958LINDEMANN, ERICH, M.D., psychiat. 1956LINGLEY, JAMES R., M.D., roent. 1935-1945 LORENZ, MARIA, M.D., r.p. 1946-1947, c. Men's Serv. 1948-1950, psychiat. 1952-1957, assoc. psychiat. 1958LUDWIG, ALFRED O., M.D., r.p. 1936 LYFTON, WILLIAM B., M.D., r.p. 1936 LYNN, JOHN G., M.D., r.p. 1935, res. f. 1936 MAGRAW, CHARLES E., M.D., assoc. attend, psychiat. 1957, asst. attend. psychiat. 1958MASON, EDWARD Α., M.D., r.p. 1945 McDERMOTT, NEIL T., M.D., r.p. 1935 McGINN, SYLVESTER, M.D., cardiol.-v. 1938-1944 McKENNA, JOHN B., M.D., sr. p. 1935 MEATH, JAMES Α., M.D., sc. res. asst. 1952-1953 MITTEL, NEUMAN S., M.D., r. psychiat. 1957* MIXTER, WILLIAM JASON, M.D., s.-cons. 1936-1958 MOGUL, SAMUEL L., M.D., clin. asst. in psychiat. 1958MUELLER, EGBERT H., M.D., r.-psychiat. 1958MURPHY, RUTH M., M.D., clin. f. in psychiat. 1956MURPHY, WILLIAM F., M.D., attend, psychiat. 1957MUSGRAVE, RHODA, M.D., sr. p. 1935-1936 β MYERSON, ABRAHAM, M.D., psychiat.-cons. 1938-1947 NEVILLE, CHARLES W., M.D., r. psychiat. 1957PARSONS, ANNE, Ph.D., asst. sociol. 1957, asst. soc. anthr. 1958PAVENSTEDT, ELEANOR, M.D., res. f. 1937-1939 PELTZ, WILLIAM L., M.D., r.p. 1937 PERRIN, GEORGE M., M.D., clin. asst. in M. 1956PERRY, JALNA, M.D., r. psychiat. 1957PERRY, JOHN WEIR, M.D., r.p. 1946 PIER, ARTHUR S., JR., M.D., int.-cons. 1945-1946 PIERCE, IRENE R., Ph.D., psychol. 1935-1955, c. psychol. 1956POPE, ALFRED, M.D., sc. res. assoc. in N.P. 1946-1954, assoc. n.p. 1955, n.p. 1956PORTER, HUNTINGTON, M.D., sc. res. asst. 1952-1954, asst. biochem. 1955-1956 POTSAID, MAJIC S., M.D., roent. 1958QUARTON, GARDNER C., M.D., sr. r. 1949-1950 RAPOPORT, ROBERT N., Ph.D., assoc. soc. 1957, assoc. anthr. 1958RICE, JACK O., M.D., r. psychiat. 1958β RICHARDSON, WYMAN, M.D., int.-v. 1935-1941, int.-cons. 1942-1952 ROBBINS, LAURENCE L., M.D., roent. 1943-1945 ROBINS, ELI, M.D., r.p. 1945 ROBINSON, PHELPS M., M.D., r. psychiat. 1958ROSENBAUM, MILTON, M.D., r.p. 1936 SACK, THEODORE, M.D., r. psychiat. 1957, clin. f. in Psychiat. 1958-
455
APPENDIXES
SCHNITZER, ROBERT D., M.S., asst. psychol. 1958SEMRAD, ELVIN, M.D., r.p. 1937 SHARPE, J. DOUGLASS, M.D., r.p. 1948-1949, sr. r. 1950, assoc. psychiat. 1951-1957 SHERMAN, LEWIS, Ph.D., assoc. psychol. 1958SHINNERS, BURTON M., M.D., r.p. 1940 SIFNEOS, PETER E., M.D., r.p. 1949, asst. psychiat. 1950-1952, assoc. psychiat. 1953-1955 SILVERMAN, SAMUEL, M.D., attend, psychiat. 1957SLOANE-STANLEY, GERALD H., M.D., sc. res. asst. 1954, res. f. in biochem. 1955 SMITH, WILLIAM DAVID, M.D., int.-cons. 1936-1949 SOLOMON, HARRY C., M.D., psychiat.-cons. 1936SPENCER, KATHERINE, Ph.D., res. assoc. in Soc. Anthr. 1958STALVEY, HAROLD D., M.D., clin. asst. in Psychiat. 1957, asst. attend, psychiat. 1958STONE, ALAN Α., M.D., r. psychiat. 1956-1957, clin. f. in Psychiat. 1958STOTZ, ELMER H., Ph.D., Supervisor of Lab. 1938-1941, dir. Chem. Lab. 1942 β SULZBACH, WOLFGANG, M.D., r.p. 1937-1940, sr. p. 1941, c. Diag. Lab. 1942-1944 SUTHERLAND, GEORGE F., M.D., r.p. 1940 SWINSON, MILDRED Ε., M.A., asst. psychol. 1957TEMBY, WILLIAM D., M.D., asst. attend, psychiat. 1958THOMPSON, JOHN H., M.D., res. f. 1936 TILLOTSON, KENNETH J., M.D., p.i.c. 1935-1947 TOMPKINS, JOHN BUTLER, M.D., r.p. 1935-1937, sr. p. 1938-1940, c. Men's Serv. 1941-1943, c. Women's Serv. 1944-1946 TUCKER, WALTER I., M.D., r.p. 1941-1944 VANDERPOL, MAURICE, M.D., asst. psychiat. 1957VARNEY, HEWITT I., M.D., r.p. 1936-1937 VERNON, J. TAYLOR, M.D., sr. r. 1949, assoc. psychiat. 1950-1951 VIETS, HENRY R., M.D., n.-cons. 1936-1949 WALDFOGEL, SAMUEL, Ph.D., psychol. 1949-1952 WALTER, MARK M., JR., M.D., asst. in Psychiat. 1955, r. psychiat. 19561957, asst. psychiat. 1958WASHBURN, STEPHEN L., M.D., r. psychiat. 1956-1957, asst. psychiat. 1958WEBSTER, GEOFFREY R., M.D., res. f. in Biochem. 1958WEIS, RUTH S., M.D., asst. in psychiat. 1954, asst. psychiat. 1955 WERMER, HENRY, M.D., attend, psychiat. 1957WHISKIN, FREDERICK E., M.D., r.p. 1949, asst. in psychiat. 1950-1951, asst. attend, psychiat. 1958WHITE, PAUL DUDLEY, M.D., cardiol.-cons. 1945WHITEHORN, JOHN C., M.D., dir. Lab. 1935-1937 WHITNEY, RAY L., M.D., sr. p. 1943-1946 WIES, DAVID, M.D., r.p. 1937-1940, sr. p. 1941-1942 WIMBERGER, HERBERT C., M.D., r. psychiat. 1957-
456
STAFF, MCLEAN HOSPITAL,
I935-I959
W I N C H E L L , GORDON D., M.D., clin. asst. 1954, clin. asst. in M. 1 9 5 5 1958 W Y A T T , FREDERICK, Ph.D., psychol. 1 9 4 4 - 1 9 4 7 WYMAN, S T A N L E Y M., M.D., roent. 1946-1949 YOUNG, DAVID Α., M.D., sr. p. 1 9 3 6 - 1 9 3 9 , c. Men's Serv. 1940 ZARSKY, E D W A R D L., M.D., clin. asst. in Psychiat. 1957, asst. attend. psychiat. 1 9 5 8 Z E T Z E L , E L I Z A B E T H R., M.D., psychiat. 1 9 5 8 ZINBERG, NORMAN E., M.D., assoc. attend, psychiat. 1 9 5 8 -
457
APPENDIX
I
Honor cI(oll A complete Honor Roll of all doctors, nurses, and employees of the General Hospital in Boston who served with the armed forces during World War II hangs on the wall of the lobby of the George Robert White Memorial Building, and a similar Honor Roll for the staff and personnel of the McLean Hospital has been placed in Pierce Hall, the administration building, in Waverley. The following gave their lives in service Robert S. Hurlbut, M.D. Meinolph V. Kappius, M.D. Theodore P. Robie, M.D. Edward L. Young, III, M.D. Louis J. Annunciata, Jr. Joseph Comeau, Orderly Leonard Feingold Daniel A. Joy, Jr. Raymond LeMoine, Orderly John F. Moriaty, R.N. Herbert W. Small, R.N.
East Surgical 1939 Assistant Obstetrician East Surgical 1943 West Surgical 1939 Maintenance, McLean Baker Memorial Pharmacy Maintenance, McLean Baker Memorial McLean McLean
458
APPENDIX
J
Qitations Massachusetts General Hospital Staff Col. F. Dennette Adams, Medical Staff, LEGION OF MERIT Maj. John C. Angley, Medical Staff, BRONZE STAR MEDAL Maj. Otto E. Aufranc, Orthopedic Staff, BRONZE STAR MEDAL Capt. Franklin G. Balch, Jr., Board of Consultation, BRONZE STAR MEDAL Josephine Barbour, Chief of Social Service, MEDAL OF FREEDOM Lt. Col. Marshall K. Bartlett, Surgical Staff, BRONZE STAR MEDAL Lt. Col. Henry K. Beecher, Surgical Staff, LEGION OF MERIT Lt. Col. Edward F. Bland, Medical Staff, BRONZE STAR MEDAL Lt. Peter Brooks (East Surgical 1943) CITATION — COMMENDATION RIBBON Maj. Leo E. Bürgin, Children's Medical Staff, BRONZE STAR MEDAL, CROIX de GUERRE of France Maj. Charles Burnett (Chief Resident Physician 1946) BRONZE STAR MEDAL Lt. Col. Bradford Cannon, Surgical Staff, LEGION OF MERIT Col. Edward D. Churchill, Chief of Surgical Staff, DISTINGUISHED SERVICE MEDAL, COMMANDER ORDER OF THE CROWN OF ITALY, LEGION OF MERIT, HONORARY OFFICER OF THE MILITARY DIVISION OF THE MOST EXCELLENT ORDER OF THE BRITISH EMPIRE, WAR MEDAL OF BRAZIL Lt. Col. Milton H. Clifford, Medical Staff, BRONZE STAR MEDAL Col. Richard Collins (East Surgical 1933) LEGION OF MERIT, CROIX de GUERRE WITH PALM of France, OFFICER OF THE ORDER OF THE BRITISH EMPIRE (OBE) Cpl. Malcolm A. Connor, Employee, CERTIFICATE OF MERIT Capt. Daniel S. Ellis (East Medical 1941) BRONZE STAR MEDAL Capt. John R. Frazee, Surgical Staff, BRONZE STAR MEDAL Capt. F. Thomas Gephart (West Surgical 1941) SILVER STAR Lt. Frederick C. Gevalt, Jr. (Assistant Resident Surgeon 1943) BRONZE STAR MEDAL Ph.M. USN ist Class Martin J. Gilbride (Orderly at Baker), CITATION Col. Thomas R. Goethals, Obstetrical Staff, LEGION OF MERIT Maj. James A. Halsted (West Medical 1932) LEGION OF MERIT Lt. Irad B. Hardy (East Surgical 1939) NAVY AND MARINE CORPS MEDAL, BRONZE STAR MEDAL
459
APPENDIXES
Maj. Daniel J. Holland, Jr., Dental Service, BRONZE STAR MEDAL, ORDER OF THE CROWN of Italy Capt. Robert S. Hormell (Orderly 1942), COMMENDATION Col. Donald S. King, Medical Staff, LEGION OF MERIT Maj. Wyland F. Leadbetter, Chief of Urological Service, BRONZE STAR MEDAL Lt. Col. James R. Lingley, Radiologist, BRONZE STAR MEDAL Maj. Champ Lyons (West Surgical 1933), LEGION OF MERIT Maj. George A. Marks, Surgical Staff, LEGION OF MERIT Maj. Charles G. Mixter, Jr., Surgical Staff, AIR MEDAL with 2 BRONZE OAK LEAF CLUSTERS; PRESIDENTIAL UNIT CITATION Lt. Col. Langdon Parsons, Surgical Staff, LEGION OF MERIT Lt. Oglesby Paul, Medical Staff, CITATION — COMMENDATION RIBBON Lt. Col. Frederick E. Poulin, Dental Service, BRONZE STAR MEDAL Lt. Comdr. Theodore C. Pratt, Surgical Staff, NAVY CROSS Capt. Richard V. Riddell, Surgical Staff, BRONZE STAR MEDAL Capt. Theodore Robie, Surgical Staff, SILVER STAR (posthumous) Col. Horatio Rogers, Surgical Staff, LEGION OF MERIT Capt. Herman D. Scamey, Eye and Ear Staff, BRONZE STAR MEDAL Lt. Col. Charles P. Sheldon, Obstetrical Staff, BRONZE STAR MEDAL, LEGION OF MERIT Maj. Charles L. Short (West Medical 1930), BRONZE STAR MEDAL Lt. Col. Fiorindo A. Simeone (West Surgical 1936), LEGION OF MERIT Capt. Robert P. Smith (Resident Physician 1943), PRESIDENTIAL UNIT CITATION Maj. Lamar Soutter (East Surgical 1941), SILVER STAR Capt. Somers H. Sturgis (East Surgical 1933), BRONZE STAR MEDAL Maj. Howard I. Suby, Urological Service, BRONZE STAR MEDAL Lt. Col. Eugene R. Sullivan (Pathological Service 1937) LEGION OF MERIT T/sgt. Ronald W. Sweeney, Employee, BRONZE STAR MEDAL Lt. Col. Grantley W. Taylor, Surgical Staff, BRONZE STAR MEDAL Maj. William T. S. Thomdike (West Surgical 1923), COMMENDATION Lt. Col. Edward G. Thorp (East Medical 1931), BRONZE STAR MEDAL Lt. Comdr. Maurice M. Tolman, Dermatological Staff, COMMENDATION Lt. Comdr. John L. Ward (East Medical 1935), COMMENDATION Lt. Col. Claude E. Welch, Surgical Staff, COMMENDATION Lt. Arthur T. Willetts (Urological Service 1942), SILVER STAR MEDAL Capt. Stanley M. Wyman (Resident Radiology 1942), BRONZE STAR MEDAL CITATIONS
Graduates and former Staff Members Lt. Comdr. Richard E. Alt (West Surgical 1933), BRONZE STAR MEDAL Capt. Rafe Banks (East Surgical 1943), PRESIDENTIAL UNIT CITATION Capt. Lemuel Bowden (East Surgical 1940), LEGION OF MERIT
460
CITATIONS Maj. Richard B. Capps (Children's Medical 1 9 3 1 ; East Medical 1 9 3 3 ) , BRONZE STAR M E D A L Brig. Gen. Elliott Cutler (Resident Surgeon 1 9 1 5 ) , CROIX de G U E R R E of France, D I S T I N G U I S H E D S E R V I C E M E D A L P L U S OAK L E A F CLUSTER Capt. William E. Eaton (Dermatological Service 1 9 0 7 ) , L E G I O N O F MERIT ° Capt. Hilton H. Fowler, Reserve Corps — Medical Supply Officer, B R O N Z E STAR M E D A L Lt. Col. Norman E. Freeman (Resident Surgeon, West Surgical 1 9 3 5 ) , COMMENDATION Lt. Col. Harold H. Hamilton (Resident Surgeon 1 9 3 2 ) , B R O N Z E S T A R MEDAL Maj. James Keeley (Resident Surgeon 1 9 3 7 ) , B R O N Z E S T A R M E D A L Col. Thomas H. Lanman (East Surgical 1 9 1 8 ) , 2 C O M M E N D A T I O N S , LEGION OF MERIT Lt. Col. Donald McNeil (Orthopedic Staff 1930), B R O N Z E STAR M E D A L Comdr. E. Ross Mintz (Resident Surgeon, Urological Staff 1 9 3 2 ) , B R O N Z E STAR M E D A L Maj. Merrill Moore (Graduate Assistant in Neurology 1 9 3 3 - 1 9 3 4 ) , B R O N Z E S T A R M E D A L . Y E N HUI S P E C I A L C L A S S of China Lt. Col. Robert L. Patterson, Jr. (Orderly 1 9 3 5 ) , L E G I O N O F M E R I T Lt. Col. Milton S. Thompson (Orderly 1 9 3 4 ) , B R O N Z E S T A R M E D A L " Capt. William S. Worthy, Reserve Corps Detachment Commander, BRONZE S T A R M E D A L β
Member 6th General Hospital only.
461
APPENDIX
Κ
JÇetters Headquarters Mediterranean Theatre of Operations United States Army October 16, 1945. AG 201./034-P Subject: Commendation To: The Chairman of the Board of Trustees Massachusetts General Hospital, Boston, Mass. With the inactivation of the Sixth General Hospital, after long overseas service in this command, it is fitting to extend to the Board of Trustees and the Staff of the Massachusetts General Hospital appreciation and commendation of this unit. Established at Casablanca in the early phases of the North African Campaign the Sixth General Hospital formed the nucleus of medical service in Atlantic Base Section, North Africa Theatre of Operations. The busy period at Rome and the subsequent establishment at Bologna continued to demonstrate the high standards of professional work maintained by its competent officers. Credit is reflected on the officers and nurses of the Sixth General Hospital as individuals; the unit as a whole has brought great credit to the Massachusetts General Hospital. Joseph T. McNarney General USA Commanding. The Rt. Rev. Henry K. Sherrill Chairman, Board of Trustees Massachusetts General Hospital Boston, Massachusetts Dear Bishop Sherrill: It is indeed a great pleasure to salute the Massachusetts General Hospital on the occasion of this outstanding anniversary of the first public demonstration of the use of ether in surgery which took place at your hospital one hundred years ago this time. Many of the staff of the hospital served under my command of A.F. H.Q. in Italy with distinction. The work of the Sixth General Hospital in World War II in the cause of relieving suffering and assisting in the war effort reminds us all of the past, of the
462
LETTERS Massachusetts General Hospital in World War I, when previously the Sixth Base Hospital did such splendid work on the Western Front. It gives me great pleasure to send the heartiest greetings and to wish all my friends who are now back at their peacetime jobs best wishes and congratulations. Sincerely yours, Alexander of Tunis. The White House Washington. September 21, 1946. Dear Bishop Sherrill: It gives me great pleasure to extend to you greetings on the one hundredth anniversary of the first public demonstration of the use of ether which took place at the Massachusetts General Hospital on October 16, 1846. It is a significant occasion not only for the immediate results of the demonstration which took place in your Bulfinch Building on that date, but also as it was the opening event in one hundred years of research at the Massachusetts General Hospital. The Surgeon General of the Army and the Director of the Office of Scientific Research and Development have both congratulated the Massachusetts General Hospital on the effective assistance which you gave in the war effort. As in war, so in peace, the people of this country can count on institutions like the Massachusetts General Hospital to pioneer to achieve results in curing the ills of mortal flesh. Again let me extend my heartiest congratulations to you and other members of the Board of Trustees, the Staff of the Hospital, and the whole hospital community. Very sincerely yours, Harry Truman. THE CHIEF OF STAFF Washington Dear Dr. Faxon: I welcome this opportunity to extend greetings to the Massachusetts General Hospital on the occasion of the 100th Anniversary of the first public ether operation. That significant advancement in the field of surgery established a great tradition of medical research which has continued with remarkable results throughout the century. The Sixth General Hospital, which served with distinction under my command in North Africa and Sicily, was staffed by the Massachusetts General Hospital. I am sure the comradeship, born in the war years, will be a source of lasting satisfaction to the men and women of your famous hospital and will perpetuate a feeling of unity and forward the advancement of your great profession. Sincerely, Dwight D. Eisenhower.
463
APPENDIX
L
c\An Old To incorporate certain persons by the name of the Massachusetts General Hospital. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Sect. ι . BE it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, That James Bowdoin, Christopher Gore, Samuel Brown, James Perkins, Isaac Parker, Thomas Dawes, George Cabot, David Tilden, John Lowell, Thomas Handesyde Perkins, Thomas C. Amory, Benjamin Bussey, Joseph Coolidge, Elias Haskett Derby, John C. Jones, Joseph Hall, Jonathan Davis, William Phillips, Arnold Welles, Jonathan Amory, Robert Hallowell, Andrew Craigie, William Payne, John Warren, Richard Sullivan, and Henderson Inches, together with such other persons as may hereafter be admitted members of the Corporation herein after created, according to the Bye Laws thereof, be, and they hereby are, incorporated and made a Body Corporate and Politick, by the name of the Massachusetts General Hospital, and by that name may sue and be sued, and shall have and use a common seal, to be by them devised, altered and renewed at their pleasure. [February 25, 1811.]
464
Notes
NOTES Looking Backward ι . Leonard Κ. Eaton, New England Hospitals, 1790-1933 (Ann Arbor, i957)> P· 55· 2. Joseph Garland, M.D., "The Story of a Hospital. The Massachusetts General and the Medical School," Harvard Alumni Bulletin, 48:762 (July 6, 1946). Acknowledgment is also made to [Henry R. Viets, M.D.], "The Hospital Tradition in New England," editorial in New England Journal of Medicine, 257:783 (October 17, 1957). 3. Frederic A. Washburn, M.D., The Massachusetts General Hospital. Its Development 1920-1935 (Boston, 1939) p. 356. (This book is hereafter referred to as "Washburn, History.") 1937 1. Washburn, History, p. 40. 2. Report of the Trustees, Annual Report (1937), p. 8. 3. Minutes of the Trustees, May 28, 1937, p. 200. 193S 1. Report of the Trustees, Annual Report (1938), p. 7. 2. Report of the Director, Annual Report (1938), p. 1 1 . 3. Minutes of the Trustees, March 25, 1938, p. 61. 4. Report of the Trustees, Annual Report (1938), p. 8. 1939 1. Report of the Trustees, Annual Report (1939), p. 7. 2. Report of the Director, Annual Report (1939), p. 13. 3. Report of the General Executive Committee, Annual Report p. 32.
(1939),
1940 1. Report of the Trustees, Annual Report (1940), pp. 5-6. 1941 1. Report of the Director, Annual Report ( 1 9 4 1 ) , pp. 1 1 - 1 3 . 2. Report of the General Executive Committee, Annual Report Ρ- 29· 1942 1. Report of the Trustees, Annual Report (1942), pp. 28-32.
467
(1941),
APPENDIXES
1943 χ. Report of the Director, Annual Report (1943), p. 30. 2. Report of the Dietary Department, Annual Report (1943), p. 85. 1944 1. Report 2. Report p. 44. 3. Report 4. Report
of the Trustees, Annual Report (1944), pp. 27-28. of the General Executive Committee, Annual Report (1943), of the Director, Annual Report (1944), pp. 32-34. of the Director, Annual Report (1944), p. 36.
1945 1. Report of the Director, Annual Report (1945), p. 34. 1946 1. Report of the Director, Annual Report (1946), pp. 41-42. 2. Minutes of the Trustees (1946), p. 64. 3. Report of the Director, Annual Report (1946), p. 37. 1948 1. Minutes of the Trustees, March 26, 1948, p. 53. 2. Report of the School of Nursing, Annual Report (1948), p. 89. 3. From a letter to the author, dated November 25, 1958, from Mr. Ralph Lowell. 4. Nathaniel W. Faxon, ed., The Hospital in Contemporary Life (Cambridge, Mass., 1949). 1949 1. Report of the Trustees, Annual Report (1949), p. 33. 2. Massachusetts General Hospital News, 85:1 (December 1949). 1950 1. Report of the Director, Annual Report (1950), pp. 39-41. 2. Report of the Director of Nursing, Annual Report (1950), p. 80. 1951 1. Report 2. Report 3. Report p. 48. 4. Report
of the Trustees, Annual Report (1951), p. 34. of the Committee on Research, Annual Report (1951), p. 49. of the General Executive Committee, Annual Report (1951), of the Trustees, Annual Report (1951), p. 36.
1952 1. Report of the Chief of Social Service, Annual Report (1952), p. 96. 1953 1. Report of the Nursing Department, Annual Report (1953), pp. 85-86.
468
NOTES 1954 1. Report of the General Executive Committee, Annual Report p. 48. 2. Ibid., p. 51. 3. Report of the Trustees, Annual Report (1954), p. 37. 4. Report of the Director, Annual Report (1954), pp. 40-41.
(1954),
Postscript 1. Report of the General Director, Annual Report (1956), p. 40. Notes, Part II 1. The Massachusetts
General
Hospital
1. Annual Reports, 1821-1955. 2. H. I. Bowditch, History of the Massachusetts General Hospital 1810ι8γζ (Boston, 1872). p. 203. 3. Grace Whiting Myers, History of the Massachusetts General Hospital 1872-iQoo (Boston, 1929), p. 69. 4. This and the preceding two quotations are from Washburn, History, pp. 48, 49, 50. 5. Report of the Director, Annual Report (1939), pp. 17-23. 6. Report of the Director, Annual Report (1936), p. 19. 7. Report of the Director, Annual Report (1939), pp. 1 2 - 1 3 . 8. Report of the Trustees, Annual Report (1938), p. 7. 9. Report of the Director, Annual Report (1946), pp. 41-42. 10. Report of Out-Patient Committee to General Executive Committee Nov. 21, 1946, p. 2. 2. The McLean Hospital in Waverley 1. Washburn, History, p. 268. 2. Report of the Psychiatrist-in-Chief (McLean Hospital), Annual Report (1940), p. 173. 3. Report of the Clinical Service (McLean Hospital), Annual Report ( 1 9 5 4 ) . pp· 198-199· 4. Report of the Psychiatrist-in-Chief (McLean Hospital), Annual Report (1938), p. 158. 5. Report of the Clinical Service (McLean Hospital), Annual Report (1948), pp. 2 1 6 - 2 1 7 . 6. Report of the Director (McLean Hospital), Annual Report (1937) p· 137· 7. Report of the Clinical Service (McLean Hospital), Annual Report (1952), pp. 181-182. 8. Robert I. Watson, " A Brief History of Clinical Psychology," Psychological Bulletin, 50:329-331 ( 1 9 5 3 ) . 9. Report of the Director of Scientific Research (McLean Hospital), Annual Report ( 1 9 4 7 ) , p. 206. 10. Report of the Director of Scientific Research (McLean Hospital), Annual Report ( 1 9 5 1 ) , p. 194.
469
APPENDIXES
1 1 . Report of the Director of Scientific Research (McLean Hospital), Annual Report (1954), p. 208. 12. Report of the Psychiatrist-in-Chief, (McLean Hospital), Annual Report (1946), p. 183. 13. Report of the Director of Internal Medicine and of Research in Clinical Physiology (McLean Hospital), Annual Report (1949), p. 224. 14. Report of the Director of Internal Medicine and of Research in Clinical Physiology (McLean Hospital), Annual Report ( 1 9 5 1 ) , p. 192. 15. Report of the Director of Internal Medicine and of Research in Clinical Physiology (McLean Hospital), Annual Report (1954), p. 204. 3. Affiliations with Other Hospitals 1. Report of the Vincent Memorial Hospital, Annual Report (1943), p. 61. 2. Report of the Vincent Memorial Hospital, Annual Report (1945), p. 50. 3. Report of the Vincent Memorial Hospital, Annual Report (1949), p. 62. 4. Mrs. Ruth Graham, The Cytologic Diagnosis of Cancer, Vincent Memorial Hospital (Philadelphia, 1950). 5. Report of the Vincent Memorial Hospital, Annual Report (1953) p. 61. It is interesting to note that Dorland's Medical Dictionary ( 1 9 0 1 ) defines gynecology as "that branch of medicine which treats of Woman's constitution and diseases." 6. Harvard Medical Alumni Bulletin, 19:85-88 (April 1945). 7. Report of John Collins Warren Laboratory, Annual Report (1956), pp. 67-68. 4. What Are the Rewards of Research? 1. Report of the General Executive Committee, Annual Report (1934), pp. 23-24. 2. Building for Tomorrows Better Health: The New Research Building of the Massachusetts General Hospital (Boston, 1 9 5 1 ) , p. 15. 3. Report of the Trustees, Annual Report (1952), p. 36. 4. Report of the General Director, Annual Report (1954), p. 44. 5. Tablet in lobby of Warren Building. 5. Teaching at the Massachusetts General Hospital 1. Benjamin Castleman, M.D., The Clinico-Pathological Conference. Proceedings of the First World Conference on Medical Education. London, 1953. (Oxford University Press, 1954). 2. Richard C. Cabot, Differential Diagnosis (Philadelphia, 1 9 1 1 , 1914. 2d ed. [2 vols.], 1 9 1 5 ) . 3. Letter to the author, April 23, 1958. 4. Joseph Garland, M.D., "Harvard and the Massachusetts General Hospital," Harvard Alumni Bulletin, 48:761 (July 6, 1946). 5. Report of the General Executive Committee, Annual Report (1949), p. 60. 6. Report of the General Director, Annual Report (1950), p. 39.
470
NOTES
7. 8. 9. 10. 11.
Ten Year Program oí Development, June 1950. Report of the General Director, Annual Report (1955), pp. 46-47. Washburn, History, p. 148. Washburn, History, p. 149. Washburn, History, p. 150.
6. Certain Services and Departments 1. 2. 3. 4. 5. 6. 7. 8.
Editorial, Archives of Pediatrics (May 1 9 1 4 ) , p. 3 2 1 . Report of the Trustees, Annual Report ( 1 9 3 1 ) , p. 7. Report of the Tumor Clinic, Annual Report (1942), pp. 69-70. George W. Holmes, "The Role of the Radiologist in the Cancer Clinic," Surgery, Gynecology and Obstetrics, 74:552 (1942). Claude E. Welch (Chairman of the Tumor Clinic), "The Tumor Clinic," Massachusetts General Hospital News, 175:3 (1958). West Surgical Record, vol. 767, p. 91. Washburn, History, p. 314. Minutes of the Trustees, April 15, 1955, p. 21.
7. Women and the Massachusetts General Hospital 1. Washburn, History, pp. 468-469. 2. Ibid., p. 472. 3. Reprint by the Massachusetts General Hospital, entitled Home Made Hospital Furniture, about 1900. 8. The Nursing Service and the Nursing School 1. Sara E. Parsons, History of the Massachusetts General Hospital Training School for Nurses (Boston, 1922). 9. Medical Social Service 1. Letter from Miss Josephine C. Barbour to the author, May 1, 1958. 2. Report of Chief of Social Service, Annual Report (1935), p. 29. 3. Elizabeth Wheeler, "The Recent Years 1 9 4 1 - 1 9 5 5 , " Selected Papers and Reports, Fiftieth Anniversary Celebration (published by the Social Service Department, Massachusetts General Hospital, 1955), p. 44. 10. The Dietary
Department
1. Washburn, History, p. 483. 11.
Some Other Departments
1. 2. 3. 4. 5.
Washburn, History, p. 146. Ibid., p. 419. Ibid., "The Treadwell Library," pp. 490-500. Ibid., p. 136. The history of the Apothecary and the Pharmacy up to this point has been compiled from various sections of Washburn's History. 6. Letter to the author, March 16, 1958. 7. Washburn, History, p. 136. 8. George Adams, The Massachusetts Register, a State Record for the year 1852 (Boston, 1852), p. 328.
471
APPENDIXES 9. Letter to the author, April 3, 1958. 10. I am indebted to Mr. George H. Jacobson and Mr. D . C . Withee for much of the data included in this chapter, as well as to Dr. Washburn's History. 12. The War Effort and the 6th General 1. Letter to the Massachusetts p. 4.
Hospital
General Hospital News
(October 1947),
Notes, Appendix A 1. Record book of the Dalton Scholarships (unpublished ms. notebook, kept in the office of the Director, Massachusetts General Hospital). 2. Ibid. 3. The titles are taken from the list of proposed studies to be carried out under the Dalton Scholarship, as entered in the official record book of the Dalton Scholarships.
472
Index Abbott, Gilbert, 285 Abbott, John, 62 Accident Room, 18 Accounting, 10, 182 Aeree, Mrs. Marjorie, 322 Act of incorporation, 141 Adams, Dr. F. Dennette, 121, 247 Adams, Dr. Raymotìd D., 109, 127, 190 Administrative assistant, 76, 135 Administration, McLean, 173 Admission, McLean, 174 Affiliations with other hospitals, 26, 44, 45. 134, 193-207; Vincent Memorial, 44» 193-199; Hall-Mercer, 45, 200203; Huntington, 55, 56, 204-207; North End Diet Kitchen, 26 Allbright, Dr. Fuller, 127, 212, 213, 217, 229 Allbright's syndrome, 213 Allen, Dr. Arthur W., 16, 89, 90, 121, 216, 219, 260 Allen, Dr. Freeman, 6 Allen Street, 141, 144, 152, 153, 157, 158; house, 155 Allergy, 221, 236, 272; clinic, 265 Altschule, Dr. Mark D., 176, 186, 189, 191. 192 Ambulatory patients, 118 American Association of Medical Social Workers, 342 American Association of Medical Record Librarians, 363 American Association of Nurse Anesthetists, 245 American Board of Pediatrics, 280 American Board of Radiology, 288 American Cancer Society, 126, 190, 198 American Dietetic Association, 26, 244, 347 American Hospital Association, 25, 29, 60, 65, 180, 220, 255, 312, 313, 322, 323; women's auxiliaries, 104, 312,
313
American Hospital in Great Britain, 43 American Medical Association, 23, 42, 92, 196 American Nurses Association, 25 American Philosophical Society, 228 American Psychiatric Association, 180, 187, 188 American Red Cross, 11, 41, 53, 175, 298. 339. 365. 370, 375. 385 American Society of Clinical Pathologists, 245 Ames, Mrs. John, 309 Anesthesia, 6, 16, 28, 50, 92, 98, 130, 221, 245, 255, 256, 282, 288 Anesthestist. See Chiefs of Service Anesthesia laboratory, 285, 286, 287 Angeli Memorial Animal Hospital, 237 Antibiotics, 331 Appleton, Francis H., 33 Appointments, joint, M.G.H. and Harvard Medical School, 249, 250, 251 Apothecaries, 349-355 Apprentice system, 258, 259 Archives, 38, 365, 366 Armistice, 365, 368 Army and Navy: nurse corps, 41; research grants, 211; reserve corps, 364 Arnold, Mrs. David B., 310, 312 Arrowood, Dr. Julia, 256 Artery Bank, 299 Arthritis, 19, 213 Arthroplasty, 219 Assistant Director, 8, 42, 48, 49, 66, 72, 95, 100, 105, 115, 117, 128, 134, 154 Atomic energy project, 207 Atto, Kathleen H., 181, 182 Aub, Dr. Joseph C., 56, 87, 94, 204, 206, 207, 212, 213, 223, 224, 229, 236 Aub, Mrs. Joseph C., 315 Aufranc, Dr. Otto, 384 Auxiliary Service, 77, 310, 322, 331
473
INDEX See also Red Basket; Nursing and Dispatch Service Ayer, Dr. James B., 69, 70, 76, 79, 220 Bacteriology, 112, 133, 134, 236, 245 Badger, Dr. George S. C., 266 Bailey, Maxine, 22, 25 Baker Memorial, 7, 10, 13, 14, 18, 22, 26, 27, 28, 35, 39, 45, 47, 48, 64, 68, 76, 88, 99, 103, 106, 112, 113, 114, 130, 132, 143, 152, 154, 160162, 165, 166, 237, 253, 289, 310, 340, 345, 347, 353 Baker, Dr. Myles P., 18, 167 Baker, Dr. Norman C., 6, 8, 48 Balboni, Dr. Gerado M., 33 Barack, Dr. A. L., 2 1 2 Barbour, Josephine C., 28, 72, 113, 336, 337, 339, 341, 342, 385, 386 Barnes, Charles B., 164, 165 Barney, Dr. J. D., 29, 30, 70, 2 1 3 Barr, Dr. Joseph S., 79, 123, 170, 219, 220 Bartlett Hall, 114, 119, 133, 134, 154, 158, 330, 333 Bartlett, Harriet M., 1 3 1 , 339, 340, 341 Bartlett, Rev. John, 3, 17, 179 Bartlett, Dr. Marshall K., 123, 167, 170, 382, 384 Baruch Committee, 72 B;:se Hospital No. Six, 41, 78, 365, 367, 386 Bauer, Dr. Walter, 19, 61, 76, 87, 109, 127, 212, 213, 225, 231, 232, 233, 236, 247 Bauer, Mrs. Walter, 3 1 5 Bay State Rehabilitation Clinic, 99, 102, 103, 106, 302, 3 1 2 Bay State Society, 302 Bayley, Maxine, 25 Beacon Street Number 301, 72, 134, 159 Beaton, Laura, R.N., 267, 268, 269 Beaverbrook, Lord, 376 Beckman, Dr. William, 340 Bed capacity, 35, 132 Beecher, Dr. H. K., 16, 22, 27, 48, 74, 87, 94, 221, 229, 231, 282, 283, 286 Belmont, Town of, 172, 173, 175, 178 Benedict, Dr. Edward, 16, 223 Benedict, Dr. Francis G., 274 Bennett, Dr. G. Α., 2 1 3 Berg, Dr. Robert L., 109, 126 Berry, Dr. George P., 106, 132 Bidwell, Mrs. Robert, 3 1 6
Bigelow, E. Thayer, 61 Bigelow, Dr. George H., 5, 8 Bigelow, Dr. H. J., 210 Bigelow Surgical Amphitheatre, 17, 100, 150, 155 Binger, Dr. Carl Α., 128 Biochemist, 1 1 5 Bixby, Dr. Oliver F., 267, 274 Blackfan, Dr. Kenneth, 276 Blake, Dr. Gerald, 48 Bland, Dr. Edward F., 123, 167, 170, 215, 217, 382, 384 Blank, Dr. I. H., 223 Bliss, Mrs. Henry M., 3 1 3 Blood, 214; technicians, 299; transfusion of, 295, 296, 297 Blood Bank, 51, 53, 65, 92, 134, 218, 245, 295-300, 321, 355; committee, 298 Blood grouping laboratory, 298 Blossom Street, 151, 154; Number Thirty, 125, 134, 150, 156, 330, 333 Blue Cross, 7, 82, 172 Blue Shield, 20 Bock, Dr. Arlie V., 10, 38, 100, 214 Böhm, Dr. Max, 300 Boisen, Rev. Anton W., 303 Boland, Lt. C. M., 368, 370 Bone Bank, 98, 299 Boring, Dr. Edwin C., 188 Boston Alms House, 17 Boston, City of, 148, 153 Boston College, 244 Boston Council for Social Agencies, 28 Boston Edison Company, 24, 101 Boston Hospital Council, 8, 72, 81 Boston Lying-in Hospital, 117, 181 Boston Museum of Science, 121 Boston Psychopathic Hospital, 191, 228 Boston School of Occupational Therapy, 245 Boston Traffic Commissioner, 44 Boston Training School for Nurses, 324, 329 Boston University, 104, 1 1 3 , 242, 244, 245, 334 Boston Visiting Nurse Association, 93, 108, 332 Bowditch, Dr. Henry I., 350, 360 Bowditch History, 282 Bowen, Dr. John T., 40 Bowman, Lt. G. B., 368, 378 Boyer, Sgt. A. M., 385 Boyer, Helen, 33, 38, 56 Brace, Lloyd D., 62
474
INDEX Brackett, Dr. Elliott G., 56 Bradbury, Mrs. Harriet J., 13, 3 1 , 162, 165 Bradshaw, Dr. H. H., 6, 283 Brain surgery, 32 Brain waves, 223 Braman, Mrs. Constance, R.N., 49, 100, 103, 334 Bramhall, Priscilla, 3 1 8 Breed, Dr. William B., 16, 67 Brewster, Dr. G. W. W., 3 3 Brewster, Dr. Henry H., 128 Brick Corridor, 12, 3 1 1 Brickley, Bartholomew Α., 6γ Broedel, Max, 358 Brooks, Rt. Rev. Phillips, 194 Brown, Louis S., 356 Brown, Mrs. Theodore, 98, 291 Brownell, G. L., Ph.D., 225, 233 Brues, Dr. A. M., 207, 224, 229 Brzostowski, Sgt. John Α., 384 Buchanon, Betsy, 322 Bucher, Dr. Nancy, 223 Bucholz, Dr. C. H., 300 Building Committee: White, 163; M.G.H. Staff Associates, 170 Bulfinch Building: 4, 6, 12, 17, 35, 37, 4 1 , 91, 127, 134, 136, 142, 155, 157, 158, 164, 2 1 5 , 273, 277, 278, 345. 352, 356, 361; fireproofed, 152; lawn, 1 1 7 ; wards, 36, 37; wings, 147, 148, 157; yard, 127 Bulfinch, Charles, 4, 1 4 1 , 145, 154 Bullard Professor of Neuropathology, Harvard, 1 2 7 Bulletin, 56 Burnell, Mrs. Alice C., 57, 3 1 0 Burnham, Marian, 277 Burnham Memorial Ward, 77, 79, 80, 130, 195, 277» 278, 3 3 1 . See also Children's Medical Burns, treatment of, 49, 50, 5 1 , 218, 229 Burrage, Dr. Walter S., 95 Burrell, Perry J., 3 2 1 Burwell, Dr. C. Sydney, 45, 96, 164, 200, 202 Butler, Dr. Allan M., 7 1 , 80, 87, 196, 2 1 3 , 2 2 1 , 228, 229, 276, 277 Cabot Course, 246, 247 Cabot, Dr. Hugh, 15, 72 Cabot, Dr. Richard C., 3 1 , 33, 130, 210, 214, 225, 229, 246, 247, »67, 270, 303, 304, 3 1 7 , 337
Cabot Room, 3 1 , 135, 338 Cabot, Sarah, 328 Cadet Nurse Corps, 59, 64, 70, 182, 327, 328, 3 3 1 , 332 Cafeterias, 1 1 , 55, 66, 344, 345 Cambridge Street, 1 5 1 , 152, 153, 157 Cameron, William Α., 355, 359 Campbell, Dr. Archibald, 196 Campbell, Elspeth, R.N., 79 Cancer, 1 1 6 , 293, 294 Cancer Commission, Harvard, 204 Cannon, Dr. Bradford, 2 1 8 Cannon, Ida M., 28, 72, 73, 130, 267, 270, 337, 338, 34°, 3 4 1 , 342 Cannon, Dr. Walter B., 72, 209, 229, 301 Captain Martel, 2 1 3 , 2 1 7 Cardiac Clinic, 2 1 5 , 339; Children's, 46, 269, 270 Cardiac laboratory, 37 Cardiology department, 2 1 5 Cardio-vascular research laboratory, 106, 126, 2 1 5 , 250 Carnegie Institution, 274 Cart: library, 308; store, 3 1 0 Case Records, C.P.C., 6 1 , 247 Cass, Mrs., 322 Castleman, Dr. Benjamin, 70, 1 1 6 , 2 1 3 , 229, 237, 247, 289 Castleman, Mrs. Benjamin, 3 1 4 Cathode-ray, 290 Central Supply Room, 1 1 3 , 1 2 5 Chapel, 30, 45, 134, 153, 158, 309, 313, 315 Chaplains, 305. See Institute of Pastoral Care Chapman, Dr. Carrie E., 256 Chapman, Dr. Earle M., 2 1 2 Charter of hospital, 3, 242, Appendix L Charles Street, 1 1 4 , 148, 150, 1 5 1 , 158, 166, 193, 302, 330 Chase, Mrs. Genevieve, 3 6 1 , 363 Chemical Research Laboratory, 250 Chief Dietitian, 60, 105, 344, 347 Chiefs of service, 123; anesthetist, 6, 16, 22, 283, 284; bacteriology, 1 2 1 , 127; children's medical, 2 1 , 80, 196, 275, 277; dentistry, 89, 95; dermatology, 9, 16, 2 1 , 89, 9 1 , 222; gynecology, 126, 195; medicine, 2 1 , 90, 109, 210; neurology, 76, 79, 109, 127, 128; neurosurgery, 32, 48, 53; obstetrics, 53; orthopedics, 19, 78; pathology, 2 1 , 53, 90, 109, 1 1 6 ; psychiatry, 2 1 , 90, 127, 128, 226;
475
INDEX psychiatrist, McLean, 90, 173, 176; radiology, 53, 70, 79, 90, 290; surgery, 53, 90, 91; east surgical, 8, 16, 21, 78, 89, 90, 100; O.P.D., 100, 128; west surgical, 16, 213; syphilis, 32, trauma clinic, 220; urology, 29, 30, 127; Vincent Staff, 80, 126, 195, 196, 198 Chief of Social Service, 1 3 1 , 336, 338, 339, 342 Chief of Volunteers, 46, 128 Child psychology, 114, 122, 134, 281 Children's Medical Center (Children's Hospital), 130, 181, 217, 266, 275, 276 Children's Medical, 35, 80, 92, 117, 123, 181, 221, 228, 250, 254, 255, 265-282, 338; executive council, 32 Children's Mission, 46, 270 Chittich, Dr. R. Α., 175, i8g Church, Miss Ruth K., 185 Churchill, Dr. Edward D., 10, 16, 32, 42, 48, 70, 76, 87, 90, 91, 94, 127, 132, 213, 216, 217, 232, 259, 260, 282, 283, 356 Churchill, Mrs. E. D., 312, 3 1 5 Churchill, Hon. Winston, 376 Circulatory system, surgery of, 216, 337 City stables, 152, 153, 158, 166 Civilian Defense, 42, 49, 57, 101, 175, 300, 320, 321; defense organization, 35, 41, 42, 135; emblem, 60 Civilian Service Camp, 228 Clark, Dr. Dean Α., 95, loo, 106, 110, 120, 123, 127, 132, 167, 170, 241, 251, 312, 341 Clark, Sydney P., 45, 202 Clarke, T. Parker, 88 Clay, Dr. Charles L., 1 1 5 Clinic Secretaries, 318 Clinical Assistant, 88. See also Graduate Assistants Clinical laboratories, 51 Clinical medicine, 246, 247 Clinical meetings, 27 Clinical Pathologist, 26, 70, 128 Clinico-Pathological Conference ( C.P.C. ), 27, 225, 226, 246, 247 Clinical Physiology, 176, 186, 189 Clinical Training, 303, 304 Clinics: Adolescent, 280; Alcohol, 109, 339; Allergy, 265; Ambulatory, 112; Amputee, 122; Aphasia, 339; Nerve, 317; Paraplegic, 303; Peripheralvascular, 12, 210, 219; Postnatal,
117; Prenatal, 117; Renal stone, 9, 213; Thoracic, 9, 10, 216; Staff, 27, 91, 347 Clinics of M.G.H. and E.&E., 122. See Out Patient Dept. Closed wards and floors, 57, 63, 64, 68, 74 Clymer, Dr. George, 79, 1 2 1 Cobb, Dr. Stanley, 6, 76, 77, 87, 90, 94, 128, 226, 229, 281 Cocoanut Grove, 32, 49~52, 129, 135, 218, 290, 297, 340 Cochrane, Mrs. Alexander, 195 Codman, Dr. Ernest Amory, 40, 210, 215, 303 Co-enzyme Α., i i 6 Coghlan, Helen J., R.N., 1 1 3 , 119, 334, 376 Cohen, Dr. Mandel, 229, 236 Cohn, Dr. R. Β., 207 Colby College, 244, 363 Colby, Dr. Fletcher, 70, 73 Cole, Genevieve, 363 Coller, Dr. Frederick Α., 31, 6o Collins, Miss Isobel, 185, 309 Comeau, Joseph, 64 Committees: ad hoc, 76, 90, 91; Advisory to Director of Scientific Research, 189; Hall-Mercer Hospital, 200; Home care of children, 270; Advisory on Nursing, 22, 108; Advisory to Nursing School, 327; McLean, 182; Research, 106, 232, 233, 234; Staff, 123 Commonwealth Avenue No. Twentyseven, 66. See Herrick House Commonwealth Fund, 45, 162, 221, 278, 341 Community Fund (United Community Services), 9, 20, 99, 205 Community relations consultant, 104 Compton, Dr. Karl T., 74, 87, 232 Comptroller, 80, 135 Conant, Pres. James B., 90, 99, 102, 250 Conant, Dr. William M., 23 Connecting Bldg., 150, 152, 157, 352, 361 Connick, C. J., 178 Conscientious objectors, 55 Consulting visiting physicians and surgeons, 1 1 8 Convalescent ward, 38, 45 Converse, Mary E., 363 Coolidge, Dr. Algernon, 33, 37
INDEX Coolidge, Mrs. Alison J., 179, 180 Coordinating Committee, 120, 136, 3 1 2 Cope, Dr. Oliver, 48, 76, 87, 94, 213, 217, 218, 225, 228, 229, 232, 257, 258, 341, 356 Cope, Mrs. Oliver, 312, 3 1 5 Corbett, S. Daphne, 334 Cori, Dr. Carl F., 87, 232 Corkum, Adele L., R.N., 334 Cornwall, Dr. Andrew P., 70 Corporation, 29; dinner, 83, 85, 101 Council of Social Agencies, Boston, 319 Courtney, Mrs. Dorothy M., 79, 88, 322, 323 Cost: of living, 55; per patient day, 133 Cowles, Dr. Edward, 187, 188 Crawford, Dr. G. Marshall, 89, 1 1 0 Crawford, Dr. John D., 221, 222, 279 Crawford, Mrs. John D., 3 1 5 Credit Office, 96 Credit Union, 102 Crockett, David C., 76, 109, 135, 232, 233. 341 Croft, Caroline Brewer, 204 Crone, Dr. Neil, 18 Crouch, Mrs. R. K., 47, 57, 310 Culver, Dr. Perry, 91 Cummin, Dr. John W., 128 Cummins, Dr. Loretta J., 40, 255 Cushing Gen. Hospital, 383 Cytological diagnosis, 1 1 2 , 197 Daland, Dr. Ernest M., n o , 292, 294, 295 Daley, Mrs. G., 323 Dalton, Mrs. Phillip S., 3 1 3 Dalton Scholarship, 210, 390-393 Damon Runyon Fund, 190 Davenport, Maj. L. F., 383 Davis, Dr. and Mrs. Hallowell, 175 Davis, Dr. Lincoln, 29, 78, 1 1 5 Deane, Mrs. Frederick, 310 Dearing, Dr. W. Palmer, 106 Decker, Ira, 23 Deficits, operating, 69, 80, 81 Degan, Joseph W., 128 DeLorme, Dr. T. L., 301 Dental Service, 15, 80; intern, 16 Departments of Public Health, U. S. and Mass., 18, 19 Department of Public Welfare, 303. See also Welfare Derby, Miss Lucy (Mrs. S. R. Fuller), 194, 195
Dermatology, 9, 16, 39, 76, 222, 237, 250, 255; laboratories, 92 Deutsch, Dr. Helene, 73 Diabetic Clinic, 12, 337 Dicks, Rev. Russell L., 304 Dienes, Dr. Louis, 1 1 2 Dietary: Aides, 93; Clinic, 25 Dietary department, 6, 1 1 , 22, 66, 71, 114, 133, 244, 343-348; advisory committee, 347; dietitian, 26, 343, 344; food store, 10; manual, 127, 348; school, 22, 66, 344, 345, 347 Diets: cost of, 39; discharge, 114; hospital ( 1 8 2 1 ) , 343; special, 114 Dieuaide, Dr. Francis R., 32 Dill, Dr. D. B., 175 Director of Massachusetts General Hospital, 8, 21, 33, 41, 57, 59, 62, 63, 69, 77, 81, 90, 95, 100, 163, 347, 367; general director, 100, 120, 167, 169, 241, 251, 312; McLean, 177, 184, 185 Directors: medical clinics, 123; personnel, 46; McLean, 179; research in clinical physiology, 189; research and education, 126; scientific research, 189; volunteers, 65 Dispatch Service, 119, 3 1 1 , 333. See also Red Basket; War and Auxiliary Service Dispensary (O.P.D.), 98 Distaff Club, 120, 126, 136, 3 1 1 , 312, 315; News, 316 Division of Vocational Rehabilitation, 302 Doctors' Offices, 154, 165, 166, 167, 170, 171. See also Warren Building Dodd, Dr. Walter J., 350, 351, 355, 359 Domestic Building, 56, 92, 97, 134, 150, 156, 236, 297, 301, 332, 352, 355 Donovan, Katherine J., 89 Dorr Chair of Anesthesia, 48, 282, 283 Draft boards, 42, 54, 58 Dresser, Dr. Richard, 288 Drinker, Dr. Cecil K., 189, 216 Dubos, Dr. René J., 120 Ducks, 24 Duguid, Isobel, 342 Dumaine, Betty, 7, 12, 3 1 2 Dunn, Agnes V., R.N., 89 Dupee, Ruth, 300 Durant, Dr. F. Chester, 105, n o
477
INDEX Eastman, George, 35s "Edible Garbage," 22, 346 Edsall, Dr. David L., 72, 210, 2 1 1 , 274, 282 Edwards, Miss Grace, 33 Eisenhower, President D. D., 2 1 5 Eldredge, Mrs. Cressida P., 77, 159 Eldredge House, 93, 123, 134, 153, 159 Electric shock, 183, 184 Electrician, 300 Electroencephalography, 23, 37, 175, 188, 223 Eliot, Dr. Martha, 274 Eliot Memorial Chapel, 178, 186 Ellis, Dr. Daniel S., 123, 170 Emergency Defense Committee, 101 Emergency Ward, 49, 50, 133, 164, 259, 339, 362 Emerson, Dr. Haven, 45, 162 Emerson, Dr. R. P., 272 Employees: clinic, McLean, 179; war service, 43, 54 Endicott, William, 8, 29, 48, 164 Endoscopy, 16, 223 Engel, L. L., Ph.D., 224 Englebach, Dr. Albert G., 23 Epilepsy: clinic, 272; Harvard Commission, 272; International Society, 265 Ernlund, Dr. C. H., 217 Ernst, Dr. Harold C., 247 Ertel, Edgar H., 45 Ether: Centenary, 73, 135; Day, 15, 3 1 , 71, ι ο ί , 164, 238; Dome, 282; Stamp, 40 Eustis, Dr. Richard S., 89, 267, 268 Evarts, Sarah, Room, 338 Evening clinics, 46 Everett, Mr. H. C., Jr., 195, 197 Executive Officer, 1 1 5 Fairbanks, Rev. Rollin J., 67, 304 Family Health Program, 1 1 2 , 122, 124, 136, 281, 339 Farrar, Elizabeth, 309 Farrisay, Ruth M., R.N., 125, 334 Fatigue Laboratory, Harvard, 175, 214, 228 Faxon, Dr. Henry H., 216 Faxon, Dr. Nathaniel W., 6, 8, 45, 87, 90, 94, 95, 163, 235, 236, 299 Federal Parole Board, 64 Federation of Churches, 135 Feingold, Leonard, 64
Fellows, Clinical and Research, 61, 67, 106, 107, 133, 251 Fernald, Helen, 318 Ferrier, Grace, 47, 320 Ferris, Rev. Theodore P., D.D., 196 Fessenden, S. W., 40, 6i, 97, 163, 164 Fiegel, Capt. Walter L., 384 Field, Edward, 62 Finances, 29, 123 Findlay, Dr. C. W., Jr., 217 Finesinger, Dr. Jacob E., 105 Fitz, Dr. Reginald H., 61, 208, 210 "The Flat," 253 Floyd, Marion D., 60, 344, 347, 348 Folch-Pi, Dr. Jordi, 176, 189, 190, 191 Folin, Dr. Otto, 173 Fosdick, Dr. Raymond B., 74, 200 Foster, Frederick D., 120 Fowler, ist Lt., 368, 370, 378, 384 Fowler, Rev. Cuthbert, 186 Fracture Clinic (Service), 9, 12, 219, 248, 327; course, 219, 246, 248 Frankson, Eric, 71, 73 Frantz, Dr. Ivan D., Jr., 106, 126, 172, 188, 215, 224, 233, 235, 236 Franzee, Dr. John R., 384 Fraser, Miss Jean Cameron, 195 Frazier, Dr. Chester N., 91, 222, 223 Free Hospital for Women, 126 Fremont-Smith, Dr. Maurice, 1 1 5 , 220 Friends of the M.G.H. 3 1 2 Fruit Street, 117, 150, 1 5 1 , 152, 154, 156, 193; Place, 1 5 1 Funds: General, 10, 29, 69, 81, 101, 102, 235; Ladies Visiting Comm., 313; Multiple Sclerosis, 190; Professional Services, 107; Social Service, 338, 341; White, G. R., 162 Furniture Exchange, 314 Gamble, Dr. James L., 228, 229, 265, 275, 278 Garland, Dr. Joseph, 1 2 1 , 248, 274 Gasser, Dr. Herbert S., 87, 232 Gates, Gertrude M., R.N., 30 General Council on Research, 136 General Executive Committee, 9, 14, 16, 20, 21, 26, 27, 3 1 , 32, 39, 43, 67, 7 1 , 75, 76, 82, 90, 102, 103, 106, 107, 122, 123, 163, 165, 166, 277, 294, 318 General Hospital, 14, 22, 35, 39, 68, 76, 82, 88, 92, 109, 1 1 1 , 112, 122, 132, 141, 142, 143, 146, 1 5 1 , 154, 181, 253, 289, 344, 349, 353
INDEX General Research Committee, 87, 91 "The General Store," 47, 58, 126, 3 1 0 Generator, million-volt X-ray Van de Graafe, 205, 207, 289, 291 Genito-Infectious Disease Program, 46 Genito-Urinary Department, 15. See also Urological Service Giberti, Miss, 376 "G. I. Bill," 68, 69, 182 Gick, Sgt. R. G., 385 Giddings, Dr. Harold G., 70, 73, 100 Gilbert, Dr. Louis, 267 Glendy, Dr. Margaret Moriarty, 274 Godsoe, Joseph, 62, 350, 3 5 1 , 352, 353, 355, 359 Goethals, Dr. Thomas R., 34, 365, 367, 382 Goff, Carleton Ν., 236 Golz, Lt. Col. Harold Η., 384 Goodale, Dr. Joseph, 272 Gorman, Dr. Rosemary V., 256 Gorrell, Dr. John E., 49, 73 Graduate Assistants, 67, 88 Graduate Fellows, 61 Grady, Frances C., 335 Graham, Dr. Evarts Α., 74 Graham, Dr. John B., 126, 197, 198 Graham, Dr. Ruth M. (Mrs. John B.), 126, 196, 197, 198, 220 Grand Rounds, 27, 197 Gray, Francis C., 8, 45, 78, 87, 106, 123, 1 3 1 , 167, 170, 202, 233 Gray, Mrs. Francis C., 3 1 3 Gray, Reginald, 45, 61 Graybiel, Dr. Α., 228 Greenhood, E. Russell, 80, 1 3 5 Greenough, Dr. Robert B., 23, 292, 294 Greenwood, Dr. Arthur M., 88 Greenwood, Eleanor, 46, 65, 73, 320, 322, 323 Grey Ladies, 63. See also Red Cross Volunteer Aides Grier, Dr. R. S., 224 Griffen, Anna C., R.N., 29 Gross, Dr. R. E., 2 1 7 Grove-Rasmussen, Dr. Morten, 298, 299 Guild, Henry R., 33 Guiles, Rev. Austin P., 303 Gundersen, Dr. Trygve, 383 Gynecology, 44, 133, 195, 197, 198, 220, 250, 256, 279 Haase, Dr. Ferdinand, Jr., 100 Haberlin, Rt. Rev. Richard J., 164 Hale, Mrs. Richard, 3 1 1
Hall, Marion, 341 Hall-Mercer Hospital: M.G.H. Division, 45, 134, 193, 200-203, 226; Penn. Division, 202, 203 Halstead, Dr. W. S., 260 Halsted, Dr. James Α., 8g, 381, 384 Hamilton, Dr. Bengt, 273 Hamilton, Dr. T. Stewart, 49, 79, 378, 382, 384 Hamlin, Elizabeth P., 3 1 7 Hammond, Dr. John, 267 Hampton, Dr. Aubrey O., 48, 70, 79, 2 1 3 , 220, 226, 288, 289, 290, 292 Hand Clinic, 1 1 8 , 122, 2 1 0 Hanelin, Dr. Joseph, 291 Harden, Dr. Monica, 6 Hardy, Dr. Harriet L., 98, 224 Harington, Sir Charles, 106, 236 Harmer, Dr. Torr W., 40 Harmon plan, 98, 332 Harrison, Capt., 383 Hartwell, Dr. Harry F., 30, 62 Harvard: Botanical Gardens, 272; Cancer Commission, 205, 206; Department of Pediatrics, 276; Pension Plan, 250; Red Cross Hospital, 42; School of Public Health, 18, 266 Harvard Dental School, 15, 150, 1 5 1 , 157 Harvard Medical School, 4, 6, 9, 10, 20. 3 1 , 39, 63, 72, 76, 90, 99, 102, 109, 126, 142, 157, 180, 198, 204, 2 1 1 , 222, 226, 237, 241, 242, 243, 245, 246, 247, 248-252, 266, 275, 276, 277, 278, 281, 282, 283, 292, 348; faculty, 109, 1 1 5 , 1 1 6 , 126, 127; Physiology Dept., 72; students, 124, 242 Harvard University, 10, 55, go, 102, 1 1 6 , 134, 1 5 1 , 180, 204, 205, 232, 234, 243, 248, 283, 320, 3 2 1 Harvard University Press, 2 1 2 , 222, 3 4 1 Hatch, Francis W., 78, 83, 85, 89, 96, 117, 154 Hatch, Louise, 105, 1 1 4 , 345, 347, 348 Hawes, Dr. Lloyd E., 289 Haywood, Howard, 3 2 1 Health: clinic, 18, 134; examinations, 1 1 8 ; officer, 134 Heart, 2 1 5 ; research, 236 Heffernan, Dr. Roy J., 73 Henderson, Dr. Lawrence J., 214, 274 Henderson, Robert, 7 1 , 79 Henry, Phyllis, 320 Herman, Dr. William J., 8
479
INDEX Hemon, Frances M., 96 Herrick House, 134, 153, 158, 345 Herrick, Robert F., 66 Herter, Gov. Christian Α., i 2 i Hertz, Dr. S., 2 1 2 Herwick, Lt. Ε. B., 385 Higgins, Dr. Harold, 273, 276 Higginson, Maj. George, 194 Higginson House, 173 Hirsch, Dr. Oscar, 128 Hoagland, Dr. Mahlon B., 126, 224 Hoch, August, 188 Holmes, Dr. George W., 47, 70, 205, 213, 226, 227, 288, 289, 290, 292, 293, 294 Holowka, Sgt. Michael J., 385 Homans, Robert, 7 Homans, Mrs. Robert, 341 Home care: children, 221, 280; children with heart disease, 269 Honor Roll, 364 Hopkins, Mrs. A. Lawrence, 8, 44, 277 Hopkins, F. G., 207 Horse meat, 347 Hospitals: 6th General Hospital, 41, 68, 112, 135, 289, 331, 364-386; 6th Mobile Hospital U.S.N., 364; 63rd General Hospital, 367; 105th General Hospital, 364; 160th Station Hospital, 364; Harvard Red Cross Hospital, 42; Lovell General Hospital, 382, 383; Marine Hospitals, 3 Hospital Aides, 75 "Hospital Full Time," 249 Hospital Research Council, 27, 231 Hospital Volunteer Service Bureau, 58 House Officers (House Pupils), 252257; Flat, 18; Medical, 349. See also Interns House Physician, 252, 253, 350 House Pupils' Alumni Association, 15, 3 1 , 38, 74 House Staff, 50, 255, 256, 258, 338; women, 255, 256. See also Residents and Interns House Surgeon, 252, 253, 349, 350 Household Nursing Association, 108, 244, 333 Housekeeping Department, 88, 133, 332 Houser, Dr. Gerald F., 23, 42, 73 Housing, 18; file, 314 Hovey, Mr. and Mrs. Chandler, 309 Howard, Dr. Herbert B., 61, 97 Howard, Dr. P. M., 173, 176, 177, 178, 184, 185
Howland, Dr. John, 266, 273, 274, 275, 308 Huggins, Mrs. Charles, 316 Hunter, Rev. David R., 304 Hunter, Dr. Francis T., 26, 70, 128, 214, 226, 294 Huntington, Mrs. Collis P., 204 Huntington Memorial Hospital, 20, 55, 135» 193. 204-207, 2 1 1 , 224, 290, 291, 294, 336, 339; laboratories. See also Warren Laboratory Hurlbut, Dr. Robert S., 80 Hurlbut Room, 80, 135 Hyams, Isabel F., 120 Hyams, Sarah Α., 120 Hyams Trust, 80, 114, 119, 190, 197, 237, 302 Hydrotherapy, 300, 301 Hypothermia, 175 "In Bed Club," 270 Industrial Accident Board, 82 Industrial Clinic, 224 Infant's Hospital, 266 Inflation, effect on wages and rates, 69, 109 Ingraham, Dr. Lena V., 194 Inhalation Therapy Unit, 98 Institute of Pastoral Care, 67, 135, 245, 303-306, 304 Insulin shock, 183, 184 Interns, 32, 43, 51, 53, 54, 58, 59, 63, 64, 66, 69, 107, 243, 252-257, 274, 279; women, 255, 256, 274. See also House Officers Intervertebral Discs, 220 Irving, Dr. "Fritz," 3 1 Isotopes, 225 Isotope Committee, 227 Isselbacher, Dr. Κ. I., 2 1 5 Jackson, Dr. James, 3, 4, 61, 241 Jackson, Dr. James M., 268 Jacobi, Dr. Abraham, 265, 275 Jacobson, Dr. Β. M., 214 Jail, Charles Street, 114, 153, 165 Jessner, Dr. Lucie N., 281 Johns Hopkins, 187, 260, 261, 266 Johnson, Sally, R.N., 12, 21, 78, 324, 328, 334 Jones, Dr. Chester M., 123, 127, 128, 214, 229, 247 Jones, Dr. Daniel Fiske, 23 Jones, Rufus, 55 Joy, Daniel Α., Jr., 176 O
INDEX Joy (or Barrell) Estate, 141 Junior League, 28, 319 Kazanjian, Dr. V. H., 40 Keefer, Dr. Chester, 62 Keller, Dr. Elizabeth, 224 Keller, Dr. William S., 303 Kelley, Dr. S. B., 381 "Kelley's Comet," 381 Kellogg, Dorothy, 338, 340, 342 Kennard Street No. Five, 152, 157 Kent, Grace H., 188 Ketchum, Phillips, 29, 45, 87, 123, 163, 167, 170, 200, 202, 233 Kidder, Nathaniel T., 30 Killian, Dr. James R., Jr., 106 King Committee, 71, 75, 92, 135, 166 King, Dr. Donald S., 71, 105, 369, 376, 377, 381, 382, 383, 384 King, Dr. Robert L., 78 Kingsley, Dr. George L., 350 Kingsley Studio, 350, 352, 355 Kinsey, Dr. Dera, 256 Klein, Dr. Armin, 128 Knights, Doris, R.N., 94, 309, 383, 384 Knott, Lt. Col. W. C., 368, 378 Korostoff, Capt. Bernard, 384 Kramer, R. D. Tech., 384 Krane, Mrs. Stephen, 316 Kranes, Dr. Α., 382, 384 Krebs, Dr. Η. Α., 230 Kresge Foundation, 236 Kubík, Dr. Charles S., 76, 77, 79, 109, 128, 220 Labor Unions, 59, 76 Laboratories, 12, 26, 37, 62, 80, 92, 97, 98, 136, 137, 216 Laboratory, Mixter, 238 Laboratory, Edwin S. Webster Research, 238 Laboratory, James Homer Wright Pathological, 238 Ladder House, No. Ten North Grove St., 152, 153 Ladies Advisory Committee to the School of Nursing, 113 Ladies' Committee, Bay State Rehabilitation Clinic, 120 Ladies' Visiting Committee, 8, 16, 47, 58, 67, 104, 120, 130, 135, 136, 307313, 317, 321, 331; committees, 120, 308, 309, 312; funds, 313; manual, 313; seventy-fifth anniversary, 3 1 1
Ladies' Visiting Committee, Massachusetts Eye and Ear Infirmary, 120 Lamb, Sydney, 7 Lamson: carrier, 362; tube, 361 Landis, Dr. Eugene M., 87, 94 Lane, Dr. C. Guy, 9, 17, 69, 70, 76, 89, 128, 292 Larson, Dr. Carroll B., 71, 105, 220 Laudig, Capt., 383 Laundry, 85, 86, 87 Lawrence, Mrs. James, 8 Lawrence, John E., 78, 89 Lawrence, Capt. K. B., 383 Lawrence Memorial Hospital, 116 Lawrence Memorial Room, 92, 135 Lawrence, Bishop William, 30, 45, 164 Leadbetter, Dr. Wyland, 110, 127 Leaf, Dr. Alexander, 215 Lee, Dr. Roger I., 214, 295 Lee, Mrs. R. I. (Ella Lyman), 317, 318 Leland, Dr. George Adams, 62, 295 Lemuel Shattuck Hospital, 19, 130 Lepper, Edna S., R.N., 310, 334 Leiman, Dr. J., 212 Leussenhop, Mrs. Alfred, 316 Lewis, Eleanor Α., 49, 363 Lewis, Ora M., 317 Lezer, Dr. Leon R., 105, 128 Librarian, 360, 361 Library: Palmer-Davis ( student nurses ), 22, 39, 327, 333; record, 361; Tracy Burr Mallory Memorial, 238; Treadwell (medical), 350, 360, 361; Warren (patients), 317 Lichty, Dr. Joseph S., 79, 105 Lindemann, Dr. Eric, 127, 229 Linenthal, Dr. Arthur, 228, 278 Lingley, Dr. James R., 226, 288, 289, 290, 369. 370, 376, 384 Linton, Dr. Robert R., 167, 216 Lipmann, Dr. Fritz, 48, 92, 115, 216, 230, 233, 237 Lister, Lord, 208 Litton, Ruth, 340 Liver, 214 Lloyd, Dr. Henry D., 1x5 Lloyd, Malcolm, Jr., 45, 200, 202 Loan fund for House Staff, 102 Lobotomy, 19, 175, 183, 184 Lodge, The, 97, 150, 151, 155, 332 Loftfield, Dr. R. B., 224 Long, Dr. Crawford W., 40, 282 Loomis, Dr. Alfred L., 37, 223 Lootz, Alf C., 23 Lord, Dr. Frederick T., 48, 61 I
INDEX Lord, Mrs. Frederick T., 48 Lowell, A. Lawrence, 200, 209, 283 Lowell House, 152, 154 Lowell Institute, 93 Lowell, John, Jr., 93 Lowell Lectures, 135 Lowell, Miss Lucy, 194 Lowell, Ralph, 40, 87, 94, 123, 167, 170, 233 Lown, Wilbour C., 351, 356, 359 Lyman, Ella (Mrs. Roger I. Lee), 317, 318 Lynch, Dr. F. G., 110 Lyon, Dr. Arthur B., 110 Lyons, Dr. Champ, 46, 228, 229 MacGill, C. F., 167 Macomber, John R., 7, 31, 71, 97, 101, 117, 163 Magee, James C., Surgeon General USA, 34 Maintenance, 55, 65. See also Wages Malaria, anti-, drugs, 64 Mallinckrodt, Edward, Jr., 99, 116, 288 Mallinckrodt — Ward IV, 99, 105, 114, 117. 345 Mallory, Dr. T. B., 70, 87, 90, 109, 213, 215, 225, 237, 246, 247, 294 Mangiaracine, Miss A. B., 62 Manion, Sgt. Stanley E., 384 Manual: dietary, 127, 348; fracture, 219 Marble, Dr. Henry, 295 March, Waldo, 355 Market House, 117, 151, 152, 154, 157 Martin, Lawrence, n o Mason, Mrs. Elizabeth Andrew, 267 Massachusetts College of Pharmacy, 354 Massachusetts Dental Society, 74 Massachusetts Dept. of Labor and Industries, 81 Massachusetts Dept. of Public Health: arthritic patients, 19; tubercular patients, 10, 19 Massachusetts Dept. of Public Welfare, 66 Massachusetts Eye and Ear Infirmary, 20, 99, 111, 114, 117, 150, 166, 170, 193, 242, 273, 278, 312, 322, 330, 344, 345, 352, 353; Ladies Visiting Committee, 312 M.G.H. Staff Associates, 106, 118, 122, 123, 132, 136, 165-171, 238; con-
stitution, 169, 170; executive board, 170 Massachusetts Hospital Association, 82 Massachusetts Hospital Service Corporation (Blue Cross), 19, 82 Massachusetts Institute of Technology, 20, 42, 212, 225, 232, 233, 242, 243 Massachusetts Transit Authority, 127 Matthie, Mrs. Margaret, R.N., 103 Matron, 343 Mattos, Edmund J., 115 Mayo Clinic, 301 McArthur, Dr. Janet W., 197, 221, 222, 256, 279 McCann, M. J., Jr., 356, 359 McCort, Dr. James J., 115, 291 McCrae, Annabelle, 11, 94, 324 McCoy, Mrs. Lois D., 46 McDermott, Dr. W. V., 215 McDonald, Dr. Charles Α., 88 McGahey, Capt. C. E., 383 McGill University, 113 Mclver, Dr. Μ. Α., 2i6 McKhann, Mrs. Charles, 316 McKittrick, Dr. Leland S., 70, 71, 90, 94, 118, 121, 216, 220 McLatchie, Muriel ( Mrs. Floyd Miller ), 31. 47, 358 McLean Hospital, 39, 40, 141, 172-192, 210, 300; nursing school, 122, 180, 181, 182 Mead, Dr. Sedgwick, 383, 385 Means, Dr. James Howard, 16, 73, 76, 87, 90, 109, 131, 211, 212, 232, 247, 292, 311, 338, 340 Medical Arts Department, 355, 358 Medical Department U.S.A. and U.S.N., 301 Medical Executive Committee, 21 Medical records, 359, 360, 361 Medical Research and Development Board, 288 Medical Reserve Corps, 34 Medical Science Building, 170, 171, 238. See also Warren Building Medical Schools, 243 Medical Service, 9, 14, 32, 33, 37, 130, 245, 250, 254, 256, 303, 338, 339, 366 Medical-Social Conference, 340 Medical Social Service. See Social Service Meigs, Dr. Joe V., 44, 71, 80, 112, 114, 126, 127, 195, 196, 197, 198, 220, 279, 322
2
INDEX Medical Staff Room, 37 Medico-Mechanical Dept., 300. See also Lander Mental Health Act, 336 Mercer, Rev. Alexander G., 45, 200 Mercer, Mrs. Alfred, 179 Merrell, Mrs. Alice Α., 363 Merrill, Ο. Ε., B.E.E., 226 Metric System, 67, 7 1 , 134, 353 Metropolitan District Commission, 1 1 4 , 117 Meyer, Dr. Adolph, 188 Michelson, Dr. J. J., 220 Michie, Dr. Catherine B., 256 Miller, Dr. Carroll, 297 Miller, Dr. Richard H., 40, 1 1 4 , 2x7 Million volt X-ray Van de Graafe generator. See Generator Miner, Dr. Leroy, M.S., 56 Minichiello, Mr. and Mrs., 1 5 2 Minot, Dr. George R., 104, 207, 214, 230 Minot, Dr. James J., 29, 196 Mixter Laboratory, 1 3 2 Mixter, Dr. Samuel J., 3 2 Mixter, Dr. W. Jason, 32, 48, 70, 175, 220 Mixter, Mrs. W. Jason, 3 1 2 Monks, Dr. John P., 340 Moore, Dr. F. D., 76, 87, 95, 218, 229, 232 Moran, Lord, 376 Morgan, Mrs. William, Jr., 3 1 6 Moriarty, Dr. Margaret, 255, 272. See also Glendy Morgue, City, 1 5 3 Morris, Miss Cherry, England, 341 Morrison bequest, 338 Morrison, Dr. L. R., 92, 104 Morse, Dr. George W., 259 Morse, Dr. John L., 275 Morse, Lucy, 88, 301, 309, 3 2 1 Morton, Dr. W. T. G., 40, 74, 208 Morton plaque, 74 Moseley Memorial Building, 37, 38, 3g, 72, 92, 1 5 1 , 152, 157, 164, 273, 297, 304, 310, 327, 338, 358, 361 Mosher Laboratory, 62 Mueller, Dr. H. Peter, 290 Munroe, Sgt. Harry E., 385 Murphy, Henry J., 1 1 5 Murphy, John T., 3 5 1 , 352, 353, 355 Murphy, Dr. W. P., 207, 214, 230 Music Therapy, 176, 3 1 3 Myasthenia Gravis Clinic, 225
Myers, Mrs. Grace W., 361, 362, 363 Myers, Dr. G. S., 2 1 5 Nathan, Maj. H., 368, 378 Nathanson, Dr. Ira, 128, 207, 225, 229, 294. 295 National Cancer Institute, 236 National Council, 57 National Defense Act, 365 National Heart Institute, 236 National Institute of Health, 2 1 5 National Institute of Mental Health, 281 National League of Nursing Education, 25, 32, 104, 1 8 1 , 326 National Research Council, 46, 2 1 1 , 218, 228, 288 Neice, Judson, 356 Nervous Diseases, Section on, 77 Neurology, 12, 39, 76, 77, 130, 190, 225, 238, 244, 250, 269, 337, 338 Neurosurgery, 10, 32, 39, 77, 132, 210, 238, 250, 254, 303; neurological institute, 238 Neurocirculatory asthenia, 64 New drugs, 106 New England Hospital Assembly, 65, 3 1 2 , 322 New England Journal of Medicine, 46, 61, 247, 248 New Hampshire School of Occupational Therapy, 245 Neumann, Dr. Ellsworth T., 100, 1 1 5 ,
121
New York Hospital, 3, 5 Newell, Dr. Franklin S., 100 News, The M.G.H., 56, 60, 134 Nightingale, Florence, 324 Nigro, Dr. Michele, 274 9-9-9 Program, 261 Nobel Prize, 48, 1 1 5 , 216, 230, 233 Nomenclature of diseases, 362 Norris, Dr., 225 North Anderson St., 1 1 7 , 154; Gate, 1 1 7 , 1 5 1 , 154; No. Thirty-five, Lowell House, 152, 154, 157, 158 North End Diet Kitchen, 25, 26, 77, 134, 344. See also Nutrition Clinic North End Morgue, 1 5 3 North Grove Street, 154, 164, 166; No. Four, 152, 157, 330; No. Eight, 152, 157; No. Ten, 152, 153, 158 Noyes bequest, 108 Noyes, Mrs. Mary Bartlett (Mrs. James B. Noyes), 17, 1 1 9 , 179 Noyes, William, 188
INDEX Nurse anethetists, 245 Nurses: aides, 63; auxiliary service, 77, 119, 310, 313, 322; homes, 104, 108; library, 25; male, 181, 330; research projects, 118; shortage of, 54, 74, 88; war service, 43, 54, 364, 365 Nursing, School of, 1 1 , 21, 22, 25, 32, 39, 66, 67, 70, 93, 97, 108, 125, 135, 142, 181, 243, 324, 325, 328, 329, 330-334; accreditation, 104, 327; advisory council, 1 1 3 , 114, 118, 120; cost of, 124; courses, degree and diploma, 21, 70, 71, 108, 243, 324, 326; marriage policy, 326; principal of, 78; scholarships, 118; students, 14, 1 1 3 , 118; student house, 98, 326; trustee committee, 88; tuition, 1 1 3 , 118, 3 3 1 Nursing, McLean School of, 122, 179, 180, 181, 182, 183 Nursing Service, 103, 107, 125, 325, 330-334; assistant directors, 125; graduates, 14, 1 1 3 , 325, 326; head nurses, 103, 107, 182, 333; hours, 98, 119» 331. 332, 333; salaries, 63, 98, 119, 331» 333, 334; stafi, 125; superintendent or director, 78, 328, 3 3 1 Nutrition Aides, 346, 347 Nutrition Clinic, 77, 344, 345. See also North End Diet Kitchen Nutting, P. Α., 350, 359 Oak Ridge, 225 Obstetrics, 1 1 3 , 117, 333 Occupational Medical Clinic, 98, 118, 122 Occupational Therapy, 16, 38, 65, 301, 309, 310, 313, 318, 319 Office Building, 118, 132, 165-171. See also Warren Building Office of Price Administration, 66 Office of Procurement and Assignment, 255. See also Procurement and Assignment Office of Scientific Research and Development (O.S.R.D.), 46, 59, 64, 87, 2 1 1 , 228, 229, 230 O'Keefe, Dr. Edward S., 89, 267, 272, 274 Old Age and Survivors Insurance, 102. See also Social Security Oliver, Dr. E. Lawrence, 16, 1 2 1 Oliver Professorship of Hygiene, 10 O'Neil, Joseph H., 8 O'Neil, Dr. Richard F., 67
Operating rooms, 1 1 3 , 1 1 9 "Operation Strategic," 101 Oraway, Dr. Clarence E., 28 Orthopedics, 9, 10, 39, 218, 219, 254, 301, 303, 337 Osgood, Dr. Robert B., 19 Osier, Sir William, 275 Ottesen, Capt. Karl R., 384 Ouchterlony, Dr. Orjan T. G., 127 Outflanking disease, 91 Out Patient Building, 150, 156, 317, 352 Out Patient Department, 15, 16, 17, 18, 19, 25, 27, 39. 46, 47, 65, 69, 76, 98, 1 1 1 , 1 1 2 , 117, 122, 123, 127, 133, 134. 153, 166, 252, 266, 267, 268, 280, 301, 318, 353, 359, 362 Outhouse, Dr. Alice, 255 Paine, Dr. Thomas F., Jr., 1 1 2 , 1 2 1 Palmer-Davis Library, 22, 3g, 327, 330 Palmer, Dr. Robert S., 18, 91 Papanicolaou, Dr. G. N., 220 Parathyroids, 213, 217, 225 Parker, Carol, R.N., 268 Parker, Mrs. H. McB., 197 Parker, Maj. M. O., 383 Parker, Dr. Willard S., 70, 267 Parking, auto, 44, 114, 1 1 7 Parkinson, Royal, 72 Parkman, Mrs. Samuel, 328 Parkman Street, 18, 59, 104, 117, 125, 134, 1 5 1 , 152, 153, 157, 158, 330 Parran, Dr. Thomas, Surgeon General U.S.P.H., 18 Parsons, Dr. Langdon, 71, 95, 197, 377 Parsons, Sara E., R.N., 324 Pasteur, Louis, 208 Pathology, 6, 51, 92, 109, 1 1 1 , 112, 132, 154, 197, 225, 235, 237, 245, 246, 250, 256, 347 Pathology Building, 101, 1 1 2 , 116, 1 1 7 , 125, 127, 150. 156, 235 Patients' Activities Association or Central Council, 176, 177 Patients: patient days, 132, 133 Patton, Gen. George, 376 Pauling, Dr. Linus, 232 Pay cafeterias. See Cafeterias Payroll, 133 Pearl Harbor, 4, 364 Peebles, Mrs. Thomas, 316 Penfield, Dr. Wilder Graves, 1 3 1 , 238 Penicillin, 62 Pennsylvania Hospital, 3, 5, 45, 200, 201
INDEX "Penny in the pound," 7 Perkins, Miss Dorothy, R.N., xoo Perkins, Sylvia, 335 Pernicious anemia, 20, 214 Perrin, Mr. and Mrs., 163 Perry, Mr. Osbom R., 65, 321 Personnel Department, 46, 72, 133, 180, 346 Peter Bent Brigham Hospital, io, 126, 197 Peters, Andrew J., 30 Pharmacy, 71, 80, 352-355 Phillips House, 7, 1 1 , 14, 19, 22, 26, 28, 35, 37, 39, 47, 64, 68, 76, 106, 1 1 2 , 1 1 3 , 114, 127, 130, 132, 143, 152, 154, 157, 165, 237, 253, 289, 309, 310, 340, 343, 345, 353 Phillips, William, 4 Photography, 350, 351, 352, 355-358 Physical plant, 17, 35, 92, 136, 1 4 1 - 1 5 9 Physical medicine or therapy, 33, 38, 67, 72, 76, 106, 130, 133, 134, 245, 300-303 Physiology, 176, 186, 189 Physiology Department, Harvard, 175 "Play Lady," 265, 274 Plante, Wilfred M., Technician, 384 Policies, Harvard Medical School and Affiliated Hospitals, 90, 135 Polio epidemic, 129, 136, 219, 340 Pondville Hospital, 126 Pope, Dr. Alfred, 189, 191 Porter, Dr. C. H., 295 Post Graduate Courses, 246 Potter, Mrs. Brooks, 310 Power House, 150, 155, 156, 235 Pratt, Dr. John W., 359 Pregnant pig, 77 Prekup, Joseph T., 173 Prince, Dr. Morton, 188 Procter House, McLean, 176 Procurement and Assignment Service, 42, 54, 63, 69, 255 Professional Practice Committee, 170 Professional Service Fund, 107 Presser, Col. W. C. H., 382, 383 Province House, 3 1 Psychiatry, 6, 35, 37, 45, 77, 114, 173, 176, 180, 187, 202, 203, 226, 238, 250, 339 Psychological laboratory, McLean, 176, 180, 187, 188, 189 "Pup" (surgical), 12, 28, 253 Putnam, George, 166 Putnam, Dr. James J., 300
Quick, Raymond, 227 Quinlan, Mary, R.N., 125, 335 Rackemann, Miss Dorothy, 196, 3 1 7 Rackemann, Dr. Francis M., 94, 221 Radcliffe College, 70, 71, 88, 104, 107, 181, 243, 326, 331, 372 Radiation therapy, 224 Radiology, 6, 9, 18, 20, 47, 92, 114, 164, 226, 245, 250, 256, 288-292, 293, 350. See also X-ray Radioactive arsenic, 214 Radioactive iodine, 20, 212, 214 Rae, Dr. R. G., 369, 370, 376 Ragland, Mrs. Stuart, 316 Ragle, Dr. Benjamin H., 23, 166 Ragsdale, Dr. Luney V., 30 Raker, Dr. John W., 128 Rates, 22, 47, 76, 81, 82 Ration Board, 66 Rationing, 55, 60, 346 Rawson, Dr. R. W., 76, 87, 100, 212, 232 Reception center, 314 Records: committee, 360; patients, 20, 134, 349, 350, 360, 362; room, 361, 362 Recreational therapy, 322 Red Basket Service, 58, 310, 321. See also War Errand Service; Auxiliary and Dispatch Service Red Cross Volunteer Aides, 1 1 , 28, 35, 58, 75; Grey Ladies, 63, 319, 320, 321, 324, 330. See also American Red Cross Reed, Elizabeth, 185, 309 Rehabilitation: Act, 336; clinics, 302; ward, 130 Reggio, Dr. A. William, 89 Renal stones, 213 Research, 5, 87, 91, 97, 142, 209-240; chemist, 48, 230; committee, 97; consultant, 189; council, 136; funds, 39, m , 116, 239, 240, 251 Research Building, 76, 97, 101, 106, 133, 137, 154, 158, 207, 2 1 1 , 233, 235 Research Laboratory, McLean, 189192, 250 Residents, 6, 14, 27, 3 1 , 32, 35, 43, 53, 54, 63, 64, 69, 252-257, 258-263, 284. See also House Officers Resident Physician, 252, 253. See also Director
INDEX Resident Physicians' House, 97, 150, 156, 236 Respirator patients, 130 Retirement plan, staff, 102 Reyersbach, Dr. Gertrud R., 217 Rhees, Dr. Morgan J., 48, 154 Rhineiander, Dr. F. W., 218, 228, 229 Rice, Emily, 341 Richards, Alfred N., Ph.D., 45, 200, 202 Richardson, Dr. E. P., 10, 67, 216, 217, 259 Richardson, E. P., Lectureship, 100, 236 Richardson, Sgt. Francis H., 384 Richardson, Dr. M. H., 360 Richardson, Mrs. Mary, 154, 160 Richardson, Dr. Oscar, 40 Richardson, Dr. Wyman, 70, 90, 100 Ripley, William S., 52 Robbins, Dr. L. L., 70, 79, 90, 220, 226, 288, 289, 290 Robbins, Dr. William B., 30, 1 1 0 Robie, Dr. Theodore P., 64 Robinson, Dr. G. Canby, 341 Robinson, Dr. Samuel, 10, 216 Roche, Virginia, 309 Rockefeller Foundation, 6, 61, 91, 124, 190, 222, 226, 266, 276 Rockefeller Institute, 189 Rockwood, Dr. Ethel M., 100 Rodkey, Mrs. Grant V., 314, 316 Roentgen, William C., 350 Roentgenologist, 21, 47, 289, 290. See also Chief of Radiology Rogers, Dr. Horatio, 101, 367, 369, 383, 384 Rogers, Dr. William Α., l i s Romberg, Dr. Eli C., 1 2 1 , 128 Ropes, Dr. Marian W., 2 1 3 Rose, Dr. Augustus S., 110, 228 Rosenwald Fund, 45, 161 Rosenwald, Julius, 161 Rotch, Dr. Τ. M., 265, 266 Roth, Sgt. Clarence E., 384 Rufle, Miss Esther L., 185 Russell, Col. Frederick F., 18 Sacchi, Lt. Ruggiero, 383 Sahler, Dr. Otto, 289 St. Clair, R. W., 356, 359 St. Elizabeth's Hospital, Washington, 188 Salaries and wages, 13, 39, 104, See also Nursing Service; Salaries
Saltonstall, Gov. Leverett, 65, 321 Sampson, Charles H., 355, 359 Sanatoria, State T. B., 10 Sarris, Dr. E. P., 383 Sawyer Construction Company, 24, 163 Schatzki, Dr. Richard, 226, 288, 289, 290 Schloss, Dr. Oscar M., 272 Schmitt, Prof. Francis O., 233 School for Dietitians. See Dietary School of Medical Illustration, 47, 244, 358 School for Medical Record Librarians, 244. 363 School of Nursing. See Nursing, School of School of Public Health, Harvard, 189 Scholz, Frank, 291 Schulz, Dr. M. D., 227, 291 Schulz, Mrs. Milford, 3 1 5 Schwab, Dr. Robert W., 23, 218, 223, 225 Scientific Advisory Committee, 87, 97, 101, 1 1 2 , 136, 232, 235 Scientific Laboratory, McLean, 176 Scott, Sgt. William G., 384 Scudder, Dr. Charles L., 100 Seem, Dr. Ralph B., 13, 48, 163 Segali, Dr. H. N., 2 1 2 Selective Service, 34, 42, 57, 175 Selverstone, Dr. Bertram H., 1 1 0 Sergott, Mrs. Kathleen, 309 Service Pins, 71, 114, 179, 322 Seymour, E. Louise, 89, 363 Shattuck, Dr. Frederick C., 61, 210, 275 Shaw, Dr. Benjamin S., 252, 300 Shaw, Dr. E. B., 272 Sheldon, Dr. Russell F., 79 Shepley, Bulfinch, Richardson and Abbott, 163, 164, 235, 237 Sherrill, Rt. Rev. Henry K., 8, 74, 78, 117, 164, 237, 3 1 1 Shipley, Dr. Margaret, 256 Shock, 64, 229. See also Office of Scientific Research and Development Short, Dr. C. L., 213, 382, 384 Sidis, Boris, 188 Simeone, Dr. Fiorindo Α., ios Simmons, Dr. Channing C., 30, 1 2 1 , 294 Simmons College, 7, 22, 99, 104, 181, 243, 244, 245, 324, 330, 332, 363 Sinclair, Ruth, R.N., 79 Singer, Lt. Walter, 375, 381, 385 Siscoe, Dr, Dwight L., 105
INDEX Sixth (6th) General Hospital, 34, 43, 54, 61, 67, 68, 289, 365-386; Bologna, 68, 382, 383; Camp Blanding, 53, 61, 68, 367, 368, 369, 370, 374, 384; Camp Kilmer, 370, 385; Casablanca, 61, 372-376 passim, 378, 380, 384, 385; Oran, 378; Naples, 378, 379; Rome, 68, 379, 380 Skiagrapher, 350 Sleeper, Ruth, R.N., 21, 25, 39, 93, 108, 119, 124, 327, 328, 330, 334 Smith College, 244 Smith, Prof. Elliott Dunlap, 131 Smith, Dr. G. G., 29, 69, 72, 213 Smith, Dr. Judson Α., 128 Smith, Lauren H., 45 Smith, Dr. P., 213 Smith, Dr. Richard M., 267, 268, 273 Smith, Capt. V. D., 368, 383 Smith, Dr. William David, 23 Smith-Petersen, Dr. Marius, 38, 78, 121, 219 Smithwick, Dr. Reginald H., 79, 220 Snow, Helen, 342 Sobel, Dr. E., 222, 279 Social Relations Department, Harvard, 180 Social Security, 29, 102, 104, 336 Social Service, 12, 16, 23, 28, 31, 51, 52, 65, 109, 112, 120, 126, 129, 131, 210, 218, 227, 244, 267, 302, 313, 317, 318, 322, 336-342; anniversary, 131, 340; library, 338; records, 337; supervisory committee, 130 Society of Pediatric Research, 275 Solomon, Dr. Harry, 180 Sosman, Dr. M. C., 292 South Medical, 32, 46, 91 Southworth and Hawes, 355 Soutter, Dr. Lamar, 53, 115, 296, 297, 298, 299 Sowles, Dr. Horace K., 89 Spear, Charles E., 89 Specter, Dr. L. B., 224 Spiro, Dr. David, 123 Spofford, Rev. William B., Jr., 305 Sprague, Dr. Η. B., 215, 217, 236 Sprague, Mrs. Henry B., 23 Spring Street Court, 152, 153, 157, 158 Squire, Dr. Lucy F., 256 Staff Clinic, 27, 91, 347 Staff, medical: active, associate, and house, 133; tenure, 102, 249; war service, 43, 53, 57. See also M.G.H. Staff Associates
Staff, nursing and employee, war service, 64, 68 Staff Wives' Association, 120, 126, 311, 312, 314, 315 Stanbury, Dr. J. B., 212 Stanton, Dr. Alfred H., 173, 180 Staples, Miss Caroline, 194 Starr, Dr. M. P., 212 State Asylum, Worcester, 172 Stearns, Howard O., 288 Steward, 343 Stevens, Alvira B., R.N., 89 Stewart, Jessie, R.N., 335 Stewart, Dr. John D., 49, 217 Stigmatine Fathers, 182 Stillman Infirmary, 10 Stoeckle, Dr. John D., 123 Storrow House, 77, 93, 134, 142, 153, 159 Storrow, James J., 159 Stotz, Dr. Elmer H., 175, 188, 189 Strock, Dr. M. S., 213 Strong Memorial Hospital, Rochester, Ν. Y., 8, 226, 301 Strong, Dr. Richard P., 94 Strong, Mrs. Richard P., 67, 309 Student Association, McLean, 182 Sturgis, Dr. Somers H., 110, 196, 197, 383. 384 Suby, Dr. Η. I., 213 Sullivan, Rev. D. F., 186 Sullivan, Lt. Col. E. R., 385 Sulzbach, Dr. Wolfgang, 179 Surgeon General U.S.A., 41, 226, 254, 366, 367 Surgical Amphitheatre, 253 Surgical Building, 18, 143, 155, 156 Surgical Executive Committee, 9-10, 21 Surgical Service, 6, 9, 10, 14, 32, 57, 136, 250, 254, 261, 301, 303, 366; East Surgical Service Chief, 16, 27, 117, 217, 259, 263; South Surgical Service, 12, 28, 253, 259, 260; Third Surgical Service, 259; West Surgical Service Chief, 16, 27, 28, 31, 117, 217. 259, 260, 263 Swartz, Dr. Jacob H., 110 Sweet, Dr. Richard H., 167, 216, 217, 225 Sweet, Mrs. Richard H., 314, 315 Sweet, Dr. W. H., 225, 233 Sympathectomy, 220 Syphilis, 9, 16, 18, 32. See also Dermatology
INDEX Talbot, Dr. Fritz Β., s a i , 264, 265, 371, 274» 275. 276. 278 Talbot, Mrs. F. Β., 269 Talbot, Dr. Nathan Β., 115, 22i, 222, 277, 278, 279, 280 Talbot, Dr. John, 175, 228, 369, 370, 385 Taylor, Dr. Grantley, 295 Teaching: at General Hospital, 5, 142, 241-263; McLean, 180; missions, 87 Technicians, 244, 318 Ten-year Plan, 99, 102, 135, 250, 251 Tenney, Dr. Vivian, 256 Terry, Edith T., 270 Terry, Dr. Theodore L., 77 Thacher, Catherine (Mrs. Robert Vickery), 317 Thayer, Mrs. Nathaniel, 7, 313 Thayer Nurses' Home, 150, 155, 330 Therapeutic Trials Panel, 112 Third party fees, 102 Thoma, Dr. Kurt H., 62, 74, 80, 89 Thompson, Dr. W. O., 212 Thorndike, Dr. Augustus, 302 Thorndike, Mrs. Augustus, 120, 312, 313 Thorndike, Dr. W. T. Sherman, 33, 42, 95 Thymus Surgery, 218 Thyroid Clinic, 212, 214 Tibbetts, Miss Margaret C., 182 Tillotson, Dr. Kenneth J., 39, 173, 174, 176, 191 Titus, Dr. Raymond S., 79, 100 Tobin, Maurice J., 164 Tomasello, Joseph Α., 17, 163 Tomasello, Samuel J., 73 "Total push" treatment, 183 Towle, Dr. Harry P., 23 Townsend, Dr. Charles W., 266 Townsend, Dr. James H., 110 Trauma Clinic, 219 Treadwell, Dr. John G., 350 Treadwell Library, 37, 49, 72, 114, 127, 273. 338, 361, 363 Trinity Dispensary, 194 Trull, Agnes J., R.N., 49 Trump, John G., Ph.D., 205, 289 Trustees, 8, 9, 20, 24, 25, 27, 30, 34, 38, 39. 47, 53. 58, 59. 61, 62, 66, 67, 69, 78, 83, 84, 87, 89, 94, 95, 101, 102, 105, 109, 132, 144, 163, 165, 167, 249, 251, 277, 304, 305, 317, 324, 337, 349, 350, 351, 358, 360; Committee on Nursing School, 328;
room, 37, 38; Vincent Memorial, 195, 196; visiting committee of, 252 Tufts University, 245 Tufts University Medical School, 242 Tumor Clinic, 9, 32, 56, 205, 227, 289, 290, 292-295, 339 Ulfelder, Dr. Howard, 123, 126, 167, 170, 198 Unit Record System, 20, 134, 360. See also Records United Community Services ( Community Fund), 9, 111 United States Air Force, 288 United States Army and Navy, 211, 240 United States Government, 255 United States Public Health Service, 103, 107, 190, 234, 236, 288, 291, 327, 333 United Mine Workers, 303 University of Göteberg, 127 University of Leeds, England, 20 University of Massachusetts, School of Nursing, 181 University of Pittsburg School of Public Health, 127 Urmy, Dr. Thomas V., 18 Urology, 9, 10, 15, 18, 29, 46, 250, 303 Vance, Dr. Robert G., 288 Van de Graafe, Dr. R. J., 205, 207, 289, 291 Van Gorder, Dr. George W., 79, 100 V.E. and V.J. Day, 68, 74, 256, 364 Venereal disease clinics, 18 Veterans, reception, 74, 135 Vickery, Dr. Herman F., 40, 247 Vieillot, Mlle Marie-Thérèse, 341 Viets, Dr. H. B., 218, 225 Vincent, Dr. Beth, 8, 214, 266, 295 Vincent-Burnham Building, 74, 114, 133, 134, 143. 153. 158, 278, 352, 353 Vincent Club, 44, 71, 194, 195, 196; show, 194, 195; drill, 195, 322 Vincent, George E., 285 Vincent, Mr. and Mrs. J. R., 194 Vincent Laboratory, 112, 116, 126, 196, 197 Vincent Memorial Hospital, 44, 76, 77, 79. 80, 97, 112, 120, 126, 134, 193199, 277, 312, 322, 336, 339 Vincent tube, 295 Visiting: to children, 281; hours, 112, 333
INDEX Volunteers, i l , 28, 46, 52, 55, 58, 63, 64, 65, 111, 130, 316-323; days, 58, 65, 71» 135. 321, 322; manual, 65, 320, 322; service bureau, 317, 320, 322 Volwiler, Dr. W., 215 Vose, Dr. R. H., 70 Wages and salaries, 13, 47. See also Salaries Walcott, Henry P., Fellowship, 210 Walcott House, 22, 39 Waldfogel, Samuel, Ph.D., 176 Walsh, Sen. David I., 40 War: of 1812, 41; Civil, 41, 142, 317; Korean, 101, log, 336; Spanish-American and Phillipine, 41, 317; World War I, 219, 229, 248, 296, 300, 366; World War II, 32, 135, 170, 182, 196, 211, 225, 228, 229, 231, 254, 261, 278, 288, 289, 291, 301, 364, 365, 366; war effort, 364-386 War Department, 365, 366, 367, 370, 384 War Errand Service, 58, 77, 119, 135, 310, 321, 322. See also Red Basket; Auxiliary and Dispatch Service War Production Board, 66 Wards: A (Warren), 150, 152, 155; Β (Jackson), 150, 155; C (Bigelow), 35. 150. 155; D (Townsend), 35, 150, 155; E (Bradley), 12, 35, 37. 92, 143, 150, 156, 277; F (Gardner), 150, 152, 156, 288; G (Weld), 72, 156, 215; I, 38,( 45, 72, 102, 150, 156, 302; Children's Medical Ten and Twelve, 37, 44, 273; Gay Ward (O.P.D.), 17, 18, 150, 153, 155, 288, 352; Mallinckrodt-Ward IV, 64, 87, 92, 134, 137, 212, 322; Pavilion Wards, 143; Touro Ward, 148, 155 Warren Building, 76, 129, 131, 134, 137, 154. 158, 211, 234. 235, 237, 238 Warren, Mrs. Edward, 3 1 2 Warren, Dr. John C., 3, 4, 241, 317 Warren, Dr. John Collins, 204 Warren, John Collins, Laboratories, 56, 87, 125, 126, 134, 135, 204, 205, 206, 207, 216, 223, 236, 250 Warren Library, 114, 308, 313, 314, 317. 318 Warren Triennial Prize, 120 Warton, Mrs. Helen S., 57, 310 Washburn, Dr. Frederic Α., 5, 17, 23,
33, 38, loo, 134, i54, 253. 276, 308, 317. 324, 336, 350, 355, 360, 365 Washburn's History, 134, 151, 172, 205, 212, 282 Watkins, Dr. Arthur L., 33, 38, 301, 302 Watson, Katharyn Hoyt, 310 Webster, E. W., Ph.D., 226 Webster, Edwin S., 125, 313 Webster, Mrs. E. S., 313 Webster Laboratory, 125, 132 Weisberger, Dr. David, 95 Weiss, Mrs. Elizabeth S. (Mrs. Soma Weiss), 104, 341 Welch, Clara M., 269 Weld, George S., 73, 170 Welfare: committee of General Court on, 81, 82; departments, 81; patients, 96, 1 1 1 Wells, Dr. Charles E., 115 Wells, F. Lyman, McLean, 188 Wells, Shirley, 347 Welsh, Elizabeth, R.N., 93 West End development, 117, 127 West End Nursery, 266 West, Mrs. Weldon, 316 Wharf, old, 150 Wheelwright, Mary, 93 Wheelwright, Mrs. Sarah Cabot, 93 Whipple, Dr. G. H„ 230 White Building (George Robert White Memorial Building), 13, 17, 24, 31, 35. 37. 44. 47, 48, 50, 51, 61, 64, 92, 117, 130, 133, 136, 143, 149, 153, 158, 162-165, 211, 216, 260, 288, 289, 293, 338, 344. 345. 358, 361 White, E. Michael, 106, 117, 120, 167 White Fund, 31, 162 White, Dr. James C., 48, 70, 77, 216, 220 White, Dr. Paul D., 15, 78, 87, 94, 215, 264, 270, 291, 295, 317, 356 Whitford, Mr. Homer Α., 176, 185 Whiting, Isabel, 341 Whiting, Mrs. Richard G., 314 Whittemore, Dr. Wyman, 10, 216 Whittier, Isabelle, 274 Wigglesworth Professor of Dermatology, Harvard Medical School, 91 Williams, Carrie L., 49, 361, 363 Williams, Dr. C., 215 Williams, Dr. Hugh, 72, 159 Wilson, Maj. Gen. Arthur R., 377 Wilson, Eleanor, 73, 79, 322, 323 Wilson, Eunice W., 28, 337, 341 Wise, Dr. C. S., 72
INDEX Withee, D. C., 356, 359 Wolcott House, 93, 152, 157, 330 Wolf, Miss Mary R., 128, 323 Women's Defense Corps, 52 Women's Education Association, 328 Women's Industrial and Educational Union, 319 Women's Medical College, 126 Wood, Dr. W. Franklin, 40, 173, 177, 178 Woodhouse, Mr. (Harvard), 272 Worcester, Mrs. David, 46, 318, 320, 323 Worcester Memorial Hospital, 111 Workmen's Compensation Act, 59—60 Worthy, Capt. W. S., 368, 384 Wright, Dr. James Homer, 208, 210, 214, 246, 295
Wright, Dr. Mary, 255, 274 Wright, Dr. Wade, 224 Wyatt, Frederic, Ph.D., 176, 180 Wyman, Dr. Rufus, 172 Wyman, Dr. Stanley, 123, 170, 227, 289, 290, 383 X-ray: high voltage, 20, 204, 224, 227. See also Radiology Young, Dr. Edward L., 78, 338, 341 Young, Dr. James H., 267, 274 Zander, Dr. J. G., 300 Zander Room, 300 Zamecnik, Dr. Paul C., 91, 115, 206207, 224, 229, 231 Zinsser, Dr. Hans, 40, 229
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