Good Medicine: The First 150 Years of Rush-Presbyterian-St. Luke's Medical Center

GOOD MEDICINE

The First 150 Years of

Rush- Presbyterian- St, Luke^s

Medical Center

JIM BOWMAN

$16.95

This is a story of medicine as it
moved from the pioneer care-giving
era of the early 1800s to the
sophisticated health settings of today.
It is the story of the many colorful,
caring physicians whose vision helped
spawn new ways to educate caregivers
and new methods to heal the sick
. . . and of the generations of
dedicated health professionals and
civic leaders who, over the past 150
years, shaped one of the nation's
leading academic health centers. It is
the story of Rush-Presbyterian-St.
Luke's Medical Center.

This informal history of the medi-
cal center traces its development from
the chartering of Rush Medical Col-
lege in 1837 just two days before the
City of Chicago obtained its charter,
the early beginnings of St. Luke's
Hospital on the city's near south side
and of Presbyterian Hospital on the
city's near west side, through the
subsequent merger of these institu-
tions.

Along the way, the story presents a
procession of Chicago's great medical
names — Herrick, Fenger, Senn,
Bevan, Billings, Hektoen — and in-
stitutions— The University of
Chicago, Cook County Hospi-
tal— and the part each played in the
growth of the medical center. The
narrative proceeds against a back-
ground of the great events that have
occurred in the life of Chicago and
the nation — the cholera epidemic of
the 1850s, the Great Fire, two world
wars and, in our own day, the dra-
matic changes occurring in health
care delivery.
(continued on back flap)

GOOD MEDICINE

LIBRARY OF RUSH UNIVERSITY

600 SOUTH PAULINA STREET

CHICAGO, ILLINOIS 60612

Benjamin Rush, M.D., 1746-1813.

(Portrait attributed to Thomas Sully)

GOOD MEDICINE

The First 150 Years of

Rush-Presbyterian-St. Luke's

Medical Center

Jim Bowman

ChTSS^^^^'-'N'^ STREET
CHICAGO, ILLINOIS 60612

CHICAGO REVIEW PRESS

All photos, unless otherwise credited, courtesy of Rush- Presbyterian- St. Luke's
Medical Center.

ISBN: 1-55652-015-8 (cloth)
1-55652-016-6 (paper)

LC No. 87-10305

Copyright © 1987 by Rush-Presbyterian-St. Luke's Medical

Center
All rights reserved

Printed in the United States of America •
First Edition

Published by Chicago Review Press Incorporated,
814 North Franklin, Chicago, IL 60610

Like the institution it chronicles, this book is dedicated
"To the Glory of God and the Service of Man."

Digitized by the Internet Archive

in 2011 with funding from

CARL!: Consortium of Academic and Research Libraries in Illinois

http://www.archive.org/details/goodmedicinefirsOObowm

Contents

Prologue ix

Rush is Chartered & Opened, 1836-1857 1

Ferment in Medical Education, 1836-1871 10

Presbyterian Hospital & Rush Medical College

in the Late Nineteenth Century, 1871-1898 18

St Luke's Hospital is Established, 1864-1900 38

A Marriage Made In Heaven:

Rush & The University of Chicago, 1898-1924 66

Rush & The University of Chicago

Go Their Separate Ways, 1924-1941 76

Clinical Observations, 1898-1946 86

Postwar Revival, 1946-1955 121

The Merger & Campbell's Accession
to the Presidency, 1955-1965 137

The Second Founding of

Rush Medical College, 1963-1983 161

New Leadership, New Directions
Rush-Presbyterian-St. Luke's After Campbell 184

Appendix I 195

Appendix II 198

Bibliography 205

Index 211

Prologue

This essay is meant not to close the book on Rush-
Presbyterian-St. Luke's Medical Center but to open it. That is
to say, it is an attempt at history by a writer who is not a
historian in the hope that historians will have their interest
piqued and others will find it a lively story.

If that sounds as if meant to disarm, let it. My approach has
been to tell a story, though at times I have been more a mapper
of landscape. In neither case have I tried to break new ground.
Rather, I have leaned on others who did so — historians and
other chroniclers, including journalists, who write history by
the day.

It's a commemorative work in which I tried not to be too
commemorative, lest readers feel called on more to praise
famous men and women than to finish the book. I want readers
to finish the book, though the table of contents and index will
encourage browsing, which is all right too.

What I don't want is for readers to feel they have to read it
because it describes a worthy cause (which it does). Hence it
tells a story and moves as quickly as possible without footnotes

IX

X GOOD MEDICINE

and with a minimum of base-touching. The text itself has
some footnote material.

At the end is a bibliography which expands what I say here,
namely that I have written while standing on others' shoul-
ders. There is also a list of interviewees. Maybe in the inter-
view material a historian will fmd something to use. I am
grateful to the interviewees, who helped me write the book.

I am also grateful to Bruce Rattenbury, who commissioned
this book and shepherded it and me through the process of
research, composition and approval. Pesky he wasn't, how-
ever, and for that I am doubly grateful. His associate Nancy
K. Gallagher contributed editing help. William Kona, the
Rush archivist, was very helpful in providing materials and
verifying dates, titles and a dozen other details.

The advisory committee appointed by President Leo M.
Henikoff, M.D., helped to flesh out my narrative. These are:
Evan Barton, M.D., Doris Bolef M.L.S., Max Douglas
Brown, J.D., Frederic de Peyster, M.D., Stanton A.
Friedberg, M.D., the late Ruthjohnsen, R.N., Janet R. Kin-
ney, M.D., C. Frederick Kittle, M.D., and again, William
Kona. Erich E. Brueschke, M.D., provided helpful comment
on the typescript, which was also read by Harold A. Kessler,
M.D.

The usual disclaimer is in order: what's good is mine,
what's bad is mine. Whatever you do, don't blame the advisors.
In any event, I trust the book will tell you less than you want to
know about a marvelously health-abetting enterprise prepar-
ing for its second 150 years.

Jim Bowman
February 1987

Rush is Chartered & Opened
1836-1857

The young surgeon Daniel Brainard came to Chicago in 1836
riding on a pony, one of many wise young men from the East
who flooded into that village by the lake with streets of dust
and mud and sidewalks made of wood. He was part of a human
avalanche.

"Strangers fill our public houses and streets," said a local
newspaper. "Our wharves are covered with men, women and
children." Warehouses were thrown open to hold them. It was
not unusual for 50 new immigrants to arrive in one day. One
day, 200 came on 12 ships. Not a day passed with fewer than
10 arrivals. The village not yet a city numbered some 3,000
people.

Brainard himself was born in upstate New York, the fifth of
nine children of a prosperous farmer. A tall, well built man, he
was restless and ambitious.

He had studied at the small but influential College of Physi-
cians and Surgeons at Fairfield, New York, as did Nathan S.
Davis, later his colleague and competitor in Chicago. His Doc-
tor of Medicine degree was from the highly respected Jefferson

1

2 GOOD MEDICINE

Medical College in Philadelphia. As an Easterner, he was a
typical newcomer to Chicago, where all but one of the first 10
mayors were Eastern-born.

Arriving in the village, he was met by John Dean Caton, a
lawyer, whom he had known three years earlier when they
were students in Rome, New York. On Caton's advice
Brainard sold the pony to nearby Indians and deposited his
saddle bags in Caton's office, there to begin his practice. It
would do for a start.

He connected almost immediately with other physicians —
movers and shakers of the community who shared his vision of
a city served by well-educated doctors. The need was obvious.
Sanitary, not to mention dietary, conditions were dismal. Peo-
ple didn't know how to eat or how to clean up after themselves.
Thousands were crammed into tight spaces. A typical great
American city was being born. Medicine was a high priority.
Decent medical education was a must.

A medical school was in order, and no one knew it better
than Brainard and these community leaders. In the fall of
1836, he and one of them. Dr. Josiah Goodhue, the son of a
medical school president in Massachusetts, drew up a charter
for one. A few months later, in the winter of 1837, they had it
presented to the legislature in Vandalia, then the state capital.

They named the new school after Benjamin Rush, a Phila-
delphia physician active in Revolutionary politics and a post-
Revolutionary medical and humanitarian leader, who had
died in 1813. Rush was the only formally trained physician
who signed the Declaration of Independence. The first presi-
dent, George Washington, was his patient.

Rush pioneered in psychiatry and published papers and
books about alcoholism. His theories about "excess excitability"
of blood vessels led to a controversial emphasis by him on
bleeding and purging of patients. In Philadelphia in 1786, he
founded the nation's first free dispensary and later was pro-
fessor of medicine at the newly founded University of Penn-
sylvania. His family was well established in Philadelphia, and
Brainard hoped to gain financial support from family
members.

Rush is Chartered & Opened 3

Goodhue was a prominent civic figure and debater who
pushed successfully for the city's first public school system. He
died in 1847 when he fell into an open well while making a
night house call. Another was Dr. John T. Temple, who like
many physicians of the day, had wide business interests. His
shipping firm was the first to ship mail out of Chicago. He
operated a stagecoach line and built part of the Illinois-
Michigan canal. Another of Brainard's contacts. Dr. Edmund
S. Kimberley, was a commercial pharmacist who sold patent
medicines.

They and Brainard and other incorporators received their
charter for Rush Medical College on March 2, 1837, two days
before the city of Chicago received its charter. It was the first
school of any kind chartered by Illinois, the first health care in-
stitution in Chicago, one of the first medical schools west of the
Alleghenies. The date was otherwise inauspicious. The year
was one of financial panic and depression, and the school's
opening had to be delayed. Neither did the Rush family see fit
to contribute to its support, as Brainard had hoped. An in-
terim began.

Brainard became the city's first health officer and served for
a year. He was appointed to the largely inactive Chicago
Board of Health in 1838 and in that year did a difficult leg am-
putation (for an injured canal worker) with medical colleagues
watching. He performed with his usual boldness and coolness
and made a reputation that attracted the first of his "aristo-
cratic" clientele.

As a frontier surgeon, he was no bumpkin. His polish set
him apart. Indeed, some considered him cold and remote, ap-
parently because of his seriousness and directness. Later, he
was the first to use ether in the city, while amputating a finger
at the dispensary in Tippecanoe Hall, at Wolcott and Kinzie
streets on January 12, 1847. It was the same dispensary where
chloroform was used 12 days later — either by Brainard or
another surgeon — 10 days before it was used in New York.

In 1839 Brainard went to Paris, where he observed and per-
formed various studies, doing a number of surgical procedures
on cadavers. He returned to Paris in the mid- 1850s and again

4 GOOD MEDICINE

in 1866, just before he died, each time to revel in the oppor-
tunities for experimentation which he found there. He liked it
there, and they liked him. The superintendent of the "garden
of plants" in Paris, where experimental animals were kept,
approved his work and gave him the help he needed.

Brainard was a scientist, unlike most of his medical col-
leagues in the U.S., where a sort of common sense empiricism
was the order of the day. Furthermore, when he wrote about
his work, either experimental or surgical, he did it in the con-
text of what others were doing and recording. He weighed and
balanced various procedures, carefully noting pros and cons.
His article on un-united fractures won a prize.

But he and his colleague James Van Zandt Blaney, whom
he met during this interim, were exceptions to the rule. U.S.
and especially Midwestern doctors were not systematic experi-
menters, but rather tried things out at random, pretty much in
isolation from each other. Brainard and Blaney were two of the
few who pursued solutions with the systematic approach we
call science.

One of the factors that worked against experimentation was
widespread Midwestern antipathy to dissection of cadavers,
which in turn led to the "body-snatching" and grave-robbing
problem immortalized by Mark Twain in his Adventures of Tom
Sawyer. (Tom and Huckleberry Finn watched the murder of a
young doctor by one of his grave-robbing accomplices, Injun
Joe.) Indeed, medical schools were damned if they did and
didn't equally: without cadavers they could not train students
in anatomy, with them the public rose up to complain.

A school in St. Charles, Illinois, west of Chicago, broke up
when a mob invaded its quarters and shot the president. Years
later, in 1857, a Rush student and the city sexton were charged
with "resurrectionism" (student's term for body-snatching)
and were vilified in the press as "hyenas" and "barbarians."
Before 1859 the only bodies available were those of hanging
victims, and not until 1885 did Illinois law give students access
to paupers' bodies otherwise destined for burial at public
expense.

In 1842 Brainard taught at St. Louis University medical

Rush is Chartered & Opened 5

school. The Rush trustees had met at least once while
Brainard had been in Paris. As would be the case a hundred
years later, the Rush charter was there to be used, but the
users had to await their opportunity. In St. Louis Brainard
met the young and likable Dr. James Van Zandt Blaney,
whom Brainard recruited as the school's first teacher.

In 1843 Brainard finally opened his medical school. (He had
given anatomy lessons in the interim, in his office.) In his in-
augural address, he set forth noble goals. "The health, the
happiness and the life of your dearest friends and your own,"
he told the students, "may and will some day depend on the
skill of some member of the [medical] profession .... To
elevate the standard of skill and knowledge in the profession,
to excite an honorable emulation among its members, to dis-
seminate for their successors in this new region the principles
of medical science . . . such are the objects held in view by the
founders of this institution."

The institution's curriculum was standard: two 16-week lec-
ture courses, held in the winter so the farm boys wouldn't miss
planting or harvesting, of which the second simply repeated
the first. There was a variation: the second 16 weeks could be
dropped in favor of two years working with "a respectable
physician." In any case, three more years were apparently re-
quired with such a preceptor. The Doctor of Medicine degree
recipient had to be 21 and of good character. He had to pre-
sent a thesis in his own handwriting for faculty approval, in
addition to passing examinations on lectures. Students were
male.

The sole female student during Rush's first 60 years or so,
Emily Blackwell, was dismissed in 1852 after Rush was cen-
sured by the Illinois State Medical Society for accepting her.
Students were white except for David Jones Peck, whose Doc-
tor of Medicine degree in 1847 was the first for a U.S. black
from a U.S. medical school.

Fees were $10 a course, or $60 a term, plus a $20 graduation
fee and $5 to cover dissection costs if the student were so in-
clined. Fees were payable by note in some cases, but these
were not always collectible. When Austin Flint, one of the first

6 GOOD MEDICINE

Rush teachers, returned East, he took notes with him; they
weren't worth much in Chicago and presumably dechned in
value the farther east he traveled. Flint said he would not
return to Chicago until they were paid. They apparently
weren't; he certainly didn't. Board was $2 a week.

Later, Rush teacher Nathan Davis, intent on opening medical
education to as many as possible, insisted on reducing fees,
which were dropped to $35 a term. Some 20 years later, in
1879, the regular medical schools of Chicago and Cincinnati
agreed to fix fees at $75; it was one more step in removing
medical education from the category of "a competitive com-
modity," to use historian Thomas Bonner's phrase.

Twenty-two students matriculated in Rush's first class, in
December of 1843. They met for lectures in a rented hall in the
Saloon Building on Clark Street south of the river. Teachers
and students waded through mud to the minimally furnished
classrooms.

Plans were already afoot to build. Civic leaders William B.
Ogden, the city's first mayor and chairman of the Rush board,
and Walter Newberry and others offered help if Rush moved
north, across the Chicago River. This is where the first Rush
building went up, at the corner of Dearborn Street and what is
now Grand Avenue, in the summer of 1844, at a cost of
$3,500, most of it from faculty pockets. The Chicago Democrat
called it "an ornament to the city." Rush Medical College was
showing people that Chicago could hold its head high not only
commercially but intellectually and morally as well, the news-
paper proclaimed.

Operating expenses were financed in part by sale of stock
certificates at $50 each. These were apparently donations or
free loans, redeemable at face value but earning no interest for
the buyer. Later, in 1855, another building was erected. The
faculty again covered the cost. Indeed, Rush trustees (who
held bonds that did earn interest) were mostly faculty through-
out the century. Rush was not for profit, but it was run as if it
were.

This is not to say there was much money to be made from
the venture. The problem with the proprietary schools (and

Rush is Chartered & Opened 7

most were proprietary) was not profit-taking but control. And
in Rush's case, non-proprietary as it may have been, Brainard
pretty much ran the show, as became clear when he successfully
resisted a faculty majority in the late fifties.

As for Rush's moneymaking potential, it could not have
been much. Blaney may have decorated his cabin beyond
frontier standards, and Rush professors bought their surgical
instruments in Europe, but none of this pointed to their Rush
connection as a source of wealth. Medical education in general
at the time was a business, it is true, entered mostly for profit
by entrepreneurs, including instructors. There was sharp com-
petition for students and low standards, such as eight months
"reading" with a practitioner for whom students "ground the
powders and mixed the pills." That and four months of listen-
ing to lectures, and one had his M.D.

By the start of Rush's third year, in any event, the school
enjoyed "increasing facilities," according to the Chicago
Democrat. By 1848 it had produced 71 graduates, 30 in the class
of '48. It had given five honorary degrees.

Teachers were picked for their lecturing ability. Not until
the 1880s did lecturing begin to give way in medical schools,
and then to periodic student recitation as an aid to motivation,
as Nathan Davis urged. These early lecturers were a young
lot, as befitted their pivotal roles in a young city, not to men-
tion profession, since medical education was in a pioneer state
as well. In Rush's first 16 years, 12 of its 14 professors were 35
or younger. Among the first were James Blaney, William Her-
rick (no relation to the famous James Herrick, who came
later), Austin Flint and Moses Knapp (who was older than
35).

James Van Zandt Blaney was all of 23 when he became a
charter member of the Rush faculty, teaching chemistry and
pharmacy. An attractive young man of winning disposition,
he was much liked by students and about everyone else, for
that matter. Without fanfare, as was his style, he started the
city's first medical dispensary in his office across the street
from the Sherman House, reportedly in 1839. Later, Brainard
began a surgical dispensary to go with it, to greater acclaim —

8 GOOD MEDICINE

testimony to Brainard's personality as much as the substance
of the achievement.

In 1843 the combined medical-surgical dispensary was moved
to the newly occupied Rush Medical College building. Its
attending physicians were largely Rush faculty. In 1845 it was
moved to a large warehouse called Tippecanoe Hall, at
Wolcott and Kinzie streets, where Brainard, Blaney and
William Herrick established Chicago's first general hospital in
1847. This was the first Cook County hospital, insofar as the
county furnished most of its supplies.

But it didn't last long, and dispensaries remained the near-
est thing to a hospital. People went either to a doctor's office or
a dispensary, which in essence provided outpatient care. At
the latter they could pay or not, according to ability. Paying
patients might use the dispensary, which was not much publi-
cized; people just seemed to know it was there. It provided no
place to keep trauma cases, of course. As such it was prelude to
the hospital, which could lodge such patients.

The Rush faculty was extensively involved in organizing
hospitals. The first to survive was the Illinois General Hospital
of the Lakes, which opened in 1850 in rooms rented at the
Lake House Hotel at North Water and Rush streets. This
hospital was largely the work of Nathan Davis. Brainard ran
surgery. Dr. John Evans ran obstetrics, Davis and Dr. Levi
Boone ran the medical department. Medical students did the
nursing according to a vague arrangement that proved unsat-
isfactory. The Sisters of Mercy took over the nursing and run-
ning of the place in 1851. The Rush faculty reserved beds in
return for its offer of free care to the needy.

As for Blaney, who in a sense started it all with his dispen-
sary, work at the dispensary wasn't enough in the way of
extracurriculars. He also was founding editor of The Illinois
Medical and Surgical Journal, the city's first such publication, in
1844. In its first issue he explained, as does every editor in a
maiden issue, that his publication was to meet needs not being
met, in this case among Midwest physicians.

It would carry local medical news, including epidemic statis-
tics and descriptions of remedies both reliable and otherwise.
The latter would be branded as "newfangled impostures," and

Rush is Chartered & Opened 9

Midwestern doctors and their patients would be suitably warned.
The journal, later called the Chicago Medical Journal and edited by
Rush professors Evans and Davis, ran mostly reprints from
Eastern and European publications. Some Rush originals also
were printed, including articles by Evans and others on the
dreaded cholera. Later it served as a vehicle for one side of the
Brainard-Davis feud of the 1860s.

Blaney also lectured around the city to great effect and success,
and later succeeded Brainard as president of Rush following
Brainard's death in 1866.

William B. Herrick, 31, a Dartmouth M.D., class of 1836,
and an Illinoisan since 1839, was a popular anatomy lecturer.
Promoted to professor in 1845 in recognition of his popularity
with students, but over objections of some of his Rush col-
leagues, he left not much later for service in the Mexican War.
From Mexico he wrote letters to Blaney's journal about health
conditions among U.S. troops and in Mexico in general. He
returned to teach at Rush, where he remained until 1857. In
1850, he became the first president of the Illinois State
Medical Society.

Another of the original faculty, Austin Flint, stayed three
years at Rush and then returned east to build a distinguished
career as author and professor at Bellevue Hospital Medical
College in New York City.

Brainard's evident keen ability to choose top performers
stands out even more brightly when one considers the mistakes
that were available to him as demonstrated in the case of
Moses Knapp. Knapp was not liked by the students and was
cashiered at the end of the first 16-week term. Once dismissed,
he told stories about his former colleagues apparently to
discredit them, leading Blaney to conclude they had been
doubly right to fire the man. Then Knapp was caught seeking
to lead a young girl astray on graduation night at the La Porte,
Indiana, medical school, where he taught after Rush, and was
dismissed from that institution as well. Nonetheless, he had in
all an apparently distinguished career in and out of Chicago,
including a stint as dean of the Rock Island (Illinois) Medical
School, which eventually became part of the University of
Iowa.

Ferment in Medical Education
1836-1871

The second wave of Rush teachers brought with it the
Nestor of Chicago medicine, Dr. Nathan S. Davis, already
founder of the American Medical Association and founder-to-
be of Northwestern University Medical School. He was also
an evangelist and prophet for reform in medical education and
was destined to be a thorn in the side of his counterpart at
Rush, Daniel Brainard, who, it may be said, gave him his start
in Chicago.

Known for his activism in the cause of medicine and medi-
cal education, Davis was recruited for Rush at the AM A con-
vention in Boston in 1849 by John Evans, another trailblazer
whom Brainard had already drawn to Chicago.

Evans was a mental-health progressive from Indiana, praised
by reformer Dorothea Dix for his work in that state on behalf
of the mentally ill. A Cincinnati College medical graduate,
class of 1838, who overcame his Quaker father's objections to
studying medicine, Evans became also a railroad and real
estate investor and philanthropist. He played a key role in
founding Northwestern University (its location, Evanston,

10

Ferment in Medical Education 1 1

bears his name), took an abolitionist position on slavery and
spent the last 36 years of his long life in Colorado, where he
began as territorial governor and among other things founded
the University of Colorado.

Evans was a gung-ho recruiter for Rush, which he joined in
1844, enthusiastically pumping the hinterlands for students,
going in fact beyond what Brainard thought suitable. Brainard
didn't believe in pushing young men in the matter of medical
careers. He thought Evans overdid it.

Maybe Brainard came to think Evans overdid it when Evans
brought the prophetic, reformist Davis into Chicago. Davis's
first big splash was to call immediately for free medical educa-
tion, something he said both community and students deserved,
stating this as a Rush goal. On the spot he promised three free
"tickets," as they were called, for Rush courses. Other schools
naturally complained at the underpricing, but Davis was un-
moved. Native ability alone should be the only requirement
for medical school, he said. Indeed, he is better known for his
insistence on higher requirements, of which more later.

Another of this second wave of Rush teachers was Edmund
Andrews, a paragon of the polymath physician. An expert in
botany, zoology, ornithology and geology, he pioneered in
antisepsis and in 1856 helped found the Chicago Academy of
Natural Sciences (of which Blaney was the first president). His
adding of oxygen to nitrous oxide made long-term anesthesia
safe.

These gentlemen were teaching and practicing medicine
and surgery in virtually epidemic surroundings. The state was
only decades removed from the "graveyard" category into
which it had been lumped early in the century. One Illinois
county in the 1820s had lost 80 percent of its population to
malaria. In Chicago the chief problem, worse even than
malaria and typhus, was cholera, which broke out in 1832 and
1849, providing a number of scares in between.

The city's bad reputation endured into the 1850s. In 1850 it
had no sewerage system. Davis pushed for one and in addition
lectured on alcoholism, infant care and other matters of per-
sonal hygiene. Like Brainard, he stayed abreast of the latest.

12 GOOD MEDICINE

"Out of the hydrants came fish dinners. MilHons of rats lived
under raised wooden walks," said one breezy chronicler years
later, when it was too late to count the rats. In this frontier-like
town, men far outnumbered women: by three to two in the
20-50 age bracket. Over half the people were foreign-born: 52
percent in contrast to New York's 45 percent.

In the midst of it all stood Rush Medical College, already in
1850 the 10th largest of the nation's 150 medical schools. And
within its not yet hallowed walls, a first-class fight was brewing.

Davis had brought with him strong ideas about the ideal
availability of medical education. On the one hand he wanted
it unrestricted by cost considerations, on the other more rigidly
restricted according to ability. He also faced up to the anomaly
of the curriculum: the bright students he wanted to attract
were asked to sit through two identical 16-week lecture
courses.

He pushed immediately, therefore, for a "graded curricu-
lum," that is, one in which the second year built on the first
without repeating it, offering clinical matter as follow-up on
basic science. Andrews the multifaceted scholar backed him
up. They and others pressured the "imperious and auto-
cratic" Brainard, who for various reasons resisted.

Among them was the natural reluctance of the successful to
change their ways. The Rush way was how everyone did it.
Older students probably took some responsibility for teaching
younger ones. The system seemed to be working, illogical as it
was. Anyhow, wasn't repetition the mother of studies?

Secondly, good teachers were hard to find. Nobody knew
that better than Brainard, who had already put together
several faculties. There was the serious question whether
doubling the curriculum content might not put a strain on or
even exhaust the available teacher-pool. It was the sort of thing
a medical school founder who had been there might worry
about.

Nonetheless, Brainard found himself a minority of one on
the graded-curriculum issue, if not at first, then at least by the
summer of 1857, when in his absence the faculty voted in favor
of it. The die being thus cast, they told Brainard on his return

Ferment in Medical Education 13

that they wanted to take it to the trustees. Brainard said no, he
would take it. He did and returned with the answer no. Rush
would not switch.

If Rush wouldn't, Davis, Andrews and others would. In
1859 they left Rush to form their own school, Chicago Medical
College, which later became Northwestern University Medical
School. The split was permanent and it was a blow to Rush.
Davis and five allies — Hosmer Johnson, William Byford,
David Rutter, Ralph Isham, and Andrews — took Mercy Hos-
pital with them, leaving Rush without adequate clinical train-
ing facilities. Brainard's students had to use their dispensary
and later the U.S. Marine Hospital, neither of which appar-
ently was a match for Mercy.

Brainard, bitter, criticized Davis and the others, though not
by name, as "incompetent, noisy individuals." Medical
knowledge, he maintained, depended not on curriculum but
on teacher. If you wanted to improve it, you got better
teachers. Neither did you cut fees, as Davis wanted to do,
since fee income paid for better libraries and led to better
educated doctors. Brainard's approach was to multiply stu-
dents, not requirements.

When Davis said the country was full of "half-educated
physicians," Brainard called him a traitor to the cause of the
"regular" physicians, as opposed to homeopathic and other
"irregular" physicians, calling Davis's comment "an unjust
attack upon physicians and schools." Davis was no softy on
the homeopathic question, however. In 1850, as secretary of
Rush Medical College, he had refused admission to a homeo-
path, that is, a doctor who cured with minute doses of what in
large amounts would induce the symptoms.

In drinker's parlance, homeopathy offers a hair of the dog
that bit you. In those days it enjoyed considerable popular
support, and the dispute between the two schools was a lively
one. The allopath, one who sought directly to alleviate symp-
toms, was classed as "regular," however.

Davis's refusal of the homeopathic applicant had caused a
protest over alleged violation of the man's rights. Again, in
1857, he had refused to serve on the staff of the new city

14 GOOD MEDICINE

hospital because homeopaths would also be serving there. A
typical man of principle, Davis was hard to live with at times.

Brainard had his own prickliness. He also refused coopera-
tion when he felt used, as when he led a boycott in 1850 of the
newly formed Chicago Medical Society, which elected as
president Dr. Levi D. Boone, who later won the Chicago
mayoralty on the Know-Nothing ticket. Brainard, who looked
on medical societies as "trade unions" concerned with fee
standards or "punitive leagues" concerned with ethics en-
forcement, didn't like Boone anyhow. So the decision was an
easy one. His boycott killed the baby society, but Davis, a
proven believer in group action, revived it two years later.

Brainard instead gave his support to a rival organization
with more professional and academic goals, the Chicago
Academy of Medical Sciences, which was founded in 1859 and
consisted largely of Rush teachers for its three years' existence.

Meanwhile, Davis announced the program for his new
school in an inaugural address at Market (later Wacker) and
Randolph streets, in a building called Lind's Block. (His
school began under the aegis of the short-lived Lind Univer-
sity. Decades later. Northwestern University took it over.)
The program included these changes (or reforms) from the ac-
cepted way of doing things: a five-month term (versus 16
weeks), fewer lectures per day, more professors, full recogni-
tion of clinical chairs, daily clinical hospital experience for
students, and the vaunted graded curriculum. Bonner notes
that Harvard did not adopt these changes for 12 years. On the
other hand, neither was all of it strange and new, notably the
clinical training part, which was a Rush staple from the start.

Rush resisted most of this, waiting nine years to add two
weeks to its course length and 17, well after Brainard's death,
to adopt the graded curriculum. The Brainard-Rush position
was that graded curriculum forced students to cram basics in
their first year while neglecting them in the second, clinical,
year. In 1868, The Chicago Medical Journal, a Rush-allied
publication, referred to Davis not complimentarily as "the
apostle" and to his school as "the reform school."

The competition did not hurt Rush enrollment, however. It

Ferment in Medical Education 1 5

rose from 119 in 1859, the year Chicago Medical College
began, to 374 in 1866, the year of Brainard's death. Chicago
Medical College on the other hand did not reach 100 students
until 1865. Some of Rush's enrollment gains, it should be
noted, came from courses offered in military surgery during
the war.

Davis later promoted another reform, higher entrance re-
quirements. As early as 1867, he required English, mathe-
matics, science, Latin and Greek of his incoming students.
This sort of thing had no appeal to the Rush administration.
Of 135 students in the Rush class of 1888, for instance, only
seven had a college diploma of any kind, according to its
distinguished alumnus James Herrick, a man of extensive
liberal arts credentials in his own right. Only by 1891 did
Rush ask applicants to prepare themselves in algebra, geom-
etry, rhetoric, logic, Latin, English and physics — 20 years
after the state first tried to raise entrance requirements in Il-
linois medical schools.

In all this Davis comes off the dreamer, Brainard the moss-
back. But Brainard had his dreams too, in scientific medicine.
He had been impressed in Paris with the French emphasis on
student involvement in hospital work and experimentation
and thought lecturing could be overdone. Davis wanted more
lectures, though fewer per day. The problem was, as Brainard
knew from experience, where to find the lecturers. Rush for its
part had from the beginning offered classes in anatomy (with
dissection) and clinics in surgery. Rush students from the start
learned about medicine in the dispensary.

Davis thought more in societal terms than Brainard and
cared deeply about education, but he wasn't the scientist
Brainard was. His articles do not refer to others' positions on
the matter he was treating. Brainard's always did. So did those
of his colleague (and protege?) Blaney. Judged in this light,
Davis was the plunger, Brainard the thoughtful one who took
others' opinions into consideration, but it's only one light, and
neither profits from too much thumbnail-sketching.

Brainard was arrogant but very good at some things, judg-
ing men, for instance. He picked some top-drawer performers

16 GOOD MEDICINE

and never worried about the competition this would cause
him. Witness the hall of fame he gathered around himself at
Rush, including Davis. Then beginning all over when Davis
and the others left, he put together another good team.

Another difference between the two was that Brainard
favored specialization while Davis didn't, even though his
graded curriculum idea seemed to call for it. Brainard hired
Edward Holmes, the eye doctor, at the first opportunity. He
thought it was wonderful that this young man knew so much
about the eye. As a result. Rush had its ophthalmology depart-
ment (after Brainard 's death, in 1869) a year before Chicago
Medical College.

Finally, perhaps the crucial difference was that Brainard
thought education depended on the teacher and patient con-
tact, almost regardless of the curriculum. Davis, more the
theoretician and logician in the matter, seemed to put curric-
ulum first.

In a sense these two giants of early Chicago medical educa-
tion complemented each other. Their feud may be seen as fer-
ment which led to progress, as another kind leads to wine. In
any event, neither threw in his lot, in the final analysis, with a
losing proposition. The professional heirs of each can be grate-
ful for that.

Brainard the politician and civic figure was a Chicago type.
He tied in with the Democrats early in his Chicago experience.
By May 1847, he was serving with William B. Ogden, the
city's first mayor and president of the Rush board of trustees
from 1843 to 1872, on a committee to help raise money for
Irish relief during the potato famine.

In 1858, with the slavery question dominant, he ran for
mayor on a pro-choice platform, enjoying the support of
"every pimp, every shyster, every blackleg, base men and
lewd women," who expended "fiendish energy" on his
behalf, according to the Daily Democratic Press, which obviously
did not support his candidacy.

He sided with national or mainstream Democrats in opposi-
tion to the moderate position taken by U.S. Sen. Stephen A.
Douglas of Illinois. National Democrats had supported the

Ferment in Medical Education 1 7

Dred Scott decision, but Douglas broke with the administra-
tion on a related issue, whether the pro-choice Kansas consti-
tution had been fairly presented to the Kansas electorate. In
the ensuing political fallout, Brainard sided with the regulars.

Then Douglas faced Lincoln in the 1858 senatorial election,
in the midst of which a phony story surfaced that Douglas
owned slaves in Louisiana. Brainard was in the middle of this
one. He was the first to be told the story, by a visiting Louis-
ianan named Slidell, and passed it on. Slidell and Brainard
eventually denied the accuracy of the report but not until it
had made the rounds and damaged the Douglas campaign.
Douglas won the election, but Brainard lost his, for mayor.

The war years passed, Brainard made what turned out his
final trip to France, and then the end came. He died of gallop-
ing cholera, on October 10, 1866, a few hours after he was
stricken while working on a lecture about the disease to be
given that night. An alderman and another doctor died the
same day. Brainard was 54 years old.

Two hundred Rush students panicked when they realized how
close they were to the dread disease and voted to adjourn
classes until December because of the danger. The faculty talked
them out of it. "They of all men should not fly," added The
Tribune editorially, and the students stayed.

The Rush-Chicago Medical College feud began to fade im-
mediately. Davis even drew up a plan for merging the two
schools according to which the Rush course would be expanded
to five months and the Rush faculty's "proprietary relation-
ship" to their school would be ended. (Rush operated on a
not-for-profit charter, but faculty members held the bonds and
were its trustees.) But Davis's reunion plan was never taken
seriously. Excitement lay ahead but not yet a merger.

%

Presbyterian Hospital &
Rush Medical College in the
Late Nineteenth Century
1871-1898

The Chicago fire of 1871 left thousands homeless and devas-
tated the city's medical facilities, including the four-year-old
Rush Medical College building at Dearborn Street and Grand
Avenue. Dr. Joseph W. Freer, Rush's new president-elect,
found his half-melted microscope stand and various pieces of
chemistry apparatus in the rubble.

This was all that remained of Rush as a physical plant.
Throughout the city, devastation reigned. Over 200 doctors,
including most of the Rush faculty, were without home, office,
library, entire practices. Moses Gunn, Brainard's successor as
professor of surgery, lost books, office, instruments, anatom-
ical specimens and a huge manuscript. Many students lost
everything they owned, with no way to replace it.

Ten-year-old James Herrick watched the flames from his
home in Oak Park. After the fire his father with other Oak
Parkers, including author Ernest Hemingway's grandfather,
brought food and blankets to the homeless and hungry, return-
ing shaken from the expedition.

"They were starving," the senior Herrick reported on his

18

Presbyterian Hospital & Rush Medical College 19

return. Men, women and children, huddled on the Lake
Michigan shore, wept and kissed his hand as he distributed
sandwiches, crackers, hard-boiled eggs, milk and coffee from
his covered delivery wagon. He wept himself as he told of the
scene, unable to continue his account.

Later James Herrick rode with his father through the
burned-out area, less impressed with the ruins than with the
huge unpainted barracks hastily erected by General Phil
Sheridan's soldiers to house the homeless during the coming
winter. These and soldiers' tents stayed with the memory of
the boy who decades later would make his own contribution to
the relief of human suffering.

Rush Medical College needed space. Its sole rival, Chicago
Medical College (later the Northwestern University Medical
School), had escaped the fire. Its leaders, the reformer Davis
among them, invited Rush students to continue studies there,
at 26th Street and Prairie Avenue, free of charge. Rush did use
their dissecting laboratory. But for lecture purposes (and this
was the heart of the curriculum). Rush reopened four days
after the fire in the small amphitheater on the top floor of Cook
County Hospital, at 18th and LaSalle (then Arnold) streets,
also on the South Side.

The institution was a "large brick building of a dirty red
color ... in a badly kept lot," with nothing about it to "cheer
the spirits of a sick man," according to a news account. Sur-
rounded by a tilting "low, rickety fence," it was neighbor to
shanties. The grounds were strewn with garbage. The street
was muddy and full of holes. The building was terribly over-
crowded.

It was next to this less than salubrious institution and onto
these garbage-strewn grounds that Rush moved after the fire.
Rush was already almost umbilically tied to this now-County
Hospital, which for 11 years had been where its students
received the bulk of their clinical training. But Rush College
itself had been on the other side of town, three miles north. So
the move to the hospital, though forced by catastrophe, none-
theless made sense. Once winter was past, therefore, Rush
built on its grounds, partly below sidewalk level. The new

20 GOOD MEDICINE

building cost $3,500, which was all the trustees could afford.

It was "a rude, brick affair" with a tar roof. On its first
floor at one end was an amphitheatre, at the other was a labor-
atory. Over the lab was a dissecting room. The whole was
unplastered throughout and was "very rough and amazingly
ugly," Rush historians Norman Bridge, M.D., and John Edwin
Rhodes, M.D., tell us. But for under $4,000, Rush students
and faculty couldn't complain. The "rude structure," known
also as "the college under the sidewalk," served for four years,
until both Rush and County Hospital moved to the West Side.

Meanwhile, James V. Z. Blaney, whom Brainard had re-
cruited to the first Rush faculty, retired as president not six
years after succeeding the deceased founder. He was 52 and
had been in Chicago for almost 30 years after graduating from
Princeton and obtaining his M.D. in Philadelphia. He had
served as surgeon with the rank of major of artillery during the
"war of rebellion," as the Rush yearbook called it. Blaney
died two years later.

In 1876, both County Hospital and Rush built anew, this
time on the West Side. Rush built on the northeast corner of
Harrison and Wood, where a successor building remains;
Cook County Hospital built on the southwest corner, where
the 1876 structure remains today.

The Rush building was a considerably grander affair than the
"rude structure," though Bridge and Rhodes later found it sur-
prising that its anatomy museum, which the students didn't even
use, took up more than half its space. The building and lot cost
$75,000, mostly contributed by several faculty members who
purchased long-term bonds to finance construction.

At cornerstone-laying on March 20, 1875, Grand Master
(later Mayor) DeWitt C. Cregier led Masonic ceremonies
after a procession of dignitaries, faculty and students, in that
order, from the LaSalle Street site. "A great concourse of peo-
ple" gathered to hear Dr. J. Adams Allen deliver "sonorous
periods" which Bridge and Rhodes could compare only to
Tennyson reading his own poetry. "Modern Rome is built
upon the roofs of its ancient temples and palaces," began

Presbyterian Hospital & Rush Medical College 21

Allen, and took it from there with a historical overview of
kingdoms rising and falling.

Ten months later, in January of 1876, Allen gave the first
lecture in the finished building, dipping frequently into his
"fund of classical lore" to illustrate his remarks.

The destinies of the two neighbor institutions, Rush and
County Hospital, were intertwined. Rush had its need for
clinical education which County seemed to fill; County had
reason to welcome Rush, with its wealth of talent. The rela-
tionship would have worked wonderfully if it hadn't depended
on people.

At stake was control of this publicly funded hospital, built
by the city in 1857 but not opened until it was leased by Rush
in 1859. Two doctors who joined the Rush faculty in 1860, Dr.
Joseph Presley Ross and Dr. George K. Amerman, apparently
had a vision of a public hospital that would meet the health
care needs of poor people and the medical education needs of
Rush students.

This city-built public hospital was operated by Rush faculty
on contract with city government from 1859 to 1862, when the
Army took it over. After the war, the issue again lay before
Ross and Amerman how to get this public hospital functioning
in answer to community needs for health care and medical
education. Their solution was to go political. Each got himself
elected to the county board of supervisors, Amerman in 1865
and Ross in 1866. Together, they persuaded Cook County
authorities to take over. Thus was established Cook County
Hospital as such.

Medical politics had to be observed in its organization. Its
medical board was to be one part Rush, one part Chicago
Medical College (both equal parts), and one part independent
(greater than the other two combined) — consisting of doctors
connected with neither school.

The arrangement respected medical politics but did not pro-
tect against them. In 1867 Dr. Edwin Powell, a newly ap-
pointed Rush professor who was also a nephew of the late
Brainard, resigned from Rush long enough to be elected to the

22 GOOD MEDICINE

delicately balanced hospital medical board as an independent.
He was then promptly re-elected to the Rush faculty, thus
upsetting the delicate balance.

His maneuverings somehow led, four years later, to the
dismissal by the county board of the medical board and subse-
quent increased involvement by politicians in the hospital's
affairs. This ended hopes for a self-perpetuating, self-
governing medical staff and created an opening for political
interference and mismanagement. Control by politicians thus
followed on doctors' inability to manage their own affairs.

Rush's clinical education needs were being met in part by
its own dispensary, the U.S. Marine Hospital and St. Joseph's
Hospital. But County Hospital with its 130 beds (later 750)
was the biggest in the city, and it was the basket into which
Rush was prepared to put by far the majority of its clinical-
training eggs.

So much the more disappointing were developments of the
early and middle 1870s, when the County Hospital situation
unravelled and the Rush people saw their plans go awry. The
culmination of this unravelling process was the mass dismissal
by the county board of the medical staff in 1878, an episode
shrouded in mystery as far as historical accounts go, its nar-
rative reduced to laconic references to "disruption" and reap-
pointment of a new staff.

Whatever the specifics, it was clear to the Rush people that
County Hospital would not meet their needs. In 1877 Ross
and his allies had seen trouble coming and had already decided
Rush should start its own hospital. It would not be the first
time the college had done so. Mercy Hospital had begun as the
Illinois General Hospital of the Lakes in 1850, largely a Rush
faculty creation. Blaney and Brainard had started dispensaries
and a short-lived city hospital even before that.

The interest was there from the medical school point of
view. As the Rush yearbook of 1895 says, "The value of
clinical instruction can hardly be exaggerated. It far over-
shadows didactic lectures and in some institutions has entirely
supplanted them." Or in the words of the 1894 yearbook,

Presbyterian Hospital & Rush Medical College 23

"Medicine cannot be taught in the abstract; theory without
practice is Hke swimming on dry land." Rush needed a
hospital it could control, so that the hospital's service could
keep pace with Rush's "didactics."

In 1879, the Rush trustees bought land with the intent to
finance and maintain a hospital on their own, but found the
challenge more than they could handle. Ross, the faculty's
"financial wheelhorse," devised a plan whereby a separate
corporation would receive this land in return for Rush control
over the planned hospital.

An offer was made on the spot by "a religious body famed
for its hospitals and amply able to redeem its pledges," the
1894 yearbook tells us. (Moses Gunn was negotiating with
several Catholic nuns' groups.) But Ross, a dedicated Presby-
terian, saw no reason why the city's Presbyterian churches
could not meet the challenge, as they had done in the case of
New York City's Presbyterian Hospital.

To his aid in this venture came several clergy and laymen,
including his father-in-law, Tuthill King, who donated
$10,000. Others who helped and with King became incor-
porators of the new institution (on July 21 , 1883) were William
Blair, Cyrus H. McCormick, Rev. Willis Craig, Henry Lyman
and Dr. Robert C. Hamill, after whom was named the 40-bed
"Hamill Wing," the hospital's first addition.

The new hospital was chartered to offer "surgical and
medical aid and nursing to sick and disabled persons of every
creed, nationality and color." At the same time, it was to pro-
vide care for the "hundreds of people of the better class" who
each year were "stricken by disease or injury," according to
an 1883 appeal for funds. The appeal noted that the city's only
Protestant general hospital, St. Luke's, was "trying to meet
this want" but could "accommodate only a small part of those
who apply for hospital care and treatment."

The new Presbyterian Hospital of Chicago opened in Sep-
tember of 1884, with a nominal capacity of 80 beds, 35 of
which were needed to house nurses and hospital staff. This
first building was the "Ross Wing," named after its chief

24 GOOD MEDICINE

founder. The Hamill Wing was added a few years later, fol-
lowed by the 300-bed Daniel A. Jones Memorial Building in
1889.

Jones was a meatpacker, banker, cable car line operator, in-
surance executive and president of the Chamber of Commerce
and the Board of Trade who died a millionaire in 1886. His
widow and family gave $100,000 to the hospital, which with
$50,000 given by the hospital's president. Dr. D. K. Pearsons,
paid for the new building. Jones had already given $10,000 to
the hospital, reportedly after reading about the first of Pear-
sons' gifts, which were spread over several years.

Later additions to the hospital included the Private Pavilion
adjoining Jones to the east in 1908 and the Jane Murdock
Memorial for women and children in 1912, which to a degree
replaced the original Ross and Hamill wings.

On hand for the Murdock building ribbon-cutting cere-
monies was Elizabeth Douglass, who later as Mrs. Clyde E.
Shorey was for many years to be a mainstay of the hospital's
woman's auxiliary. Mrs. Shorey's father, William Angus
Douglass, was a member of the founding board of managers
and its secretary for more than fifty years.

From the start this auxiliary, or Ladies Aid Society as it was
known, gave the hospital crucial support. Consisting of 82
women, including many of Chicago's "leading women," from
17 Presbyterian churches, the society supplied the new hos-
pital with bedding and other linen, kitchen ware, utensils and
housekeeping appliances. The women supplied patients with
various delicacies, books, papers, magazines, even pictures for
the walls. They bought "screens, wheelchairs, complete din-
ing room furniture, china, cases of dishes." They read to pa-
tients, provided hymn books for Sunday afternoon services
and did "much to make the stay of the sick pleasant," accord-
ing to the second (May 1885) annual report of the hospital.

The Ladies Aid Society became the Woman's Auxiliary
Board in 1910. By 1913 it had 200 members. In 1915, mem-
bership was opened to non-Presbyterians. In the mid-1920s
the Woman's Auxiliary Board recognized "delegate mem-
bers" whose task was to rally support in the local congrega-

Presbyterian Hospital & Rush Medical College 25

tions. In 1928 the name was shortened to Woman's Board, the
present name. By the mid-1950s, at the time of the Presby-
terian Hospital merger with St. Luke's Hospital, the
Woman's Board numbered almost 400 members from 53 Pres-
byterian churches. Pastors' wives were members ex officio.

The churches for their part began in 1884 to endow annual
free beds at $300 each per year, and individuals followed suit.
Barbara Armour endowed one in perpetuity for $5,000,
Henry Corwith's daughter endowed another for $10,000, and
Mrs. William Armour endowed a 10 bed ward for $50,000.
The young institution was off to a good start, having tapped an
ample philanthropic lode.

Meanwhile, Rush Medical College moved ahead with its
clinical education, for which in part it now depended on the
new Presbyterian Hospital. Among the early teachers in this
new Rush-Presbyterian situation was Dr. Joseph P. Ross him-
self. A professor of diseases of the chest, Ross was recalled by
his student James Herrick as "a good family doctor" who
relied heavily on his stethoscope, which he had learned to use
from Austin Flint, one of the first Rush teachers (though Ross
was not a Rush graduate). He was not highly regarded as a
scientist or scholar, however. "Gentlemen," his students
would say, mimicking him, "we will now discuss the pathol-
ogy of tuberculosis. There are two kinds of tubercle, the gray
and the yellow. We now pass on to the symptomology of the
disease."

Ross is one of those whom Herrick classes as "less
scholarly" faculty members, along with William Byford,
Moses Gunn, Charles Parkes and James Etheridge, who were
nonetheless "earnest, forceful and always understandable,"
men trained largely by experience, with common sense and an
understanding of the needs of undergraduates.

Gunn's surgical clinic drew on his Civil War experience in
emergency bone-setting and on his extensive private practice.
Having begun his work in the days before anesthesia, he was
used to working fast. Herrick saw him repair a child's harelip
in five minutes without anesthetic. Gunn withheld judgment
on the germ theory, referring to microbes as "little devils,"

26 GOOD MEDICINE

but soaked sutures in carbolic acid solution because he knew it
speeded healing.

He was almost never late for lectures and clinics but was
held up once by a Chicago River bridge-raising. "Damn the
Chicago river bridges," he hurled at a student at the door as
he arrived two minutes late. "They are no respecters of college
teachers." To the class he apologized, saying he had lost not
two minutes of his time but "two minutes' time of each one of
you three hundred men," which made 600 minutes, or ten
hours. "It was a new point of view," commented Herrick.

A student passed a note to him asking how he kept his hair
so curly and who was his barber. Gunn read it aloud and ex-
plained how his wife curled his hair every morning, had done
so since they were married, and "by the Eternal" would con-
tinue to do it as long as she wished. The students loved it.

But when they booed the appearance of a woman intern,
Dr. Alta Mitchell, he excoriated them for acting like "Halsted
Street hoodlums." Dr. Mitchell was the niece of a good friend
of his, Gunn told them. She was competent "and a lady." He
had appointed her intern, "and Gentlemen, she's going to
stay," he told them. They, however, would leave, all 300 of
them, if they booed her again. "Make your choice," he said.
They kept quiet and stayed, and so did Dr. Mitchell, who as
daughter of the late pastor of First Presbyterian Church had
been admitted as an intern "out of respect to her father,
though her qualifications eminently fitted her for the place,"
according to the 1894 yearbook.

Gunn died of cancer in 1887. He was succeeded by Charles
T. Parkes, another surgeon of the old school who nonetheless
sought younger men's opinions to stay abreast of new dis-
coveries. Parkes was criticized for operating in the clinic on
abdominal cases because of the supposed danger of germs
dropping into the exposed area — a view on its way to being
discredited. He responded: "Gentlemen, I do not know much
about these new germs, but I am convinced that what does the
harm is not something that may float in the air and settle into
the open abdomen. ... It is what I put into the abdomen that
makes the trouble." Therefore he washed and scrubbed his
hands and boiled the instruments, gauze and ligatures, going

Presbyterian Hospital & Rush Medical College 27

far beyond what his colleagues did in this matter.

Parkes, the first surgeon in the Midwest to experiment in
gunshot wounds of the small intestines, died of pneumonia in
1891 at forty-nine. Herrick says he had "a majestic, magnetic
personality" and would have been "one of America's out-
standing surgeons."

The germ question was central to medical controversies of
the day. Antisepsis, the philosophy and procedures by which
the surgeon and others fought germs as the cause of disease
and infection, was resisted in the 1870s and 1880s even by
some heroes of the '50s and '60s. The great Nathan Davis, for
instance, in 1876 attacked the notion that specific germs caused
specific diseases, arguing that not everyone exposed to them
caught the disease in question. He wouldn't accept the argu-
ment regarding natural immunity. In 1879 he opposed the im-
position of quarantine during an epidemic, still resisting the
germ theory.

Moses Gunn, Chicago's best-known surgeon in the 1870s,
came around to the new view slowly if at all (opinions
differed), holding long to the doctrine of "laudable pus" as a
measure of surgical success. Even when he wavered from that
view, he still saw suppuration as "a dangerous thorn, from
which occasionally, at least, a fragrant flower was plucked."

He had company in his footdragging. In 1883, most sur-
geons at a meeting in Cincinnati of the American Surgical
Association, Gunn among them, agreed with a speaker who
deplored the "reckless abandonment" of bloodletting (leech-
ing) in combating inflammation.

Rush had all kinds. James Herrick mentions scholars and
old-schoolers and makes it clear he benefited from both.
Among the scholars was the immensely learned Dr. Henry M.
Lyman, who held the chairs of both physiology, an elementary
subject, and neurology, an advanced one. It was a situation
that epitomized Rush academic disarray in the mid- 1880s.
From September to Christmas, Lyman lectured on physiol-
ogy, from Christmas to late February on neurology. The final
examination was on both together. It was not the ultimate in
academic good order.

In February of 1887, Lyman, smarting from allegations of

28 GOOD MEDICINE

being an easy grader, threw his students two curve balls — two
barely defined essay questions, including one about poliomye-
litis, a term known to few. Herrick heard a fellow test-taker
whisper "infantile paralysis"; so he caught the drift and was
one of four who passed out of 200 or so.

Lyman distinguished himself as a neurologist and in 1893
was elected president of the American Neurological Associa-
tion— the first Chicagoan to hold the position since pioneer
neurologist James S. Jewell, of Chicago Medical College, held
it in the 1870s.

If the Rush system didn't always make sense, it must be
viewed in the context of how little was expected of medical
students at the time, and also with a look at the role of the
clinics, where students sometimes seemingly through osmosis
captured the essence of what had to be known from remarks by
the professor.

Not that the students as a rule were hankering for more.
Herrick himself, later a major scientific medical figure of his
day, had never heard of Rush but was sent there by an Oak
Park physician alumnus. He had taught school and considered
a career in literary scholarship. When he got to Rush, he found a
mixed bag of fellow students. Many were born leaders, bound
to succeed in anything they tried. Some of the older ones,
veterans of careers as druggists or salesmen or even cowboys,
seemed "crude and raw" but had the advantage of beginning
with a good working knowledge of human nature. The faculty
made the difference, thus confirming Brainard's position some
decades earlier in the graded-curriculum controversy.

The students could be a rowdy bunch when the spirit moved
them. On one occasion they greeted Lyman with a stunning
pre-lecture mess of thrown snowballs, spitballs, overshoes, apples
and the like. Lyman entered, and the throwing stopped, but its
evidence was there. The arena floor was a pigsty. Lyman turned
and walked out, disgusted. There was no lecture that day.

Sometimes the play was vocal, as when three or four hun-
dred voices burst forth at intermission time with "Clemen-
tine" or "My Old Kentucky Home." Sometimes it was
physical, as in "passing up," when a front-row student was

Presbyterian Hospital & Rush Medical College 29

passed bodily up to the last (top) row, where, when he was
dropped, the several hundred students stamped their feet as
one.

There were free-lance efforts as well. One student, acting as
clinical assistant during an operation, took exception to being
asked to step aside by another who wanted to see better and
thereupon with surgical clamps pulled the other's mustache.
The mustached student waited till the operation was over and
then punched the other in the nose. "I got what was coming to
me, Professor," the punched one explained to Dr. Parkes, the
operating surgeon, who took him into the hospital to have his
nose fixed.

Other professors whom Herrick considered scholars were
Walter S. Haines the chemistry professor, Edward L. Holmes
the ophthalmologist, De Laskie Miller the obstetrician, and
James Nevins Hyde the dermatologist and author in 1883 of
the textbook. Diseases of the Skin. A dapper man, Hyde was
widely known for his book and for his clinics.

At County Hospital Norman Bridge was one of four attend-
ing physicians whom a young doctor was lucky to work under;
the others were Christian Fenger, John B. Murphy and P. J.
Rowan. His lectures on pathology were considered sound and
thorough, however much students chafed at their length.

Compared to Dr. William Quine at the nearby College of
Physicians and Surgeons, Bridge was maddeningly vague
about the symptoms of typhoid fever. Quine's students got a
picture clear as glass but, as students discovered later, some-
what clearer than reality. Diagnosing typhoid was apparently
not as easy as a student of Quine might have thought.

Bridge's manner with a patient during clinic was respectful
and courteous, even if the patient was poor and ignorant. His
diagnosis, furthermore, respected the "natural tendency
toward recovery" which called sometimes for "drugless man-
agement" of an illness.

One day Bridge informed Herrick that the tuberculosis
bacilli he had been examining were Bridge's own — a flareup of
an old problem. "In a few days I shall be leaving Chicago
never to return," Bridge said matter-of-factly. And he did

30 GOOD MEDICINE

leave the Chicago medical scene, moving to California for his
health. Eventually he made a great deal of money in oil and
donated generous amounts to Rush and The University of
Chicago. He died at a ripe 81 in 1925.

A "learned and wise medical philosopher," though not a
scientist, was Dr. J. Adams Allen, who came to Rush in 1859
as professor of medicine and was Rush's president from 1877
to 1891. Patriarchal in appearance, "Uncle Allen," as he was
called, discussed general causes of disease, including tempera-
ment or humors or even the weather, rather than symptoms,
diagnosis or treatment. He rejected bacteriology and even
mocked the stethoscope as just another appurtenance of the
pompous diagnostician.

His lectures were scholarly and witty, his anecdotes not
always of "the parlor variety." Not surprisingly, he clung to
the lecture method and to the large amphitheatre clinic — the
sort Will Mayo called "windy (and) wordy" — and routinely
recommended consideration of "condition of blood, of the
nerve and the part," as students inscribed on a pedestal in his
honor. It was not a bad short statement of what caused
disease, Herrick noted. Allen died of cancer in 1899.

Dr. De Laskie Miller, who held the Rush chair of obstetrics
for many years, was a superb lecturer to whom students listened
attentively, without the show of rowdyism that some lecturers
inspired. Miller spoke without notes or props, "with excep-
tional clarity," calling on his wide reading and extensive expe-
rience in midwifery.

His successor, J. Suydam Knox, on the other hand, lectured
in "casual, rambling" fashion, drawing exclusively on his ex-
perience, "of which he often boasted," rather than on scholar-
ship bolstered by practice. In 1892, pediatrics was separated
from obstetrics at Rush, with Alfred C. Cotton, a descendant
of New England Cottons, its first professor.

"Uncle" Allen's successor as Rush's president was Edward
Lorenzo Holmes, the famed ophthalmologist, a Chicagoan
since 1856 and principal founder, in 1858, of the Illinois
Charitable Eye and Ear Infirmary. As a young man he en-
joyed the company of New England literary lights, including

Presbyterian Hospital & Rush Medical College 31

the poet Henry Wads worth Longfellow, and spent summers at
the Utopian Brook Farm community in Massachusetts. A Har-
vard College graduate before studying medicine in Vienna,
Paris and Berlin, Holmes was a modest and retiring soul. He
is said to have been so stunned by the (apparently normal)
students' noise and uproar that greeted him when he arrived
to give his first lecture at Rush that he turned around and left
without lecturing.

William H. By ford, one who had left Rush with Nathan
Davis to start Chicago Medical College in 1859 and later had
been founding president of Woman's Medical College, lec-
tured in gynecology at Rush in the mid- 1880s, having rejoined
Rush in 1879. Always on time for class, dignified, deliberate,
he began each lecture session by quizzing students, calling
names from a class list. He spoke without notes — "plain,
straightforward talks" without repetition. When the bell rang,
he stopped, bowed politely, took his hat and left. Byford died
in 1890, apparently of angina pectoris.

By the 1890s the Rush yearbook was claiming the biggest
surgical clinic in the world, as to numbers of students and
cases, thanks to the Presbyterian Hospital connection. On the
minds of clinic students sometimes overflowing the 300-seat
college amphitheatre were "photographed lasting impressions
of great value." At Rush "the limited value of didactic work"
was recognized. Indeed, the gynecological and medical clinics
and the clinics in eye and ear, chest and throat, skin and
venereal and children's diseases "afforded unsurpassed oppor-
tunity" to graduate and undergraduate students.

Professor Nicholas Senn's surgical clinic met on Tuesdays
from 2 to 4 and Thursdays from 2 to 6. They were "the great-
est in the world," said the yearbook. Cleanliness "in the strict
modern sense" was "the watchword." In the first hour, recent
patients were presented as sequel to preceding clinics and as
sample of results achieved. A student "consulting staff" was
subjected to the "ordeal" of Senn's cross-examination. Dur-
ing operations Senn himself gave a running account.

The Swiss-born Senn, raised in Wisconsin, was one of the
Big Three in Chicago surgery in the late 19th and early 20th

32 GOOD MEDICINE

centuries, with Christian Fenger and John B. Murphy
(Fenger's student). An 1868 Chicago Medical College gradu-
ate who had studied in Munich, Senn joined the Rush faculty
in 1878 as professor of surgery after practicing in Chicago at
County Hospital and in Milwaukee. He combined American
practicality with German analytical methods and was a top
diagnostician though not as good a teacher as Fenger, accord-
ing to a former student writing in 1896.

Courageous, brilliant and original, he once planted cancer
in his arm in an experiment which if successful would have
ended his life. A hard worker with "a passion for authorship"
and an encyclopedic memory, he was inclined to hasty judg-
ments to which he clung tenaciously. "To be on good terms
with him," wrote William Quine in 1908, "you could not
question his supremacy." Those who managed to show proper
respect, however, found him "a prodigy of generosity" and a
delight to be with.

One of Senn's research areas was gunshot wounds. Many
years after his death. Dr. Francis Straus found a room in the
basement of the old Rush building filled with guns, including a
"Nadel Gewehr" from the German army of the 1850s. Senn
worked with animals, shooting them in the abdomen which he
then explored in order to find and close the bullet holes. His
assistant would bubble hydrogen through a catheter into the
animal's rear and then light matches (!) to find the leaks. Senn
toured Europe demonstrating this technique.

Senn's contemporary, who in some ways overshadowed him
and like him had a Chicago high school named after him, was
Christian Fenger, a Danish-born surgeon and pathologist who
arrived in Chicago from Egypt in 1877. (Chicago elementary
schools are also named after Rush teachers Norman Bridge,
William Byford, Nathan Davis and John B. Murphy and after
alumnus Frank Reilly.) Fenger had worked directly for the
Khedive, or Egyptian ruler, who had rewarded him for research
on trachoma in part by the gift of several mummy heads. The
story is told that he brought an entire mummy with him and
sold it to make ends meet in his first months in Chicago; but
his daughter, Augusta Marie Fenger Nadler, of Winnetka, said
there was no record of any such large baggage or transaction.

Presbyterian Hospital & Rush Medical College 33

His early days in Chicago were financially difficult, how-
ever. Before going to Egypt, the young Fenger had studied in
Copenhagen and served in two wars. Like Senn, he made gun-
shot wounds a specialty. He then went off to Vienna to study
surgery and pathology, returning to Copenhagen, where in
one year he did 422 postmortems. Failing to win an important
university appointment when a competitive examination was
not given, he left for Egypt, whence he came to the U.S. after
two years.

Sick and almost out of money when he arrived in Chicago,
he began a small practice and in the spring of 1878, with the
help of a Danish-born merchant, bought himself an appoint-
ment to the politically controlled County Hospital. He was a
lecturer and demonstrator in pathology, which was unknown
territory for his listeners, and filled in for other surgeons when
they went on vacation. In 1879 he took a one-year appoint-
ment at Rush as lecturer in pathological anatomy. In 1880 he
was appointed to the regular surgical staff at County and at the
same time became "curator" of the Rush "museum" of
pathology specimens.

He had arrived at County a "stammering Dutchman." (He
could stammer in seven languages, it was said of him.) W. E.
Quine asked him to do an autopsy and was given "one of the
most astounding experiences" of his life as he watched Fenger
at work. Later he told a student that this "Dutchman," the
Danish Fenger, would be "Chicago's greatest surgeon." Stu-
dents flocked to watch him. He was the best they had seen at
translating autopsy findings into clinical terms and assumed
legendary proportions as a diagnostician.

For his clinics at County, he was at first given the second
half of a two-hour lunch period. Among the few at the start
who came to view and help were L. L. Mc Arthur and J. B.
Murphy, who were smart enough to know what they would
otherwise be missing. "Fascinated" by Fenger's technique
and "thrilled" by his findings, the two were the vanguard of
hundreds who learned pathology from Fenger, who came to be
regarded by interns as a court of last resort in difficult cases.

Before performing major surgery he would read on the sub-
ject in several languages, summarizing it all the night before

34 GOOD MEDICINE

and outlining it the next day on a blackboard for his students,
listing seventeen steps to the removal of a bronchial cyst, for
instance. Sometimes he would stop in the middle of an opera-
tion, cover the wound and go to the blackboard to sketch what
was happening. Now and then, absorbed in his subject, he
would forget to wash his hands as he returned to the patient,
and students would intercept him on his way back to the oper-
ating table.

His operations took longer than normal for the time, up to
six hours. Indeed, he was considered "too thorough for the
abdomen" by his onetime clinical assistant, Dr. T. A. Davis,
closing off every nook and cranny that might be host to sup-
puration or bleeding. His student Murphy, on the other hand,
"got in and out" as fast as he could. During one period Murphy
performed twenty-three appendectomies without a fatality,
while Fenger with his thoroughness and slowness considered
50 percent a good record.

He once performed a thyroidectomy with Gray's Anatomy on
one easel and his own drawings from Swiss surgeon Emil
Theodor Kocher on another, having an assistant turn the
pages of each as various muscles and the like came into view.
At one point he rather roughly handled (with forceps) a
laryngeal nerve, picking off bits of thyroid or fat until it lay ex-
posed, at which point he said, "There, now I know where it is
and that I have not cut it."

Next morning he checked with the patient, a 35-year-old
woman, and asked her to sing, then to say "Ah." She did so,
whispering hoarsely, and Fenger, knowing he had handled the
nerve too roughly, said, "God damn it to hell" and walked
out. It was his expression of guilt at being too thorough in
handling and exposing the nerve. The woman did not suffer
permanent damage to voice or health, however.

On another occasion he cancelled a 9 A.M. operation at 7:30.
He told his helper Herrick about it but not the patient, nurses,
relatives and friends. At 10:30 Fenger walked in and explained
briefly to the dozen or so waiting people why he had decided
not to perform the operation. He left most of the explaining to
Herrick, however, leaving abruptly with his bag of instru-

Presbyterian Hospital & Rush Medical College 35

ments. The autopsy later showed that Fenger was correct, the
operation would have been useless.

In this performance Fenger demonstrated his "childlike lack
of tact" but also perhaps his shrewdness and understanding of
human nature, Herrick says. In any event it was typical of
both his thoroughness and his honesty.

Fenger died of pneumonia in 1902, a few days after his last
clinic, in which he performed a laryngectomy. The operation
finished, he went behind a screen to change his clothes while
his assistants dressed the wound. But in a minute he was back
in front of his students, dressed only in long underdrawers,
bare from the waist up, to make a small point he had missed. It
was about 6:30 P.M., and all but a few students had left. That
night at 2 A.M. he had a chill, developed lobar pneumonia, and
several days later was dead.

Fenger' s achievement was to draw the connection between
pathology and surgery for Chicago doctors. Before him the
paths of pathologist and surgeon did not cross, the surgeon be-
ing more interested in results than in knowing why he got
them. He introduced surgical pathology as a basis for surgical
therapy.

Another lecturer in pathology at Rush at this time was
William T. Belfield, who promoted acceptance of the new
science of bacteriology by showing lantern slides of micro-
organisms. In 1883 Belfield did an autopsy on a tuberculosis
victim, inviting his audience to come down from their Rush
amphitheatre seats and look through the microscope at the
bacillus he uncovered. But there was no systematic teaching of
bacteriology at Rush until 1896, when Edwin C. Klebs, the
famous German investigator of typhoid fever and diptheria,
assumed the chair of bacteriology and Rush became the center
of attention in this new field.

Belfield endorsed the ideas of Robert Koch, the founder of
bacteriology, calling them no mere theory but an "ocular
demonstration" of germs as the cause of tuberculosis. His
published lectures on the relationship between bacteria and
disease at the College of Physicians & Surgeons in New York
comprise one of the earliest U.S. sources on bacteriology.

36 GOOD MEDICINE

Another promoter of Koch's views was Frank BilHngs, who
returned from Vienna in 1886 bringing urine tests, instru-
ments and shdes which he explained to his students at the
Northwestern University-affiliated Chicago Medical College
(finally united with the university in 1891). Billings' distin-
guished career at Rush was to begin some years later, in 1898.

One of Fenger's prime successors in pathology in Chicago,
Ludvig Hektoen, joined the Rush faculty in 1890 as curator of
its "museum" of pathology specimens and lecturer in patho-
logical anatomy and histology. He had interned in pathology
under Fenger at County Hospital and may have participated
in the Wednesday night sessions at Fenger's apartment on
Ohio Street, to which came "students and doctors of all ages"
to pore with him over slides viewed under microscope.

In 1890 Hektoen also became Chicago's first coroner's
physician. Later he was County Hospital pathologist and
headed the McCormick Institute for Infectious Diseases,
which was eventually renamed after him.

The County Hospital internship was a prize won by a dis-
proportionate number of Rush graduates between 1887 and
1894 — 66 of 147. Rush, in fact, was one of four medical
schools which prepped students for the competitive examina-
tion.

Herrick and Hektoen were interns together at County for
eighteen months beginning in April of 1888. Herrick joined
the Rush faculty in 1889 as assistant demonstrator of
anatomy, a year later added a lecturing position on materia
medica, and in 1891 became an adjunct professor of medicine.
The two were to loom big in the life of Rush during its next
phase, the years of its connection to The University of
Chicago.

Another affiliation preceded that one, however — with Lake
Forest University from 1887 to 1898. The affiliation was
nominal and existed for purposes that were vague on both
sides. Lake Forest University, in the distant north suburb of
that name, had all of 63 students and 13 teachers, compared to
Rush's 392 students and 35 teachers. The university title was
questionable at best.

Presbyterian Hospital & Rush Medical College 37

What was in it for Lake Forest was the possibihty of control
of a major institution that dwarfed it. The Lake Forest endow-
ments would accrue to Rush until Rush's debts were retired,
at which time ownership of Rush would revert to Lake Forest.
What was in it for Rush was the possibility of substantial
financial aid without loss of academic autonomy, which the
agreement guaranteed.

The "curious" agreement was struck on June 21, 1887. But
the affiliation in the end was advantageous to neither party.
The hope on which it was based, that Lake Forest would gain a
medical school while Rush gained financial independence,
never materialized. By 1897 Rush was the biggest medical
school in the U.S., with 848 students and 80 teachers, and
money was no longer the problem it had been 10 years earlier,
such were the student fees such a student body generated.

Meanwhile, the two institutions functioned worlds apart.
The Rush baseball team got probably as close as any Rush en-
tity to Lake Forest, defeating its nominal affiliate 17-1 in
1894. This was the year Rush footballers tied Notre Dame
6-6. Few Lake Forest students moved on to Rush for the Doc-
tor of Medicine degree, as the Lake Forest leadership hoped
would happen. Rush was doing rather nicely in a money way.
Late in 1897 the end of the affiliation drew near.

Doctors De Laskie Miller and Henry Lyman and Trustee
Nathan M. Freer were authorized to discuss the matter with
the Lake Forest president and board. They discovered the two
boards' feelings were mutual, and the relationship was dissolved
in June of 1898.

St. Luke^s Hospital
is Established
1864-1900

Chicago was "a pretty crude place" when St. Luke's Hospital
was founded in 1864 by the Reverend Clinton Locke, rector of
Grace Episcopal Church at Peck Court (later 8th Street) and
Wabash Avenue. Catholics operated "a small but excellent
pay hospital," Locke notes in his memoirs. The only other was
the City Free Hospital at 18th and Arnold (later La Salle)
streets, "a small, dirty, ill-arranged place, devoid of all
comfort."

Locke's own church was nothing to write home about to the
folks back in his native Sing Sing (later Ossining), N.Y. It was
the same "hideous wooden building" he had discovered five
years earlier when he had arrived from Joliet — "a wretchedly
built, run-down wooden shell, scattered and peeled."

Some of this was simply life in the big city. In due time
Locke had a new church and lived in what he considered ease
and comfort. But some of it, such as that City Free Hospital,
was bad by any standard. One night he returned from visiting
a patient there in a bug-infested room and decided to do some-

38

St. Luke's Hospital is Established 39

thing about it. He was inspired, he was "not afraid to say, by
the spirit of God."

A week or two later he preached about the need for "a
clean, free. Christian place where the sick poor might be cared
for." Among his listeners were women of the parish already
committed to helping the sick — members of the Camp Douglas
Ladies Aid Society, who cared for sick Confederate prisoners
held at 33rd Street and Cottage Grove Avenue.

They came to him after the service, his wife Adele at their
head, and asked why there shouldn't be a "church hospital."
And would he take the lead in starting one? It was an answer
to Locke's sermon and to the "whisper" in his soul.

On the next day, February 18, 1864, Locke met with the
Douglas society women at the F. B. Hadduck house. They
made him president of the new hospital. Dr. Walter Hay
became its first doctor. Neither the women nor Locke knew
anything about running a hospital, but they were willing to
learn. They went to work not in "rising to a point of order,"
or "moving to adjourn," or "laying a motion on the table, as
so many of their daughters and granddaughters" were doing
30 years later, when Locke wrote his memoirs. "They just
worked as hard as they could to get the hospital going."

They raised $1,500 and "comfortably furnished" a small
wooden house on State Street near Eldridge Court (later East
Ninth Street), "a pleasant little place with grass and flowers
and one or two poplar trees." Into it they crowded seven beds.
Two nurses cared for patients. The first patient, a delirium
tremens victim, left unguarded for a moment, jumped out a
window, seized a knife from a butcher shop and stabbed a
pedestrian, who presumably became the next patient.

Another early patient, ostensibly paralyzed, recovered
rapidly when the skeptical Hay instructed a nurse in the pa-
tient's presence to prepare a hot poker for some cauterizing of
the spine the next day. Two years later the same patient was
reported in a Chicago newspaper as miraculously healed of yet
another ailment. It was apparently another case of either the
woman's extreme suggestibility or her shrewdness.

40 GOOD MEDICINE

In a few months Locke and his alUes moved the hospital
three blocks south to a large, three-story brick house, until
recently a well-known brothel. Its owner-proprietor had died.
Locke officiated at her funeral, speaking "plainly and earnestly
of the sinfulness of their lives" to parlorfuls of "abandoned
women," some of them nearly hysterical with grief and worry.
"It was a curious scene," he observed later.

The house's new owner rented it to Locke for his hospital.
This new place was no better adapted for hospital use than the
first one, but it was bigger. Now there was room for eighteen
beds.

So far, Locke had not gone outside parish bounds for sup-
port. If he had, he wouldn't have gotten any, since "nearly
everybody," including the bishop, Henry J. Whitehouse,
"threw cold water on the project." The rector of St. James,
then the city's leading parish, a friend of Locke, warned him
against the project.

But Locke saw that it had to be more than a parish venture.
Some well-known churchmen listened "good-naturedly" and
agreed to be trustees when he laid his plan before them,
though Locke was sure they thought he'd be better off attend-
ing to his parish.

One of them, Melville Fuller, a state legislator and later
chief justice of the U.S. Supreme Court, shepherded a charter
through the legislature. The trustees of the newly chartered
hospital were the rector and a lay representative of each of the
city's fourteen Episcopal parishes.

Bishop Whitehouse "began to thaw" on the question and in
September of 1865 spoke "tolerably well" to the diocesan con-
vention of what Locke called his "baby hospital." Others
began to lend a hand, including "good women from all the
parishes," who solicited donations in kind: "jams, jellies,
fruits, flowers, cakes, and barrels of oysters."

But in 1868 Grace Church still bore most of the considerable
expense. When things got tough, Locke would call the board
together and threaten to close the place. The trustees "would
hearten (him) up a little," and he would agree to go on.

St. Luke's Hospital is Established 41

Dr. John E. Owens became medical director in 1865. He
held the position to 1911. The early staff included a number of
Rush professors, including Dr. Hay, who reorganized the
Chicago Health Department in 1867. Hay lectured on the
brain and nervous diseases at Rush beginning in 1873. Later
he organized Rush's department of neurology and was editor
of The Chicago Medical Journal.

Dr. Moses Gunn, head of surgery at Rush, was a consulting
surgeon at St. Luke's, as was Dr. William O. Heydock, a
Chicago Medical College professor. Later staff members in-
cluded Rush professors Dr. James H. Etheridge, a gynecol-
ogist, and Dr. Isaac N, Danforth, an early user of the micro-
scope who in his later years was a kidney specialist.

The State Street house was almost comically inadequate.
Autopsies were done on the dining room table. The staff found
this unappetizing. Drugs were kept in the dining room. Ven-
tilation was bad. A machine shop in the rear was dreadfully
noisy. There was no good place to keep a corpse between
expiration and burial.

The dining room doubled as a free dispensary from 1869.
This was no problem. All it took was an "airing out," and it
was ready to be a dining room again.

But "a great deal of earnest Christian work" was done at
the State Street building, said Locke. Overseeing it all was the
"matron" Sarah Miles. "How wise she was, how economical,
how she hated whiskey and lies, and how far she could see
through a stone wall!" Locke wrote in praise of this woman,
the first superintendent of St. Luke's.

In 1869 an eye and ear department was added, with Dr.
Samuel J. Jones in charge.

But Locke wanted out of the State Street place. The trustees
were talking up a storm but no rain was falling, probably
because six years after it was founded the hospital was operat-
ing at a grand annual surplus of $25. Finally John de Koven
made his move.

De Koven, treasurer for the trustees and a warm friend of
the young hospital, came to Locke with news that a big frame

42 GOOD MEDICINE

building was for sale on Indiana Avenue near 14th Street. The
builder of a boarding house had gone broke and was looking
for a buyer. De Koven urged Locke to buy the place. He put
$2,000 of his own money where his advice was and promised
fund-raising help besides. Others helped to raise more, in-
cluding Mrs. John Tilden, who gave a concert, and Mrs. B. F.
Hadduck, who held a fair. Millionaire lard manufacturer
Nathaniel K. Fairbank, destined to be a major St. Luke's
benefactor, gave $500.

The new place opened May 15, 1871, at 1426-30 South In-
diana Avenue, with 25 beds bought with proceeds from a
charity ball. All but a few were for charity patients, St. Luke's
being for "the relief of respectable poor people," in Locke's
words. As in its previous location, the hospital existed to "fur-
nish a Christian home" where "the chaplain daily directs (pa-
tients') thoughts to God." The chaplaincy at this time was
taken over by Reverend William Toll, Locke's assistant at
Grace Church.

In the following October came the fire. Locke was at the
Episcopal general convention in Baltimore. Worried sick, he
hurried back by train but found his family safe and Grace
Church and rectory unharmed, though furniture was piled on
drays in case the fire came near. His assistant, Mr. Toll, had
taken Locke's children and his sermons to the far South Side.
The fire had stopped two blocks north of the church and three
north of the hospital.

Locke thought the end had come for his "baby hospital,"
even if it had been spared, because he expected funds to dry up
after the fire. But the fire was a mixed disaster. Two million
dollars in relief money became available, and Mayor R. B.
Mason assigned its management to the nine-year-old Chicago
Relief & Aid Society — not to the city's aldermen, who were
dying to get their hands on it. The society's members — includ-
ing Grace parishioners N. K. Fairbank and Marshall Field
— were citizens used to caring for the poor and sick.

This group turned to St. Luke's Hospital as "just the place
for the sick and poor of the more respectable class." (For
Locke respectability did not depend on solvency.) The society

St. Luke's Hospital is Established 43

took over most of the hospital's operating expenses and gave it
an additional $28,000, of which $16,000 was to be used to buy
land.

St. Luke's in return was to hold 28 beds for use by the society
when needed. (The society never used more than five at a
time.) The $16,000 paid for a lot on State Street near 37th
Street; the intention was to build a new hospital there. St.
Luke's also received $4,000 from the Episcopal Church.

The Relief & Aid Society later matched a $4,000 hospital
building fund which had survived the financial panic of 1873.
In the same year, 1876, a free dispensary was opened. Locke
fed eight to ten panhandlers a day at the hospital door with
food left over from patients' meals until the trustees told him to
stop, because it encouraged street begging.

"Of course, the wisdom of a Board of Trustees is unques-
tionable," observed the irrepressible priest. There were 12
trustees in all, a priest and two laymen from each side of the
city. Locke called it "a curious arrangement, and very nar-
row." It was expected to increase church interest, "but it
never did."

In 1878 E. K. Hubbard raised money for the long-awaited
morgue, a nagging problem since the days on State Street.
And George Chamberlain, a member of the St. Luke's medical
board, did the same towards supplying hot water throughout
the building. The first endowed bed, known as "the Church-
man Cot for children," had been established with $3,000 raised
by The Churchman, an Episcopal magazine in New York, which
printed a "moving appeal" for small donations and listed con-
tributors weekly.

Another early fund raiser was Mrs. Locke's sale of Angora
cats at $25 each. It may indeed have been the first money raised
for the hospital. Locke memorialized the effort with riddle-
<:Mm-doggerel: "How would you battle with sin and strife
(precious wife)?" Answer: "With the simple Cat-echism." He
called the women who helped his wife sell cats the "Cat club."

But major early contributions were in kind — fruit, vege-
tables, meat, linen supplies which flowed "without ceasing"
into the St. Luke's storeroom. Not a cent was spent on hospital

44 GOOD MEDICINE

linen until the early 1890s. Locke's wife played a major role in
keeping this philanthropic effort rolling, but others helped too.

Among them was Mrs. Joseph T. Ryerson, of the iron and
steel family. Her "counsel and energy" were "invaluable,"
said Locke. Mrs. Ryerson 's son Arthur was president of the
St. Luke's trustees when she died in 1881, the same year Dr.
M. O. Hey dock, one of the first of the medical staff, died.
Arthur Ryerson later succeeded Locke as president of the
hospital.

Indeed, an era passed with Mrs. Ryerson 's death. Gifts in
kind slowed to a trickle by the mid- 1890s, though the need was
"ten times greater" because of the larger number of patients.

The institution was chartered a second time, in 1880, as St.
Luke's Free Hospital. This was to take advantage of new legis-
lation allowing not-for-profit organizations to hold assets of
more than the $100,000 to which it was limited by the first
charter. The name represented no change of policy. St. Luke's
had been free to the needy from the beginning. In 1894 it was
chartered a third time, and the hospital was again called simply
St. Luke's.

Locke's "darling child," as he called St. Luke's, "took prodi-
gious strides" in 1881. In that year N. K. Fairbank bought and
gave to the hospital 100 feet of adjacent Indiana Avenue front-
age, bringing this to 164 feet in all. Others at Fairbank's urging
bought and donated 70 feet of Michigan Avenue frontage. Fair-
bank also helped raise money for a permanent structure.

The new building would be on the Indiana Avenue site, not
farther south as had been planned. The advantages were its
central location and proximity to lake and train stations. The
trains' noise annoyed almost no patients but instead became
"an unfailing source of entertainment" to the many railway
employees who were patients at St. Luke's, Locke claimed.

Indeed, the Illinois Central Railroad endowed a bed and
kept it occupied for over ten years with a series of injured
employees. The hospital took care of IC accident victims, and
the railroad responded generously, "paying well" for patients
not covered by the endowed bed and otherwise showing the
hospital "many favors."

St. Luke's Hospital is Established 45

When the cornerstone of the first "real hospital" was laid
on All Saints Day, 1882, $57,000 was already subscribed, of
which $25,000 was the gift of Dr. Tolman Wheeler. The rest
had been solicited by Fairbank, much if not most of it from
fellow Grace parishioners and civic leaders — meatpacker
Philip D. Armour, retailer Marshall Field, wholesale grocer
John W. Doane, and utilities investor Columbus R. Cummings.
Mrs. Marshall Field raised $2,610 by holding a benefit concert
at her home.

Dr. Wheeler helped St. Luke's in other ways and willed it a
substantial piece of property. But shortly before he died in
1889, he sold the piece in question, having been "poisoned
against" St. Luke's in his final days. "The hospital had a
friendly visit with the heirs about this business, but lost the
case," noted Locke.

Another potential benefactor, Thomas Lowther, coupled
"crankiness" with his generosity, as in specifying that no mar-
ried priest could live in the cathedral parish house for which he
donated the lot, "a thing which . . . much hampered the
bishop in his management of the cathedral." Lowther, a
prominent promoter of a public library for the city, once
offered Locke "a fine site" for St. Luke's, but Locke declined
because of conditions he attached which Locke left un-
specified.

A benefactor whom Locke called "peculiar" was George
Armour, a Grace church member who built what in effect was
a competitor church at 20th and State streets which eventually
collapsed for lack of interest, including Armour's. Armour's
eccentricity took a nice turn at the 1882 cornerstone
ceremony, however, when he laid a $5,000 donation on the
cornerstone.

St. Luke's moved into the new building January 29, 1885,
$25,000 in debt. But Locke appealed in the press for funds to
cover it and in a week had thousands more in hand. The new
building forced St. Luke's to make changes, the first of which
was to develop a nursing department. Four nurses — two men
and two women — had handled everything in the old place,
under Sarah Miles' guidance. But now there were wards and

46 GOOD MEDICINE

more complicated work to be done. The solution was to form a
nurse-training program much like the Illinois Training School
for Nurses. Thus was begun the St. Luke's training school for
nurses in 1885, the 35th nurses' school in the U.S., organized
on the Florence Nightingale model — that is, run by nurses
(mostly women), rather than by doctors (mostly men).

Early candidates for the new school had to be high school
graduates (though no proof was required for this) and had to
be between 21 and 31 years old and of good family background
and "upbringing." It was a period when nursing was coming
into its own as work considered suitable for young women of
' ' respectable ' ' background .

Twelve of the first 29 students were graduates of Dearborn
Seminary, a girls' private school. The rest were public school
graduates. One of the early candidates came from Scotland,
recommended by a galaxy of acquaintances that included the
archbishop of Canterbury, a dozen nobles, several physicians,
a veterinarian and the village blacksmith. Students came as in-
dividuals when openings occurred, as was typical of nursing
schools of the day, not as groups or classes. The first six
graduated in 1887, nine more in 1888.

The school's superintendent from 1888 to 1893 was Miss
Catherine L. Lett. She died in office, mourned as "a devout
daughter of the church" who left her life work "in the hearts
and lives of others." Among other things, she set up a pay
scale for graduate nurses of three dollars a day or $20 a week
for general and surgical nursing, $25 a week for contagious
disease work.

Life for the students was religious and disciplined. In fact,
the acting chaplain, the Rev. George Todd, wanted to make of
them a full fledged religious society, but Locke couldn't see it.
They prayed before meals and sang in choir, even those con-
nected to no church. None of these ever objected but were
"thankful for the privilege," said Locke. A student was expelled
for staying overnight in Waukegan without permission. Lett
scolded another for going to hear a sermon by a dissenting
clergyman.

St. Luke's Hospital is Established 47

A lighter side prevailed as well. When student and other
nurses felt the need, they unburdened themselves to Mr.
"Canary," as they called the owner of Carnegie's drug store,
at 16th Street and Indiana Avenue. The English-born Maria,
matron in charge of the nurses' residence, warned them that
"ladies don't whistle." The now retired Sarah Miles in her
wheelchair, Old John the baker and Ike the newsboy were
other fixtures of hospital life.

In 1889, nurse alumnae formed the Blue Cross Society, to
care for sick nurses and to strive for higher nursing standards
and mutual encouragement. A room was set aside for sick
nurses called the Blue Room. The blue cross, the society's
emblem, was to be worn on the left arm "as a badge and token
of service to the sick and suffering."

In 1896 this blue cross became part of the uniform, 38 years
before a blue cross was first used by an office of the hospital in-
surance association of that name and 43 years before it was
copyrighted by the American Hospital Association.

The uniform for street wear included a long gray cloak, little
gray stringless bonnet edged with black velvet, and veil. The
bonnet gave "a becoming look" and was said to "soften the
face." It was worn until 1912.

The working uniform included an apron and an organdy
hat that couldn't be flattened once it was assembled for wear-
ing. The hat was carried in a hatbox to and from one's assign-
ment, which was usually in a private home. (Nurses at
Presbyterian Hospital, on the other hand, wore washable hats
that could be carried flat.)

In 1939 white shoes and stockings were prescribed for St.
Luke's nurses. The uniform came to mean much for students
and alumnae. A St. Luke's graduate of the 1940s pleaded,
"Don't let anyone change our caps — ever!" The plea was to
take meaning during the sometimes difficult merger in the
1950s of the Presbyterian and St. Luke's schools of nursing.

The head of the St. Luke's medical staff. Dr. John E.
Owens, took great pride in the new nursing school. The tall,
bearded Owens made his late afternoon rounds with a red car-

48 GOOD MEDICINE

nation in the buttonhole of his white coat and a friendly word
for everyone. He became a much appreciated source of en-
couragement to nurses.

Housing the student nurses was a problem. Trustee Byron
L. Smith, president of the Northern Trust Company, built a
two-story addition on the West Pavilion (facing Michigan
Avenue) for $13,000.

St. Luke's meanwhile was demonstrating a "quality of mercy
not strained" to people of "all sects and nationalities,"
according to Rush Medical College Professor J. Adams Allen,
a member of the St. Luke's consulting board, in remarks at the
hospital's annual meeting.

This consulting board was dispensed with in 1887, notwith-
standing Allen's kind remarks. Indeed, the whole medical
board was reorganized, including the obstetrical and gynecol-
ogical department, which was divided into two separate entities.
Also that year. Dr. Moses Gunn died. He'd been senior attend-
ing surgeon, a Grace Church parishioner and a good friend of
Locke, in addition to being for years the chairman of surgery
at Rush.

The year also was marked by "large donations in kind," in-
cluding "no small quantity of beer" from the Seipp Brewing
Company and all the ice the hospital needed from the J. P.
Smith Ice Company. In addition, Mrs. John Tilden solicited
for the hospital "a very large amount of groceries."

But unspecified "petty squabbles" among members of the
new medical board drove Locke "nearly frantic" in 1888. He
"devoutly wished" to get a whole new medical staff at the
time, as unwise as he knew that would be. Difficulties were
ironed out, however; and "peace and harmony" reigned
thenceforward.

To make matters worse, some "unknown person in our
midst" was passing "garbled and childish information" to the
press about internal matters, Locke wrote. He claimed he was
stopped on the street in the midst of this and asked if St.
Luke's burned babies in its furnace. "Yes we do. Madam,"
he said. "We find them cheaper than coal." The woman re-
mained staring after Locke as he strode away.

Also in 1888 the State Street property (the former brothel)

St. Luke's Hospital is Established 49

was sold and the $25,000 proceeds were deposited in the en-
dowment fund. The property would have been sold earlier for
much less if N. K. Fairbank hadn't persuaded them to hold on
to it. In the same year, an addition was begun in honor of the
late Samuel Johnston, a landowner and traction executive who
had left the hospital $55,000. This was finished in 1890, and a
"noble pile" it was in Locke's estimation, "built with great
economy." Its top story, he noted, was "beautifully fitted for
pay patients," who, it should be added, had to be paying more
than their share for St. Luke's to afford giving so much free
care.

The addition doubled capacity, raising it to 152 beds, which
in turn called for an increase in nurses. Housing them was
again a challenge. The solution was to raise the training school
department roof and add a floor. Mrs. E. H. Stickney footed
this expense. Later, she willed St. Luke's its biggest gift so far,
a $75,000 bequest which the hospital received in 1897. This
went to build the Stickney House for nurses in 1898.

In fiscal 1889 the hospital cared for 1,050 patients, 611 of
whom paid nothing. This total was well over the previous
year's 817 and many times the 124 cared for in fiscal 1865, the
first year. But there were still waiting lists; and people com-
plained when they couldn't get in, exhibiting an "unreason-
ableness" which "much tried" Locke and the staff. It was a
wonderful year nonetheless. Railroad car magnate George M.
Pullman and his daughter contributed to the children's ward
and helped make it "the most beautiful and complete home for
sick children in this country." In the hospital as a whole,
Locke reported, "harmony reigned in every department."

The operating deficit rose to $30,000, however. A partial solu-
tion was to use invested endowment funds to build an apartment
building on Michigan Avenue in back of the hospital, in the hope
of earning a greater return. The new building was called "The
Clinton" in honor of Locke. For a year or so, it gave a better
return, perhaps because of increased demand for housing during
the world's fair. In 1899 it was rebuilt after a fire and renamed
"The Saranac," possibly after the vacation and health resort in
the Adirondacks.

Meanwhile, in fiscal 1892, 59 percent of St. Luke's efforts

50 GOOD MEDICINE

went for charity patients and much of the rest was only "part
pay." On the poorest patients as on the rich, the medical staff
"lavished every attention" at a per-patient per year cost of
$47.66, which did not reflect the "great quantities" of linen
and bedding supplied by members of Grace and another
Episcopal church, Trinity.

Fund raising by individuals remained a major advantage.
Helen K. Fairbank, wife of Nathaniel, worked especially hard
soliciting funds for endowed beds, sometimes in amounts as
low as $5 and $10. At her death a ward was named in her
honor.

The 1893 world's fair gave St. Luke's a chance to shine.
The hospital was full "almost constantly," Locke reported,
and nurse Grace Critchell Tracy walked 25 miles a night
covering the wards. She knew this thanks to a pedometer she
wore to track her perambulations.

At the fairgrounds several miles to the south, 12,000 lived.
Dr. Owens ran an emergency hospital there for fairgoers and
workers. Three of its four nurses were from St. Luke's.

Another emergency that engaged the St. Luke's staff was
the 1903 Iroquois theatre fire which killed 571 and loaded St.
Luke's morgue beyond capacity. People lined up to identify
their dead. St. Luke's was also called on after the capsizing of
the excursion steamer Eastland at its docking place in the
Chicago River in 1915, when 812 drowned.

Two turn-of-the-century St. Luke's physicians of note were
Dr. Henry Baird Favill, of Rush, and Dr. Robert B. Preble.
Favill could stand in a ward and "smell measles" among the
patients, the story goes. "Let me see that case of bronchitis
you admitted this morning," he once asked, and discovered a
measles rash.

Favill, a Rush alumnus and longtime Rush faculty member,
succeeded Owens as president of the St. Luke's medical staff.
He was the son of a physician of English ancestry but a descen-
dent on his mother's side of an Ottawa Indian chief and proud
of it. When his wife was inducted into the Colonial Dames, he
was asked if he qualified for the Society of Mayflower
Descendents. "No," he answered, "my people were on the

St. Luke's Hospital is Established 51

reception committee."

Preble, an internist who later joined Herrick, Billings and
others in forming the Society of Internal Medicine in Chicago,
was also a canny diagnostician. Faced on one occasion with a
presumed case of gastric hemorrhage, he expressed immediate
doubt, lifted the sheet and discovered what he suspected, the
dilated veins that showed cirrhosis of the liver.

Surgery in the late 19th century was sometimes performed
in people's homes. Not always, however. St. Luke's may have
been the scene of an historic first in 1894, when Daniel Hale
Williams, a black surgeon on the St. Luke's staff, is said to
have performed heart surgery. Some question this, saying the
first such operation was performed in St. Louis.

The medical historian Thomas N. Bonner doesn't even
mention it in relation to Williams, whom he does credit with a
similar first, not at St. Luke's but at Chicago's Provident
Hospital, which Williams helped to found. This operation, an
emptying and suturing of the pericardial sac in the chest of a
stabbing victim in 1893, was noteworthy in any event, heart
surgery or not and the first of its kind or not.

St. Luke's was the scene in 1898 of what may have been the
first Caesarean section in the Midwest. Nurses watched it
from "the long windows" of what in 1946 was known as the
"old building," shrieking in subdued fashion when the baby
appeared. The director of the nurses' school was "victorianly
shocked" at her nurses witnessing the event, says Marie Mer-
rill in her history of the nursing school. The baby's parents
wrote the trustees to thank them, noting, "Being poor, we
have nothing to give you, but will give small things whenever
we can afford to."

Money problems abounded. Like the reputedly wealthy
English hospitals, St. Luke's had to operate regularly at a deficit,
trusting donations to keep it in what was essentially a catch-up
ball game. One problem was lack of sufficient endowment.

Another was how to afford the latest in medical
equipment — special splints or braces for patients suffering
from hunchback, curvature of the spine, club feet and the like.
Most were able to pay little or nothing toward the cost of such

52 GOOD MEDICINE

apparatus. The problem presaged huge expenditures of a com-
ing age, when new equipment was to cost far more than spUnt
and braces.

A related problem was what to do about nonpaying pa-
tients, who usually stayed longer than paying ones because the
hospital was more comfortable than anywhere else they had to
go. Locke does not say how he solved this problem.

In 1885 Locke resigned as president of St. Luke's and was
succeeded by Arthur Ryerson. The end of an era came with
the end of Locke's involvement. As its first president and
chaplain, he was a beloved figure and a genuine human being.
In 1895 his vocal organs gave way, and he had to call a halt to
his pastoral work. At first he couldn't preach, then he couldn't
talk at all. An "awful silence" ensued. Bishop McLaren
wrote. "The charm of life vanished," and he "longed for the
death he did not fear."

Locke took to playing cribbage at the hospital, where he
went apparently as much for companionship as anything else.
Locke died in 1904 on the Mississippi gulf coast, where he and
his wife were vacationing. He was 74 years old, the oldest
priest in the diocese. Adele Locke, his helpmate in pastoral
labors, spent her final years at the Grace Church rectory on
Indiana Avenue. She died in 1919 at 79.

Daniel Brainard, M.D., 1812-1866.

"Wolf's Point in 1833."

(Photo courtesy Chicago Historical Society)

James Van Zandt Blaney,
M.D., 1820-1874.

Rush Medical College, 1844.

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Nathan Smith Davis, M.D.,

1817-1904. (Photo courtesy of
Chicago Historical Society)

Rush Medical College building of 1867.

(Photo courtesy of Chicago Historical Society)

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1822-1887: "A surgeon must
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heart of a lion, the hand of a
woman."

Christian Fenger, M.D.,
1840-1902.

Rush Medical College, 1875 building, and
Senn Building (right), added in 1902.

Nicholas Senn, M.D.,
1844-1908.

Joseph P. Ross, M.D.,

1828-1890.

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Rush baseball team, 1894.

Rush football team, 1894.

DATE OPFONEXTS

Sept. 22. West Division High School,
Sept. 29. Prairie Club, Oak Park, Hi., -
Oct. 13. University of Chicago, - - -
Oct. 20. Chicago Athletic Association, -
Oct. 27. Beloit College, at Beloit, Wis.,
Nov. 3. Lake Forest Universitv, - - -
Nov. 22. Notre Dame University, at Soutli Bend. Ind., 6 to 6

Nov. 25. Iowa College, at Grinnell, Iowa, - - - 6 to 28
Nov. 29. Monmouth College, at IMonmoutii, Hi., - 18 to 6

The 1894 football season.

RUSH

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Jones Building of Presbyterian Hospital with Ross-Hamill Wing
at right, late 1880s.

The Reverend James
De Witt Clinton Locke,
1829-1904, pastor of
Grace Episcopal Church
and founder of
St. Luke's Hospital.

The first St. Luke's Hospital, 1864.

(Photo courtesy of Chicago Historical Society)

St. Luke's Hospital old main building, 1882.

A Marriage Made In Heaven:
Rush & The University Of Chicago
1898-1924

The final split of Rush Medical College from Lake Forest
University set the stage for a "final union" with The Univer-
sity of Chicago. It was a marriage made in heaven by most
standards, but nevertheless destined to end on the rocks.

The matchmakers were Doctors E. Fletcher Ingals and
Frank Billings on the Rush side (though Billings was then at
Northwestern University Medical School) and University of
Chicago President William Rainey Harper on the other.

Ingals was a Rush teacher (since 1871), trustee and its con-
troller. He realized the Lake Forest connection was worth little
to either party, partly because Lake Forest would never attract
endowment funds sufficient to help Rush achieve its potential.
In the dealings with Harper, Ingals played a crucial role.

At one point he alone among Rush trustees voted for affilia-
tion. Deputed to inform Harper of the deal-killing vote, he
persuaded the others to wait a while. It was that close to not
happening.

Billings, a distinguished medical practitioner and researcher
with an itch to promote medical education, was winning a

66

A Marriage Made in Heaven 67

reputation for getting things done. As secretary of the facuhy
at Northwestern, he had helped build Wesley Hospital and a
new classroom structure. He was later to resign over what he
considered Northwestern trustees' failure to support the
medical school adequately.

Ingals saw possibilities in the new university and went to
work on Harper immediately with his Rush affiliation idea.
Billings joined him in the effort in a year or two, so that by
1893 or 1894, they both were after Harper. It took a few years
more, but by December of 1897, Harper liked the idea, under
four nonnegotiable conditions:

1 . The Rush trustees would resign in favor of new ones with
"no pecuniary interest" in Rush's earnings, named by the
University trustees. Gone were the days when Rush was
"what would now be termed a proprietary medical school," to
use Rush alumni president Dr. H. Gideon Wells' 1922 expres-
sion. Proprietors or not, Wells hastened to add, they were
dedicated, idealistic men.

2. Rush entrance requirements would be raised to two years
of college by 1902. This drastically cut the number of eligible
students, since only 10 or 12% of high-school graduates entered
college at the time. Later enrollment dropped accordingly.

3. Rush would retire its debt.

4. The Rush faculty would resign and await reappointment
by the university.

A Rush man asked how they knew Harper would reappoint
Rush men. They didn't, a colleague replied. But either
Harper knew what he was doing or didn't. If he didn't, they
shouldn't affiliate. If he did, they shouldn't tie his hands.

The affiliation was neither a union of the two schools nor a
commitment to one. Harper emphasized. It left both parties'
options open. But University of Chicago founder John D.
Rockefeller was still not pleased. He and his advisor Frederick
T. Gates felt the university lowered itself by the union partly
because Rush trained practitioners, not researchers.

Harper, on the other hand, saw that Rush and University of

68 GOOD MEDICINE

Chicago goals might be joined to make something new and
grand in U.S. medical history. He saw Rush as something he
could mold into the medical school with everything: it would
educate both scientifically trained practitioners and researchers.

Harper went at the molding process with vigor, beginning
with an 18-point agreement he produced for Rush signatures,
a document that included the four basic conditions and added
other details:

The university would examine and approve applicants at
Rush's expense. It would furnish "at cost" teachers, books
and supplies and would lend books and apparatus "at net cost
of transit and handling." Rush would do nothing academic
without university approval, including hiring and firing facul-
ty. Rush would raise student requirements "as rapidly as the
university may require."

On top of all this. Harper put it in writing (and Rush gladly
signed) that (a) nothing in the above implied encouragement
that Rush would ever become the university's medical school,
and (b) the university intended to establish such a school of its
own as soon as money was available.

The whole deal was, on its face, no bargain for Rush. But if
the Rush people were bargain-hunting, they wouldn't have
dealt with Harper, whom they revered as a medical-education
Moses who would lead them to glory. On January 5, 1898, the
seven Rush trustees — Professors Holmes, Lyman, Etheridge,
Ingals, Hyde, Haines and Bridge — resigned, and eight univer-
sity trustees, including food-wholesaler A. A. Sprague, were
appointed in their places.

The faculty retired the debt as stipulated — $73,000 incurred
six years earlier to build the Rush laboratory building. Dr.
Nicholas Senn, the surgeon, and Ingals each came up with
$25,000, and others supplied the rest.

In June the affiliation became official, and the Rush faculty
asked Harper to be president. He declined the title but assumed
the responsibility, presiding at faculty meetings and appointing
committees. He also persuaded the faculty to democratize itself
by giving the vote, previously the preserve of an 11 -man ex-
ecutive committee, to all above assistant professor. He argued

A Marriage Made in Heaven 69

that this would balance conservative and progressive influence.
Faculty meetings weren't for voting anyhow, he explained, but
for mutual education.

Education was necessary, since radical changes were in
store. Whatever the 1894 Rush yearbook had said in favor of
practical experience, lectures were still the norm. Students sat
on amphitheatre benches eight or nine hours a day, listening
or watching. The course was rigid and inflexible and the same
for all. The university was trying other methods, and so would
Rush.

Rush, which operated eight months a year, became a year-
round school. The earliest Rush students had gone only four
months a year. Later an optional spring session had been add-
ed. Now the year was divided into quarters, and students
could attend all four quarters and still have seven weeks' vaca-
tion. Faculty could teach two or three four-quarter years and
then take a year or 18 months off for study. The student need-
ed 12 quarters to graduate but had to take 45 months to do it,
because of state requirements.

Furthermore, the curriculum was reorganized to reflect
what students could do, rather than what teachers thought
necessary to cover the subject. Thus eight or nine hours a day
for five or five and a half days the first two years and six days
the second two years would be realistic goals. Another change,
a medical school first, was the institution of electives. The pur-
pose was pedagogical. Choosing courses was an event in itself.
On at least one occasion, students stood in line from a little
after midnight to be sure they got the course of their choice.

Another change was the admission of women, again to con-
form to University of Chicago practice. The first, in 1901,
were received with no more "altered demeanor" among male
students "than if an equal number of men had been added to
the student body," according to Dean of Students John
Milton Dodson. By 1917, 68 women had graduated.

Another momentous change occurred in 1901, one for
which Ingals and Billings argued at length: Rush freshmen
and sophomores moved to the South Side university campus
for basic science classes — the first two years of the curriculum.

70 GOOD MEDICINE

Rush Medical College on the West Side at this point became a
two-year school, educating only third- and fourth-year
medical students in their clinical or "clerkship" studies. In-
coming Rush freshman took classes on the South Side and
enrolled as students of both Rush and the university.

The move not only pleased the Rush leadership but also fit-
ted into Harper's plans for a medical school whose first two
years were "almost entirely courses in pure science." Rush
students had to be sold, however. Horse-drawn coaches were
hired one day in May, and the freshmen were driven out south
to view their new surroundings, eat lunch and hear from
Harper and others the advantages of a University of Chicago
education.

Harper was as persuasive with them as he had been with the
faculty, and all but a few continued their studies on the Mid-
way the following September as students in the university's
Ogden Graduate School of Science. Third- and fourth-year
students continued on the West Side, where Billings became
dean of faculty and Dr. John Milton Dodson became dean of
students.

Other medical schools followed suit and offered pure science
in the first two years. Third- and fourth-year students from
many of these schools transferred to Rush for clinical studies.
In fact, during the next 15 years, up to half the Rush enroll-
ment hailed from elsewhere than The University of Chicago
and never less than 20 percent.

A year after Ingals and Billings argued successfully for the
move to the university campus for basic science, they went for
even closer "organic union" with the university. This organic
union would make Rush an integral part of the university,
rather than a mere affiliate or working partner. Harper favored
it, notwithstanding his proviso four years before, when he cau-
tioned Rush not to get its hopes up. On the contrary, by 1903
he was convinced the university's medical school future lay with
Rush.

What he wanted was something he could call the "Rush
School of Medicine of The University of Chicago." So apt a
partner had Rush already proven and such was its rich history,

A Marriage Made in Heaven 7 1

that the name alone was worth a milHon dollars, he said. Full
of enthusiasm, he persuaded the university trustees and went
off to New York to persuade the founder. Rockefeller.

He did so, but not completely. In any event, in order to be
finally united with the university, Rush had to raise a million
to qualify for the needed $5 million from the man who so far
had made everything possible. Billings went to work with his
usual energy, and the million was raised almost immediately.

But more than a third of it was a donation in kind, namely
the McCormick Institute for Infectious Diseases, which Bill-
ings persuaded the Harold Fowler McCormicks to give to
Rush. It wasn't unfettered cash with which to endow research,
which is what Rockefeller had in mind.

No deal, said the philanthropist, and Harper was ready to
tear his hair out. "I shall resign," he threatened, pacing back
and forth in front of his deans at the Chicago Club. Indeed, he
was looking at a tempting offer from the St. Louis world's fair
to be director of its scientific and educational section. He
would have taken it, but Rockefeller and the trustees talked
him out of it.

His frustration lay in seeing a medical school so near and yet
so far. Everything was ready for his grand plan:

• A five-pavilion, 250-bed research hospital on the South
Side that would take patients of its choice from its outpatient
department and other hospitals, based on the disease to be
studied.

• The Rush complex on the West Side for undergraduate
clinical work.

• A postgraduate school on the Near North Side. Chicago
Policlinic School, at Chicago Avenue and LaSalle Street, was
ready to become Rush's postgraduate school and bring its
Henrotin Hospital as part of the bargain.

Research would be pursued at all three of these centers, and
the staffs of each would use facilities of the others.

None of it happened in 1904. Harper entered Presbyterian
Hospital early in the year for an appendectomy. Cancer was

72 GOOD MEDICINE

suspected but not found. A year later, exploratory surgery
found it. A year after that, in February of 1906, he was dead.
So was his dream of organic union — the absorption or integra-
tion of Rush — at least in its particulars and at least for another
20 years.

Meanwhile, as Rush's admission standards rose, its enroll-
ment declined. Only 65 freshmen entered in 1905 — a steep
drop from 250 a few years earlier. It could have been worse.
Rush raised its standards over a five-year period. Some
schools raised theirs all at once and sank to as few as six
freshmen, not even a baseball team.

Rush had enough for several baseball teams but still not
enough to pay the bills. Many of the faculty were asked to
forego their small stipends. Those who had pledged to give
toward the million required by Rockefeller were asked to give
to help meet current expenses. As dean of faculty, Billings
solicited from potential donors. As controller, Ingals managed
astutely. In a few years, the students began to return, even
with the higher standards limiting the pool. By 1910 Rush
enrollment topped 360, up from 253 in 1905, and the crisis
had passed.

The question remained abut organic union. Harper's suc-
cessor, Harry Pratt Judson, assured Billings, Dodson, and In-
gals of his interest but said the matter should remain on hold.
He took up where Harper had left off as a Rush trustee and de
facto president but not as its champion in the halls of the
mighty. Four years later, even the mighty took his leave.
Rockefeller pulled out in 1910, promising the university a final
$10 million over the next 10 years, including $1.5 million for a
chapel.

Rush's big three — Billings, Dodson and Ingals — again ap-
proached the university, this time with the American Medical
Association stalwart and Rush professor. Dr. Arthur Dean
Bevan, at their side. Billings put it to Martin Ryerson, presi-
dent of the university trustees: would they rather Rush went
its own way while the university formed its medical school?
Ryerson 's answer was that they would not. They wanted Rush

A Marriage Made in Heaven 73

to remain in affiliation, just as it was, until something stronger
might develop.

A strain was developing nonetheless. Rush had no money to
speak of. Billings was again given the task of raising some. But
no big plans were there to inspire giving, and Rush's future
was unclear.

To complicate matters further, other institutions were look-
ing around, including the University of Illinois, which had
taken over the College of Physicians and Surgeons in 1913. Il-
linois proposed organic union with Rush, but with the smell
about it of annexation. Rush would surrender its charter, dis-
band its trustees and give up its name. Furthermore, while the
(tax) money was there, legislators controlled it year by year,
and Rush shied away from that dependency. The Rush faculty
said no to Illinois in April of 1914. Northwestern University
Medical School also approached Rush with a view to union.
This didn't happen either.

Then in the summer of 1916, Billings, ever the planner and
promoter, presented Rockefeller interests with three options
for the university's medical education: move it all to the South
Side, move it all to the West Side, or move only Rush's
undergraduate clinical education south and make Rush a
postgraduate medical school.

The Rockefeller organization, in the person of medical
education expert Abraham Flexner, liked the third option,
which was a variation of Harper's plan for research south,
undergraduate education west and postgraduate education
north.

Money again was the problem, but this time it was solved in
rapid fashion. Billings raised in record time (a matter of months)
the $3.3 million required by the Rockefeller Foundation and the
General Education Board, each of which promised $1 million.
His family gave $1 million, including $400,000 from his cousin
Cornelius K. G. Billings, former president of People's Gas, and
$100,000 from himself. He solicited the rest almost entirely from
Rosenwald, Ryerson, Armour, Swift and other philanthropic
sources.

74 GOOD MEDICINE

Banker Frederick H. Rawson and his wife gave $300,000 for a
laboratory on the West Side, where Presbyterian Hospital and
Rush were to form a European-style "university college" (post-
graduate school of medicine) for M.D. practitioners.

Albert Merritt Billings Hospital on the South Side — named
after an uncle of Frank, also a former head of People's
Gas — was to be fully endowed and run on a "strictly scientific
basis," without "any element of commercial medical
practice," said university president Judson. It was to be con-
trolled by staff, who would have no duties but to teach and do
research and research-related clinical work.

The Rockefeller grant and accompanying plans made page
one around the country. The Chicago Tribune called the idea "one
of the most important events in the history of Chicago." The
Boston Transcript said the grant gave the university its opportunity
to form the nation's premier medical school. The Nation said the
"new move at Chicago" would greatly help U.S. medical educa-
tion meet the best European standards.

Congratulations were premature, however. It was wartime,
and the grand plans had to be delayed. Not until several years
after the war were they realized, in 1924. According to agree-
ment Rush kept its name, and construction was begun on the
new building on which were carved the words "Rawson Lab-
oratory, Rush Postgraduate School of Medicine. A.D. 1924.
The University of Chicago." On the South Side, Billings
Hospital was begun.

The Rawson building held offices, library, classrooms and
laboratories, including the fifth-floor pathology labs named
after Dr. Norman Bridge, who with his wife had given
$100,000 for their construction. In the basement was occupa-
tional therapy and on the second floor the Central Free Dispen-
sary— moved there from Senn Hall, the 1902 five-story
laboratory building next to it, named after the famous surgeon,
Dr. Nicholas Senn, who gave $50,000 to help build it.

The affiliated institutions which gave Rush its strong
clinical-education base were adjacent or nearby: the 440-bed
Presbyterian Hospital, the McCormick Institute for Infectious

A Marriage Made in Heaven 75

Diseases, the Home for Destitute Crippled Children, County
Hospital was on the opposite corner.

On the South Side, Doctors Franklin McLean and Dean
Lewis set to work organizing the undergraduate clinical pro-
gram meant some day to replace Rush's clinical program.

In May of 1924, Rush and the university signed the agree-
ment which joined them in marriage-like union. On June 7,
the day after the Rush graduation, the Rush faculty and
students became University of Chicago faculty and students.

In August the old Rush building was torn down to make
way for Rawson. A cornerstone removal ceremony on August
28 was presided over by A. E. Wood, grand master of the
lodge which had performed the cornerstone-laying ceremony
not quite 50 years earlier.

Rush & The University of Chicago
Go Their Separate Ways
1924-1941

Their marriage consummated in 1924, Rush Medical College
and The University of Chicago upgraded requirements. A
bachelor's degree was made compulsory. (Ten years earlier,
Rush had been the first U.S. medical college to enforce the in-
tern year requirement.) The new postgraduate school of
medicine (for M.D. practitioners) was begun as the presumed
justification of Rush as a university appendage. The M.D.
undergraduate program was to be moved south as soon as
possible.

On the West Side, Dr. Ernest E. Irons was the new dean.
Here Rush continued to offer the third and fourth (cHnical-
education) years leading to the M.D. degree. These were the
years of learning applied medicine, after years one and two
spent on basic science courses on the South Side. Most
clinical-education students, or "clerks" as they were called,
came to Rush from the university's South Side campus. But
quite a few came after taking basic science courses at some
other medical school.

The mid- 1920s to early 1930s were a sort of extended

76

Separate Ways 11

honeymoon period for Rush and the university. The univer-
sity contributed to Rush's new postgraduate school, and Rush
alumni pledged $250,000 as their share of $3 million being
raised by university alumni.

Identification was legally complete between the two institu-
tions. It seems to have been morally complete as well. In addi-
tion to giving substantial help to university fund raising, Rush
professors attended university functions such as the trustees'
dinner for faculty at the South Shore Country Club and per-
formed university duties such as serving on the university
senate.

Rush's role in postgraduate medicine was to be
"dominant," according to a university spokesman. The
Rawson building which undergirded this role was dedicated in
December of 1925, a five-story, all-steel structure connected
by walkways to Senn Memorial on one side and Presbyterian
Hospital on the other.

Rush's laboratory and classroom facilities put even North-
western to shame, not to mention its principal claim to medical
educational excellence — its proximity and working relationship
with Presbyterian Hospital and the Central Free Dispensary.

The postgraduate program proceeded sluggishly, however.
The offerings were generous: one to three years in otolaryn-
gology, dermatology, ophthalmology or radiology. But only 20
enrolled in its first year. Dean Irons suggested a harder sell. He
reported optimistically that a "week of clinics" during Rush
Homecoming Week in June of 1926 had been well attended.

Rush's undergraduate (clinical) program, on the other
hand, became increasingly attractive. Of 141 M.D. recipients
in 1926, only 78 had done their first two (basic science) years
at The University of Chicago. The rest had transferred from
other medical schools. The university was becoming for Rush
one of many feeder schools offering basic science (preclinical)
courses.

At the same time the university was well on its way to the
goal of offering a full four-year undergraduate program (basic
science and clinical) on the South Side. The 1924 plan to
which Rush had agreed was essentially what the Rockefeller

78 GOOD MEDICINE

organization's Abraham Flexner had worked out in 1916 with
Frank Billings. Undergraduate medical education was to be on
the South Side campus, postgraduate on the West Side.
According to agreement, Rush was providing undergraduate
clinical study only until the university could do it on the South
Side.

But the Rush faculty thought or hoped it wouldn't turn out
that way. They looked instead for a continuance of the status
quo, apparently ignoring signs to the contrary, such as the
Billings Hospital development with its promise of taking over
Rush's clinical education role.

Rush graduated 142 M.D.s in 1927, of whom 98 had done
preclinical work on the South Side. Rush's clinical and
laboratory capacities were at a peak, with the new Rawson
building in use for a year or so and increased cooperation
reported with Presbyterian, The Central Free Dispensary
cared for over 107,000 patients.

The death knell was sounding nonetheless. On October 10,
1927, the university opened for business on the South Side a
full-service, four-year medical school. Rush faculty who cher-
ished hopes of continuing to give undergraduate education
must have found that unsettling.

The university now had two medical schools, one on the
South Side staffed mainly by "so-called 'full-time' men," as
acting President Frederic Woodward called them, the other on
the West Side staffed by part-timers.

This was an important distinction. These "full-time men"
were new for Chicago. They represented a system promoted
by the Rockefeller organization, which had gotten the idea
from the John Hopkins School of Medicine in Baltimore. The
idea was that medical school teachers were to be free of the
distraction of patient work except as it contributed directly to
research. This freedom from the requirements of patient care
cost money, of course; these men were on salary and responsi-
ble only to the medical school. Thus they were "full-timers."

From its start the university's South Side medical school
program of the 1920s was based on full-time or "whole-time"
salaried faculty. In charge of it was Rush alumnus and

Separate Ways 79

Rockefeller-group protege Dr. Franklin C. McLean. The pat-
tern here was of the professional teacher as opposed to the
teacher who is primarily a practitioner. It made sense in view
of the university's commitment to medical research. It did not
make sense where money was a concern.

At Rush, on the West Side, for instance, the full-timer was
nonexistent. Nor, apparently, did the Rush teacher feel
distracted from teaching by his practice, which he clearly felt
contributed to his teaching while it paid the bills. Thirty years
later, the full-timer issue was to rise at Presbyterian Hospital,
during its postwar revival period.

The new South Side clinical undergraduate program ran
into trouble at first, apparently because of its research orienta-
tion. Students who came to learn medicine were apparently
put off by the number of electives, for instance — one out of
three courses. Only those of "exceptionally clear vision and
research ability" were expected to like the new program, said
Dean Basil C. H. Harvey.

Each student was encouraged to pursue his or her interests;
such was the belief in the educational value of research. The
emphasis was on nurturing habits, rather than on transmitting
information required by state licensing boards. Not all saw the
value of this approach, lamented Harvey, who expected the
program to be "relatively unpopular" for a few years.

Rush's future was being discussed. The university trustees
announced it was to remain one of the university's two
medical schools. Acting President Woodward acknowledged
"differences in organization, method and emphasis" and said
he hoped experience would show the way to reconciling them.
The two schools "should complement each other with valuable
results," he said. The Rush faculty was free to take what com-
fort they might from this oracular comment.

They were also free to judge as they might the next major
announcement from the university — the appointment, effec-
tive July 1, 1929, of the young dean of the Yale law school,
Robert Maynard Hutchins, as its fifth president. Hutchins
was installed in November. One of his early pronouncements
was to acclaim Rush Medical College as "a jewel in the

80 GOOD MEDICINE

crown" of the university. The Rush faculty was to have time
to meditate on this encomium and to wonder what the new
president had in mind when he bestowed it.

On the South Side, McLean as professor of medicine and
Dr. Dallas B. Phemister as his counterpart in surgery were
encountering "enormous" difficulties in organizing depart-
ments from scratch. As we have seen, McLean had overall
responsibility for the new school, which he was creating on the
approved Johns Hopkins model with an entirely full-time staff.
He had organized the Rockefeller-sponsored Peking Union
Medical College along the same lines. An apparently selfless
individual, he put the whole South Side operation together but
apparently stepped on some toes in the process and had to
resign his supervisory position in December of 1932.

McLean and Phemister were joined in 1927 by Dr. Emmett
B. Bay, also from Rush, who headed a cardiology section in the
department of medicine. The new program was competing with
Rush for faculty. It began also to compete for students. Students
now had their choice of finishing on the South Side or at Rush.
At first, they all took Rush, which was the proven commodity
and offered superb clinical-education opportunities. But as Bill-
ings Hospital and the other university "clinics" became
established, more chose the South Side.

The presence of highly respected former Rush teachers add-
ed to the appeal of the South Side campus. Phemister in 1925
had set up the first "full-time" surgery department in the
world, leaving a lucrative private practice to do so. Bay had
become the first physician to practice on the university's cam-
pus. Researcher George F. Dick became chairman of medicine
in 1933. Neurologist Richard B. Richter came in 1936.
Department of medicine members Doctors Walter L. Palmer,
C Philip Miller, Louis Leiter and Russell M. Wilder were
Rush-University of Chicago alumni who also joined the South
Side school. Wilder chaired medicine from 1929 to 1931,
before Dick took over. All in all, the situation had a distinctly
Rush-University of Chicago flavor to it.

The university "clinics" (the term covered the hospitals as
well as the Max Epstein clinic) reached a bed capacity of over

Separate Ways 81

500 by the early thirties, with a 500-a-day outpatient capacity.
To medicine and surgery had been added obstetrics-cum-
gynecology, pediatrics, and orthopedics. Billings Hospital had
216 beds, Bobs Roberts Memorial Hospital for Children (now
part of the Wyler's Children's Hospital) had 80, Chicago Lying-
in had 140 and the McElwee and Hicks hospitals provided a
100-bed orthopedic unit — all on the university campus.

In addition to these, the affiliated Children's Memorial
Hospital, in the North Side's Lincoln Park area, accounted for
250 beds. The formidable West Side clinical-education com-
plex was not overshadowed by all this, but like the long-
distance runner in a hard race, it was hearing footsteps.

Not that Rush was standing still. Frank Billings gave
$100,000 for four fellowships in 1930. Nancy Adele McElwee,
a prominent benefactress of the South Side program, gave
$500,000 for a surgical pavilion. Both gifts were part of what
Rush and Presbyterian Hospital were presenting as a "com-
prehensive plan" for their joint development.

But it was time for the Hutchins factor to assert itself. In
June of 1931, the "boy wonder" president told Rush grad-
uates, alumni and friends that the university still didn't know
what to do with Rush. "We must have either one school or
two on a different basis," he said. Costs prohibited develop-
ment of two "first-class" institutions.

This was waving a distress signal in front of Frank Billings,
who stood up and told the audience he could raise the money
they needed. "I'm 77 years old now," said the old cam-
paigner. "But if I live to the time when we campaign for
funds . . . I'll do as big a job as [I did] in 1917, when I raised
two and a half million."

About this time Billings went to Alfred T. Carton, Sr.,
president of the Presbyterian Hospital's board of managers,
with tears in his eyes to ask Carton to move the hospital to the
South Side. Billings saw this as the move that would preserve
the Rush-University of Chicago connection, and he desper-
ately wanted to see it happen. He never did, of course.

In a few years, rumors flying. Rush students met to protest
their coming "affiliation" with the university, according to a

82 GOOD MEDICINE

news account. But affiliation was hardly the issue. Rush was
already part of the university. The issue was whether remain-
ing a part of it would require a closing down of Rush under-
graduate medical education or even of Rush itself on the West
Side. Dean Irons told the students nothing "immediate" was
being considered. University Vice President Woodward told
the press that merger had been discussed.

This merger discussion had included an offer to the senior
attending staff of Presbyterian Hospital to come to the South
Side campus. The university would give land on which
Presbyterian could be built anew. But the Presbyterian's
bylaws required it to stay whre it was, to care for the indigent,
among other purposes.

Suspicions abounded anyhow: Hutchins would take the
whole thing over, he didn't like doctors anyway, he was a dic-
tator. Faculty members without tenure would be on their toes,
the formidable A. J. (Ajax) Carlson, professor and chairman
of physiology, was told by one of his colleagues supporting
Hutchins. "You mean on their knees," he responded, mean-
ing to the incumbent president.

The rumored merger, or "complete consolidation," as the
Chicago Times reported in June of 1936, would be physical, in
contrast to the mostly legal ties which made no day-to-day dif-
ference in students' lives. Up to half of them in any given year
had no University of Chicago experience or loyalty anyhow.

By 1936 the university was ready to go it alone on the South
Side. Rush submitted plans for a graduate program. But it was
clear from these plans that Rush still wanted primarily to train
practitioners. The university, on the other hand, wanted to
advance medical science. This continued philosophical dif-
ference between the two institutions at least cooled university
enthusiasm for a Rush graduate program.

In October of 1937, the university in effect gave Rush and
Presbyterian five more years, at which point it would call a halt
to its undergraduate involvement on the West Side. In June of
1938, what The Chicago Herald- Examiner called the "secession"
question was discussed by both sides. Moving south ("Rush
removal") was still a possibility. The advantages would be

Separate Ways 83

"closer association of scientific minds, elimination of overlapping
departments and greater economy," according to Dr. Robert H.
Herbst, retiring head of the Rush alumni association. Hutch-
ins was "eager" for the move, some unidentified proponents
said. Rush faculty and Presbyterian trustees were split on the
question.

The faculty wanted to move. A faculty committee headed by
Dr. Horace W. Armstrong reminded trustees that Presby-
terian was "essentially a teaching hospital." Hutchins had
already implied that the move to the South Side was the only
solution, and the faculty committee understood that. Stay on
the West Side, Armstrong said, and Rush had better look to
Northwestern or the University of Illinois for a university
affiliation.

Almost a year later, on June 1, 1939, 102 Rush faculty voted
overwhelmingly to stay with the university, as opposed to shifting
Rush affiliation to Northwestern for the sake of continued
undergraduate teaching. They were split almost evenly in a
subsequent mail ballot in the matter of "Rush removal" to the
South Side. Eighty-five preferred to continue the connection by
way of a West Side graduate program; 76 were willing to move
south to keep the undergraduate program.

An alumnus who caught a reporter's ear cited familiar ob-
jections to moving: old-school ties and the complaint that on
the South Side patient care was second to medical research.
The university clinic patient, said the anonymous alumnus,
was "just another experiment ... a guinea pig." At "tradi-
tional schools like Rush," on the other hand, doctors were
taught to feel "personal responsibility for their patients."

Reporting eight days later to the Presbyterian trustees,
faculty spokesman Dr. George E. Shambaugh, Jr., argued for
the graduate school solution. But Dr. Wilber Post, the Rush
dean, argued for the move south. The proposed 300-bed South
Side Presbyterian Hospital would cost only $3 million, he said,
not the $4 million then projected, if the hospital would
eliminate free beds and free outpatient service. This would
make sense, he said, in view of coming national health and
hospitalization insurance and expected loss of private dona-

84 GOOD MEDICINE

tions. The Presbyterian endowment would subsidize research
while patient care and clinical teaching paid for themselves,
Post argued.

The Presbyterian trustees (more precisely, board of managers)
were not convinced. The move south would cost too much and
they were committed to the West Side. Three months later they
voted to stay where they were and cooperate with the university
in a graduate program.

In October of 1939, Hutchins, having been informed of their
position, announced that the university would close Rush as an
undergraduate school in 1942 and reopen it as a graduate school.
Presbyterian board president John McKinlay announced at the
same time that the hospital would stay where it was.

The Chicago Tribune reported the decision was made mostly
because of expenses involved but also because of West Side
clinical opportunities, which were considered more ample than
those on the South Side.

At this point the university and Rush were still joined. But
their union was headed for dissolution. In June of 1940, eight
months after announcement of the decision to close the Rush
undergraduate program, the divorce was also announced.
Rush and the university would go their separate ways.
Presbyterian Hospital (with Rush as a sort of alter ego) would
affiliate with the University of Illinois.

This parting was friendly enough. The university returned
everything it had acquired in the 'Tinal union" of 1924 — even
what had been added to the Rush endowment since then.
Classes would be held for undergraduates during the coming
year, after which no new students would be enrolled.

Hutchins said the problem had been the Rush faculty's in-
sistence on continuing to do undergraduate teaching, followed
by Presbyterian Hospital's refusal to come to the South Side.
It had been agreed since 1916 that two undergraduate schools
were out of the question and that Rush was to be a graduate
school. Rush's decision to affiliate with the University of Il-
linois had finally ended the matter.

Some in the Rush camp, however, laid the problem at
Hutchins' feet. He had wanted to close Rush down in any

Separate Ways 85

event, they claimed. He was not comfortable with privately
practicing physicians as faculty members, referring to them as
"quasi-faculty." He wanted everything on the South Side
where he could control it.

Hutchins wore horns in the eyes of any number of people.
But as Dwight Ingle observed in his sketch of Ajax Carlson, a
critic of Hutchins, "In general, science flourished during his
administration." So did Rush, up to a point.

Clinical Observations
1898-1946

THE GIANTS

When antimedicine evangelist John Alexander Dowie boldly
invited Rush Medical College students to hear him lecture on
"Drugs, Devils and Doctors" in the late 1890s, the students
came in force, stank up the hall with a foul-smelling chemical
and threw eggs at the man who had thrown down the gauntlet
to them. It was not Rush's finest hour, though it did show
school spirit of a sort.

Throwing eggs at Dowie was a bad idea. The students had
better arguments against him in the persons of their teachers.
There were giants in those days at Rush — Ludvig Hektoen,
James B. Herrick, Frank Billings, Howard Taylor Ricketts,
Arthur Bevan and Frederick Tice, to name a few. And there
were giants yet to come — Bertram W. Sippy, Rollin Woodyatt,
George and Gladys Dick and Dallas Phemister, all clinicians and
researchers who strode the Rush, University of Chicago and
Presbyterian and St. Luke's hospital corridors like colossi.

Hektoen, a pathologist, was Chicago's first medical scien-
tist. A precise, charming man with a slight Norwegian accent,

86

Clinical Observations 87

he was the first to say it mattered who gave blood to whom in
the new field of blood transfusion and the first in Chicago, if
not in the U.S., to make blood cultures from living patients.
He helped produce measles in monkeys and discovered opsonin,
a blood substance that helps leukocytes kill infection. He pro-
moted autopsy as a research and teaching tool and performed
the one in 1912 which James Herrick used as basis for his
pioneering report on coronary thrombosis.

He and Herrick interned together at Cook County Hospital
for 18 months beginning in April of 1888. Hektoen had been
valedictorian of his class at the College of Physicians and
Surgeons (later University of Illinois Medical School), Herrick
of his at Rush. They had won their internships at County in
competitive examinations, as was the rule in those days. Their
friendship lasted 63 years, to Hektoen 's death in 1951.

At County they had the good and bad experiences that went
with working in that busy, beleaguered institution. Hektoen
complained about rain leaking "in torrents" into the
obstetrics ward, but he also worked under Senn and Fenger
and finally chose pathology for his life work. In all, it was a
heady experience.

He and Herrick left County after 18 months feeling they
knew more than their peers who had interned elsewhere, more
even than veterans — "old fogies" — who knew so little about
bacteria, asepsis and the like. "Bright young men of promise"
in their own eyes, Herrick wrote, in the eyes of others they
may have been "conceited upstarts."

Hektoen joined Rush for a year as curator of its anatomy
museum and lecturer in pathological anatomy and histology.
In 1890 he became Chicago's first coroner's physician, lend-
ing credibility to that essentially political office. During the
1890s, he served also at his alma mater, the College of Physi-
cians and Surgeons, and at Presbyterian, St. Luke's and
County hospitals. In 10 years he published 30 papers. In the
next 40 years, he published 270, winning for himself dozens of
followers.

In 1902 he rejoined Rush and was, in addition, made head
of the Memorial (later McCormick and yet later Hektoen) In-

88 GOOD MEDICINE

stitute for Infectious Diseases, and in 1904 became founding
editor of The Journal of Infectious Diseases. In this capacity he
became an expert, said Herrick, "at eUminating unnecessary
words."

He held the Rush and McCormick Institute positions for
more than 30 years. It almost was far less than that. Not long
after he took them, he had an offer to teach at the University of
Pennsylvania, at one of the nation's premier medical schools,
but turned it down out of loyalty to Chicago.

The son of Norwegian Lutheran immigrants who became
Wisconsin farmers, Hektoen had chosen medicine over
theology. In his own life he combined intensity that sometimes
flared into harshness with humility and a prankster's wit. "As
a rule he was calm," Herrick wrote. But at least once he did
not hold back and coauthored a book review that offended a
Rush or university personage and almost cost him his job. The
day and his job were saved when he apologized and showed
that he hadn't written the offensive part.

Medical writer and Rush alumnus Dr. Morris Fishbein said
Hektoen never showed pride except during a golf game when
he sank a long putt. His pranksterism reportedly extended to
the overnight feminization of a billboard bull across Harrison
Street from County Hospital. Once he stationed an organ
grinder on the sidewalk outside fellow pathologist Dr. E. R.
LeCount's laboratory, where the man performed until paid to
leave. To a prim colleague, he gave as a present a book dating
from Elizabethan times using earthy Elizabethan language for
body parts.

These were apparently part of his campaign against an over-
hostile response to life's problems. Eventually, he learned to
face life "with astonishing stoicism" and used his gift of
humor to help others over hard spots. "But you don't itch!"
he wrote Herrick in 1950, after Herrick had listed his many
physical complaints in a note. The remark, like the man, was
"laconic," noted Herrick the classicist — and yet "not only
Spartan but Scandinavian" in its essence.

James Bryan Herrick was a suitable companion for Hek-
toen. He is known for two of the most famous achievements by

Clinical Observations 89

the Rush-Presbyterian-University of Chicago staff in these
years, the descriptions of coronary disease and of sickle-cell
anemia — two otherwise unrelated pathologies.

He presented his sickle-cell discoveries in an article in
November of 1910 in The Archives of Internal Medicine, where he
described a patient of his and of Dr. Ernest Irons — a 20-year-
old black man from Grenada, West Indies, who had been in
the U.S. only three months. He had a chill, fever and head-
ache and suffered from weakness and dizziness. His tongue
was coated. He bore syphilis-like scars and had an enlarged
heart with a "soft systolic murmur." The Wasserman test, for
diagnosing syphilis, was negative. In the patient's blood, Her-
rick made "unusual findings."

Red corpuscles viewed under the microscope were of very
irregular shape; many were thin, elongated, sickle-shaped and
crescent-shaped. No parasites were found to account for any of
this. The treatment was rest, good food and doses of syrup of
iodide of iron. After four weeks the patient felt much better;
some "sickling" remained, but it was not as noticeable. The
ailment described here for the first time is what is now called
sickle-cell anemia.

Others later identified the disease as inherited and chronic,
chiefly among blacks. Pauling and others described the
hemoglobin responsible for the condition. But Herrick's was
the original description.

Herrick foreshadowed his second great discovery, a nuanced
description of coronary artery thrombosis, in 1910 and 1911. But
his 1912 article in The Journal of the American Medical Association is
considered the first recognition of the disabling blockage of blood
to the heart muscles known as myocardial infarction, or coronary
thrombosis.

The coronary thrombosis had been, described in the 1840s;
most doctors thought it was inevitably fatal. But Herrick
distinguished among occlusions (artery blockages) and thus ar-
rived at a more hopeful outlook. Manifestations vary greatly,
he said. He identified sufferers in whom the pain is great and
symptoms recognizable, for whom the attack is usually fatal
but not always and not immediately.

90 GOOD MEDICINE

He warned against mistaking thrombosis for gall bladder
disease, pancreatitis, hernia or other diseases and expressed
his hope for development of a procedure of achieving adequate
blood supply "through friendly neighboring vessels," which
sounds a lot like bypass surgery. He showed that many victims
can survive a heart attack and live useful lives if treated.

When Herrick read the 1912 paper before The Association
of American Physicians, it "fell like a dud." But he "ham-
mered away" at the topic in various forums for six years, until
in 1918 he read another paper on the subject to the same
group, and "the scales fell away from their eyes. . . . Physi-
cians in America and later in Europe woke up and coronary
thrombosis came into its own," he said. Herrick also, with Dr.
Fred Smith, was the first to show a pattern of coronary
blockage on an electrocardiograph machine.

After the 1912 article, he had to fight the term "heart
specialist" for himself, because of its implication that he knew
about nothing else. He knew about a lot else. Throughout his
career, he dealt with all manner of medical problems. As an
intern in 1888, he wrote about hemophilia, bladder rupture
and tuberculosis. By 1954, when he died, he had written more
than 160 articles on typhoid fever, leukemia, rheumatism,
diabetes, pleurisy, gastric ulcer, gallstones, meningitis,
malaria and many other subjects. Three articles he wrote for
Sir William Osier's 1909 book. Modern Medicine, were about
kidney disease.

As a clinician his experience was wide. He told an assistant
how as a "heart specialist" he had that day discovered
leukemia and several other ailments in four of six supposed
heart patients. He was the first practitioner in Chicago to use
the new diphtheria toxoid. Surgeons Senn, Murphy and
Fenger relied on him, as later did Dean Lewis, Arthur Bevan
and Vernon David. He was consultant of choice to the surgical
giants of his day.

He possessed and cultivated what University of Chicago
cardiologist Dr. Emmett Bay called "an absolute sense of
touch," like the sense of pitch that a musician might have. "I

Clinical Observations 91

would put a needle in there if I were you," he once said, point-
ing to the back of a patient whose problem had puzzled the
Presbyterian Hospital staff for two weeks. They did as he
directed and drew forth pus that hadn't shown on the X-ray.

He had an unusual ability to elicit a patient's history by
questioning. Dr. Paul S. Rhoads, a Rush graduate and intern
under Dr. George Dick at Presbyterian Hospital in the middle
twenties, did an inadequate writeup of a patient for whom
Herrick was called in to consult. Herrick sat down at bedside,
questioned the patient and rewrote the history while Rhoads
stood suffering in silence. Dick gave Rhoads a wink to show he
knew what was happening. Herrick said not a word to the hap-
less intern, who learned this and other lessons well enough to
be named distinguished Rush alumnus in 1979.

Herrick was a modest, almost shy man, careful about his
appearance including the condition of his goatee. He and the
husky, broad shouldered Dean Lewis were great friends.
Lewis, for whom it was an especially proud moment when
baseball star Ty Cobb consulted him about a sprained knee,
took him to football games, where he explained things to the
athletically untutored Herrick.

Among other giants was Dr. Frank Billings, whose focal in-
fection theory remained a staple of medical practice for
decades, though it was much abused and finally discarded.
The theory was that chronic infection in one part of the body
sometimes showed in other parts. Thus arthritis sometimes
stemmed from infection in teeth or tonsils. Some practitioners
carried the idea to extremes, needlessly removing teeth or ton-
sils. Billings also wrote extensively on arthritis and changes in
the spinal cord during illness from pernicious anemia.

But he is known best as a fund raiser without equal — for
Northwestern Medical School, The University of Chicago,
Rush Medical College, Presbyterian Hospital, the McCor-
mick Institute, Provident Hospital and probably a dozen other
causes. In his philanthropic efforts he did not hesitate to call on
relatives who walked in the first ranks of Chicago entre-
preneurs. One of them, his uncle, Albert Merritt Billings,

92 GOOD MEDICINE

headed People's Gas Light and Coke Company for many
years. The University of Chicago hospital was named after
him.

Born on a Wisconsin farm in 1854, Frank Billings attended
Chicago Medical College and interned at County Hospital.
He returned to teach at his alma mater, left for European
studies, returned to teach again at Chicago Medical College
(now Northwestern University Medical School), and in 1898
joined Rush, where he became dean of the faculty. Shrewd
and able to "pull wires," he had a "genius for leadership"
which enabled him, in Herrick's phrase, to plan and "push
plans through."

He organized doctors to form a professional office complex
on the 14th floor of the People's Gas Building on Michigan
Avenue. Many Presbyterian and St. Luke's Hospital staff
members, years before the merger of these two institutions, of-
ficed there. The 14th floor became the place to go for treat-
ment by the city's medical elite.

A genial, sympathetic man who "radiated the impression of
power," Billings had an infectious sense of humor. Herrick
called him "a rare personality" who "attracted people by his
big frame, his strong face, and his evident sincerity of
purpose." He was "forceful, often aggressive, intensely
human, with strong likes and dislikes, even inconsistencies"
but "did not cringe or fawn before wealth, title or social posi-
tion, nor did he shrink from poverty or ignorance." Among
his trainees he counted some of the city's leading medical and
surgical lights, including Doctors Ernest Irons, Joseph Miller,
Joseph Capps and Wilber Post.

He died in 1932, widely mourned. His colleagues Herrick,
Post and Vernon David praised the "moral factor" that domi-
nated his activities, drew others to him, inspired them to do
their best and "created high morale in the institutions where
he worked."

Another notable performer was Dr. Frederick Tice, a Rush
alumnus who for years was Chicago's leading authority on
tuberculosis. He was medical superintendent at County Hos-
pital, taught at the College of Physicians and Surgeons and at

Clinical Observations 93

Rush and opened one of the city's first tuberculosis clinics.
Later he became president of the Municipal Tuberculosis
Sanitarium.

Tice was also notable for the 10- volume, loose-leaf encyclo-
pedia of medical practice which he started in 1915. Its special
value lay in the way it could be regularly brought up to date by
publication of new loose-leaf pages.

Dr. Arthur Dean Bevan, Rush teacher and Presbyterian
staff member, was a major figure especially because of his
work on the 1910 study of U.S. medical education known as
the Flexner Report. As a surgeon, Bevan pioneered the use of
ethylene-oxygen as an anesthetic, an area in which he and his
friend Arno Luckhardt did research.

Bevan 's connection with the Flexner Report in essence
began in 1905, when the American Medical Association's
Council on Medical Education, which Bevan chaired, singled
out five states ("especially rotten spots") responsible for
"most of the [country's] bad medical instruction." One of
them was Illinois; of its 54 medical schools, at most six were
"acceptable" to the council.

This almost blanket condemnation led eventually to funding
by the Carnegie Foundation in 1909 of the study by Abraham
Flexner, an educator chosen partly because he lacked medical
background and thus presumably would bring a fresh approach
to the problem. Flexner' s report, published the following year,
echoed the comments by the AMA committee that Bevan had
headed, harshly criticizing medical education in the U.S. and
Canada.

This is not surprising, since Flexner was acting as unan-
nounced surrogate for the AMA, which wanted to attack with-
out being attacked. In Illinois only three institutions — Rush,
Northwestern and the College of Physicians and Surgeons
(later University of Illinois) — made the cut. Rush made it
because of its recently raised admission standards and its
facilities and scientific work, which Flexner rated tops in the
state.

Flexner had toured 155 schools, including 34 in six states
during a one-month "meteoric dash" in April of 1909. He

94 GOOD MEDICINE

decided only 35 of the 155 were needed. Bevan downgraded
the report before a Chicago audience but later endorsed it. He
didn't admit AMA involvement in the study until 1928.

Apart from his kind words for Rush's standards and labora-
tories, Flexner was hard on the place, calling it "a divided
school" whose two branches, one on the West Side, one on the
South, did not form "an organic whole." Presbyterian
Hospital he said was "not by any means a genuine teaching
hospital," which may or may not have reflected Bevan 's
thoughts about his own institutions.

At those institutions Bevan was a hard taskmaster, training
many surgeons, including Dallas Phemister, who later was
head of surgery at Billings Hospital and himself trained a
number of outstanding surgeons. Bevan "gave every man of
promise a square deal and the opportunity to make good," in
Herrick's words.

Even in his 70s, Bevan remained a master surgeon, operat-
ing with almost no bleeding. He worked fast and well and was
a "gentle, superb and technical operator," according to Dr.
R. Kennedy Gilchrist, who was an intern at the time.

Dr. Bertram W. Sippy gained fame through his treatment of
peptic ulcers, as by use of "Sippy powder," and by his quanti-
tative analysis of a patient's gastric content. One of his great
achievements was to teach patients how to measure and con-
trol their own acidity. Patients would remain hospitalized for
up to six weeks, regularly extracting material from within
themselves for testing.

Sippy would discuss a patient's condition with patient and
numerous staff present for as long as 45 minutes, so absorbed
was he in his subject. He was well liked anyhow, in spite of his
"garrulity, needless repetition of medical truisms and lack of
promptness," said Herrick.

THE INSTITUTIONS

Dr. Francis Straus recalls having his adenoids removed at
Presbyterian Hospital in 1901 when he was six years old.
Arriving by train from his suburban home, he was taken to a

Clinical Observations 95

second-floor corner room in the Jones Building where coals
burned in an open fireplace. From there he was taken to the
operating room, where he inhaled ethyl bromide as an anes-
thetic. It was considered potentially fatal at the time, he learned
years later. The operation finished, he was taken the same day
in a hansom cab to catch the Burlington Railroad train back
home.

Seven years later, Straus, who later taught at Rush and was
on the Presbyterian staff, might have been put up in the new
Private Pavilion adjoining Jones, built in 1908 mainly for use
by private patients. This pavilion was built only after the
hospital's medical board practically guaranteed its economic
viability to the board of managers, promising that as an invest-
ment its $300,000 cost would outperform bonds and mort-
gages. Thus paying patients would subsidize charity patients.

Four years later, Presbyterian built the Jane Murdock
Memorial Building for women and children, which partly
replaced the original Ross and Hamill wings. Its $175,000 cost
had been willed for the purpose by the late Thomas Murdock.
The Jones Memorial was later remodeled and expanded, so
that by 1922 the hospital had room for 435 patients.

The Memorial Institute for Infectious Diseases was founded
in 1902 in memory of John Rockefeller McCormick, the son of
Harold F. and Edith Rockefeller McCormick, who donated
the money for it at the urging of Frank Billings after their son
died of scarlet fever. In 1918 it was renamed the John McCor-
mick Institute for Infectious Diseases and in 1943 renamed
again the Hektoen Institute for Medical Research. It was at
first quartered in the Rush laboratory building at 1743 West
Harrison Street.

Operated under direction of the institute was the 40-bed
Anna W. Durand Hospital, where sufferers from diphtheria,
scarlet fever, measles and other infectious diseases were cared
for without charge. Durand opened in 1913 in its own building
at Wood and Flournoy streets under Dr. George H. Weaver as
director. A connecting institute laboratory opened in 1914 just
north of it on Wood Street. Each building was four stories.
The hospital also had a sun room and roof garden.

96 GOOD MEDICINE

Bedside instruction was given to groups of three to five
Rush students in the Durand wards. Students wore caps and
gowns to protect against infection. Each carefully washed his
or her hands after touching anything in the patient's vicinity.
The precautions were successful; no students were known to
become infected.

Rush faculty and students were closely associated with both
institute and hospital. Rush provided many young men and
women willing to work at both places, which in turn provided
clinical material and helped Rush maintain its atmosphere of
research.

An example of the research was a description by Dr. Stan-
ton A. Friedberg, Sr., in 1916 in The Journal of the American
Medical Association of removal of tonsils as neutralizer of the
diphtheria carrier. The carrier would infect others though not
infected with diphtheria. Dr. Friedberg's son, Stanton A., Jr.,
also a distinguished otolaryngologist at Presbyterian and
Presbyterian- St. Luke's hospitals, was medical staff president
from 1964 to 1966.

As director of the institute, Hektoen supervised and contrib-
uted substantially to the studies of scarlet fever by Dr. George
Dick and his wife, Gladys Henry Dick, who together found its
cause and devised a test for susceptibility to it and an antitoxin
for treatment of it.

Contemporary with McCormick-Durand was the Otho S.
A. Sprague Memorial Institute founded in 1911 by Rush
trustee Albert A. Sprague with funds from the estate of his late
brother Otho S. A. Sprague. The Spragues were in the whole-
sale food business, under the company name of Sprague-
Warner. They had already contributed to the Presbyterian
Hospital nursing school building.

The Sprague Institute built no buildings but supported
research at The University of Chicago and at Rush, Presby-
terian, Children's Memorial, St. Luke's and Cook County
hospitals, with emphasis on discovering chemical solutions to
medical problems. University of Chicago pathologist Dr. H.
Gideon Wells was its first director. Like McCormick-Durand
it became part of the 1916 plan for the university's medical
school.

Clinical Observations 97

By the early twenties, half of the 20-member Sprague pro-
fessional staff worked full time for the institute. James Herrick
headed its advisory council, which included pathologists Hektoen
and E. R. LeCount and internist Billings, who also headed its
trustees. Among these were Albert A. Sprague II and Martin
Ryerson, president of The University of Chicago board of
trustees.

Sprague Institute work included search for a safe anti-
tuberculosis drug and work on rheumatism and diabetes. Bill-
ings headed the rheumatism work in specially designated Pres-
byterian Hospital wards. Dr. Rollin Woodyatt led the diabetes
research.

Sprague-sponsored work also took place at Children's
Memorial Hospital, which was affiliated with Rush from 1910
to 1919. Rush faculty not only supervised the teaching at
Children's but staffed and ran the place, which had room for
about 30 patients and a small outpatient department. Various
additions expanded capacity to 150 patients by the early twen-
ties, including contagious ones. In 1919 Children's transferred
its affiliation to The University of Chicago in anticipation of
the coming South Side medical school.

In spite of Rush's research orientation, the college was ac-
cused in 1917 of shirking its academic responsibilities and
turning out mere practitioners. Rush graduates knew no more
about current medical experimentation than would a "club-
woman in three weeks reading for a 'paper,' " editorialized
The University of Chicago Magazine.

H. Gideon Wells, director of the Sprague Institute, could
not let this pass. "Nothing could be farther from the truth,"
he responded. The emphasis at Rush was on investigation in a
graduate school atmosphere, he said. Rush students, more-
over, regularly published in various journals, including The
Journal of the American Medical Association. Actually, Wells wrote,
the usual complaint was the opposite, that Rush made its
students investigators, not physicians. Wells said he found
"balm" in the magazine's allegation. "Perhaps we are doing
something to make doctors after all," he said.

The Rush program for making doctors included "ward
courses" for small groups of seniors three hours a day for one

98 GOOD MEDICINE

quarter at Presbyterian. Some students took "extramural"
courses, not supervised by Rush faculty, at the West Side
Hebrew Dispensary and at Alexian Brothers, St. Anthony's
and St. Luke's hospitals.

In general the many options for clinical work at Rush gave it
major appeal and helped to draw medical students to The Uni-
versity of Chicago. The pathologist LeCount, for instance,
was doing thousands of autopsies and was a first-rate pedagog
besides. He would ask a student to look at a piece of tissue, and
then cover it with his hands and ask the student what he saw. If
the student began to describe what was covered, as most did,
he was in trouble. What LeCount wanted to hear was what the
student saw (the hand), not what was covered. It was a test of
hearing what was asked and no more and answering that alone.

Presbyterian Hospital itself was controlled in medical matters
by the Rush faculty, who staffed it. The superintendent of
Presbyterian in the early part of the century. Dr. Henry B.
Stehman, retired in 1906. Many of his duties fell to a former
clerk who had developed a talent for innovation in what was then
a new field. This was Asa Bacon, a protege of the first president
of the hospital's board of managers. Dr. D. K. Pearsons.

Bacon is credited with creating the concept of training
courses for hospital administrators and running the first one in
1907. In the same year, he founded and became first president
of the Chicago Cook County Hospital Association. Plans for
hospital construction that he developed in 1916, considered
revolutionary at the time, later became common practice.

Stehman 's successor as president of Presbyterian was Albert
M. Day, a retired businessman who knew little about hospitals
but did well as a fund raiser.

The Presbyterian Hospital School of Nursing was established
in 1903. Its nurse training had been done by the Illinois Train-
ing School for Nurses. The first director, M. Helena McMil-
lan, was one of only four in its 53 years. She served to 1938.
Persuaded by her father not to pursue a doctor's career, she
acquired a bachelor of arts degree from McGill University (far
above nursing standards of the day) and studied at the Illinois
Training School.

Clinical Observations 99

A generous, determined woman with a sense of humor,
Miss McMillan pretty much created the Presbyterian school,
which was one of the first to put its students on an eight-hour
day and one of the first to charge tuition. Its course of three
and a half years was longer than most schools, and it was affili-
ated with a medical school. Rush, whose clinics provided good
learning experience. Unlike many schools, its classes were held
in the daytime and nurses lived close by.

The first nurses' residence was a former girls' club at 277
South Ashland Avenue, at Congress Street. After 1912 nurses
lived at the Sprague Home, at 1750 West Congress Street,
across from the hospital.

Incoming Presbyterian students were told to bring four
gingham or calico dresses and "noiseless shoes." Students
wore a pin with "PHSN" engraved on it, not a cross, as most
nursing students wore. The cap, which sat on the back of the
head, was simple, without folds and tucks, and kept the
nurse's hair out of the way.

Early lecturers in the nursing school included Billings, Her-
rick, Bevan, and LeCount. In 1907 obstetrics training was
moved to the Lying-in Hospital, and pediatrics to the Jackson
Park Baby Sanitarium. There was also pediatrics at Presby-
terian, headed in the twenties by Dr. Clifford Grulee.

Other clinical learning opportunities were offered by the
Home for Destitute Crippled Children, at Washington Boule-
vard and Paulina Street on the West Side. Rush conducted
teaching clinics in orthopedic surgery and other subjects at the
Home, which was a short walk away.

Presbyterian Hospital received Chicago's first electrocardio-
graph in 1913, 10 years after it was developed as a practical
device for recording heart activity. It was the gift (through Dr.
James Herrick, who used it to track coronary thrombosis) of Net-
tie McCormick, widow of Cyrus.

In 1921 Rush opened a five-room children's clinic at the
Central Free Dispensary, with kindergarten-style tables and
chairs in its waiting area. This was the first section of the
dispensary set aside for children, though 500 children a month
were seen there. That number was sure to rise, dispensary

100 GOOD MEDICINE

superintendent Gertrude Howe Britton told a reporter.

Medicine in general in the early twenties had its own flavor
and ambience. Its appeal to ambitious young men was limited,
for one thing, as a Yale graduate of the time recalled in 1977.
He is Dr. Samuel G. Taylor III, an oncologist who was direc-
tor of the Illinois Cancer Council and helped start the Rush
Cancer Center.

Most of Taylor's class at Yale went on to Wall Street to
make money. Medical schools did not require top grades.
Once in the trenches, as it were, as when Taylor interned at
County Hospital, one found the chief killer was pneumonia,
which had an 80 percent mortality rate. Syphilis was common
and treatable only in the early stages. Scarlet fever and
erysipelas cases crowded the contagious wards. Cerebral
damage from whooping cough and measles encephalitis were
also common.

A few miles to the east, at St. Luke's Hospital, Doctors
Casey Wood and Frank Allport opened an eye, ear, nose and
throat clinic about 1910. An outpatient division was opened in
1917.

In the twenties, half the St. Luke's staff had teaching
appointments at Northwestern Medical School, the rest at the
University of Illinois. Many St. Luke's doctors also served at
Northwestern-affiliated Passavant Hospital.

St. Luke's had 400 beds in 1923 and was caring for more
than 9,800 patients a year. Costs of non-paying patients were
covered by users of the George Smith Memorial Building. St.
Luke's, though founded by members of the Episcopal Church,
was "in no sense a sectarian institution" and practiced "no
discrimination as to race or creed," according to a fund rais-
ing brochure. The fund raising was successful. The Indiana
Avenue building went up, and by 1930 St. Luke's had reached
a capacity of 697 beds.

The twenties were distinguished by yet another, more aus-
picious St. Luke's Hospital event with the advent in 1927 of
the annual Woman's Board fashion show, which by the mid-
fifties was raising more than $50,000 a year and by the mid-
eighties was raising many times that amount.

Clinical Observations 101

DOCTORS, NURSES, PATIENTS

In the early thirties, there were 25 applicants for each intern-
ship at Presbyterian Hospital. The heavy patient load was the
main attraction, since other aspects of the assignment were
anything but engaging. The intern was given room and board
and had his laundry done for him but was paid nothing. He
even bought his own uniform. Now and then he could pick up
a few dollars for a pint of his blood. Otherwise, he was on his
own.

One of the "services" in which he might work for three
months or so at a time was with Dr. George Dick of scarlet
fever fame, who was to leave for Billings Hospital on the South
Side in July of 1932. Dick and his wife, Gladys, had isolated
the scarlet fever organism and produced an immunizing serum.
He was a big quiet fellow, well over six feet tall and bald, with
expressive eyes and a sense of humor.

He was a very good teacher, "one of the few who really
made one think," according to R. K. Gilchrist, one of his in-
terns. If an intern asked him something he could have learned
from a textbook, Dick wouldn't answer him. But if Dick
realized the intern had looked it up first and still had a ques-
tion, he would give the young man or woman 15 minutes of his
time while standing in a stairwell or wherever else the question
was asked.

A pathologist, he taught students to "think disease," a skill
more important in the days before laboratory tests played their
all-important role. That is, students were to take a patient's
history, examine, take blood counts and blood pressure and do
urine analyses staying ever alert to identifying the problem.

Another "service" was under the distinguished Dr. Kellogg
Speed, former University of Chicago football star, English
scholar and war hero. When Speed gave his course on frac-
tures at County Hospital, guards had to be posted to make
sure Rush students got their half of the amphitheatre seats,
such was Speed's popularity.

Another service was with Dr. Rollin T. Woodyatt, the
world famous diabetes specialist. Woodyatt was the first to use

102 GOOD MEDICINE

insulin in Chicago and in the thirties at Presbyterian was
teaching children as young as five years old how to give them-
selves insulin. He and a biochemist, Dr. E. J. Witzemann,
produced insulin at Rush. Woodyatt was a nephew of the famed
city planner Daniel Burnham.

Dr. Herman Kretschmer, later president of the AMA, had
another service. Kretschmer was a shrewd diagnostician who
gave two or three blood transfusions a day of whole, uncitrated
resident blood which worked wonders, passing on antibodies
and the like where they could do the most good.

Among nurses at Presbyterian were endowed nurses, spe-
cialists who cared for the indigent. These were widely used
during these years, beginning with the first such endowment
in 1917. Endowed nurses were known by the name of the per-
son in whose honor the endowment was given. Thus there
were Helen North Nurses, Gladys Foster Nurses, Ernest A.
Hamill Nurses, etc.

The floors at Presbyterian were designated by letters — A
floor, B floor, etc. The head nurse on D floor and trainer of
many nurses, a woman named Dessie Greek, had served dur-
ing the Great War with the 13th Army Base Hospital, staffed
by the Presbyterian-Rush contingent, and had not forgotten
what she learned of military discipline.

She kept her floor sparkling clean and enforced regulations
to the letter unless a patient belonged to the American Legion,
in which case special attention would be paid. She also was not
above (or below) ordering up scrambled eggs from the diet
kitchen for a surgeon and his resident whom she met in the
midst of their rounds.

Nurses and doctors then as now often married each other.
Nurses were forbidden to marry while in training, however,
whether doctors or anyone else, though some did and kept it
secret. Many married once the course was complete.

Durand Hospital was the scene of sometimes heroic efforts
to save children choking to death from laryngeal diphtheria.
They would be brought in at all hours, their chests heaving,
gasping for air that could not make it past the diphtheric mem-
brane formed in the windpipe. A big fire gong would go off at

Clinical Observations 103

the foot of a resident's bed on the fifth (top) floor. He would
jump up, put on pants and slippers and hit the floor running.

A nurse would meet him at the top of the stairs with a gown,
cap and mask which he donned in seconds. He was with the
patient almost immediately, slipping a rubber tube into the
trachea, if necessary through a metal one inserted first. Nurses
would slip in a mouth gag to keep the child from biting the
doctor as the two engaged in their life-and-death struggle.
Then the blocking membrane would be sucked out. R. K.
Gilchrist, whose recollections these are, did 20 such "intuba-
tions" in his first three weeks at Durand, where he spent three
months. After that he lost track.

Diagnoses in those days were made without expensive testing
and relied heavily on the doctor's experience. When a needle in-
serted into the chest of a moderately sick patient drew out
"brick red fluid," for instance, the examining physician might
spot the problem immediately as an amoebic abscess of the
liver that had broken through the diaphragm.

Presbyterian Hospital, being on Chicago's West Side, had
its dealings with the crime syndicate. Al Capone's successor as
syndicate chief, Frank Nitti, known as "The Enforcer," a lit-
tle dark-haired man, was a patient. So was another syndicate
member whom Dr. Ernest Irons treated, without knowing the
man's provenance. In gratitude, the man threw a party for
Irons and gave him a watch, which later checked out as worth
a paltry $15.

Dr. Vernon David operated on the syndicate's slot-machine
chief, Eddie Vogel, under an alias — Vogel's, not David's.
Later a syndicate lawyer sent a scrubwoman to be treated for
skin cancer and, in Robin Hood style, paid her bill. Gilchrist
later, knowing nothing about the man's clients, begged $200
from him to fund a research project.

Others gave and raised money from a different background
— the women's auxiliaries or boards of Presbyterian and St.
Luke's hospitals. The president of the St. Luke's Woman's
Board from 1926 to 1944, Mrs. John W. Gary, presided at
meetings in no-nonsense fashion. She and the other older
members sat at a long table, she at one end and Mrs. Walter

104 GOOD MEDICINE

B. Wolf, who later succeeded her, at the other. The younger
women sat along the wall.

It was at the start of Mrs. Gary's incumbency that two
Woman's Board members, Mrs. Hathaway Watson and Mrs.
Frank Hibbard, suggested an annual fund raising fashion
show. The two had seen charity fashion shows in France, one
in Deauville and the other in Cannes. Together they decided
that what was good for Deauville and Cannes was good for
Chicago. The elegant, popular event became an institution.

The first show was held at the Stevens (later Hilton) Hotel
on October 27, 1927. Afternoon and dinner shows were held
with a tea in between. After some years at the Stevens, shows
were held at Orchestra Hall and, since 1945, the Medinah
Temple.

Mrs. Clyde E. Shorey was president of the Presbyterian
Hospital Woman's Board in the mid-thirties (1936-1938) and
early forties (1941-1945) and dedicated herself unstintingly to
its success over several ensuing decades. She died in 1984 in
her 90s.

Those who served the St. Luke's Woman's Board in the for-
ties and fifties included Mrs. Gordon Lang, Mrs. Eric
Oldberg, Mrs. Robert McCormick Adams, Mrs. Charles H.
Morse, Jr., and Mrs. Fentress Ott. Working with the board in
its various ventures were Leo Lyons, director of St. Luke's
Hospital from 1942 to 1956, and Cornelia Conger, its decor-
ator, who bought all the hospital's china and decorated its
rooms, leaning often on Woman's Board members for guidance.

At the two hospitals during these years, including the early
forties, several health care milestones were passed. During
1932, for instance, the Presbyterian-Rush staff-faculty per-
formed 75 cornea transplants. During the same year, only a
few were done elsewhere in the U.S.

Dr. Eric Oldberg's successful performance of brain surgery
in 1933 was among the first done in that field. St. Luke's opened
Chicago's first audiology service in 1937. Presbyterian offered
such a service in the early fifties. Also in the thirties, the new
psychiatric unit at St. Luke's was another first for a private
hospital in the U.S.

Clinical Observations 105

THE TWO WARS

The two world wars involved staffs of both hospitals. The first
Presbyterian staff person to enter service in the first war was
the nurse in charge of outpatient service, Alma Foerster, who
enlisted in the fall of 1914 with the American Red Cross for
service in Russia. She later served in Rumania and was decor-
ated by both these countries and by the Red Cross.

One who left shortly after her was Serbian-born Dr. John
M. Kara, who died of typhus fever while on duty with the
Serbian army medical corps. The epidemic in which he died
was finally brought under control with delousing methods based
on the findings of another Rush teacher, the medical martyr
Dr. Howard Taylor Ricketts.

Ricketts had died five years earlier in Mexico working on a
cure for typhus, which he discovered was transmitted by lice.
Hence the delousing, which in Serbia and elsewhere saved
thousands of lives. Ricketts had already done extensive work
on Rocky Mountain or tick fever in Idaho and on
blastomycotic (fungus) infection of the skin.

Foerster and Kara were the first of dozens of Rush and Pres-
byterian personnel who went to war, almost all in medical
service. The 13th U.S. Army Base Hospital was organized at
Presbyterian in the fall of 1916. Dr. Frank Billings, dean of the
Rush faculty, was its commanding officer. But Billings caught
a near fatal pneumonia and was replaced by Dr. Arthur
Bevan.

Others on the staff of the 13th were Dr. Dean D. Lewis, of
the department of surgery; Dr. Basil C. H. Harvey, professor
of anatomy and later dean of students on the South Side
medical campus; and Dr. Ralph C. Brown, of the department
of medicine. The unit entered service in January of 1918 at
Camp Jackson, Mississippi, and left for Europe in April. It
served to the war's end in November.

In the summer of 1917, Billings headed an American Red
Cross mission to Russia to survey conditions there. Dr. Wilber
Post joined him on this mission, which lasted two months. Just
after the war. Dr. H. Gideon Wells headed a similar relief mis-

106 GOOD MEDICINE

sion for the U.S. Army to Rumania. Post was also part of a
four-month relief mission to Persia in 1918 headed by University
of Chicago President Harry P. Judson.

Dozens of Rush faculty helped at ROTC camps. Fifteen
Rush graduates took Navy medical commissions. Seventy of
the Rush junior class signed as nonmedical personnel in the
13th, and over 60 sophomores joined an ambulance corps
organized by Captain Elbert Clark, of the department of
anatomy. Most of these dropout volunteers later withdrew to
stay in medical school, heeding an urgent government plea to
do so.

The Medical Enlisted Reserve Corps., composed of medical
students who belonged to the Army, was formed in August of
1917. The entire Rush-University of Chicago Medical School
student body began studying on both campuses under military
command, living in barracks opposite Hull Laboratories on
the South Side and in the West Side YMCA on Monroe Street
on the West Side.

They wore uniforms for the few months that remained of the
war and drilled three times a week on the former Chicago
Cubs baseball field two blocks south of Rush.

In all, 100 or so of the Rush-University of Chicago faculty
served in the Medical Corps, many overseas in the hospital at
Limoges, France. Seventy-five others served in other ways.
Both South and West Side campuses remained open at full
capacity.

The St. Luke's staff formed the 14th Field Hospital together
with the staff of Michael Reese Hospital. Dr. L. L. McArthur
and nurse Ellen Stewart organized it, but neither could accom-
pany it overseas. Instead, Dr. Samuel Plummer, a St. Luke's
surgeon, and Mrs. Lynnette L. Vandervort, a nurse who later
won a Distinguished Service Medal, headed the unit when it
went to France. Fifty of the unit's nurses were from St.
Luke's, 50 from Reese. Activated in the fall of 1917, it went
first to camps in this country, where pneumonia and conta-
gious diseases had to be fought in barracks conditions and
without the help of sulfa and penicillin.

The unit later paraded in New York City before sailing in

Clinical Observations 107

July of 1918 for Liverpool, which it reached on August 11.
Some of its members served in Paris, others on the English
coast in an early Elizabethan house from which they could see
France on a clear day. The old house was loaned by its owner,
Sir Arthur Markham, who also donated an X-ray and ambu-
lance. Lady Markham, his wife, did most of the cooking for
staff and patients. The house-hospital had beds for 50 and an
operating room. More primitive conditions prevailed in
Belgium, where some of the war wounded had to undergo am-
putations without anesthetic, according to one account.

In World War II, Presbyterian and St. Luke's doctors and
nurses served again in the 13th and 14th Army hospital units,
though not all. The Presbyterian unit began recruiting in
1942, thanks largely to Dr. L. C. Gatewood, a veteran of the
Presbyterian unit in the first war, who had remained in con-
tact with the War Department.

The 13th's doctors and nurses were recruited with ease
almost entirely from Presbyterian. The unit offered the doctor
a way out of being drafted, which was universally considered a
bad way to enter the Army even by those who were willing to
go. The Army would use doctors as it wished in any event,
removing them from this unit as they were needed elsewhere
— to head other units, for instance. This World War II unit
was a general hospital, not a base hospital, as was the one in
World War I.

Recruiting for enlisted men was harder, but the quota was
filled by October of 1942. Once formed, the unit met several
nights a week on the South and West sides for drilling and lec-
tures. In December the first cadre was inducted and sent to
Camp Grant near Rockford, Illinois. From there they were off
to Camp Robinson, near Little Rock. In all, the unit num-
bered 20 or so doctors, almost 100 nurses and 350 enlisted men
— plumbers, barbers, carpenters and the like. Among the doc-
tors were Edwin Miller, the unit's chief of surgery, Evan Bar-
ton, R. K. Gilchrist, Holmes Nicoll, Francis Straus and
George Stuppy.

Many Presbyterian nursing students joined the U.S. Cadet
Nurse Corps during these years. The cadet program, 1943 to

108 GOOD MEDICINE

1948, marked the first underwriting by the federal government
of nursing education. It was also the first time nursing classes
were offered at Presbyterian on a racially and religiously non-
discriminatory basis.

The 13th hospital left Little Rock in May for the Desert
Training Center at Spadra, California, a camp in the desert
near Los Angeles, where they pitched tents and dug in to care
for those injured in nearby desert maneuvers. Wooden bar-
racks, hot water and other amenities eventually replaced the
tents.

In September they went to Utah, and in January of 1944
they left on a converted Dutch liner for New Zealand,
Australia and finally New Guinea. In New Guinea, they set up
a general hospital 60 miles behind the lines to receive
casualties from station hospitals. In the early weeks in this
jungle location, dysentery and skin diseases, such as jungle
rot, were a regular concern.

In May of 1945, Evan Barton, who had headed the unit's
laboratory service, was made commanding officer. In June the
unit was off to the Philippines, in October to Japan. By
December of 1946, when the unit was officially deactivated,
most had gone home.

Not all Rush-Presbyterian doctors went with the 13th. A
group was taken from it while in Australia and sent to form the
second and 25th portable surgical hospitals. This was even-
tually commanded by Dr. Frederic de Peyster (later Major), a
1940 Rush graduate. As part of the 32nd Infantry, the 25th
saw action on a series of Pacific islands, including Okinawa, le
Shima (where correspondent Ernie Pyle was killed by a
sniper's bullet), and the Philippines. On September 6, 1945,
after the Japanese surrender, the 32nd entered southern
Japan, where de Peyster' s portable hospital group set up the
first American hospital. Every doctor but one in the 25th was a
Rush graduate.

Presbyterian's doctors for the most part stayed together dur-
ing the war, but St. Luke's did not. Some served in North
Africa and Italy with the 14th General Hospital, setting up
hospitals in Naples and then in France. In the one in France,

Clinical Observations 109

there was one nurse to every 100 patients and the staff per-
formed 60 to 90 operations a day.

Others, 35 of them, joined the Army Air Corps after the Army
and Navy told Dr. Foster McMillan they weren't needed.
McMillan finally went to Washington, where he found the Air
Corps needed them very much. St. Luke's had two Air Corps
units, one headed by McMillan and Dr. John Brewer, the
other by Dr. Marvin Flannery. The first went to Denver, to
set up Buckley Hospital, near Buckley Field.

The other went to Amarillo, Texas, though later Brewer
went to Amarillo too, to head the hospital there. Doctors
Ormand Julian and Earl Merz (later head of ophthalmology at
Northwestern) were in the Amarillo group. In general the St.
Luke's men were split off from the original St. Luke's group as
the Air Corps found other posts for them.

Back on the home front at Presbyterian, nonprofessional
volunteers were trained to help the short-handed staff, in-
cluding a contingent of male Wilson & Company employees in
1944. Women volunteers came from the Red Cross and from
the ranks of the Woman's Board. Mrs. Clyde Shorey headed
the latter group. It was the first time direct service for patients
— taking temperatures, for instance — was performed by
volunteers. A bright spot in the middle of the war was the be-
quest to the hospital of $450,000 from the estate of the widow
of Dr. Arthur Bevan.

William Rainey Harper,
1856-1906, founder of
The University of Chicago.

(Photo courtesy University of Chicago)

E. Fletcher Ingals, M.D.,
1848-1918.

Frank Billings, M.D.,

1854-1932, and Arthur

Dean Be van, M.D.,

1861-1943.

OJ

>

Q

o
o

o
X

c

O
O

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o

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Teaching surgery, 1938.

James B. Herrick, M.D.
1861-1954.

Ludvig Hektoen, M.D.
1863-1951.

Bertram W. Sippy, M.D.
1866-1924.

Nicholas Senn, M.D., conducts surgery clinic in amphitheatre of
Rush Medical College.

M. Helena McMillan, R.N.

1868-1970, founder of

Presbyterian Hospital School

of Nursing in 1903.

Surgical supplies room, Presbyterian Hospital, 1910.

Children's Ward,
Presbyterian Hospital,
1937.

Central Free Dispensary waiting room, 1923.

First electrocardiogram at Rush Medical College/Presbyterian
Hospital, 1913.

St. Luke's Hospital operating room, 1913.

John Benjamin Murphy,
M.D., 1857-1916.

(Courtesy Mercy Hospital of
Chicago)

St. Luke's Hospital, 1925.

Madeleine McConnell, R.N.,
1888-1983.

p

FASHION-SHOW

BENErnia

Poster for Woman's Board
Fashion Show in 1927.

Fashion Show Poster, 1986.

Postwar Revival
1946-1955

At Presbyterian Hospital in 1946, the mood was shaped by
two major events of the past five years, the war just ended and
the split with The University of Chicago. The war had been
disruptive, of course. Doctors and nurses left. Supplies and
services were short. The hospital functioned short-handed.
Life went on but with a sometimes grim expectancy. At the
same time, there was a huge, unprecedented governmental in-
volvement in medical matters which was to make a great dif-
ference to Presbyterian.

The split with the university was disrupting, as was the
simultaneous mothballing of Rush Medical College. For the
first time in its almost 60 years, the hospital had gone it alone
without Rush. The Presbyterian staff was adjusting to its new
identity.

The hospital affiliated with The University of Illinois in
1941, the year the Chicago Medical Center District was
created by the state legislature and given power to buy and
clear slum land, Presbyterian and The University of Illinois
were in the district. So were Cook County Hospital and its

121

1 22 GOOD MEDICINE

affiliates, the Loyola University and Chicago Medical schools
and some state laboratories. Presbyterian might have felt
orphaned, but its West Side location was receiving a powerful
boost from government.

The Presbyterian-University of Illinois agreement preserved
the independence of each. The hospital pledged cooperation
with the university, which was to have access to the hospital's
facilities. Neither institution assumed budgetary obligations
for the other.

Hospital appointments were to be made by hospital trustees
after a process of nomination and approval by the university.
This nomination process has been commonly thought to have
given the university veto power, never exercised, over hospital
appointments, but it didn't quite say that.

Furthermore, the university was to appoint the hospital staff
to its own clinical staff (would "blanket" them in, as one
veteran put it) and was free to nominate "a limited number of
qualified members" of its faculty to the hospital staff.

Former Rush faculty members were to be designated "Rush
Professors" — "to provide continuity between the old and the
new organizations." Rush veterans understood this to cover
not only Rush staff at the time of the agreement but also those
who joined Presbyterian (and the university faculty) later.

But university administrators did not agree, and when
papers came into their offices describing newcomers as
"Rush," they crossed out the "Rush" part. In any event the
nomenclature was honorific and apparently a nod to the feel-
ings of those recently bereaved of their medical college. At the
university it denoted neither special standing nor automatic
professorship.

The University of Illinois, then a shadow of what it would
become, was Presbyterian's second choice for affiliation. The
hospital had tried Northwestern first — the city's other strong
medical school. But Northwestern had just completed its affili-
ation with Wesley Hospital and was not ready for another.

First choice or not, the Illinois affiliation provided university
appointments for the hospital faculty and made it easier to
recruit house staff. At least half of these would eventually come

Postwar Revival 123

from the University of Illinois. It also helped the hospital when
it sought research grants.

University of Illinois students began coming immediately to
Presbyterian. William Grove, later to spend his career at the
university, much of it as dean of the medical school, was one of
them. A senior student in medical school in 1942, he took
classes at Presbyterian and was one of the first University of Il-
linois students to take a clerkship (do third- and fourth-year
clinical studies) at Presbyterian.

For the most part, the university-hospital relationship went
smoothly, in spite of what Dr. Grove later called an "uneasy"
relationship among administrators. The uneasiness was there
from the beginning, however more obvious it became later.
But among medical staff and faculty there was generally coop-
eration, even comradeship.

Meanwhile, the war veterans returned beginning in 1946,
greeted with a half-serious "Welcome back but not here" from
some colleagues who saw increased competition for patients.
Attending physicians had to start their practices over again.
Surgeons who had not gotten board certification found places
saved for them by Dr. Vernon David. One of these. Dr.
Frederic de Peyster, joined David and Dr. R. Kennedy
Gilchrist for practice in general surgery.

Once back on the West Side, de Peyster, one of Rush's most
recent graduates, "picked up the ball to carry Rush into the
future," as Bill Grove saw it at the time, assuming the role of a
"quiet but key leader" in maintaining alumni interest and
keeping quiet pressure up for some sort of Rush revival.

St. Luke's a few miles away was at a high point academically,
what with University of Illinois appointments in orthopedics,
plastic surgery, neurosurgery and the like. But these all dated
from the thirties, which were a golden age for that institution
(as the twenties had been for Rush Medical College). There
had been no new appointments in 10 years. So there was a
10-year gap in age of the staff, not to mention a modicum of
hard feeling about those who hadn't gone to war.

The house staff was older than had been normal. Some who
had run field hospitals were reduced to interns when they

124 GOOD MEDICINE

returned. Most were married (the old rules had forbidden
marrying during internship), but were expected to be on call
24 hours. During his internship months in the urology depart-
ment, Dr. Philip N. Jones was not even allowed out of the
hospital. In the department of medicine, it was two nights on,
one off, two weekends on, one off.

Presbyterian was to have its postwar revival, but at St.
Luke's disadvantages began to predominate. St. Luke's had
patients, a solid reputation and a thriving Northwestern
University clerkship (without full affiliation).

But it was off the beaten path, while Presbyterian sat along-
side the route of the new Congress (later Eisenhower) Express-
way, which was to be fully operative in 1960. Presbyterian
thus was to be near a gateway to downtown from three direc-
tions. Northwestern had the same advantage north of the
river. St. Luke's on the other hand, enjoyed no such visibility
and accessibility, and its neighborhood was in sharp socio-
economic decline.

So was Presbyterian's, but again location made the differ-
ence. Presbyterian was in the world's biggest medical district,
while St. Luke's was isolated. St. Luke's began to slip in
recruitment of patients, doctors and employees.

Neither had St. Luke's suffered the trauma of disaffiliation
from a major university, as had Presbyterian, which now, like
a man or woman after a divorce, had to pull itself together. It
was nothing like that at St. Luke's, where business continued
pretty much as usual.

Neither did St. Luke's have money sources comparable to
Presbyterian's. The Bevan and Sprague funds, for example,
though not university-size, nonetheless were important for
funding research and professorships. War's end was a peak
time for St. Luke's. The slide was coming.

For Presbyterian it was another story. The immediate post-
war period was a slough for Presbyterian. Full of "prominent,
nationally known senescent doctors," as one Presbyterian
veteran said, it was on the verge of either something great or
something very bad. Staff had to be strengthened, weakened
as it was by lack of new blood during the war, not to mention
the University of Chicago split.

Postwar Revival 125

The board felt the same way. "The only way to make this a
distinguished hospital," said trustee A. B. Dick, Jr., "is to get
distinguished physicians." Presbyterian had some already.
Dick wanted more. So did Alfred Carton, another board vet-
eran, the lawyer for the hospital who had functioned as its
part-time president in the thirties.

Management consultants Booz, Allen & Hamilton were
called in — a move unheard of for hospitals at the time. Some
eminent professor might have been consulted, but not a com-
mercial, nonmedical consulting firm. Booz, Allen recom-
mended funding full-time professors. Rush (Presbyterian) was
supposed to be a postgraduate school. Let it be one then.

Most teaching hospitals worth their salt had full-timers. But
Presbyterian's teachers supported themselves with their prac-
tices and taught interns and residents in their spare time. This
worked with James Herrick and his contemporaries, but Her-
rick could function with little more than a microscope. Things
had changed with the coming of the modern laboratory. World
War II had started a revolution in academic medicine. Get
salaried people, said Booz, Allen.

The first of these were Dr. George M. Hass, a pathologist,
and Dr. Douglas A. McFadyen, a biochemist, who arrived in
January of 1946. Hass, now professor emeritus at Rush-
Presbyterian-St. Luke's Medical Center, was to exert national
influence, training a dozen or more pathologists who later
headed departments around the country. A great believer in
basic research, he recorded gains in seeking out the causes of
arteriosclerosis.

Two years later, in January of 1948, Dr. S. Howard Arm-
strong, Jr., came as Presbyterian's first full-time chairman of
medicine. These were the nucleus of the new staff. Armstrong
stood out among them as a colorful, dynamic leader, but
neither he nor McFadyen were to remain.

Staff veterans welcomed the developments, determined as
they were that Rush should one day reopen. Even before the
13th General Hospital had gone overseas, its members had
recommended hiring new people. The hirings represented an
important move by the board toward keeping alive hopes for a
revived Rush Medical College. The University of Illinois rela-

126 GOOD MEDICINE

tionship, cordial and valuable as it was, could be no substitute
for a new Rush risen from its limbo state. The board had funds
which it was expected to put to just such a use.

More would be needed, however. In April of 1950, A. B.
Dick, Jr., was announced as chairman of a campaign to raise
$5.5 million. It was the first general public subscription cam-
paign in Presbyterian Hospital history. Philanthropic muscles
were beginning to ripple.

In December of 1951, a full-time surgeon arrived. Dr. Ed-
ward (Ted) Beattie, from George Washington University
medical school, in Washington, D.C. Beattie was to become,
in September of 1954, Presbyterian's first full-time head of
surgery.

Beattie and Dr. Fred de Peyster had known each other as in-
terns at Peter Bent Brigham Hospital in Boston before the
war. When de Peyster heard Presbyterian was looking for a
chest surgeon, he told Dr. Edwin Miller, Presbyterian's head
of surgery, about him. Beattie, then at Brigham, couldn't
come to Chicago right away but came after a stint at George
Washington.

When Beattie did come, he was greeted on his first two visits
in Chicago fashion — once when a hospital security guard and
doorman known as "Bill the cop" shot to stop a purse snatcher
right in front of Presbyterian and again when there was a rob-
bery on the floor of the Drake Hotel, where he and his wife
were staying.

Surgical research began under Beattie; he generally revital-
ized the program in surgery. Once or twice when he was chair-
man, for instance, his staff read more papers at the Forum of
Fundamental Sciences (part of the annual meeting of the
American College of Surgeons) than the surgical staff of the
much bigger University of Illinois medical school.

Beattie left in July of 1965 for Sloan-Kettering Institute in
New York City, where he became medical director and head
of general and thoracic surgery. He was succeeded by Ormand
Julian, another full-timer, who was succeeded by Dr. Harry
Southwick, a private practitioner.

Meanwhile, in September of 1950, progress was reported by

Postwar Revival 127

Presbyterian researchers in another field, cardiovascular
medicine — specifically in the search for causes of arteriosclerosis.
This was James A. Campbell's work. Campbell had arrived in
March of 1949 as the fourth of the full-timers, the second in
medicine, recruited by Armstrong, who had known him at
Harvard, as director of the new cardiovascular research labo-
ratory. A mere 31 years old, he was destined to spend his life at
Presbyterian and was to become the second founder of Rush
Medical College.

In some respects Campbell was an unlikely candidate for the
honor. The oldest of three children of a Presbyterian minister
in Rochelle, Illinois, 75 miles west of Chicago, he grew up
poor but educated. He attended Knox College (class of 1939),
a small liberal arts school in Western Illinois, on a scholarship.

Then he passed up a scholarship to the Yale University
School of Drama because his father blocked the move, though
the Broadway producer Brock Pemberton reportedly had
guaranteed the young man parts in his plays. (These later in-
cluded the immensely successful "Harvey," in 1944.) Camp-
bell went instead to The University of Chicago medical school.
There is probably no one who knew the outgoing, dramatic
Campbell in later life who would doubt that he once con-
sidered the stage for a career.

After two years at Chicago, 1939 to 1941, he interrupted
medical school to spend a year working in the university's
pathology laboratory. Then he was off to Harvard Medical
School, where he got his M.D. in 1943. While at Cambridge,
he met and married a young Brookline, Massachusetts, school
teacher and recent graduate of Boston's Wheelock College,
Elda Crichton, from Johnstown, Pennsylvania.

He interned at the Harvard Service in Boston City Hospital,
then worked for a year at that hospital's Thorndike Laboratory.
In 1946 he entered the Army at Edgewood (Maryland) Arsenal,
where he became something of an expert on mustard gas. In
1947 he took the Harvey Cushing fellowship in cardiac medicine
at Johns Hopkins University Medical School, working on car-
diac catheterization under Dr. Richard Bing. In 1948 Armstrong
recruited him for Presbyterian.

128 GOOD MEDICINE

At Presbyterian, Campbell set up the cardiac catheteriza-
tion lab in the department of medicine, equipping it like a
surgical room over the objections of the head of surgery, Dr.
Vernon David, It was in this room that Campbell performed
Chicago's first heart catheterization.

He and his family lived in Lake Forest. Their next-door
neighbors, Cyrus and Mary Adams, were known to the Arm-
strongs. Cyrus Adams and Howard Armstrong's father had
been friends at Princeton. Cyrus and Mary's daughter, Mary
Adams Young, was the wife of George Young, a lawyer soon
to be a trustee of St. Luke's Hospital. Mary Young and Elda
Campbell became good friends, and so did their husbands.
The friendship would prove extremely important to Presby-
terian and St. Luke's hospitals.

The James Campbell-Howard Armstrong relationship un-
ravelled, however. The two disagreed philosophically on the
role of publicly funded medical institutions, for one thing. In-
deed, Armstrong was to leave Presbyterian eventually for
Cook County Hospital, which he believed in and which
Campbell didn't. A gap yawned between the two, whatever
the cause.

In any event, for reasons that are not clear and not clearly
related to any disagreement he had with Armstrong, Jim
Campbell walked away from Presbyterian less than three years
after he arrived, leaving to be dean of the Medical School of
Albany, New York, a part of Union College in Schenectady.

Off to Albany he went, young and young-looking. His first
day on the job, he was taken for a student and told not to park
in the staff parking lot. The incident was symbolic. Albany
was a mistake, he later told a colleague, without saying why.
Two years after he arrived there, when Armstrong was in the
process of leaving Presbyterian, Dr. Edwin Irons, son of the
former Rush dean, came out to Albany with an offer from a
search committee. Campbell jumped at it and hurried back to
become Presbyterian Hospital's second full-time chairman of
medicine. He was a few months short of his 36th birthday.

At Presbyterian he instituted the weekly medical grand
rounds, which became the best attended exercise in the cur-

Postwar Revival 129

riculum. He presided, quizzing interns and residents about
patients' treatment. The sessions were full of tension, humor
and knowledge for some, but full of trouble for others. A lot of
students were scared to death of Jim Campbell.

To a contemporary who had known him at Harvard, it was
vintage Campbell, a mixture of the fascinatingly brilliant and
the fascinatingly vindictive. Aggressive, vitriolic, a born
debater, he used the grand rounds to weed out the mediocre
and to educate the rest. Coming to what was essentially a com-
munity hospital with 350 to 400 beds, he found people he
wanted to keep and others he didn't and moved accordingly to
shape his staff.

Patients were sometimes amused by the experience, includ-
ing friends of trustees. Wheeled from their rooms down to the
A. B. Dick auditorium in the East (now Kellogg) Pavilion,
they would listen while Campbell asked opinions from
assembled "youngsters" (interns, etc.), pleased to be the ob-
ject of so much attention.

But they weren't at the receiving end. One or two surgeons
were "not very good," and Campbell "went after them all the
time," the same contemporary said. Jim Campbell was not
about to suffer fools gladly. He was hard on administrators
too. He is said to have "driven out" the first he worked under,
made it tough on the next one, who didn't last long, and forced
the board to a choice between him and the third. Recollections
differ, but a prominent trustee is among those who concede it's
possible things happened that way.

Furthermore, he clashed with his nominal superior at the
University of Illinois medical school, Dr. Harry Dowling, the
chief of medicine. A full-timer like Campbell and like him a
debater and persuader, Dowling often won the university
faculty to his views.

Conflict was to some extent inevitable. Campbell had the
manner and goals of an entrepreneur. Ambitious and impa-
tient, he was also a "medical politician" who elicited "unbe-
lievable support" from the hospital board, in the words of a
Presbyterian old-timer.

Campbell began hiring other full-timers immediately, using

130 GOOD MEDICINE

Presbyterian's strong financial base to improve its teaching
and research capabiUties. The first, in 1953, were Graettinger
and Kark, followed in 1954 by Trobaugh.

Dr. John Graettinger, also fi:'om Harvard, joined Campbell
in medicine and worked with him in the newly reestablished
cardiovascular lab, which he later headed. Dr. Robert Kark,
who held the Licentiate of the Royal College of Physicians of
London and had also trained in the Harvard Service in
Boston, was internationally known for his treatment of renal
(kidney and kidney-related) diseases. He introduced renal bi-
opsies, a powerful diagnostic tool, into the cardiovascular lab.

Dr. Frank Trobaugh, a classmate of Campbell's at Har-
vard, came to head hematology (the study of blood and blood-
related diseases). Trained in pathology, he had headed the
laboratories for U.S. forces in Europe during the war before
returning to Harvard in internal medicine. At Presbyterian he
set up laboratories for analyzing patient's blood, urine, and
the rest. These labs were moved into Campbell's department
of medicine.

Campbell and Graettinger were joined in March of 1954 by
Dr. Joseph Muenster, who came as Presbyterian's first re-
search fellow. He was just out of the Air Force, from St. Louis,
and came on a two-year assignment. He was to stay for consid-
erably longer than that, however.

As a sort of fringe benefit, Campbell told Muenster when he
hired him that he would introduce him to James Herrick, the
94-year-old founder of cardiology. But the day before
Muenster was to meet the great man, Herrick died. Herrick's
death came fittingly, perhaps, at about the time Campbell and
his colleagues were developing heart catheterization at Presby-
terian, the landmark diagnostic technique for the disease Her-
rick had first described which replaced the electrocardiograph,
which Herrick had first used to map the disease's progress.

A year later, Campbell hired another full-timer, this time in
endocrinology. Dr. Theodore Schwartz. Schwartz came from
Johns Hopkins University by way of Duke University, where
since 1948 he had been studying under Dr. Frank Engel.
Schwartz had taught Engel internal medicine while Engel

Postwar Revival 131

taught him experimental endocrinology, and the two had
taken their board examinations at the same time.

Schwartz arrived with his family in the summer of 1954 and
stayed at the Campbells' Walton Street apartment on the
city's Near North Side until he and his wife found a house in
Evanston. The Campbells were vacationing at the time.

Campbell had set up the endocrinology section which
Schwartz headed with a Hartford Foundation grant. Other
grant money followed, as one a few years later from the Na-
tional Institutes of Health, to train cardiologists. Most of
Presbyterian's grants came to the department of medicine.

Now there were five full-time salaried staff — the surgeon
Beattie and medical men Campbell, Graettinger, Trobaugh
and Schwartz — with Muenster as a fellow. An older physician
who worked with this new team was Dr. Richard B. Capps,
who also had served in the Harvard unit at Boston City
Hospital. Capps was internationally known for his work in
liver diseases.

Another, a part-timer, was Dr. Samuel G. Taylor III, who
moved out of endocrinology to make room for Schwartz and
went into oncology (the study of tumors). Taylor became the
founder of oncology at Presbyterian.

Not all supported the changes. Some practitioners, volun-
teer teachers suspicious of this new breed of salaried full-time
professors, called them "hired hands." But for these critics the
worst was yet to come, as Campbell made changes in house-
staff education and even in the hospital wearing apparel of
attending physicians.

Meanwhile, "cutting-edge" diagnostic procedures were be-
coming available. Chief among them was cardiac catheteriza-
tion, a much more powerful tool than the electrocardiograph,
which up to then was the best available in Chicago. Heart
surgery developed in tandem with the new diagnostic proce-
dure. Cardiologists identified problems, and surgeons solved
them.

Graettinger and Muenster supervised postoperative man-
agement when necessary. In this they worked closely with
Beattie, who as chairman of surgery was Campbell's surgical

132 GOOD MEDICINE

counterpart, and the 20-year Presbyterian veteran, Dr. Egbert
Fell. In 1956 Fell performed Chicago's first successful open-
heart operation in which the heart-lung machine was used.
This was at Cook County Hospital; a week later he did the
second at Presbyterian Hospital. In 1957 he reported on his
successful series of such operations (about 25) to the Chicago
Surgical Society. The hospital's fame spread.

Campbell had left lab work in Graettinger's and Muenster's
hands and had turned to administration and the training of
house staff. Presbyterian's training programs were in need of
improvement. In August of 1954, when Graettinger arrived,
the hospital had only four interns.

A recruiting program was started, and the numbers of in-
terns and residents grew rapidly. One year, seven residents
came from Harvard Medical School. Clerkships for third-and
fourth-year undergraduate clinical students also increased.
University of Illinois students began to ask for Presbyterian for
their third and fourth years. In time, well over half of Univer-
sity of Illinois clerks were being trained at Presbyterian.

During this time, not all the initiative was Campbell's.
Members of the research and education committee met in 1955
to discuss how to spend a $25,000 Sprague Institute grant. The
group included Ernest Irons, the former Rush dean; veteran
surgeons Vernon David and R. K. Gilchrist, and Dr. Karl
Klicka, the hospital's superintendent, whom Campbell opposed.
It didn't include Campbell.

Campbell continued to attend to hospital-wide concerns,
among which he considered none more important than provid-
ing a single standard of care for patients.

In Boston he had seen the best of the dual system — separate
treatment for paying and nonpaying patients. His and Graet-
tinger's chief at Massachusetts General Hospital, Dr. William
B. Castle, knew his patients by name and came to see them at
all hours, not just in the daytime. Nonetheless these patients,
captive in their poverty, were used by doctors for clinical in-
vestigation.

When this happened under doctors like Castle, it was the
reason American medicine developed rapidly between the

Postwar Revival 133

wars. Doctors did this sort of clinical research (and teaching)
in places like Cook County Hospital or Presbyterian's "lower
wards," as they were called.

The private-patient pavilions, on the other hand — Phillips
House at Massachusetts General in Boston, Harkness at Pres-
byterian in New York City, Passavant in Chicago and others
— were regarded by medical students as "dogs," because in
these places students had to stand and watch while the attending
physicians did the work. They much preferred public institu-
tions, where they could do it themselves and learn to be doctors.

Campbell decided this had to change. The double standard
had to go because of what it meant to medical trainees (clerks,
interns, residents) and paying patients as well as to nonpaying
ones.

In the old system, trainees dealt mostly with more severe
problems which were harder to treat outside a hospital and
with patients who, because of their poverty, were relatively
inert consumers of health care. The patients couldn't talk back
because they had no choice. Thus the nature of ailments
treated and the relative lack of questioning by patients pre-
pared the trainees for only one kind of service.

Paying patients, on the other hand, were denied the improved
care that stems from inquiry by trainees, who approached
problems with a fresh eye. Every student remembers the day
he caught something important that others had missed, Dr.
John Graettinger observed. The atmosphere of inquiry meant
better care for the paying patient.

Thus all patients became teaching patients, to be assigned to
students and studied by house staff, and nonpaying patients
were to have senior attending doctors assigned to them. Pay-
ing patients objected almost not at all. Instead, they welcomed
the attentions of the eager, inquiring young learners. The
learners relished the experience.

Private and nonpaying patients were roomed together,
rather than the former in the private pavilion and the latter in
the big open wards of the Murdock Building.

It was one of Campbell's most important contributions. In
achieving it he was far ahead of developments that were to at-

134 GOOD MEDICINE

tend the coming of Medicare and Medicaid in the sixties,
when many nonpaying patients became paying patients. Pres-
byterian Hospital became a superb example of how a single-
standard system could work.

Meanwhile, Campbell made another move that affected
medical education, a power play that worked. It had to do with
deployment of interns and residents who traditionally were
assigned to attending physicians — master doctors to whom
they were apprenticed.

Instead, in 1957 as chief of medicine, Campbell assigned
them "geographically" to wards, where patients themselves
were assigned according to illness or injury. This was good for
the patients, who became more accessible to their interns and
residents, and it was good for the interns and residents, who
no longer had to follow the master doctors on their appointed
rounds.

But whether good or not for attending physicians, they did
not appreciate the change. Some were used to being met at the
hospital door by intern or resident, who helped them off with
their coats, ran errands and otherwise made themselves useful.
If the young men were late, the senior doctor would sometimes
stand in the lobby, watch in hand, waiting.

The change did not affect surgery, centered as it is in the
operating room. But it represented a dramatic shift of power
from the private-practitioner, volunteer faculty to the academi-
cian. While the old way flattered the master doctor — "the chief
of his own "service" — the new way tended to deflate him.

Boston, Baltimore and New York City had made this
change. But in Chicago and Philadelphia, two major centers,
the best of the old died last. The system which had placed a
student doctor at the feet of a Herrick, Woody att or Sippy
gave way to one in which the young men became "house
staff," still learning in a "service" but no longer tied to one
teacher. The new system also provided for more give and take
between teacher and student, and accepting things on the
senior doctor's authority became less common.

There were objections, but Campbell won out. He was in
charge and acted with the support of the trustees, who may not
have fully understood the changes but trusted Campbell.

Postwar Revival 135

Campbell then introduced a physician's uniform, the white
coat already worn by the salaried "hired help." Some of the
private practitioners called it a "butcher's apron," but now
they would have to wear one while in the hospital. Accustomed
to dressing as their affluent patients dressed, they got used to
dressing like the full-timers. Again Campbell had to fight to
get his way, but he did it adroitly, and in the end this change
was also accepted.

He had not run out of ideas, however. When some years later
as president he had a Professional Building put up for practi-
tioners' offices, some of the practitioners again drew the line.
Nobody in his right mind will abandon the Loop, they argued.
Their Michigan Avenue patients would not come to the West
Side. But again Campbell prevailed: the Professional Building
went up, and eventually almost the entire staff officed in it.

Campbell did none of this in a historical vacuum. The unused
Rush charter was still alive. The Presbyterian laboratories,
built in times past by people who in some ways thought like
Campbell, were much in use. Presbyterian had been a major
teaching hospital of a major university with its own commit-
ment to research. When Campbell had come with his plans —
one might say his grand plan — he found an institution groan-
ing to be reborn. He didn't invent the atmosphere of inquiry,
but he certainly built on it.

Though not yet chief executive, Campbell was developing
the hospital along medical school lines, and people were begin-
ning to notice. He enlarged the department of medicine, which
he headed, using what money there was to pay competent
"cronies" to head subsections and specialties. Some of the sec-
tions and subsections, like cardiology, did well, while others
did not. He started the concept of fellowships at Presbyterian.

A fervent promoter of the private sector, he himself never
practiced privately. Indeed, for a time he looked down on doc-
tors who took money from patients. He retreated from this at-
titude a few years later, when as president he came to respect
the practitioner's role. But he never wavered in his belief in
salaried people, whom he considered necessary for overseeing
the education of interns, residents and fellows.

He was also largely responsible for the hospital's decision at

136 GOOD MEDICINE

this time to stay in the city — when suburban migration was ap-
peaHng to many a business and institution.

Campbell during these years was a free-wheeling type who
thrived on directness, even bluntness. When his new endocrin-
ologist, Ted Schwartz, was investigated by a federal officer,
Campbell yelled out of his office to Schwartz asking him if he
were a communist. "Some guy here wants to know," he hol-
lered. Schwartz had refused to fire a technician who was
suspected of communist tendencies.

When a senior physician complained about Schwartz's
questioning of a patient during grand rounds, Campbell im-
mediately called Schwartz in so the man could complain to his
face. The accuser became flustered, and the matter was dropped.

When Schwartz, new in town and lacking a personal physi-
cian, came to work one day with sharp abdominal pains, he
told Campbell. They decided it was appendicitis, and Camp-
bell thought it was funny. It was as if the fly had caught up
with the elephant, this specialist falling prey to one of the most
common of internal ailments.

Campbell was on a roll, and he knew it. He was having
more fun than a long Broadway run would have given him had
he taken up play-acting. And the best was yet to come.

The Merger & Campbeirs
Accession to the Presidency
1955-1965

When Jim Campbell moved back to Chicago in 1953, he
resumed his regular, even daily, contact with George B.
Young, who had become a St. Luke's Hospital trustee in the
early fifties. Campbell found a kindred spirit in the young
lawyer whose parents were Yale professors, his father of
history, his mother of English. To Young, Campbell put his
ideas about merging Presbyterian and St. Luke's hospitals. It
was the first Young heard of it. In lawyer Young's view,
Campbell "had a patent" on the idea.

The two discussed it between chess games at each other's
house or apartment. The Youngs and Campbells lived at first
in apartments on the city's Gold Coast, a high-rent district
north of the river and east of Michigan Avenue. Later they
moved to Lake Forest, where the Campbells built a house on
20 acres of land that Marshall Field III, also a St. Luke's
trustee, had bought from the Ogden Armour estate. Both
Young and Campbell had met Field at a party. Field had put
Young to work for him. Eventually Young was to head Field
Enterprises.

137

138 GOOD MEDICINE

Campbell had a plan for the two hospitals that he had been
turning over in his mind since even before the Albany assign-
ment. Now he bent Young's ear with it night after night, push-
ing the notion that neither hospital by itself had the "critical
mass" (enough staff and facilities) to make the kind of institu-
tion he envisioned.

Another Presbyterian-St. Luke's connection was between
St. Luke's trustee and later board president John P. Bent and
his friend and Lake Forest neighbor, John M. Simpson, a
Presbyterian trustee. On at least one occasion, a merger was
discussed by Bent and Simpson.

St. Luke's at the time consisted of five buildings, including
the aging five-story Smith Memorial at 1439 South Michigan
Avenue and the 20-story high-rise built in the twenties at 1440
Indiana Avenue. In effect there were two hospitals that had to
be connected by a third if they were to function as one. The
third would be very costly. The huge wards of the Indiana
Avenue building had already been divided to make more func-
tional smaller wards or private rooms. The whole St. Luke's
plant was crying for repairs and remodeling, all of which
would have been expensive also.

Presbyterian, on the other hand, was expanding at a steady
pace. Its new nursing school had gone up in 1952 at 1743 West
Harrison. Its new East Pavilion was planned for six stories,
with the option for seven more, on Congress Street opposite
the new expressway. Both institutions faced continued costs
which were to be met mostly by philanthropic donations.
Comparable in size and serving comparable clienteles, they
were to be competing for the same gift dollar.

The St. Luke's trustees discussed other merger possibilities
— Northwestern and The University of Chicago — but con-
tacted only Presbyterian. There was the feeling that the St.
Luke's identity would be lost in a merger with one of the
universities. St. Luke's might have continued on its own, in
John Bent's opinion, raising the money for the needed con-
necting building. The institution wasn't as bad off financially
as some claimed, though it did lack an endowment.

The Merger & Campbell's Accession 139

But if there were a merger, it was clear who would have to
move. St. Luke's, run-down, needing a new building and
isolated, would have to join Presbyterian in the soon to be
booming Medical Center District on the West Side.

By October of 1955, both institutions were discussing merger.
John Bent as St. Luke's board president explained the St. Luke's
options to the press. It could stay where it was, repairing its
buildings, or move to a university campus or merge with another
hospital. Norman A. Brady, Presbyterian's assistant director, in
a separate statement confirmed a report that discussions had
been going on since the summer of 1954.

Discussions continued, obviously, and in a few months the
decision was made. On February 10, 1956, the two boards
voted to merge. On the St. Luke's side, where the move would
be required, it was not an easy decision. The move was im-
mensely unpopular with the medical staff, for one thing. "You
couldn't blame them," said trustee George Young decades
later, adding with a smile, "but we did blame them." The St.
Luke's trustees voted two to one for merger, and then only
after some "arm twisting" by the board's leaders.

The move would "combine two eminent groups of doctors
who with a strong board (could) provide Chicago and the mid-
west with one of the country's foremost voluntary teaching
hospitals," Ralph A. Bard, Sr., president of the Presbyterian
board, and John Bent, the St. Luke's board president, told
reporters. In addition, the Presbyterian connection would give
St. Luke's a "direct" university affiliation (with the University
of Illinois) and a new location which allowed room for expansion.

Two months later it was official. Bard was chairman of the
new joint board. Bent its president. A $9-million fund drive
was announced, to increase the new Pavilion "probably to 12
stories," thus adding 180 beds. It was time to say something
like "Presbyterian and St. Luke's are dead. Long live Presby-
terian-St. Luke's." But it didn't happen that way.

Bent had received letters and telegrams from staff members
and trustees telling him not to do it. The woman's boards and
nursing schools didn't like it a bit. For many it was an arranged

140 GOOD MEDICINE

marriage, "for the good of the children" (patients), as staff
president Dr. Andrew Thomson told the medical staff 28 years
later.

It was like merging U.S. Steel and Bethlehem Steel. The
two groups were similar. They thought alike and had gone to
the same or similar schools. Many of the doctors knew each
other from the People's Gas Building, where Presbyterian and
St. Luke's doctors had offices on the 14th floor. But they still
didn't like it, and differences among them almost killed the
merger.

It didn't help that Presbyterian had switched to the geo-
graphic system of assigning interns and residents (to wards),
while St. Luke's still used the service-chief approach (assigning
them to attending physicians), which better served the doctors'
convenience.

Neither did the presence of full-time staff physicians at
Presbyterian contribute to the St. Luke's staffs sense of well-
being. These full-timers were the ones whom some called "hired
help" and even treated as if they were. In the competition for
department chairmanships, furthermore, the full-timers were
automatic winners. Thus Campbell headed medicine, George
Hass pathology, Ted Schwartz the endocrinology section, etc.

Some who lost out in competition for department chairs
retired or left for other institutions — one to Northwestern and
others to the University of Illinois or University of Chicago
hospitals. For years after the merger, it was common to hear
references to whether one was from Presbyterian or St. Luke's.
Even patients got the message. Some asked to be placed in the
"St. Luke's section," meaning the East (later Kellogg)
Pavilion, newly built in time for the completed merger —
rather than in Jones or other older Presbyterian buildings.

Milder reservations were registered by the genial and
literate veteran St. Luke's surgeon, Geza De Takats, in The
New England Journal of Medicine shortly after the physical
merger. In the January 21, 1960, issue, De Takats applied
Parkinson's Law to "the merging phenomenon": work ex-
pands to fill time available for its completion; subordinates
multiply without increase in productivity. With institutions as

The Merger & Campbell's Accession 141

with individuals, De Takats wrote with tongue in cheek, the
more helpers and telephones one has, the more important one
is. After the merger, "the money bag is full, and the adminis-
trator looks powerful." Yet to be learned, however, was
"whether Mr. Jones, the man on the street, gets as much good
service as he did in the premerged situation."

Resistance was diluted to a considerable degree through the
medical staff presidency of Dr. George W. Stuppy, a University
of Chicago and Presbyterian veteran, who edged the St.
Luke's surgeon, Foster McMillan, in a 1956 election for the
post. There was electioneering on both sides, but the choice
was a good one.

Stuppy was an old hand at smoothing conflicts, partly be-
cause he had both the M.D. and Ph.D. and knew what it was
to bridge hostile camps. He did a lot to smooth this conflict,
among other things keeping it to himself when an overzealous
St. Luke's trustee asked him to resign his newly won presidency.

A World War II 13th Hospital veteran who had served
though over draft age, Stuppy had earlier helped form the
Chicago Arthritis Club, later called the Chicago Rheumatism
Society. After the war he headed an arthritis clinic at Presby-
terian. He died in July of 1986.

The moment finally came, on June 26, 1959, when the
doors of St. Luke's closed, 94 years after Reverend Clinton
Locke and the members of Grace Episcopal Church had opened
its doors in a small wooden house on State Street. The last
patient, a Flossmoor woman, was given a corsage. Moving of
patients had begun in February. The hospital had stopped
admitting new patients on June 19th.

The five buildings were for sale. During the 1960 guberna-
torial campaign, candidate Otto Kerner said the state ought to
buy them. He won the election, but the state didn't buy them.
A developer announced plans for converting them to a geri-
atric hospital. Various other uses were discussed and imple-
mented over the years. In 1986 the two main buildings still
stood.

The former Smith Memorial, five stories plus a penthouse
at 1439 South Michigan Avenue, was empty and surrounded

142 GOOD MEDICINE

by vacant property. The 20-story building, erected in the
1920s at 1440 South Indiana Avenue, was a privately owned
apartment building for the elderly and handicapped.

The St. Luke's Woman's Board had its last meeting in Jan-
uary of 1959, six months before the move. Its fashion show
had been a joint venture with the Presbyterian Woman's
Board for the three years since the legal merger. Emily Fen-
tress Ott, the president of the newly combined Woman's
Board, was the niece and namesake of Mrs. John W. Gary,
president of the St. Luke's Woman's Board from 1926 to
1944. The following year's fashion show chairman was to be
Mrs. Herbert C. DeYoung, who remains active on the board
today.

The two woman's boards merged a few months later, though
with some initial discomfort. The more church-oriented
Presbyterian group had some adjustment to make when it began
participating in the socially more high-powered St. Luke's ac-
tivities. Like the doctors, however, both sides saw it through, and
in years to come the Presbyterian- St. Luke's Woman's Board
was to perform prodigious fund raising for the institution, in ad-
dition to a variety of service functions.

Among palpable benefits to the newly joined institution was
the addition of St. Luke's surgeons to the staff mix. Joining the
nationally renowned Beattie, who before and after the merger
was most responsible for the institution's reputation for
surgery, were Doctors Ormand Julian, Foster McMillan,
Geza DeTakats, Eric Oldberg and others.

Julian, a national pioneer in cardiovascular surgery, pro-
moted the use of a certain type of incision in open-heart
surgery and performed the first successful resection and graft-
ing for aneurism. DeTakats, one of the founders of vascular
surgery, was an authority on the role of the sympathetic ner-
vous system in vascular disease.

They joined Dr. Egbert Fell, a veteran Presbyterian
surgeon who successfully performed heart surgery before the
advent of the pump, or heart-lung machine, and was the first
in Chicago to do so with it. Julian also performed pre-pump
surgery, though after Fell.

The Merger & Campbell's Accession 143

Julian succeeded Beattie as head of Presbyterian-St. Luke's
Hospital's department of surgery in January of 1966. Later,
Dr. William Hejna headed surgery as an associate dean (not
chief of surgery as before) of Rush Medical College in the early
seventies. Dr. Penfield Faber succeeded Hejna in this post
when Hejna became dean.

Another of the St. Luke's surgeons was Dr. Eric Oldberg,
who in 1960 was to become president of the Chicago Board of
Health — a position he held until 1979. Oldberg, considered a
founder of neurosurgery in Chicago — with Dr. Percival Bailey
of The University of Chicago, Dr. Loyal Davis of North-
western and Dr. Adrien Verbrugghen of Presbyterian
Hospital — headed that specialty at the University of Illinois in
the thirties as he did at St. Luke's and at the new Presbyterian-
St. Luke's. Oldberg died in June of 1986 at 84 after a dis-
tinguished civic as well as professional career.

Nursing was another problem area during the merger. It
was another case of two rich traditions trying to meld, with
powerful loyalties colliding — not the easiest of tasks. Symbols
naturally meant much, as they do in any society. Thus such a
thing as the nurse's cap became a matter of negotiation and
even tension.

The two nursing schools were worthy of each other. Presby-
terian's in the late forties had multiplied college and university
affiliations and added psychiatry and tuberculosis work to its
disciplines. In 1952 the Presbyterian school got a new Sprague
building, at 1743 West Harrison Street, replacing the old
Sprague home on Congress Parkway, torn down to make
room for the new expressway. This 300-room, 14-story struc-
ture was renamed Schweppe- Sprague in 1960 to reflect both
Presbyterian and St. Luke's origins. The Schweppe School for
Nurses was part of the St. Luke's complex built in the forties.

The master of the merger by all accounts was Dr. James
Campbell. But its mistress was Edith Payne, who managed the
nursing side of the union. Payne had come to St. Luke's as
director of nursing education in June of 1953 from Phila-
delphia Woman's Hospital. She succeeded the retiring Made-
leine McConnell, who had held the position since 1939. Payne

1 44 GOOD MEDICINE

was the first St. Luke's nurse with a master's degree. Hers was
from Columbia University. She valued nursing research, that
is, the systematic observation and evaluation of how nurses
performed their daily tasks.

To this end she hired a nurse researcher and began an over-
haul of St. Luke's training and practice. At weekly meetings
with her faculty, she tried to make training coincide with prac-
tice. She began a program of getting her faculty back to school.

In September of 1956, Payne was put in charge of the school
of nursing at the newly merging institution. She moved imme-
diately to Presbyterian, where she was joined shortly by nurses
Barbara Schmidt and Dorothy Jane Heidenreich and researcher
Josephine Jones. They began at Presbyterian the methods im-
provement work they had been doing at St. Luke's.

Schmidt and Heidenreich, who had been developing a policy
and procedures manucJ for St. Luke's, were given a new task at
Presbyterian, where they evaJuated the system in use on the new-
ly remodeled second floor of the Jones Building. The changes
they recommended for "two Jones" were followed.

Strengthening the St. Luke's group's hand at Presbyterian
was the presence of Norman A. Brady, hospital administrator
under Dr. Karl Klicka, the superintendent. Brady had done
an administrative residency at St. Luke's and helped in work-
simplification efforts there. Now he worked again with Payne
and her helpers, putting observers on the floors around the
clock. From their reports he decided what changes were in
order — installation of ward clerks to relieve nurses of clerical
duties, for instance, and use of an automatic envelope-
addressing system.

Brady also improved the central supply operation, relieving
nurses of work such as sterilizing instruments and improving
the system for getting drugs to the wards, so they arrived in
patient-dose sizes rather than in big drums.

Payne was never rattled and found something to laugh
about in inconvenient situations. For instance, she made do
with various temporary offices while waiting for Sylvia Melby,
her Presbyterian counterpart, to retire. One was the first-floor
party room at Sprague, next to a serving kitchen. Even after

The Merger & Campbell's Accession 145

Melby's retirement, she officed for a time in the private-duty
nurses' lounge of the new East Pavilion, during construction
delays. Here she was joined now and then by a nurse who
came to eat her lunch while the unflappable Payne worked at
her desk.

Neither did Payne quail in the face of problems connected to
the merger. To help this along, she set up joint committees
and a nursing council which cleared changes in both institu-
tions before the physical merger. Thus when the physical
merger came, practices were alike in both places.

If one school had afternoon tea, the other got it. Presby-
terian student government activities exceeded those at St.
Luke's, so St. Luke's activities were strengthened. The alum-
nae associations were integrated. By the time of physical
merger, the two institutions were very much alike.

Fund raising for the new institution was an immediate
priority. The $9-million drive announced in April of 1956 was
chaired by John Bent and insurance executive Donald R.
McLennan, Jr. Mayor Richard J. Daley and his wife came to
the kickoff dinner, where banker and trustee Philip R. Clarke
was speaker.

The mayor also came for the laying of the Pavilion corner-
stone in the spring of 1957, along with Bent, McLennan and a
variety of clergy in ceremonial robes. The mayor had been in
office less than two years at the time. His appreciation of the
Presbyterian-St. Luke's venture was clear from the start, as
was his political support.

The eight-story, 80-apartment Kidston residential building
for house staff and their families had gone up in 1955. In 1959,
the 56-room McCormick Apartments for nursing students was
completed. Seven stories high, the building, named after
Colonel Robert R. McCormick of the Chicago Tribune, was
paid for in part by a $300,000 grant from the McCormick
Foundation. This was in addition to rooms already available
for nursing students in the Sprague (soon to be Schweppe-
Sprague) School of Nursing Building.

The Jelke Memorial, a $3.5-million medical science
research building, was opened in 1960. Oleomargarine maker

146 GOOD MEDICINE

John F. Jelke gave $1 million to help build it. McCormick and
Jelke were part of an $18.5-million expansion under way since
1956. The blueprint for this expansion was provided by
management consultants Booz, Allen & Hamilton after a
seven-month study.

Presbyterian-St. Luke's was hailed in news accounts as ap-
proaching Massachusetts General Hospital in Boston, John
Hopkins University in Baltimore and Columbia-Presbyterian
in New York City in size and services, with an expected pa-
tient capacity of over 1 ,000 beds — almost double the 554 it had
in 1960. Jim Campbell's "critical mass" had been achieved.

The merger was the best thing that ever happened to the two
medical staffs and a complete overall success, said critics and
supporters of Campbell alike years later.

And by common agreement, it was Campbell's doing. He
gave the merger direction, working hard and insisting on ex-
cellence, though making enemies along the way. He gained
support for it from board and staff. He put the whole thing
through. It was a triumph of personal diplomacy achieved by
playing largely behind the scenes. That was about to change.

The merger orchestrated, full-timers in place, geographic
placement of house staff achieved, James A. Campbell stood
in the late fifties as a first among equals at Presbyterian-St.
Luke's, minister plenipotentiary without portfolio.

He had planted the seed of the merger idea and had seen it
grow to harvest. The institution meanwhile was being run in
what he considered an undistinguished manner. And he was
not alone in his thinking.

Influential trustees like John P. Bent and A. B. Dick III
found themselves looking askance at practices that to them
were unbusinesslike. Staying in the black, to them an unques-
tioned imperative, was apparently only an attractive option to
some administrators. The medical staff did little to oppose this
view. Doctors sometimes proposed buying equipment, for in-
stance, without due regard for its economic feasibility.

Indeed, those were simpler days, and hospital business was
conducted in near hip-pocket fashion. Room rates would be
raised on a show of hands by the medical staff at the University
Club after a presentation by the hospital director.

The Merger & Campbell's Accession 147

The solution was to put a businessman in charge. Herbert
Sedwick, a Commonweakh Edison retiree, became executive
vice president in 1957, general manager in 1959, chairman of
the executive committee in 1960 and life trustee and president
in 1963 after two others had had short, unhappy terms as
president of the merged institution.

Sedwick's dollars-and-cents approach was what the trustees,
if not the doctors, ordered, though some of the latter came to
endorse profitability too. He "put the organization on its
feet," said one doctor. To John Bent he was "a pillar of
strength" for the institution. One of his early moves, however
— separating nursing education from nursing service — did not
set well with some staff. It was a classic mistake to split the
two, according to a close Campbell associate, and indeed
Campbell later reversed the move.

Meanwhile, Campbell wanted the job. If he asked himself
why he shouldn't have it — and there is no evidence he did — he
would have come up with no good answers. Seated in the chair
of medicine, he had already effected big changes. Seated in the
presidency, he could do much more.

So he "maneuvered" and "shouldered" his way, as a col-
league put it, building his base and staying close to the board.
Sedwick stayed long enough to do his duty as he saw it and
then asked out. Bent filled in, and a search was announced.
George Young, by now chairman of the board, said the board
wanted a president such as major academic institutions
wanted, one who would be responsible for policy and planning
and would report directly to the board, whose representative
he would be. Reporting to this president would be an execu-
tive vice president, who would handle operations.

Young knew whom he wanted, if some trustees didn't. His
business was to educate them to the merits of James A. Camp-
bell, on the one hand, and to keep Campbell from bolting, on
the other. New York's Mount Sinai Hospital, the University
of Washington and the University of Arizona were institutions
who shared Young's opinion about Campbell.

Offers were made. Arizona was ready to hire Graettinger,
Trobaugh and Schwartz along with Campbell in a sort of
medical-education power play. At one point, the three besides

148 GOOD MEDICINE

Campbell were getting bulletins on the half hour about the
progress of negotiations, which apparently were not successful.

The trustees presumably got wind of these near misses and
possibilities, among which the Mount Sinai offer loomed big
enough to precipitate a decision. The charade, if it was one,
ended. Young apparently convinced the last of the doubters
some 18 months after he'd described the man they were look-
ing for. He and Bent, to whom Campbell had become "the
obvious choice," drove over to the house of Bent's fellow Lake
Forest resident and made him their offer.

Jim and Elda Campbell and two guests were at dinner.
"Come with us," said Young to Campbell, who followed him
and Bent into an adjoining room. Campbell, the next presi-
dent of Presbyterian-St. Luke's Hospital, accepted on the
spot.

Young announced it October 8, 1964. Campbell was to take
office November 18. Norman A. Brady was to remain as ex-
ecutive vice president. In Campbell the institution had at its
head a nationally known working physician-scientist, what in
athletics might be called world-class performer.

He also was a businessman and a politician and "one of the
toughest characters" Edward McCormick Blair, later to chair
the board, ever met. A perfectionist, he came into office with
tremendous imagination and big plans. His forceful approach
was resented by some, his plans were questioned, but he is
widely if not universally credited with achieving what he set
out to do.

Essential to Campbell's success was the redefined presidency
that came out of his first year in office. The president that
George Young had described 18 months earlier was not a chief
executive officer. He was rather a paid chairman of the board,
or assistant chairman, who developed policy, got board ap-
proval for it, and interpreted it to the executive vice president,
who headed operations.

The executive vice president was in effect the CEO. The
EVP whom Campbell inherited, Norman A. Brady, was used
to this arrangement. He naturally looked on Campbell as
Mister Outside, dealing with the board and overseeing public

The Merger & Campbell's Accession 149

relations and fund raising, and on himself as Mister Inside,
running the hospital.

Nothing could have been further from the role Campbell
had been carving out for himself. He was used to working with
the board. But he was equally used to making things happen in
the hospital. Nonetheless, he was not sure of the role he
wanted to take as president, or so it appeared to Donald Oder,
the Arthur Andersen partner who in August of 1965 under-
took a study of the institution's corporate structure.

The financial executive was already reporting to Campbell,
and the medical staff was going around Brady to do the same.
The question was, did Campbell want to be chief executive of-
ficer? Oder, an old hand at servicing the hospital for
Andersen, put the question to him, and Campbell decided,
yes, he did want to be CEO.

In that case a second tier was called for, four vice presidents
— one each for administration, finance, public relations and
development, academic and mediccJ affairs. Each would report
to Campbell as president and CEO. Oder was promptly hired as
vice president-finance. Brady became executive vice president-
administration, keeping his title but not its full authority.
Richard S. Slottow remained vice president-public relations
and development. A few months later. Dr. Mark Lepper was
made vice president-medical and academic affairs.

The structure remained in place into the mid-eighties, by
which time it had become common in hospitals. But in 1966,
when Oder came aboard, very few hospitals were so organized.
A key element, in addition to putting Campbell in charge, was
its combining medical and academic authority in one vice
president, Lepper.

In this action a philosophical point was made in addition to
a practical one, namely that patient care and teaching went
together. Patient care personnel were teachers, and vice versa.
The medical-school character of the institution, yet to be fully
realized, served the hospital. There was to be education for the
sake of patient care and research for the sake of education.
Thus was organized the medical-academic institution that
within a decade was to blossom as fruitful in its own right.

James A. Campbell, M.D.,
1917-1983.

(Photo by Fabian Bachrach)

Presbyterian Hospital, circa 1953. (Photo courtesy of Chicago
Transit Authority)

Aerial view of Presbyterian-St. Luke's Hospital in mid-1960s.

George W. Stuppy,
M.D., 1898-1986, first
president of combined
Presbyterian-St. Luke's
Hospital medical staff.

Edith D. Payne, R.N., 1903-1976.

Rush Medical College library, mid-1960s.

Grand Rounds, with James A. Campbell, M.D., presiding.

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Mark H. Lepper, M.D.

Library of Rush University.

Lecture Hall of Rush University.

Luther P. Christman, R.N., Ph.D., the John and Helen Kellogg
Dean of the Rush University College of Nursing.

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James A. Campbell, M.D., at "topping out" of Rush University
Academic Facility, 1975.

Donald R. Oder presided at 1984 Commencement exercises.

Harold Byron Smith, Jr., chairman of the Trustees, John S.
Graettinger, M.D., university marshall, at installation of Leo M.
Henikoff, M.D., (right) as president of Rush University, in 1985.

Rush University academic facility.

The Second Founding of
Rush Medical College
1963-1983

In March of 1963, trustees of Rush Medical College met with
representatives of the American Medical Association to discuss
how to make best use of Rush's assets. These totalled
$1,677,000, including land and buildings then used by Presby-
terian-St. Luke's Hospital. One of the options was to revive
Rush.

Rush was a paper tiger. The school had gone out of business
more than 20 years earlier. Its faculty had been appointed to
the University of Illinois medical school, where they were
known as "Rush professors." These teachers continued to
teach third- and fourth-year medical students (clerks) at
Presbyterian and later Presbyterian-St. Luke's Hospital. A
few were careful also to preserve Rush as a legal entity.

Once or twice a year they met as trustees, often over lunch.
With the help of retired investment banker and fellow trustee
William J. Hagenah, they reviewed the endowment portfolio,
never more than a half million dollars. Once a year they went
through the motions, required by their charter, of appointing
a Rush faculty, namely the staff of Presbyterian or Presby-

161

162 GOOD MEDICINE

terian-St. Luke's Hospital. Thus the chairman of surgery at
Presbyterian was not only a University of Illinois professor of
surgery but a Rush professor as well. Through these and other
activities, some of them formalities, the Rush charter was kept
alive by a small group of loyalists.

The endowment income was put to use as well. For in-
stance, half the salary of Dr. Friedrich Dienhardt, a virologist
who with two other researchers, one of them his wife Jean, an
immunologist, developed a new mumps vaccine, was paid by
Rush for several years after his arrival at Presbyterian-St.
Luke's in 1961. With Dr. A. William Holmes, the Dienhardt
group also worked on cancer and hepatitis, experimenting on
small, squirrel-like monkeys called marmosets.

The 1963 meeting with the AMA, therefore, was not an ex-
ercise in nostalgia. The Rush trustees, headed by their chair-
man, Dr. Frank B. Kelly, Sr., did not come to waste their time
or that of the AMA man. Dr. W. S. Wiggins, secretary of the
AMA's history-laden Council on Medical Education. In addi-
tion to Kelly, there were Rush trustees Dr. Frederic A.
de Peyster, Dr. R. K. Gilchrist and Judge Hugo M. Friend
and former trustee Charles L. Byron. They suggested three
possibilities.

The Rush assets could be used to (a) start a new medical
school or (b) enter on a more independent relationship with the
University of Illinois or (c) set up a trust fund to aid medical
education in general. A new school — of necessity a four-year,
degree-granting institution — would cost $30 million to open and
$3 million a year to operate for the first 10 years, Wiggins told
them.

It was enough to stop the most dedicated in his tracks. The
trustees didn't have the money to start a new school. If they
wanted to revive Rush, they would have to fmd an umbrella
university. They considered three possibilities: Illinois Insti-
tute of Technology, Roosevelt University and the University
of Illinois. The last was an obvious choice, for reasons of prox-
imity and familiarity.

A few weeks after the meeting with Wiggins, three Rush

The Second Founding 163

trustees — Doctors Gilchrist, de Peyster and Fred O. Priest —
presented the case for declaring Rush a second medical school
of the University of Illinois to the dean of the university's
medical school, Dr. Granville Bennett. Bennett said he was in-
terested, but a few weeks later told de Peyster the outlook was
not good.

The response smarted. Rush had the facilities, the teachers,
even the students, that is, third- and fourth-year students
(clerks) from University of Illinois and other medical schools.
It had a history of " 1 25 years [sic] of uninterrupted teaching, ' '
as Kelly reported to 35 or so Rush alumni a month later in
Atlantic City.

The Rush alumni, members of an organization founded in
1868 and almost 3,000 strong, had a stake in reviving Rush.
As one told de Peyster at the Atlantic City meeting, "This be-
ing a graduate of a defunct school is not good." Indeed it was
not, and besides, the University of Illinois was getting "a tre-
mendous bargain" from Presbyterian-St. Luke's, paying a
mere $60,000 a year for the clinical education of one-third or
more of its clerks.

"Pretty darn cheap" at the price, de Peyster commented at
Atlantic City. Furthermore, the arrangement depended in
part on use of the Rush-owned Senn and Rawson buildings,
rented at a dollar a year by Presbyterian-St. Luke's hospital.
"These are our buildings," de Peyster reminded the alumni.

And yet though university backing was necessary, University
of Illinois backing (incorporation, actually) would place some
uncomfortable limits on a revived Rush. For instance, all but
five percent of its students would have to be Illinois residents.
Eventually Rush was to accept just such a restriction when it
accepted state funds given to educate Illinoisans who would
practice in Illinois, but for now it was all talk.

Meanwhile, Rush trustees tended the flickering flame, nursed
their modest funds and above all kept the charter from lapsing.
Frank Kelly kept James Campbell, president of Presbyterian-
St. Luke's from November of 1964, informed of his various
meetings about the future of Rush. Campbell listened with in-

164 GOOD MEDICINE

terest but had to admit the time was not ripe for reviving Rush
Medical College. It would soon be ripe, however, sooner than
those hopeful Rush trustees and alumni dreamed.

The break came in 1967, when the Illinois Board of Higher
Education asked Campbell to do a statewide study of medical
education. He pulled together a staff for the project: Dr. Mark
Lepper, Dr. W. Randolph Tucker and sociologist Irene
Turner.

Their report issued the following year, "Education in the
Health Field for the State of Illinois," or the Campbell
Report, called for massive expansion of health profession
education in Illinois and showed how expansion might be sup-
ported in public and private schools. Moreover, it convinced
the legislature of the need and the funding solution. In the
summer of 1969, the legislature voted to provide state aid for
both private and public medical schools.

Even before this, the Rush ball had begun to roll. In
November of 1967, the Rush trustees made what Campbell
called a "statesmanlike and generous" offer to cede Rush
Medical College to Presbyterian-St. Luke's Hospital with the
understanding that the hospital would try to reactivate the
college.

Hospital Trustee Chairman A. B. Dick III formed a com-
mittee headed by past chairman George Young to investigate
the matter. On it were Chairman Dick, past Chairman John
Bent, future chairmen Edward F. Blettner and Edward Mc-
Cormick Blair, and trustees Elliott Donnelley and Arthur M.
Wood. At the same time a national advisory council of top-
rung medical educators was also convened by the trustees to
consider the same question.

The stage was set for major developments. In 1968 the
Campbell Report was issued. In July of that year the first of a
series of meetings took place with University of Illinois
representatives to discuss a new relationship with a reac-
tivated, semi-independent Rush. The proposal was in effect
what Rush trustees had wanted in 1963, namely a separate
identity (Rush Medical College) within the university for
"Rush professors" and Presbyterian-St. Luke's Hospital.

The Second Founding 165

Negotiations went badly. Personalities and expectations
clashed, communication floundered. Mutual respect was
wanting. Rush wanted financial autonomy. Its people were
not ready to submit to University of Illinois control, which
they considered inadequate and ill-directed. The University of
Illinois people were suspicious.

The university president, David D. Henry, told his people
to work something out, and the university's medical faculty
approved incorporation of Presbyterian-St. Luke's with a
revived Rush Medical College as one of several university
schools of medicine, each with its own dean under a university
executive dean. Presbyterian-St. Luke's-Rush would become
a "so-called semiautonomous" school, Campbell said. But it
wasn't clear to either side what the other meant by "semi-
autonomous."

Money was, not surprisingly, a major obstacle. Campbell
wanted it from the state on a no-strings basis. But provost Lyle
Lanier, the university's number two executive, drew the line
there, saying that's not how state dollars were used. "There
had to be accountability," Dr. William Grove, University of
Illinois medical dean at the time, said years later.

But neither Campbell nor Lepper was willing to surrender
the paymaster's role. They wanted to pay their own depart-
ment heads with their own money. A compromise solution was
offered by which Presbyterian-St. Luke's would have its own
separate account from which to pay its department heads.

But more than a year went by without an agreement.
George Young's committee and the national advisory group
were at work nonetheless. By September, one issue at least was
decided: Presbyterian-St. Luke's would merge with Rush to
form a medical center that would include a revived Rush
Medical College.

"We have a new opportunity to show that medical educa-
tion belongs in the mainstream of medical care," Campbell
told the hospital's medical staff on September 3, 1969, the day
the hospital trustees voted to merge with Rush. On October
24, they signed the merger agreement, and Rush-Presbyterian-
St. Luke's Medical Center became a legal entity.

166 GOOD MEDICINE

There was still time for an agreement with the university,
which was under pressure to double its output of doctors, but
not much time. Rush Medical College would open in two
years. For more than 70 years it had leaned on two major
universities. Now there was no waiting on another institution.

A new proposal was made to the University of Illinois in
November. This was turned down in January of 1970. In
March the two institutions' 28-year connection was severed,
effective the following March. "Go it alone," national ad-
visory committee chairman Dr. Robert J. Glaser, acting presi-
dent of Stanford University medical school, had advised the
Presbyterian-St. Luke's trustees. And that's what they did.

Rush Medical College reopened on September 27, 1971,
with 98 students — 61 first-year (from 1,050 appUcants), 31
third-year and six Ph.D. candidates. Rush became Illinois'
seventh medical school and the nation's 108th. Yet it was not
strictly a new school, and this qualified it for state and federal
(matching) funds under "health manpower production"
priorities.

As an existing school opening new positions for students,
Rush qualified for state aid according to the formula spelled
out in the Campbell Report and endorsed by the legislature.
The other six medical schools also received aid as they opened
new positions, but none of these were starting from scratch as
Rush was, and none received as much.

Meanwhile, there was a changing of the guard among Rush
Medical College trustees. Seven retired as trustees — Doctors
Kelly, de Peyster, Gilchrist, Priest, Bertram G. Nelson and
Robert Morse Potter and investment advisor William Hagenah.
Other trustees of the inactive institution had retired in the
sixties — ^Judge Hugo Friend after 26 years, Frederick C.
Shafer, Earl Hostetter, Henry A. Gardner, Charles L. Byron,
Dr. Vernon C. David, and Dr. Wilber E. Post. Four of the
seven recent retirees — Kelly, Gilchrist, Potter and Hagenah
— were elected by the medical staff to the Rush-Presbyterian-
St. Luke's Medical Center board.

Rush opened with a three-year program, summers included,

The Second Founding 167

which was not uncommon at the time; such was the urgency to
produce doctors. Rush switched to the four-year schedule in
1973 — a move defended by Dr. William Hejna, associate dean
and later dean of Rush Medical College in The Journal of the
American Medical Association, where he said the three-year pro-
gram added few if any graduates, saved little or no money but
made students more tired and otherwise less capable of pursu-
ing their studies.

The Rush admissions process recognized competence in
nonmedical fields and ignored some traditional requirements
that were judged nonessential. Rush accepted more women
and more older students than the University of Illinois, for in-
stance. Ten percent of applicants were women, but 14 percent
of those accepted were women — this without special effort to
attract women students. The trend continued into the mid-
eighties, when 35 percent of Rush students were women.

Some University of Illinois medical students transferred to
Rush. The University of Illinois was in the midst of changes,
and this process of transition didn't help the instructional
situation. More important, thanks to Rush's partial subsidiza-
tion in these early years by the state, there was no difference in
tuition between the two institutions for Illinois residents. Be-
sides, Presbyterian-St. Luke's clinical training for third- and
fourth-year students (clerks) had been an attraction for
decades.

A medicine clerkship at Presbyterian-St. Luke's, for in-
stance, was considered a plum in the early seventies. So was
the surgical clerkship, depending on the specialist one served
under. Cardiac, oncologic and ear-nose-throat (ENT) surgery
were special attractions. Some teachers stood out for their
eagerness to help, such as Dr. Fred de Peyster and Dr. David
L. Roseman, who seemed to welcome the chance to increase a
student's knowledge.

Indeed, Presbyterian-St, Luke's Hospital had been almost
but not quite a medical school. Half to two-thirds of University
of Illinois third- and fourth-year students were trained there.
Even so, Rush needed new structures — admissions and

168 GOOD MEDICINE

registrar's offices, basic science departments, rules for govern-
ance, faculty contracts, and when the time came, a commence-
ment ceremony.

Many basic science teachers were on hand — biochemistry
and pathology teachers, for instance. But physiology, anatomy
and other departments had to be established. Research space
was limited. Rush did not have an animal facility until 1976,
for instance. A separate research center was part of
Campbell's original plan, but it never materialized, notwith-
standing Campbell's offer to the medical staff to put the name
on it of any doctor who put up the money for it.

These were growing pains in becoming a full-scale academic
medical center. Before these problems could be addressed,
however, there had to be a dean. Dr. Mark Lepper got the job
almost by default. In February of 1970, the search committee
told Lepper to contact Dr. Julius Richmond, of the State
University of New York at Syracuse, who was also deputy
director of Project Headstart in Washington, D. C. Lepper,
on his way to a Caribbean vacation, wrote Richmond a note
that through a series of mishaps was never mailed — and this
with the calendar counting and clock ticking to a projected
Fall, 1971 opening.

Lepper returned from his vacation some weeks later and
called Richmond, who of course knew nothing of the Rush
offer. Lepper told him the news, but Richmond had already
received an offer from Harvard Medical School which he
could not refuse. So Lepper, Campbell's right-hand man and
acknowledged resident philosopher, took the job. He held it
for three and a half years until the governor of Illinois tapped
him to head a state commission.

There were four associate deans, one for surgery, one for
medicine, one for biological and behavioral sciences, one for
student and faculty affairs. Dr. William F. Hejna, who later
succeeded Lepper as dean, was associate dean for surgical
sciences and services. Dr. Robert W. Carton held the same
post for medical sciences and services. Dr. Max E. Rafelson
held it for the sciences and Dr. John S. Graettinger for student
and faculty affairs. All four reported to Lepper, who as dean

The Second Founding 169

oversaw not only medical education but also patient care —
both medical school and hospital. Department heads reported
to the associate deans, who were also assistant vice presidents.
It was a structure that reflected the institution's joining of
patient care and education.

Rush Medical College was a medical school organized for
the benefit of a hospital, in the English manner. The hospital
would remain no matter what happened to Rush. In it health
professionals were educated in a patient-care, rather than a
research, setting. Education served patient care, and research
served education.

These were the three legs of the stool on which academic
health centers were said to rest — patient care, education and
research. Campbell argued for a fourth leg, management, to
guarantee accountability and efficiency. Around this principle
he organized his entire administrative structure and later, to
this end, he promoted a master's program in health systems
management at Rush University.

Closely linked to Campbell's emphasis on management was
his emphasis on parity among health professions. He knew
doctors would be 'Tirst among equals" in an academic health
center, but he did what he could to save the rest from second-
class status. Thus he made sure that deans of the College of
Health Sciences and The Graduate College were made vice
presidents and members of the management committee, as
were their counterparts in medicine and nursing.

These were the dean of the college of medicine, who was
vice president for medical affairs, and the dean of the college of
nursing, who was vice president for nursing affairs. All four of
these dual appointments evidenced the crucial symbiosis of
practice with education.

Later deans of Rush Medical College included Dr. Leo M.
Henikoff, who succeeded Dr. William Hejna in an acting
capacity, and Dr. Robert S. Blacklow. Blacklow, who was
dean from 1978 to 1980, is remembered for his keen interest in
and enthusiasm for the college, including great support for the
honor society. Alpha Omega Alpha. He also rewrote most of
the bylaws for the college's alumni association, though not

170 GOOD MEDICINE

himself an alumnus. Blacklow's successor, Dr. Henry P.
Russe, took office in February of 1981.

With Rush Medical College reactivated, a new academic
health center begun and a senior health university in the off-
ing, long-term planning was in order to produce facilities to
house them. From the planning came three phases of facilities
development. Phases I and II were primarily to start the new
educational programs. Phase III was primarily to modernize
patient care facilities. In each phase, however, there was
overlapping.

Phase I involved adding two floors to the Jelke SouthCenter
building for classroom space and six to the Professional
Building; erecting a 1,500-car parking facility for visitors, pa-
tients and staff; and expanding various other parts of the
medical and educational plant. It was completed in 1973 at a
cost of $23.4 million.

In Phase II, the $24.5-million Rush University Academic
Facility was built, and 883 parking spaces were added. The
cost of the Academic Facility was covered by almost $15
million in federal and state money and $10 million in privately
given and borrowed funds. Ground was broken for it in
November of 1973; it was dedicated in September of 1976.
Rush's longtime supporter and sometime patient. Mayor
Richard J. Daley, helped with the groundbreaking, symbol-
ically pushing a wheelbarrow, as the Chicago Tribune pictured
him the next day on its front page.

Phase III, as we shall see, centered around a new nine-story
patient-care facility connected to the rest of the complex.

The Academic Facility, built to house the colleges of
medicine, nursing and health sciences, was the flagship struc-
ture of Rush University, which had been founded in 1972. Six
stories high, with supports for six to eight more, it stretched
down a narrow, busy strip of Paulina Street south of Harrison.
Connected to the hospital over rapid transit "L" tracks, its
concrete-block walls were partly filled with sand to block the
noise of passing trains; its sealed joints were covered with
sound-absorptive panels. The building had classrooms, labor-
atories, study areas and library, all linked by walkways or cor-

The Second Founding 171

ridors to the hospital, Professional Building and Johnston R.
Bowman Health Center for the Elderly.

The Bowman Center also opened in 1976, when there were
very few "dyed in the wool geriatricians" in the U.S., accord-
ing to its medical director, Dr. Rhoda Pomerantz. Dr. Pomer-
antz first came to Rush as a Presbyterian Hospital intern in
1962 and learned to look on the institution as "always one step
ahead" of similar places.

In winning the Bowman Center contract, Rush competed
successfully against seven other Chicago-area institutions,
each of which proposed how to use a bequest by Lula
Bowman, widow of dairy owner J. R. Bowman. Mrs. Bow-
man had designated the money for care of the elderly. The
Northern Trust Company, as trustee of her estate, asked for
ideas. The Rush proposal was to care for sick elderly patients
with the goal of restoring them to relative self-sufficiency.

The 176-bed Bowman Center has its own board and inde-
pendent legal existence but is managed by Rush. David W.
Dangler, the Northern Trust officer who headed the search
and became a Rush trustee after Bowman was established,
chairs that board.

The building includes some residential apartments but is
mostly for rehabilitation of its patients, who are gotten in and
out as soon as is consistent with their health, always v/ith a
view to their returning home. After 10 years, in fact, three out
of four Bowman Center patients were going home after treat-
ment. The major challenge has been to give help at the right
time to stroke victims and other similarly afflicted people so
that fewer have to stay in nursing homes. In sum, Bowman is
primarily for patients who can be restored to full or near-full
social participation.

Rehabilitation is more than physical and involves counseling
both patient and family, as regards use of community services
such as "meals on wheels." A patient spends three months at
the most at Bowman, up to twice as much for psychiatric reha-
bilitation as for medical. The Geriatric Assessment Program
(GAP) involves evaluation of arrangements to be made for a
patient and communication of the findings and rationale to the

172 GOOD MEDICINE

patient's family. Commitment to the patient extends past
hospitalization, again with a view to de-institutionalizing of
care.

Consistent with its commitment to geriatric work, Rush
established an Alzheimer's Disease Clinical Center in 1985.
Within two years, Rush had been designated one of Illinois'
two Regional Alzheimer's Disease Assistance Centers by the
State Department of Public Health.

Nursing in the Rush curriculum was reconstituted under
Luther Christman, Ph.D., a nationally known nurse educator
from Vanderbilt University, where he had been the first male
dean of nursing in the U.S. Christman came to Rush in July of
1972 and two months later brought from Vanderbilt Sue
Thomas, Ph.D., soon to be Sue Thomas Hegyvary. Thomas
was to help him in reviving nurse education at Rush, where
there hadn't been any since the diploma (non-degree) school
was closed in 1968, after the degree program became virtually
obligatory.

The Christman and Hegyvary doctorates were in sociology
and anthropology, which says something about the state of
nurse education at the time; nurses' doctorates were in fields
loosely allied with nursing rather than with nursing itself. Or
they were "content-free" degrees in education. Christman set
to work immediately to offer doctorates in nursing as such.
Eventually, Rush offered a doctor of nursing science degree,
the first in the Chicago area.

The Rush University nursing program combined education
and practice, as the Presbyterian-St. Luke's diploma nursing
school had done. Like the diploma school's teachers, its faculty
were expected to practice as well as teach nursing. The pro-
gram in this respect also imitated Rush Medical College,
where teachers were also expected to be practitioners. The
nursing program began in September of 1973.

Meanwhile, Christman 's goal was to upgrade nursing to full
professional status. The first step was to institute "primary
nursing," what Christman would rather call use of a "phy-
sician-nurse team" which takes responsibility for a patient
from the time of entering the hospital.

The Second Founding 173

This approach was a long way from the assembly-line, task-
oriented nursing that dominated the field between the two
world wars. During this period, when hospitals came into
vogue as the place to go when you were sick, nurses divided
various functions. One handled this, another that, and pa-
tients received all the expert attention that a new car got at an
assembly plant.

For the Rush patient in the 1970s, however, the nursing
process was intended to resemble more closely a work of art.
Nursing services were put one by one on the "primary nurs-
ing" basis. Nurses were increasingly made responsible as pro-
fessionals for patient care. Quality assurance was placed in the
hands of nurses themselves, as it was for doctors. Sue Thomas
Hegyvary led a federally financed study which gave norms for
a self-checking process intended to put nursing as near to full
professional status as possible.

At the same time the use of nurse's aides declined drastically.
This was all right with Christman, who cites the inherent lack
of opportunity for advancement of the nurse's aide along with
the wastefulness of using one. Superiors have to spend too
much time giving instructions to nurse's aides. A degreed
nurse is more cost effective, he says.

The Rush program has been institutionalized and widely
publicized as the "Rush Model for Nursing," which health
care professionals have come from far and wide to observe. A
half-hour educational film depicting the Rush Model for Nurs-
ing has had wide distribution in health care institutions
throughout the U.S. and overseas.

This Rush Model covers everything about nursing at Rush
from the presence of an all-registered-nurse staff to the system
of compensating nurses. Primary nursing, in the hospital and
at patients' homes, is central to it. There is a process of decen-
tralized decisionmaking about patients' needs and centralized
allocation of nurse personnel based on a daily gathering of
workload information.

Teaching and the practice of nursing are merged, as we
have seen; nurse faculty, the best educated of the Rush nurses,
are Rush's managers of service, teaching and research, as is

174 GOOD MEDICINE

the case with medical faculty. Like doctors, nurses function as
members of a fully organized, self-governing group with its
own officers, bylaws, etc. Quality is assessed regularly by a
team of nurses, most of them doctoral candidates. And finally,
each nurse is paid according to demonstrated competence; in-
deed, no two nurses are as a matter of course paid the same
salary, and thus financial incentives are present for each to im-
prove herself or himself continually.

Creating and inspiring this whole Rush program has been
Luther Christman, who is something of a grand old man of
nursing in the U.S., lionized and anthologized and otherwise
praised and blamed for his outspokenness. He has blamed
nurses for their own subprofessional plight even as he has pro-
moted an educational and professional upgrading of nursing
itself. A member of the Institute of Medicine of the National
Academy of Sciences, he has been a recipient of many other
honors in his long career.

To attract undergraduate students in nursing and medical
technology, Rush University has had to look to schools which,
unlike itself, offer nontechnical undergraduate training. To
help in this recruitment process, James Campbell established a
network of colleges and universities to serve as feeder schools.
Now 40 or so students a year transfer to Rush from network
colleges in six states. The college network program thus has
enjoyed moderate success.

In November of 1971, Rush introduced a second network,
of patient care institutions, to achieve a vertical integration of
patient care among a group of independent institutions. At the
hub of this six-county network would be Rush itself, ready to
handle tertiary-care cases referred by the other hospitals. This
vertical integration would thus respect the capacities of each
institution, whether small community hospital or tertiary-care
medical center.

In the early seventies. Rush considered expanding its cor-
porately owned hospital base to the northwest suburbs. But
site approval suffered local-government delays, projected costs
doubled, and plans were abandoned. In 1975, however, another
opportunity arose to expand in the Far North Side of Chicago,

The Second Founding 175

and Rush assumed control of what became its Sheridan Road
Hospital.

Meanwhile, Rush was sending residents and students
(medical, nursing and other) to network hospitals for part of
their training. These hospitals as a result were in a position to
recruit staff from Rush residents and students. In addition,
Rush teacher-practitioners offered continuing education pro-
grams in these network hospitals.

According to Campbell's plan. Rush and its network insti-
tutions were to serve 1.5 million people. If other Northern Il-
linois academic health centers did the same, each forming its
own network and assuming its "fair share" of health care for
the poor, a half dozen such systems could handle the area's
health problems.

The Rush network began with four hospitals — Christ Hos-
pital and Medical Center, Oak Lawn; Community Memorial
General Hospital (now La Grange Memorial Hospital), La
Grange; Swedish Covenant Hospital, Chicago; West Subur-
ban Hospital Medical Center, Oak Park — and a clinic. By the
mid-eighties, there were 18 hospitals.

The clinic was Mile Square Health Center, Chicago, which
was part of an unfolding story of James A. Campbell's applica-
tion of his "single standard" to health care for the indigent. In
the late 1950s, after Campbell had integrated nonpaying with
paying patients in Presbyterian-St. Luke's Hospital, the
hospital's outpatient clinic for nonpaying patients remained, a
relic. Its name itself, the Central Free Dispensary, breathed
Chicago medical history. But it also breathed the double
standard. Patients sat on long wooden benches waiting their
turn and were called up by their first names. The Dispensary
typified poor people's experience in receiving medical care.

Campbell as chief of medicine got it moved from its old
quarters in the Rawson Building, diagonally across the street
from Cook County Hospital, to the first and second floors of
the new Jelke Building. Its name went the way of traditions no
longer considered serviceable and, in August of 1961, it
became the Presbyterian-St. Luke's Health Center.

Campbell put Dr. Joyce Lashof in charge of preventive

176 GOOD MEDICINE

medicine at the newly named health center. He had known her
when she was a staff physician at nearby Union Health Serv-
ice. Lashof was later Illinois state public health director, U.S.
Health, Education and Welfare undersecretary and dean of
the school of public health at the University of California at
Berkeley. Partly because of Lashof s influence, the clinic was
modernized and its poor people's atmosphere sharply curtailed.

Then Lashof, on loan to the Chicago Board of Health, and
Dr. Mark Lepper, who chaired the University of Illinois'
department of preventive medicine, headed a Board of Health
survey of health care for poor people in the city. Lepper had
earlier headed the Municipal Contagious Hospital, and he had
been a senior attending physician at Presbyterian-St. Luke's
since 1958. He was to work closely with Campbell throughout
the sixties and seventies.

Lepper and Lashof found huge gaps in health care in poor
neighborhoods and recommended a massive public effort in-
cluding setting up 24 neighborhood health centers throughout
the city. Presbyterian-St. Luke's promptly followed through
— the first of only two institutions to do so. In 1966 it joined a
neighborhood organization in applying for a federal grant to
begin a health center. This was the Mile Square Health
Center, named after the Mile Square Federation, whose ter-
ritory was the black ghetto community north and west of the
hospital, bounded by Ashland and Western avenues and Kin-
zie and Van Buren streets. The center, modeled on the recent-
ly reorganized Presbyterian-St. Luke's Health Center, opened
in 1967, with Lashof its medical director.

Overall responsibility for the center was Lepper's. He had
joined Presbyterian-St. Luke's full time in 1965 mainly
because Campbell and he agreed on single-standard care for
the poor and how to provide it. Interviewed by Campbell,
newly appointed president, for the chairmanship of medicine,
he was hired instead as executive vice president for academic
affairs. He saw the future of medicine as one system in the
voluntary sector, and so did Campbell.

The concept enjoyed far from universal acceptance. Some
believed in care for the poor primarily "to learn and experi-

The Second Founding 177

ment," as Lepper put it. It was "go down and do your thing,
salve your conscience," he said. The poor "didn't dare call
you. They didn't dare have any followup. If you weren't
there, the next time they saw somebody else." Lepper felt used
by County Hospital, for instance. He would make his rounds
there, and they would say people got good care, although a
patient's temperatures might not be recorded.

Campbell also argued against the double standard for edu-
cational reasons, as we have seen. He felt students should deal
with people who will talk back to them, rather than with those
who are captive by their poverty, who must accept whatever
care is given them. He also argued that paying patients would
profit by being seen by the eagerly inquiring young man or
woman. In effect, why deprive the student doctor of paying
patients and vice versa?

The Mile Square Center's approach was revolutionary be-
cause, like the Presbyterian-St. Luke's clinic, it guaranteed
poor people the same treatment as paying patients. By now, of
course, even the poor were paying, through Medicaid. But at
public institutions they were still getting separate and not
always equal care. Mile Square center patients, on the other
hand, were sent to Presbyterian-St. Luke's if their physicians
thought it necessary. There was no shunting them off to County
Hospital. It was a care system that provided private practice
continuity to "public" patients.

Campbell, who had grave misgivings about public institu-
tions, wouldn't have had it any other way. Thus the new
neighborhood health center mimicked the Presbyterian-St.
Luke's center, and Campbell's single standard philosophy was
expanded beyond Presbyterian-St. Luke's boundaries.

He tried to extend the concept city wide. He devised a plan
that would permit indigent patients to use private hospitals
throughout the city at public expense. Hospitals would each
have taken its "fair share" of indigent patients and would
each have offered single-standard care. The plan won accept-
ance from private hospitals but lost out politically, because of
feared loss of jobs at public institutions.

Years later, in 1976, Campbell closed the Presbyterian-St.

178 GOOD MEDICINE

Luke's clinics as the institution's last vestige of the double
standard. Some said he was abandoning the poor, but he ar-
ranged for most clinic-registered patients to be accepted by
private practitioners at Rush who agreed to forego their
regular fees in exchange for public-aid payments.

The patient care network of which Mile Square Health
Center was a small part was not as successful as Campbell
hoped. Rush received tertiary-care referrals from its hospitals
but mostly on a doctor-to-doctor basis rather than hospital-to-
hospital.

The network's educational and training component worked
fine, however. More than 3,500 students and 1,500 residents
completed its programs, many then taking positions in net-
work hospitals. Professional relationships developed from
these contacts have worked to patients' benefit.

At the end of Campbell's first decade as president, in
November of 1974, he recalled the comment 10 years earlier
by John Bent, former chairman and president of the institu-
tion, that it was time for the hospital board to leave adminis-
tration to the operating officers. This was a "most serious"
redefinition of responsibility for management that imposed "a
new kind of obligation," said Campbell in 1974.

Much had happened in 10 years. The $84 million budget
was 10 times that of 1964. The hospital staff of 647 was 50 per-
cent higher. Hospital capacity was up slightly, to 850 beds. It
was soon to top 1,000 beds. The department of medicine, for
instance, had gone from 140 members in 1970 to 244 in 1972
— a two-year leap of over 60 percent directly related to the
revival of Rush Medical College. Many department heads had
been recruited from outside, and many more teachers of basic
sciences. Total faculty numbered more than 1,000. The com-
bination of full-time and voluntary staff kept medical educa-
tion "hand in hand" with medical practice. Research kept the
enterprise scholarly,

Rush-Presbyterian-St. Luke's Medical Center had its own
schools, its own university, its own hospital. It was dependent
on no other institution, either for patient care or academic
training, though it was "at the heart of a vast cooperative
enterprise."

77?^ Second Founding 179

Indeed, during those early years, the glow of the enterprise
suffused everything, partly because of the ample financial sup-
port available. Campbell's dynamism was the key to it all. A
true scholar-physician, he took risks to achieve his vision.
("He gambled and won," said a critic.) Others were caught
up in the excitement.

Jewish and Catholic trustees were added (there already were
a few Catholics), so that the board more adequately repre-
sented the patient group. The additions also widened support
for the institution, which was already considerable. Doctors in
other institutions got the feeling that Rush had the money to
do anything it wanted.

The best was yet to come. In November of 1976, the trustees
approved Campbell's proposal for a $154-million capital
development program to assure "the future of success" at
Rush. The centerpiece of this Phase III of facilities develop-
ment was to be a nine-story patient care facility linked to the
existing hospital complex. A new Cancer Treatment Center
was also to be built, also linked to the existing complex.

Of the $154 million, over $112 million would be targeted for
patient-care facilities and over $10 million for academic. An
additional $21.6 million would be sought for Rush University
endowment, and another almost $9.6 million to support pro-
grams, especially research. Rush management was to raise
$79 million internally and otherwise, including some by bor-
rowing. The rest, $75 million, would come from private
philanthropy.

This $75 million was ten times the goal of 20 years earlier,
when the two hospitals had merged. Chairman Edward
McCormick Blair and the trustee committee on philanthropy
headed by Harold Byron Smith, Jr., pretty much agreed the
money was there. It just had to be sought in the right way.
Architect of the campaign was Sheldon Garber, vice president
for philanthropy and communication and secretary of the
trustees.

Early soliciting preceded public announcement of the cam-
paign, as is common with major fund raising efforts, since early
momentum is crucial. Among early major gifts was $1 million
pledged by Trustee Robert C. Borwell which endowed a pro-

180 GOOD MEDICINE

fessorship in neurology to go with directorship of the multiple
sclerosis center.

Another was $2 million pledged by the Woman's Board
towards the new Cancer Treatment Center. The center was to
be named after the Woman's Board. Other gifts followed, in-
cluding $4.5 million from the John L. and Helen Kellogg
Foundation for a national center for nursing excellence. By
November 14, 1978, former President Gerald Ford was able to
announce at a kickoff dinner that the Kellogg gift had brought
the campaign to $38 million or "past the 50-yard line."

Later, at a 1982 dinner celebrating completion of the cam-
paign. Ford was invited back to announce even better news,
that the campaign had gone $8 million over its $75 million
goal. "In football terms," he told his audience, "that's an
extra touchdown and two points on the conversion."

There were 18 gifts of $1 million or more each. These totaled
over $40 million. The campaign went over the $75 million
mark with a major gift by Life Trustee Kenneth Montgomery.
Medical staff members gave $5 million.

Eight endowed chairs were established and funding was
completed for two others, bringing the endowed-chair total to
30. One of them was the James A. Campbell, M.D., Distin-
guished Service Professorship of Rush University, established
with $2 million pledged by friends. It was "probably the only
element of the campaign of which Campbell was unaware,"
said Sheldon Garber, whose performance in the campaign re-
ceived high praise from Blair and Smith.

Spending the money was almost harder than raising it, how-
ever. The new Atrium Building had trouble from the start.
This was the 222-bed patient care and surgical wing. At $75.6
million it was the most expensive project ever approved by the
Illinois Health Facilities Planning Board, which had to certify
that it was needed. Rush's application for the certificate of
need was attacked vigorously by critics and competitors but
was finally approved with only minor changes.

A heavily publicized controversy developed during the
Atrium Building's construction. Rush, on the advice of a city
planning official, bought and closed a short city block on

The Second Founding 181

Paulina Street as a way to cut costs considerably. Rush acted
with city council approval, and only after gaining the endorse-
ment of the Medical Center District Commission. Rush made
the purchase on November 29, 1978, for $97,500.

On January 2, 1979, the contractor barricaded the work
site, as is customary in such projects, closing Paulina. Two
weeks later, a blizzard struck. Streets became impassable. In
the general frustration, the Paulina Street closing became a
focus for critics of Rush at two neighbor institutions. Cook
County Hospital and the University of Illinois.

A storm of protest and publicity ensued for months.
Mayoral candidate Jane Byrne, riding the crest of the snow-
storm that did most to elect her, stood by the Paulina Street
barricades and promised, "The walls will come down." Rush
was taken to court (not by Byrne), where it proved it had acted
without deceiving any of the apparently aggrieved parties.
Mayor Byrne eventually provided her own endorsement of
sorts three years later, when she joined dignitaries on May 25,
1982, to help dedicate the once-controversial Atrium Building.
Hard feelings in other quarters lasted several years after the
1979 uproar.

The Campbell era was drawing to a close. In June of 1983,
approaching 65, he announced he was retiring as president of
Rush-Presbyterian-St. Luke's Medical Center. No one had
done as much for the reborn institution. He was the second
founder of what had begun as Rush Medical College almost
150 years earlier. In September he was re-elected trustee,
appointed consulting physician and reappointed professor,
and was chosen for an honorary degree.

To the trustees on this occasion he spoke of the "new gener-
ation" of civic leaders and trustees, many of them present,
who 25 years earlier had "caught the vision" of serving
Chicago through "bold and enterprising" leadership. Typi-
cally, he spoke of what others had done. He was, after all, the
man you couldn't head off as he went to hold the door. He
urged them to remember that numbers weren't everything but
compassion was, that everything they did was to be measured
by the test of compassion.

182 GOOD MEDICINE

He ticked off issues for their attention.

Corporate responsibility was one. How well would health
care institutions be run? Rush had not had an operating deficit
in his memory. The institution had generated its own working
capital, thanks in part to how it was organized and run.

Another issue was competition among health care institu-
tions. "Our faith," Campbell reminded the trustees, "lies in
the private practitioner as the backbone of the institution."

Rush's ANCHOR Health Maintenance Organization,
started 12 years earlier, was an example of successful competi-
tion, anchor's membership was nearing 100,000. Camp-
bell said he had urged the state to adopt the HMO principle
for its medical welfare program, which he feared might revert
to the "old dual system" of public health care for the poor
because of cutbacks. This return to the old system would in-
volve "enormous" financial expense and even greater loss to
society because "class divisions" would be revived and
"humanistic gains" would erode. It was James Campbell
riding his single-standard horse again.

In three months, however, James A. Campbell was dead of
a heart attack, and the era ended not with a bang but a thud.
At a memorial service at Fourth Presbyterian Church on
December 7, 1983, his name was added to the Rush-
Presbyterian-St. Luke's pantheon. During his presidency the
institution had not only kept pace but had taken a leadership
position. Of greatest importance was the reactivation of Rush
Medical College and the founding of Rush University.

The institution was caring for 30,000 people a year on an in-
patient basis. Its total number of beds, having risen well over
1,200, was almost half again as great as when Campbell had
taken office. Surgery had risen from 13,500 operations a year
to 17,500. The medical staff had doubled, the number of
residents and fellows had tripled. The number of employees
had tripled. Rush with its 7,500 employees had become one of
Illinois' top 25 private employers. Its budget of $300 million
was 15 times the 1964 budget. Its assets had sextupled to
almost $400 million.

The Second Founding 183

At the memorial service, Dr. Mark Lepper was one of those
who gave tribute.

"Without reservation," said Lepper, "I feel that under no
other leadership would the resources available when Jim
Campbell entered the presidency have produced anything
remotely approximating the current Medical Center."

Campbell's goals, said Lepper, revolved around patients,
"whose needs included both compassionate and technically
excellent care." Care had to be the same for all patients, rich
or poor, black or white. All socioeconomic and racial groups
were to be served in a "fair share" manner, representative of
the "entire metro-Chicago population."

Or as Campbell had told the trustees a few months earlier,
numbers weren't everything, and everything had to pass the
test of compassion.

New Leaderships New Directions
Rush-Presbyterian-St, Luke^s
After Campbell

James Campbell considered the loss of a leader "a temporary
matter," said Rush Chairman Harold Byron Smith, Jr., when
Donald R. Oder assumed Rush's interim presidency. The
true leader "assembles echelons of managerial and profes-
sional skill" ready to take up where he left off.

Smith had both Campbell and Oder in mind. Oder took
over as acting president when Campbell left office in
September of 1983 and remained until the following July. He
was senior vice president and treasurer and associate professor
in the College of Health Sciences and chairman of the Illinois
Hospital Association. A former Arthur Andersen partner, he
had headed several Rush projects, including the 1969 corpo-
rate reorganization.

He was thus in part the architect of the presidency as Camp-
bell had filled it, namely as a physician-chief executive officer.
The pattern thus set, the board wanted another physician
active and respected in his field for its CEO. Given this re-
quirement, Oder was out of the running for the presidency
even if he did want it. But in his nine months as acting presi-
dent, he made the most of it.

184

New Leadership, New Directions 185

During that time, for instance, Rush set up its first occupa-
tional health centers in leased downtown space and consider-
ably expanded its Rush Home Health Services. But the project
that most reflected Oder's talents was Chicago Technology
Park, announced in June of 1984, a few weeks before Oder
passed the baton to Campbell's successor.

Chicago Technology Park was a $13.1 -million high-
technology industrial park financed mainly by city and state
funds as an "incubator" for small companies, a place where
individuals or small groups of scientists would work to develop
marketable high-tech products. It would include a three-story,
$8-million laboratory building for use by scientists and
businessmen.

The park itself was 56 acres almost immediately west of the
Medical Center District where Rush and the University of
Illinois Medical School were neighbors not always on the
friendliest terms. It was in part a tribute to Oder's "great skill,
judgment, patience and humor" (cited by Chairman Smith)
that the project was to be operated jointly by Rush and the
University of Illinois.

Thus passed into apparent oblivion the unseemly squabbles
of the late seventies over Rush's certificate of need for a new
pavilion and the much publicized closing of Paulina Street
— not to mention the invasion by County Hospital patients
and doctors of the Rush emergency room. Under Oder the
sometimes tense relationships between Rush and its neighbor
institutions improved considerably.

Especially did he defuse the University of Illinois situation,
which had sputtered and smoked throughout the Campbell in-
cumbency. Oder managed to bridge the gap, making apt use
of his skills as a listener with what an observer called a "down
home" quality "masking an incisive mind."

During his brief incumbency, Oder "presided over develop-
ment of new initiatives . . . while establishing and broadening
cooperative understanding" with other institutions, the city
and the state. Smith said.

Neighborhood relations also benefited from Rush's will-
ingness to stay and invest heavily in the West Side, when as a
private institution it could have moved. Its investment over

186 GOOD MEDICINE

the years of several hundred million dollars sent a message of
stability to the area and the city. For instance, Rush was im-
portant to redevelopment of the area south of the Eisenhower
expressway and east of Rush to the Chicago River. Center
Court Gardens, for instance, a group of apartments and town
houses, was developed by trustee Charles H. Shaw on Camp-
bell's urging. Shaw also provided for transfer to Rush, at
Rush's discretion, of the general partnership corporation
which he formed to develop the property.

Rush was also active in the University Village Association,
the neighborhood organization to its east, with its focus on
community development, and in the West Central Association
and West Side Project, with their thrust toward economic
goals. Much of Rush's community involvement began in the
sixties with start-up of the Mile Square Health Center. Oder
maintained a strong interest in this involvement, which con-
tinued in health fairs, health screenings and other programs of
Rush's community relations department. More important was
Rush's hiring of blacks and Hispanics over the years, helping
people to start careers who otherwise would not have had the
opportunity.

Oder presided over the June 1984, commencement at which
Campbell was posthumously awarded an honorary degree. A
few weeks later, in July, Dr. Leo M. Henikoff took over as
president praised by Chairman Smith for his "impeccable pro-
fessional credentials and demonstrated managerial talent."
Henikoff had been chosen after an eight-month national
search. The curtain had fallen on the Campbell era.

Henikoff, a pediatric cardiologist associated for many years
with Rush-Presbyterian-St. Luke's, arrived from Temple Uni-
versity in Philadelphia, where he had been vice president and
dean of the medical school for five years. He had earlier served as
associate and then acting dean of Rush Medical College and,
what was to prove a particularly useful experience, as Rush's
vice president for interinstitutional affairs with special respon-
sibility for its patient care network.

A University of Illinois medical school graduate, Henikoff
had done his internship, residency and fellowship training at

New Leadership, New Directions 187

Presbyterian-St. Luke's Hospital in the sixties, with time out
for Public Health Service work, eventually as chief of the serv-
ice's congenital heart disease program.

In April, 1984, when he'd been elected by the trustees,
Henikoff called Rush "second to none" in patient care. In his
inaugural address, he emphasized integration of academic and
patient care functions. By November he noted the reduced
need for the hospital setting and said the Rush System for
Health was going to move beyond the hospital. Patient care
was still the priority, but the patient care setting would
change. A year later, he foresaw a "wide range of new pro-
grams involving new technologies."

The primacy of patient care was reinforced before and after
Henikoff took office, by Rush's outlay for the latest in medical
scientific equipment. Rush was the first Chicago-area institu-
tion to operate a CT (Computed Tomography) scanner, the
first to use magnetic resonance imaging, and one of the first to
use a lithotripter — a machine that crushes kidney stones with-
out surgical intervention.

Such technology fits the patient profile at Rush, where
about half the medical-surgical beds are filled by patients
referred by other institutions for tertiary or advanced care. For
diagnosis and treatment of these patients. Rush keeps at hand
the most sophisticated equipment.

The Henikoff presidency coincided with fallout from cost-
cutting in health. Government, insurers, employers and other
major U.S. buyers of health care had been cutting back for
several years. Hospital occupancy levels declined, ambulatory
care hit an upswing, same-day surgery became more common.
The health care industry felt the pinch. Some fat was being
cut, but much of the lost hospital occupancy represented care
people needed but could not get because they had exhausted
their benefits.

Rush began to hurt a little, though less than most compar-
able institutions. Still, Henikoff became convinced that strat-
egy had to be threshed out at the top levels. He and Chairman
Smith assembled an ad hoc trustee committee which met a
number of times in the winter and spring of 1984 and 1985.

188 GOOD MEDICINE

From the meetings came a new strategic plan and the ground-
work for another philanthropic campaign.

Rush also laid off 200 of its more than 7,500 employees;
they were the first layoffs in memory. In a letter to employees
on April 8, 1985, Henikoff cited reductions in state and federal
reimbursement for the coming year of $14.6 million and "con-
tinuing pressures in the private sector." Budget adjustments
for the "tough period ahead" were "imperative." Counseling
and placement help were made available for laid off employees.

In the same message Henikoff said Rush was "perhaps in a
stronger position to weather these difficult times than any
comparable institution anywhere in the country." Some hos-
pitals would not survive, but Rush was upgrading facilities
and acquiring technology and equipment to ensure not only
survival but national leadership. The institution was to be
"stronger than ever."

Ambulatory care would receive greater emphasis, though
the hospital would remain central. A more aggressive
approach was to be used. Rush-quality care would become
available throughout the area. The strategy was to "bring
medicine to the neighborhoods, rather than people to the
hospitals," as former chairman John Bent put it.

ANCHOR Health Maintenance Organization (HMO) would
be expanded. So would industrial medicine clinics and down-
town satellite offices. A preferred provider organization (PPO)
and an Independent Practice Association (IPA) form of HMO
would be added. The limping patient care network would be
redeveloped. The research program would be expanded.

Some of this was already happening. The ANCHOR HMO,
a deliverer of prepaid health care services, was one of the first
of its kind in Illinois. It was begun in 1971, after the HMO
concept was put on the negotiating table by Rush's unionized
employees. ANCHOR'S share of patient care revenue, which
at Rush is 87 percent of all revenue, rose sharply in the eighties
— from 7 percent in 1980 to almost 25 percent in 1986.
ANCHOR membership rose in this period from 38,000 to
130,000.

By the mid-eighties, alternative systems were proliferating.

New Leadership, New Directions 189

Rush Contract Care, a PPO or Preferred Provider Organiza-
tion, was launched in 1986 with 16 hospitals and the services of
1,000 doctors. Rush also participated in other PPOs — Volun-
tary Hospitals of America, for instance — as a way to reach as
many patients as possible. Access Health, a more recent Rush
project, is an IPA-type HMO and as such provides prepaid
services through private physicians using their own offices and
reimbursed on a per capita basis.

Two other alternative systems were the Rush Occupational
Health Network, which serves over 3,000 employers in six
Chicago-area offices, and Rush Home Health Services. In
addition, satellite offices were established in two downtown
locations: One Financial Place and River City. A "profes-
sional building within a building" was planned for the North-
western Station Atrium Center.

All this evidenced a tilt toward ambulatory care. Indeed,
ambulatory care and surgeries rose by the mid-eighties, while
patient days (spent in hospital) declined. A Rand Corporation
study of six successful academic medical centers cited Rush's
entrepreneurial spirit. Henikoff attributed Rush's success to
diversified programming and "broadened" community pres-
ence. ANCHOR HMO and more recent efforts plus advanced
facilities and treatments had kept Rush competitive.

Rush had even gone into an entrepreneurial program of
providing skills and services to health care institutions in three
areas — pharmacy, home health care and accounts receivables
management. This is ArcVentures, a for-profit subsidiary of
Rush with a staff of 85 and 1986 revenues of about $8.5
million. ArcVentures operates the Professional Building phar-
macy and a mail-order prescription service, markets at-home
therapies and equipment, and provides billing and collection
services to hospitals and doctors' offices. Its profits return to
Rush while it promotes the Rush name and quality.

In the midst of all this bustle of alternative services and even
of entrepreneurship, however, the heart of Rush has remained
its private-practitioner medical staff. Its pursuit of health care
was there from the first and remained the foundation of what
Rush has tried to do over the decades.

1 90 GOOD MEDICINE

Rush has remained competitive, but things have changed
nonetheless since the seventies, when the sharpest disagree-
ments among administrators were about how, not whether to
spend, as Wayne M, Lerner, vice president for administrative
affairs, recalled. The creative spirit remained from those days
but not the wherewithal. The institution would fund 300 to
500 internal program requests a year, said John E. Trufant,
Ed.D., vice president for academic resources and dean of the
Graduate College and College of Health Sciences of Rush
University. "We'd fund those things and raise the room
prices," he said. When the money ran short in the eighties, "it
was a much more difficult time."

Instead, there was soul-searching as payments dropped.
The institution had to examine itself more than ever before.
No one thought Rush would abandon its academic mission,
but the new era had "severe impact," said Trufant.

Still, the institution prospered. The Campaign for the
Future of Success closed in 1982 with $83 million raised. Then
in 1986 came a resurgence of giving — $17 million, the most
since 1982. That same year, 1986, a new Benefactors' Wall
was erected on which principal contributors' names were
inscribed.

In organ and tissue transplantations — liver, heart, kidney,
bone, cornea and bone marrow — Rush became a national
leader. In liver transplantation especially, Rush pushed boldly,
and in less than a year was one of six or so U.S. institutions do-
ing the procedure more than occasionally — one a week by
1986. It was a matter of deciding to do it and then recruiting
"one of the best teams in the United States," said Dr. Henry
P. Russe, dean of Rush Medical College and vice president for
medical affairs.

Rush developed so-called specialty centers which enhanced
its abilities in the most advanced treatments, including the
Rush Cancer Center, the Multiple Sclerosis Center and The
Thomas Hazen Thorne Bone Marrow Transplant Center.
Rush also developed notable strengths in heart disease, ortho-
pedics, psychiatry and geriatrics.

Rush's achievements have been recognized. Commemo-

New Leadership, New Directions 191

rating the 100th anniversary of Presbyterian Hospital in April
of 1983, the Union League Club of Chicago gave Rush its Dis-
tinguished Public Service award for providing "the highest
quality medical service to all segments of the community."
Business Week and Family Circle magazines cited Rush for its
leadership. A book soon to be published on top U.S. hospitals
will do the same. Patients have frequently praised the care and
attention they received. Among them is the president of Hyatt
Hotels, who said in a post-stay letter, "You run one hell of a
hospital."

Meanwhile, the patient care network developed new pat-
terns. As specialization became more available, community
hospitals began to do what only major referral centers like
Rush had been doing. Henikoff had been Campbell's liaison
with the hospital network in the late seventies and had a sense
of what these institutions needed and wanted. He and others
among the Rush leadership decided that Rush should work
closely with these hospitals as they specialized, to help them in-
crease their expertise. Rush would in effect work selectively to
decentralize tertiary care activity while strengthening its com-
munication and referral patterns with these institutions. The
approach was being used with some success as 1986 drew to a
close.

Possibly even more important was the interest of some net-
work hospitals in merging with Rush. Before 1986 merger*
discussions had never moved past preliminaries. On the eve of
Rush's sesquicentennial, however, at least two network hos-
pitals were in negotiation, with agreements apparently immi-
nent. Rush-owned facilities were already the most extensive
among Chicago-area academic medical centers, and it had
more operating beds than any other private hospital in Illinois.
With mergers, the margin would widen even further.

The success of patient care at Rush has perhaps over-
shadowed an even older Rush tradition, the education of
health professionals. This story began with recognizing the im-
portance of medical education for community health. It should
end with an appreciation of health professional education in all
its aspects.

192 GOOD MEDICINE

The figures tell the story. When Rush Medical College was
reactivated in 1971, it offered only the doctor of medicine
degree. In 1987, Rush University offered 30 degrees at three
levels — baccalaureate, master's and doctoral. Rush Univer-
sity's four colleges — medicine, nursing, health sciences, and
graduate college — have granted over 3,600 degrees in this
time. Enrollment has remained for some time at about 1,150.
About 350 graduate each year.

They are a remarkable variety. President Henikoff was only
half joking when he told the trustees: "I hesitate to say that
each of our graduating classes could go out and completely
staff a small hospital, but if you added in the residents com-
pleting training each year, you wouldn't be very wide of the
mark."

Rush has 33 endowed professorships, 10 of which came out
of the Campaign for the Future of Success. Research awards
topped 1,100 in 1986, for a record. The leading categories
were in cancer, heart disease, immunology and neurology.

Henikoff had frequently mentioned the continued matura-
tion or full development of Rush University when, within a
year of his taking office, the trustees took him at his word and
arranged an academic convocation at which he would be in-
stalled as president of Rush University. Campbell had re-
gretted that in the rush of things he had never been installed as
university president. He had realized it was an opportunity
lost to tell the academic world about this new institution. The
trustees were not about to make the same mistake again.

The installation was held in May of 1985. A national panel
of speakers gathered to discuss "The Role of the Academic
Health Center in the 21st Century." Honorary degrees were
conferred. A touch of pageantry was provided. And more than
1,000 friends, colleagues and delegates from colleges and
universities around the country settled back to hear Henikoff s
inaugural address. For him it was the time to spell out his
views on Rush's academic mission:

"In the late 1800s and early 1900s," he said, "people arriv-
ing in the new towns and cities of the West would ask if there
was a 'Rush physician in town,' for such was our reputation in

New Leadership, New Directions 193

a time of greatly disheveled medical education. The public de-
manded quality."

He went on to draw parallels with today's Rush, with its
"exciting and innovative educational program in nursing and
in the allied health professions. Our Ph.D. candidates in
science," he said, "are part of a new and rapidly expanding
research program, already demonstrating national leadership
in several areas. Much remains to be done. Nurture and
growth of these research efforts are essential to the maturation
of Rush as a major health university."

He emphasized "the traditional role of practitioner as
teacher" and said it "cannot be lost if we are to educate nurses
and physicians and other health professionals who are human-
ists as well as scientists, who care about, as well as care for, the
patient. In this regard," he said, "our institutional philosophy
of education in a health care environment serves us well."

He voiced his fear "that much would be lost if such educa-
tion were to be removed from the bedside to the classroom."
Rush's "unique institutional position and philosophy" enable
it to maintain this approach to health education. Rush will not
"give up control of the academic health teaching environ-
ment, (namely) the hospital, to an entity that does not share
(its) mission and ethic. . ."

He cited a trend towards "separation of academics and
health care delivery, brought about by current economic pres-
sures." He called it "not an unlikely scenario" that univer-
sities might divest themselves "of hospitals and perhaps
medical schools." Rush's "heritage and future," on the other
hand, "lie in the uncompromising intertwining" of health
care education with medical delivery "in the forefront of pa-
tient care."

Rush's base is in the health care system, said Henikoff.
"Our priority is the patient. In this we differ from most of our
sister institutions. We have a unique role and a unique oppor-
tunity in this new era. It is up to us to make that opportunity a
reality."

President Henikoff spoke as successor to Dr. Daniel Brain-
ard, the founder of Rush Medical College, who in his in-

194

GOOD MEDICINE

augural address reminded his audience of the great stake they
had in the success of this institution, "The health, the hap-
piness, the life of your dearest friends, and your own, may and
will some day depend on the skill of some member of the
medical profession," Brainard said in 1843.

Henikoff quoted him in 1985. He also quoted another of
Rush's great men. Dr. James B, Herrick, who in 1912 said a
hospital should have the "stimulus of instructing young, active,
wide-awake" students and praised "the spirit of research" which
freshens and enlivens education. "And yet no matter what view
we may take," said Herrick, almost as if to head off any excess of
enthusiasm for education and research, "the central figure is,
and should be, the patient."

At Rush-Presbyterian-St. Luke's Medical Center for over a
century and a half, the patient came first.

Rush-Presbyterian-St. Luke's Medical Center today.

Appendix I

AN ACT TO INCORPORATE THE
RUSH MEDICAL COLLEGE

The Act of the Legislature of Illinois, Approved March 2, 1837, Entitled An Act to Incor-
porate the Rush Medical College

Section i. Be it enacted by the People of the State of Illinois, represented in
the General Assembly,

That TheophUus W. Smith, Thomas Ford, E.D. Taylor, Josiah C. Goodhue,
Isaac T. Hinton, John T. Temple, Justin Butterfield, Edmund S. Kimberly,
James H. Collins, Henry Moore, S. S. Whitman, John Wright, William B.
Ogden, Ebenezer Peck, John H. Kinzie, John D. Caton and Grant Goodrich,
be, and they are hereby created a body politic and corporate, to be styled and
known by the name of the "Trustees of the Rush Medical College," and by
that style and name to remain and have perpetual succession. The College shall
be located in or near Chicago, in Cook County. The number of trustees shall
not exceed seventeen, exclusive of the Governor and Lieutenant Governor of
this State, the Speaker of the House of Representatives, and the President of
the College, all of whom shall be ex-officio members of the board of trustees.
Section 2. The object of incorporation shall be to promote the general in-
terests of medical education, and to qualify young men to engage usefully and
honorably in the professions of medicine and surgery.

Section 3. The corporate powers hereby bestowed, shall be such only as are
essential or useful in the attainment of said objects, and such as are usually con-
ferred on similar bodies corporate, namely: In their corporate name to have
perpetual succession; to make contracts; to sue and be sued; to plead and be
impleaded; to grant and receive by its corporate name, and to do all other acts
as natural persons may; to accept and acquire, purchase and sell property, real,
personal or mixed; in aiU lawful ways to use, employ, manage, dispose of such
property, and all money belonging to said corporation, in such manner as shall
seem to the trustees best adapted to promote the objects aforesaid; to have a
common seal, and to alter and change the same; to make such by-laws as are
not inconsistent with the Constitution and laws of the United States, and this

195

196 GOOD MEDICINE

State; and to confer on such persons as may be considered worthy, such
academic or honorary degrees as are usually conferred by such institutions.

Section 4. The trustees of said College shall have authority, from time to
time, to prescribe and regulate the course of studies to be pursued in said Col-
lege; to fix the rate of tuition, lecture fees and other College expenses; to
appoint instructors, professors and such other officers and agents as may be
needed in managing the concerns of the institution; to define their powers,
duties and employments, and to fix their compensation; to displace cind
remove either of the instructors, officers or agents, or all of them, whenever the
said trustees shall deem it for the interest of the College to do so; to fill all
vacancies among said instructors, professors, officers or agents; to erect all
necessary and suitable buildings; to purchase books and philosophical and
chemical apparatus and procure the necessary and suitable means of instruc-
tion in all the different departments of medicine and surgery; to make rules for
the general management of the affairs of the College.

Section 5. The board of trustees shall have power to remove any trustee
from office for dishonorable or criminail conduct; Provided, That no such
removal shall take place without giving to such trustee notice of the charges
preferred against him, and an opportunity to defend himself before the board,
nor unless two-thirds of the whole number of trustees for the time being shall
concur in such removal. The board of trustees shall have power whenever a
vacancy shall occur by removal from office, death, resignation, or removad out
of the State, to appoint some citizen of the State to fill such vacancy. The ma-
jority of the trustees for the time being, shall constitute a quorum to transact
business.

Section 6. The trustees shall faithfully apply all funds by them collected, in
erecting suitable buildings; in supporting the necessary instructors, professors,
officers and agents; and procuring books, philosophical and chemical ap-
paratus, and specimens in naturail history, mineralogy, geology, and botany,
and such other means as may be necessary or useful for teaching thoroughly
the different branches of medicine and surgery; Provided, That in case any
donation, devise, or bequest, shall be made for particular purposes, accordant
with the object of the institution, and the trustees shall accept the same, every
such donation, devise, or bequest, shall be applied in conformity with the ex-
press condition of the donor or devisor; Provided also. That lands donated or
devised as aforesaid, shall be sold or disposed of as required by the last section
of this act.

Section 7. The treasurer of said College always, and all other agents,
when required by the trustees, before entering upon the duties of their of-
fice, shall give bonds respectively, for the security of the corporation, in
such penal sum, and with such sureties as the board of trustees approve;

Appendix I 197

and all process against said corporation shall be by summons, and service of
the same shall be by leaving an attested copy with the treasurer of the Col-
lege, at least thirty days before the return day thereof.

Section 8. The lands, tenements, and hereditaments, to be had in
perpetuity in virtue of this act, by said institution, shall not exceed six
hundred and forty acres; Provided, however, That if donations, grants or
devises of land, shall from time to time be made to said corporation, over
and above six hundred and forty acres, which may be held in perpetuity as
aforesaid, the same may be received and held by said corporation, for the
period of six years from the date of any such donation, grant or devise; at
the end of which time, if the said lands over and above the six hundred and
forty acres, shall not have been sold, then, and in that case, the lands so
donated, granted, or devised, shall revert to the said donor, grantor, or to
their heirs.

Approved 2nd March, 1837.

Appendix II

Rush-Presbyterian-St. Luke's Medical Center

CHAIRMEN OF THE BOARD OF TRUSTEES

John P. Bent, 1956-1964*
George B. Young, 1962-1966*
Albert B. Dick III, 1966-1971
Edward F. Blettner, 1971-1974

Edward McCormick Blair,

1974-1978
Harold Byron Smith, Jr., 1978-

*Presbyterian-St. Luke's Hospital

PRESIDENTS

James A. Campbell, M.D.,

1964-1983
Donald R. Oder, Acting,

1983-1984

Leo M. Henikoff, M.D.,
1984-

RUSH UNIVERSITY DEANS

Rush Medical College

Daniel Brainard, M.D.,

1843-1866
James Van Zandt Blaney, M.D.,

1866-1871
Joseph Warren Freer, M.D.,

1871-1877
Jonathan Adams Allen, M.D.,

1877-1890
Edward Lorenzo Holmes, M.D.,

1890-1898
Henry Munson Lyman, M.D.,

1898-1900
Frank BUlings, M.D., 1900-1924
Ernest Edward Irons, M.D.,

1924-1936

Emmett Blackburn Bay, M.D.,

1936-1940
Earle Otto Gray, M.D., Acting,

1940-1941
Mark H. Lepper, M.D.,

1970-1973
William F. Hejna, M.D.,

1973-1976
Leo M. Henikoff, M.D., Acting,

1977-1978
Robert S. Blacklow, M.D.,

1978-1980
Henry P. Russe, M.D.,

1981-

198

Appendix II 199

College of Nursing

Luther P. Christman, Ph.D.,
R.N., 1972-

CoUege of Health Sciences

David I. Cheifetz, Ph.D.,

1976-1981
Bruce C. Campbell, Dr. P.H.,

Acting, 1981-1982; 1982-1983
John E. Trufant, Ed.D., Acting,

1983-1985; 1985-

The Graduate College

A. William Holmes, M.D.,

Acting, 1973-1974
David I. Cheifetz, Ph.D., Acting,

1974-1977
Mark H. Lepper, M.D., Acting,

1981-1982; 1982-1983
John E. Trufant, Ed.D., Acting,

1983-1985; 1985-

DEPARTMENTAL CHAIRPERSONS

Anatomy

Anthony J. Schmidt, Ph.D.,
1974-

Anesthesiology

Reuben C. Balagot, M.D.,

1967-1970
Max Sadove, M.D., 1970-1979
William Gottschalk, M.D., Acting,

1979-1980
Anthony Ivankovich, M.D.,

1980-

Biochemistry

Max Rafelson, Ph.D., 1960-1970
Howard Sky-Peck, Ph.D.,

1970-1978
Hermann Mattenheimer, M.D.,

Acting, 1978-1979
Klaus Kuettner, Ph.D.,

1980-

Cardio vascular Thoracic Surgery

Ormand C. Julian, M.D.,

1965-1971
Hassan Najafi, M.D., 1971-

Clinical Nutrition

Rebecca Dowling, Ph.D., Acting,
1986-

Communication Disorders and
Sciences

Thomas Jensen, Ph.D., Acting,
1986-

Community Health Nursing

Iris Shannon, M.A., 1975-1976
Georgia B. Padonu, Dr. P.H.,

1977-

Dermatology

Frederick D. Malkinson, M.D.,
D.M.D., 1969-

Diagnostic Radiology and
Nuclear Medicine

Richard E. Buenger, M.D.,
1968-

Family Practice

Philip C. Anderson, M.D.,

Acting, 1975
Erich E. Brueschke, M.D.,

1976-

General Surgery
Ormand C. Julian, M.D.,

1965-1970
Harry W. Southwick, M.D.,

1970-1985
Steven G. Economou, M.D.,

1985-

Geriatric/Gerontology Nursing

Lorry Gresham, R.N., 1977
Joan LeSage, Ph.D., R.N.,
1978-

200 GOOD MEDICINE

Health Systems Management

Gail L. Warden, M.H.A.,

Acting, 1975
Richard A. Jelinek, Ph.D.,

Acting, 1976-1977
Bruce C. Campbell, M.B.A.,

Acting, 1978-1979
John G. Larson, Ph.D., 1982
Wayne Lerner, M.H.A., Acting,

1983-1984; 1985-

Immunology

Henry Gewurz, M.D.,
1973-1981

Immunology/ Microbiology

Henry Gewurz, M.D.,
1981-

Internal Medicine

John S. Graettinger, M.D.,

1966-1970
Theodore B. Schwartz, M.D.,

1970-1982
Robert W. Carton, M.D.,

Acting, 1982-1985
Roger C. Bone, M.D.,

1985-

Medical Nursing

Sue Hegyvary, Ph.D., R.N.,

1974-1977
Ellen Elpern, M.S.N. ,

1977-1979
Marilee Donovan, Ph.D., R.N.,

1980-

Medical Physics

Lawrence Lanzl, Ph.D., Acting,
1986-

Medical Technology

Marjorie Stumpe, M.A., Acting,
1986-

Neurological Sciences

Maynard M. Cohen, M.D.,
1963-1984

Harold L. Klawans, M.D.,

Acting, 1984-1985
Frank Morrell, M.D., Acting,

1986-

Neurological Surgery

Eric Oldberg, M.D., 1959-1971
Walter W. Whisler, M.D.,
1971-

Obstetrical and Gynecological

Nursing

Ann Neeley, Ph.D., R.N.,

1974-1976
Claudia Anderson, Ph.D., R.N.,

1978-1981
Constance J. Adams, Dr. P.H.,

R.N., 1982-

Obstetrics and Gynecology

George D. Wilbanks, Jr., M.D.,
1969-

Occupational Therapy

Cynthia Hughes, M.Ed., Acting,
1986-

Operating Room and Surgical
Nursing

Yvonne Munn, M.S., R.N.,

Acting, 1974
Joyce Stoops, M.S., R.N.,

1975-1976
Nellie Abbott, Ph.D., R.N.,

1977-1981
Joyce Keithley, D.N.Sc, Acting,

1982-1986; 1986-

Ophthalmology

William F. Hughes, M.D.,
1959-1975; Acting, 1976-1978

William E. Deutsch, M.D.,
Acting, 1979-1982; 1983-

Orthopedic Surgery

Robert D. Ray, M.D., Acting,
1969-1970

Appendix II 201

Claude D. Lambert, M.D.,

Acting, 1970-1971
Jorge O. Galante, M.D., 1972-

Otolaryngology and
Bronchoesophagology

Stanton A. Friedberg, M.D.,

1959-1973
David D. Caldarelli, M.D.,

1974-

Pathology

George M. Hass, M.D.,

1959-1974
Ronald S. Weinstein, M.D.,

1975-

Pediatric Nursing

Robert A. Lyons, M.S., Acting,

1975; 1976
Mary Beth Badura, M.S.N. ,

1977
Jean Kaufman, Ph.D., R.N.,

1978-1979
Jean Sorrells-Jones, Ph.D.,

R.N., Acting, 1980-1981;

1982-

Pediatrics

Joseph R. Christian, M.D.,

1960-1985
Paul W. K. Wong, M.D.,

Acting, 1985-1986
Samuel P. Gotoff, M.D.,

1986-

Pharmacology

Paul E. Carson, M.D., Acting,

1974; 1975-1985
Henri Frischer, M.D., Ph.D.,

Acting, 1985-

Physical Medicine and
Rehabilitation

Jorge A. Galante, M.D., Acting,
1975-1980

Richard E. Harvey, M.D.,
1986-

Physiology

Joel A. Michael, Ph.D., Acting,

1974-1976
Robert S. Eisenberg, Ph.D.,

1976-

Plastic and Reconstructive
Surgery

John W. Curtin, M.D.,
1969-

Preventive Medicine

Joyce E. Lashof, M.D., Acting,

1970-1972
James A. Schoenberger, M.D.,

Acting, 1973; 1974-

Psychiatric Nursing

Jane Ulsafer, M.S., R.N.,

Acting, 1975-1977
Ann Marie Brooks, D.N.Sc,

1978-1982
Karen Babich, Ph.D., R.N.,

1983-

Psychiatry

Paul E. Neilson, M.D., Acting,

1969-1971
Jan A. Fawcett, M.D., 1972-

Psychology and Social Sciences

David I. Cheifetz, Ph.D.,

Acting, 1970-1971; 1971-1975

David C. Garron, Ph.D.,
Acting, 1976

Rosalind D. Cartwright, Ph.D.,
1977-

Religion and Health

Bernard Pennington, B.D.,

Acting, 1975
Christian A. Hovde, Ph.D.,

D.D., 1976-

202

GOOD MEDICINE

Therapeutic Radiology

Frank R. Hendrickson, M.D.,
Acting, 1970-1971; 1971-

Urology

Charles F. McKiel, M.D.,

Acting, 1969-1971; 1975-
Jack E. Mobley, M.D.,

1972-1973
MalachiJ. Flanagan, M.D.,

Acting, 1974

MEDICAL STAFF PRESIDENTS

George W. Stuppy, M.D.,

1959-1960
Thomas J. Coogan, M.D.,

1960-1962
Richard B. Capps, M.D.,

1962-1964
Stanton A. Friedberg, M.D.,

1964-1966
Richard B. Capps, M.D.,

1966-1967
Rigby C. RoskeUy, M.D.,

1967-1969
William S. Dye, M.D., 1969-1971
Frederic A. de Peyster, M.D.,

1971-1973

PhUip N.Jones, M.D., 1973-1975
Maurice L. Bogdonoff, M.D.,

1975-1977
Milton Weinberg, Jr., M.D.,

1977-1979
Joseph J. Muenster, M.D.,

1979-1981
Robert J. Jensik, M.D.,

1981-1983
Andrew Thomson, M.D.,

1983-1985
MalachiJ. Flanagan, M.D.,

1985-1987
James A. Schoenberger, M.D.,

president-elect

Marcia Pencak, R.N., 1984
Sandra McFolling, R.N.,

1985-1986
William Wiessner, R.N.,

NURSING STAFF PRESIDENTS

1985

1986-1987
Helen Shidler, R.N.
elect

president-

PRINCIPAL OFFICERS

Harold Byron Smith, Jr.

Chairman
Roger E. Anderson
Marshall Field
Richard M. Morrow

Richard L. Thomas

Vice Chairmen
Leo M. Henikoff, M.D.

President

Appendix II 203

GENERAL TRUSTEES

Mrs. Frederick M. Allen

Roger E. Anderson

Angelo R. Arena

Mrs. Bowen Blair

Edward A. Brennan

John H. Bryan, Jr.

W. H. Clark

Richard G. Cline

E. David Coolidge III

Susan Crown

Dino D'Angelo

Donald B. Davidson

Mrs. Herbert C. De Young

Albert B. Dick III

Thomas A. Donahoe

H. James Douglass

James L. Dutt

Bernard J. Echlin

Wade Fetzer III

Marshall Field

Cyrus F. Freidheim, Jr.

Robert Hixon Glore

David W. Grainger

Joan M. Hall

Marilou McCarthy Hedlund

Leo M. Henikoff, M.D.

Mrs. Edward Hines

Frederick G. Jaicks

Edgar D. Jannotta

Silas Keehn

John P. Keller

Thomas J . Klutznick
Frederick A. Krehbiel
William N. Lane III
Charles S. Locke
Vernon R. Loucks, Jr.
Donald G. Lubin
John W. Madigan
Mrs. F. Richard Meyer III
Richard M. Morrow
Joseph J. Muenster, M.D.
Doncild Nordlund
William A. Pogue
Joseph Regenstein, Jr.
Robert P. Reuss
Thomas A. Reynolds, Jr.
Thomas H. Roberts, Jr.
Patrick G. Ryan
Robert W. Schaefer
John J. Schmidt
Charles H. Shaw
Michael Simpson
Harold Byron Smith, Jr.
Robert A. Southern
Philip W. K. Sweet, Jr.
Bide L. Thomas
Richard L. Thomas
William L. Weiss
H. Blair White
James R. Wolfe
William T. Ylvisaker

ANNUAL TRUSTEES

Ralph A. Bard, Jr.
Edward McCormick Blair
The Rev. Edward F. Campbell, Jr.
James W. De Young
The Rev. David A. Donovan
MalachiJ. Flanagan, M.D.
The Rt. Rev. Frank Tracy
Griswold III

Mrs. Edgar D. Jannotta
Clayton Kirkpatrick
Ronald D. Nelson, M.D.
R. Joseph Oik, M.D.
Mrs. James T. Reid
Harold L. Sherman
Andrew Thomson, M.D.

204 GOOD MEDICINE

LIFE TRUSTEES

A. Watson Armour III
Ralph A. Bard, Jr.
Edward C. Becker
John P. Bent
Edward McCormick Blair
Edward F. Blettner
William F. Borland
Robert C. Borwell, Sr.
R. Gordon Brown, M.D.
Mrs. George S. Chappell, Jr.
William M. Collins, Jr.
David W. Dangler
Robert C. Gunness
Stanley G. Harris, Jr.
Augustin S. Hart, Jr.
Robert J. Hasterlik, M.D.
Mrs. William G. Karnes
Clayton Kirkpatrick

John H. Krehbiel, Sr.
Brooks McCormick
Anthony L. Michel
The Rt. Rev. James W.

Montgomery
Kenneth F. Montgomery
George V. Myers
The Rt. Rev. Quintin E. Primo, Jr.
Richard W. Simmons
Justin A. Stanley
E. Norman Staub
T.M. Thompson
Mrs. Calvin D. Trowbridge
Waltman Walters, M.D.
B. Kenneth West
Edward Foss Wilson
Arthur M. Wood
George B, Young

MANAGEMENT

Leo M. Henikoff, M.D.

President
Donald R. Oder

Senior Vice President and

Treasurer
Henry P. Russe, M.D.

Dean, Rush Medical College

and Vice President, Medical

Affairs
Luther P. Christman, Ph.D.,

R.N.
Dean, Collge of Nursing and

Vice President, Nursing

Affairs
John E. Trufant, Ed.D.

Vice President, Academic

Resources, Dean, The

Graduate College and Dean,

College of Health Sciences

Wayne M. Lerner

Vice President, Administrative
Affairs

Kevin J. Necas

Vice President-Finance

William Gold, Ph.D.

Vice President, Prepaid Health
Programs and President,
ANCHOR Corporation

Sheldon Garber

Vice President, Philanthropy
and Communication and
Secretary

Bibliography

In writing this book, I have relied heavily on Rush-Presbyterian-St. Luke's
Medical Center archivist William Kona, M.A. Without his help and that of his
assistant, Mary Jane Kirchner, the enterprise would have been very difficult.

Among published authors I have depended most on Thomas NevUle Bon-
ner, whose Medicine in Chicago, 1850-1950 gave me a valuable overview of the
subject at hand.

Dr. Janet R. Kinney, biographer of Daniel Brainard and astute researcher,
gave important help on the Brainard-Davis conflict and other aspects of those
early years.

University of Illinois medical historian Patricia Spain Ward gave some good
early advice; her article on Abraham Flexner was especially stimulating.

Dr. Frederic de Peyster supplied valuable audiocassette recordings and a
history of the 13th General Hospital, among other items. Dr. Stanton
Friedberg supplied a transcript of his conversation with Dr. Francis Straus and
other materials.

Bruce Rattenbury, associate vice president for public relations at Rush, gave
me reams of written materials and contributed greatly to my understanding of
recent events. Some gaps in the 20th century history of St. Luke's Hospital
may be explained by the unfortunate loss of some St. Luke's records at the
time of its merger with Presbyterian Hospital. A bibliography follows.

BOOKS

Leslie B. Arey, Northwestern University Medical School, 1859-1959: a Pioneer in
Educational Reform, Evanston and Chicago, Northwestern University, 1959,
495 pp.

Thomas Neville Bonner, Medicine in Chicago, 1850-1950, Madison,
American History Research Center, 1957, 302 pp.

205

206 GOOD MEDICINE

Norman Bridge, M.A., M.D., and John Edwin Rhodes, M.A., M.D., Rush
Medical College, Chicago, Oxford Publishing Company, 1896, 154 pp.

James B. Herrick, M.A., M.D., Memories of Eighty Years, Chicago, Univer-
sity of Chicago Press, 1949, 270 pp.

Edwin F. Hirsch, M.D., Ph.D., Christian Fenger, M.D., 1840-1902, The Im-
pact of His Scientific Training and His Personality on Medicine in Chicago, Chicago,
1972, 79 pp.

Hirsch, Frank Billings, Chicago, The Printing Department, University of
Chicago, 1966, 144 pp.

James Nevins Hyde, M.A., M.D., Early Medical Chicago, an Historical Sketch of
the First Practitioners of Medicine etc., Chicago, Fergus Printing Co., 1879,
78 pp.

Ernest E. Irons, M.D., Ph.D., The Story of Rush Medical College, Chicago,
1953, Trustees of Rush Medical College, 82 pp.

Frederic Cople Jaher, The Urban Establishment, especially Chapter V,
"Chicago," pp. 453-576, Urbana, University of Illinois Press, 1982,
777 pp.

Ruth Johnsen, R.N., B.S., M.A., The History of the School of Nursing of
Presbyterian Hospital, Chicago, Illinois, 1903-1956, University of Chicago
master's thesis, Chicago, Alumnae Association, School of Nursing,
Presbyterian Hospital, 1959, 65 pp.

Rev. James DeWitt Clinton Locke, Personal Reminiscences of the Diocese of Il-
linois, 1856-1892, The Rev. R. B. Dibbert, editor, Chicago, Grace
Church, 1976, 95 pp.

Marie G. Merrill, The History of St. Luke's Hospital School of Nursing, Chicago,
1946, 258 pp.

Bessie L. Pierce, A History of Chicago, Chicago, University of Chicago Press,
1937, 3 volumes: 1673-1848, 1848-71, 1871-93

The Pulse of Rush Medical College, the school yearbook, 1894 and 1895, Arthur
Tenney Holbrook, Editor-in-Chief, 1894, pages not numbered; Samuel
Omar Duncan, A.B., Editor-in-Chief, 1895, 376 pp.

The 13th General Hospital in World War II, 1942-1945, 62 pp.

ARTICLES, BROCHURES, ETC.

Emmet B. Bay, M.D., "Herrick as a Clinician," in "Joint Meeting in
Memory of James B. Herrick" (of Institute of Medicine in Chicago and the
Society of Medical History of Chicago, Oct. 14, 1954), The Proceedings of the
Institute of Medicine in Chicago, 188-191

William K. Beatty, "Daniel Brainard — Pioneering Surgeon and Teacher,"
Ibid, Vol. 34, 1981, 2 ff.

Bibliography 207

Beatty, "JVZ Blaney, Genial Chemist, Inventor and Editor," Ibid., Vol. 39,

1986, 55-61, 111-118
Beatty, "Ludvig Hektoen — Scientist and Counselor," Ibid., Vol. 35, 1982,

7-9
Beatty, "William Heath Byford: Physician and Advocate for Women,"

Ibid, Vol. 39, 1986, 6 ff.
James A. Campbell, M.D., "Some Persons at Rush," Transactions of the

American Clinical and Climatological Assn, Vol. 89, 1977, 162-171
Chicago Daily News, September 6, 1945, p. 2, "Chicago Doctors Hit the

Beach First in Southern Japan"
Chicago Medical Society, History of Medicine and Surgery and Physicians and

Surgeons of Chicago, Chicago, 1922
Chicago Tribune, June 13, 1950, "Doctors Dig Up Old Pranks at Rush '00

Party"
"Daniel Amasa Jones," Newton Bateman and Paul Selby, editors. Historical

Encyclopedia of Illinois, Chicago, Munsell Publishing, 1906, pp. 926-928
Geza de Takats, M.D., "Parkinson's Law in Medicine," New England Journal

of Medicine, Jan. 21, 1960, 126-128 (Presented Oct. 8, 1958, at annual

meeting of the Mont Reid Society, Chicago)
John Milton Dodson, Sc.D., M.D., "The Affiliation of Rush Medical College

with the University of Chicago — A Historical Sketch," Bulletin of the Alumni

Association of Rush Medical College, 1917, January, May, September; 1918,

January, August; 1919, April, November; 1920, February; 1921, Febru-
ary, June, October; 1922, May, August; 1923, Jzmuary
Robert M. Hutchins, "The State of the University: a Report to the Alumni

and Friends of the University of Chicago, Aug. 10, 1941," 20 pp.
C. Frederic Kittle, M.D., "Benjamin Rush — Heritage and Hope," The

Magazine, Winter 1976-77, 46-51
Kittle, "The Development of Academic Surgery in Chicago," Surgery, Vol. 62,

No. 1, 1-11
DeLaskie Miller, M.D., "Rush in the Past," The Corpuscle, Vol. 7, No. 8,

May 1898, 271-274
Harold L. O'Donnell, Newport and Vermillion Township, the First 100 Years,

1824-1924 (Vermillion County, Indiana), 1969
Walter L. Palmer, M.D., Ph.D., "Franklin Chambers McLean and the

Founding of the University of Chicago School of Medicine," Perspectives in

Biology and Medicine, Winter 1979, Part Two, S2-S32
Bruce Rattenbury, "A Generation at Rush — 1964-1984," The Magazine, Fall,

1980, 8-22
Paul S. Rhoads, M.D., "James B. Herrick, M.D.," Proceedings of the Institute of

Medicine in Chicago, Vol. 35, 1982, 3-6

208 GOOD MEDICINE

Richard B. Richter, M.D., "A Short History of the Medical School at the
University of Chicago," Bulletin of the Alumni Association, School of Medicine,
University of Chicago, Vol. 22, No. 2, Spring, 1967, 4-7

Henry T. Ricketts, M.D., "Highlights in the History of the Institute of
Medicine," reprinted in Nostalgia Corner, Proceedings of the Institute of
Medicine in Chicago, Vol. 38, 1985, 84-86

John E. Rhodes, M.A., M.D., "The Making of a Modern Medical School: a
Sketch of Rush Medical College," The Medical News, Weekly Journal of
Medical Science, Vol. LXXIX, No. 20, Nov. 16, 1901, 761-767

"St. Luke's Hospital: 80th anniversary. 1865-1945," 1945

"St. Luke's Hospital, An Indispensable Institution," Chicago, 1923, Officers
and Trustees of St. Luke's Hospital, 23 pp.

James P. Simonds, M.D., D.P.H., Ph.D., "Ludvig Hektoen: a Study in
Changing Scientific Interests," Proceedings of the Institute of Medicine in Chicago,
Vol. 14, 1942, 284-287

Samuel G. Taylor III, M.D., "Reminiscing about Medicine's Progress," The
Magazine, Fall, 1977, 25-26, reprinted from American Medical News

The University of Chicago, the President's Report, July 1892 to July 1902, University
of Chicago Press, 1903; succeeding editions, 1906-1924

Ilza Veith, "Medicine as an Academic Discipline at the University of
Chicago," Bulletin of the Alumni Association, School of Medicine, University of
Chicago, Vol. 32, No. 2, Spring, 1977, 13-18

Patricia Spain Ward, "The Other Abraham: Flexner in Illinois," Caduceus
Vol. 2, No. 1, Spring, 1986, 1-66

George H. Weaver, M.D., Beginnings of Medical Education in and Near Chicago,
the Institutions and the Men, reprinted from Proceedings of the Institute of Medicine
in Chicago, Vol. V, 1925, Chicago, Press of the American Medical Associa-
tion, 132 pp.

H. Gideon Wells, M.D., Ph.D., "Investigative Work at Rush Medical Col-
lege," Bulletin of the Alumni Association of Rush Medical College, August 1922,
15-19

UNPUBLISHED MATERIALS

Arthur Andersen & Co., "Hospital Organization Study" of Presbyterian- St.
Luke's Hospital, November, 1965, 26 pp.

Robert Cunningham, "The Making of a Medical Center," Chicago, 1980,
113 pp.

Frederic A. de Peyster, M.D., "The Great Medical Department of Lake
Forest University, 1887-1898," Presidential address read before 71st an-
nual meeting of the Chicago Surgical Society, May 21, 1971

Bibliography 209

R. Kennedy Gilchrist, M.D., Its Been Fun: 1904-1984, Memoirs, 294 pp.
Dora Goldstine, draft of projected history of St. Luke's School of Nursing,

September, 1931, 82 pp.
Mark H. Lepper, M.D., transcript of interviews on April 24 and May 15,

1984, by Janis Long Harris
Rev. D. Clinton Locke, "History of St. Luke's Hospital to 1893," David

Evans, editor, 1929, 30 pp.
Madeleine McConnell, R.N., B.S., The Development of Nursing, St. Luke's

Hospital, Chicago, a Memoir (not dated)
Joan WUlard Moore, "Stability & Instability in the Metropolitan Upper

Class," a comparative study of the woman's boards of St. Luke's and

Presbyterian hospitals, unpublished Ph.D. thesis. University of Chicago,

1959.
Presbyterian Hospital, Minutes of Board of Managers, June 15, 1938;

June 9, 1939; September 7, 1939; February 26, 1941
Rush Medical College Alumni Association meeting, Atlantic City, June

18, 1963, audiocassette
Rush Medical College trustees' meeting (with meeting of medical staff,

Presbyterian-St. Luke's Hospital), September 3, 1969, audiocassette
Francis H. Straus, M.D., "Some Medical Reminiscences," transcript of

conversation with Dr. Stanton A. Friedberg, March 29 and April 1 and

2, 1980, 36 pp.
Andrew Thomson, M.D., "Remarks at Medical Staff Dinner," Nov. 1,

1984, 7 pp.

INTERVIEWS

Ralph A. Bard, Jr.

Evan M. Barton, M.D.

John P. Bent

Edward McCormick Blair, Sr.

John Brewer, M.D.

Mrs. James A. Campbell

Robert W. Carton, M.D.

Mrs. George Chappell

Luther P. Christman, R.N., Ph.D.

David W. Dangler

Frederic A. de Peyster, M.D.

Mrs. Herbert C. De Young

Albert B. Dick III

Stanton A. Friedberg, Jr., M.D.

2 1 0 GOOD MEDICINE

Sheldon Garber

William F. Geittmann, M.D.

John S. Graettinger, M.D.

William Grove, M.D.

Sue Thomas Hegyvary, Ph.D., R.N.

William F. Hejna, M.D.

Leo M. Henikoff, M.D.

Ruthjohnsen, R.N.

Philip N.Jones, M.D.

Janet R. Kinney, M.D.

C. Frederick Kitde, M.D.

Joyce Lashof, M.D.

Mark H. Lepper, M.D.

Wayne M. Lerner, M.H.A.

Joseph J. Muenster, M.D.

Donald R. Oder, M.B.A.

Rhoda S. Pomerantz, M.D., M.P.H.

Henry P. Russe, M.D.

Barbara Schmidt, R.N.

Theodore B. Schwartz, M.D.

Charles Sheaff, M.D.

William D. Shorey, M.D.

Harold Byron Smith, Jr.

Irene R. Turner

John E. Trufant, Ed.D.

George B. Young, Ph.D., J. D.

Index

Academic Facility, 170
Access Health, 189

Adams, Mrs. Robert McCormick, 104
Admissions requirements, 15, 72
Allen, J. Adams, 20, 30, 48, 59
Alzheimer's Disease Clinical Center, 172
American Medical Association, 93-94, 161-62
Amerman, George K., 21
ANCHOR Health Maintenance

Organization. 182, 188-89
Andrews, Edmund, 11, 13
Anna W. Durand Hospital, 95, 102
ArcVentures, 189
Armour, Barbara, 25
Armour, George, 45
Armour, Mrs. William, 25
Armstrong, Horace W., 83
Armstrong, S. Howard, Jr., 125, 128
Atrium Building, 180

Bacon. Asa, 98

Bacteriology, 35

Bailey, Percival, 143

Bard, Ralph A., Sr., 139

Barton, Evan, 107, 108

Bay, Emmett B., 80, 90

Beattie, Edward, 126

Belfield, William, T., 35

Bennett, Granville, 163

Bent, John P., 138, 139, 145, 146, 156

Bevan, Arthur Dean, 72, 93, 110, 111

Billings, Frank, 36, 66, 71, 81, 91-92,

105, 110
Billings Hospital, 78, 80
Blacklow, Robert S., 169
Blackwell, Emily, 5

Blair, Edward McCormick, 148, 156, 179
Blair, William, 23

Blaney, James Van Zandt, 4, 7, 20, 54, 59
Blettner, Edward, 156
Blue Cross Society, 47
Bogdonoff, Maurice L., 157
Boone, Levi, 8, 14
Borwell, Robert C, 179
Bowman Center, 171
Brady, Norman A., 139, 144
Brainard, Daniel, 1, 3, 12, 14, 15, 16, 53
Brewer, John, 109

Bridge, Norman, 29, 32, 59
Brown, Ralph C, 105
Byford, William, 13, 25, 31, 32
Byrne, Jane, 181
Byron, Charles L., 162

Camp Douglas Ladies Aid Society, 39
Campbell, James A., 127-49, 150, 152,

156, 157, 159, 164, 176, 181
Campbell Report, 164
Capps, Richard B., 131
Cardiac catheterization, 128, 131
Cardiovascular medicine, 12,7
Carlson, A. J., 82
Carton, Alfred T,, Sr., 81
Carton, Robert W., 168
Castle, William B., 132
Caton, John Dean, 2
Central Free Dispensary, 99, 117
Chamberlain, George, 43
Charter for Rush Medical College, 3, 5
Chicago, 1,2, 11

Chicago Academy of Medical Sciences, 14
Chicago Medical College, 13, 15
Chicago Medical Journal, 9
Chicago Medical Society, 14
Chicago Relief and Aid Society, 42
Chicago Technology Park, 185
Chicago fire of 1871, 18-19, 42. 56
Children's Memorial Hospital. 97
Children's clinic at Rush, 99
Christman, Luther P., 155, 172, 174
Clark, Elbert, 106

Clerkships at Presbyterian-St. Luke's. 167
Clinical education, 22, 31, 70
Clinics at University of Chicago, ,80-81
College of Health Sciences, 169
Conger, Cornelia, 104
Cook County Hospital, 8, 19, 21, 87
Coronary artery thrombosis, 89
Corwith Memorial Operating Room. 60
Cotton, Alfred C, 30

County Hospital. See Cook County Hospital
Craig, Willis, 23
Curriculum at Rush, 5, 12, 14, 69-70

Daley, Richard J., 145
Danforth, Isaac N.. 41

212

GOOD MEDICINE

Dangler, David W., 171

David, Vernon, 103, 123, 166

Davis, Loyal, 143

Davis, Nathan, 6, 8, 10-17, 27, 32, 55

Day, Albert M., 98

de Koven, John, 41

de Peyster, Frederic, 108, 123, 157, 162, 166

De Takats, Geza, 140, 142

Departmental organization, merger and, 140

Diabetes, 102

Dick, A. B., 146, 156, 164

Dick, George F., 80, 96, 101

Dick, Gladys Henry, 80, 96, 101

Dienhardt, Friedrich, 162

Diphtheria, 102

Dodson, John Milton, 70

Donnelley, Elliott, 164

Douglass, Elizabeth, 24

Dovyie, John Alexander, 86

Dowling, Harry, 129

Durand Hospital, 95, 102

Electrocardiograph, 99, 117
Engel, Frank, 130
Etheridge, James, 25, 41, 59
Evans, John, 8, 10-11

Faber, Penfield, 143
Fairbank, Nathaniel K., 42, 44
Favill, Henry Baird, 50
Fell, Egbert, 132, 142
Fellowships at Presbyterian, 135
Fenger, Christian, 29, 32-35, 57
Field, Marshall, 42
Field, Marshall, III, 137
Flannery, Marvin, 109
Flexner Report, 93
Flint, Austin, 5, 7, 9
Foerster, Alma, 105
Ford, Gerald R., 156, 180
Freer, Joseph W., 18, 59
Friedberg, Stanton A., Sr., 96, 157
Friend, Hugo M., 162
Fuller, Melville, 40

Garber, Sheldon, 179, 180

Gary, Mrs. John W., 103

Gatewood, L. C. , 107

Geriatric Assessment Program, 171

Germ theory of disease, 25, 26, 27

Gilchrist, R. K., 103, 107, 123, 162

Glaser, Robert J., 166

Goodhue, Josiah, 2

Graettinger, John, 130, 147, 160, 168

Greek, Dessie, 102

Grove, William, 123, 165

Gunn, Moses, 25-26, 27, 41, 57, 59

Hagenah, William J., 161, 166

Haines, Walter S., 29

Hamill, Robert C., 23

Harper, William Rainey, 66, 71, 110.

See also University of Chicago
Harvey, Basil C, 79, 105
Hass, George M., 125, 140
Hay, Walter, 39, 41, 59
Health Maintenance Organization,

ANCHOR, 182, 188-89
Hegyvary, Sue Thomas, 172
Heidenreich, Dorothy Jane, 144
Hejna, William, 143, 167, 168
Hektoen, Ludvig, 36, 86-88, 114
Henikoff, Leo M., 160, 169, 186-94
Henry, David D., 165
Herbst, Robert H., 83
Herrick, James, 18, 28, 36, 87-91, 113,

114, 194
Herrick, William, 7, 9
Heydock, William O., 41
Hibbard, Mrs. Frank, 104
Holmes, A. William, 162
Holmes, Edward Lorenzo, 16, 29, 30, 59
Homeopathic medicine, 13
Hubbard, E. K., 43
Hutchins, Robert Maynard, 79, 81
Hyde, James Nevins, 29

Illinois Cancer Council, 100

Illinois general Hospital of the Lakes, 8

Illinois Medical and Surgical Journal, 8

Illinois Training School for Nurses, 98

Ingals, E. Fletcher, 66, 110

Intubations, 103

Irons, Edwin, 128

Irons, Ernest E., 76, 89

Isham, Ralph, 13

Jaicks, Frederick G., 157

Jane Murdock Memorial Building, 24, 95

Jelke Memorial, 145

Jensik, Robert J., 157

Johnson, Hosmer, 13

Johnston, Samuel, 49

Jones Building of Presbyterian Hospital,

64, 95
Jones, Daniel A., 24
Jones, Josephine, 144
Judson, Harry Pratt, 72, 106
Julian, Ormond, 109, 126, 142

Kara, John M., 105

Kark, Robert, 130

Kelly, Frank B., Sr., 162, 163

Kidston building, 145

Kimberley, Edmund S., 3

King, Tuthill, 23
Klebs, Edwin C, 35
Klicka, Karl, 132, 144
Knapp, Moses, 7, 9
Knox, J. Suydam, 30
Koch, Robert, 35
Kretschmer, Herman, 102

Ladies Aid Society, 24

Lake Forest University, 36-37, 66

Lang, Mrs, Gordon, 104

Lanier, Lyie, 165

Lashof, Joyce, 175, 176

LeCount, E. R., 97, 98

Leiter, Louis, 80

Lepper, Mark H., 149, 154, 164, 168, 176,

183
Lerner, Wayne M., 190
Lett, Catherine L., 46
Lewis, Dean, 75, 91, 105
Locke, Clinton, 38-52, 64
Lowther, Thomas, 45
Lyman, Henry, 23, 27-28, 59
Lyons, Leo, 104

McArthur, L. L., 33, 106

McConnell, Madeleine, 119

McCormick, Cyrus H., 23

McCormick, John Rockefeller, 95

McElwee, Nancy Adele, 81

McFadyen, Douglas A., 125

McLean, Franklin, 75, 79

McLennan, Donald R. Jr., 145

McMillan, Foster, 109, 142

McMillan, M. Helena, 98, 115

Medical Enlisted Reserve Corps., 106

Medical technology, programs in, 174

Medicine department at Rush, 80, 178

Melby, Sylvia, 144

Memorial Institute for Infectious Diseases,

88, 95
Merz, Earl, 109

Mile Square Health Center, 176
Miles, Sarah, 41, 45
Miller, C. Philip, 80
Miller, De Laskie, 29, 30, 59
Miller, Edwin, 107
Mitchell, Aha, 26
Montgomery, Kenneth, 180
Morse, Mrs. Charles H., Jr., 104
Muenster, Joseph, 130, 157
Murdock Memorial building, 24, 95
Murphy, John B., 29, 32, 33, 34, 118

Nelson, Bertram G., 166
Newberry, Walter, 6
NicoU, Holmes, 107

Nursing

merger and, 143-45

at Presbyterian Hospital, 98-99, 102

at St. Luke's Hospital, 45-49

at Rush University, 172

U.S. Cadet Nurses Corps and, 107

Oder, Donald R., 149, 160, 184-86

Ogden, William B., 6

Oldberg, Eric, 104, 142-43

Oldberg, Mrs. Eric, 104

Open-heart surgery, 132

Organ transplantation, 190

Otho S. A. Sprague Memorial Institute, 96

Ott, Mrs. Fentress, 104, 142

Owens, John E., 41, 47

Palmer, Walter L., 80

Parkes, Charles, 25, 26-27, 59

Pathology, surgery and, 35

Patients, paying vs. nonpaying, 132, 175

Payne, Edith, 143, 151

Pearsons, D. K., 24

Peck, David Jones, 5

Phemister, Dallas, B., 80, 94

Plummer, Samuel, 106

Pomerantz, Rhoda, 171

Post, Wilber, 83, 105, 166

Powell, Edwin, 21

Preble, Robert B., 50

Preferred Provider Organization, 188

Presbyterian Hospital of Chicago, 23-25,

31, 101, 105-9, 116, 125, 127, 131,

132, 134, 135, 150, 151

merger with St. Lukes, 137-49

nursing at, 98-99

Rush-University of Chicago merger and,

82-84

surgical research at, 126

University of Illinois and, 121
Presbyterian Hospital School of Nursing,

98-99, 143
Presbyterian-St. Luke's Hospital, 139, 149
Professional Building, 135, 170
Pullman, George M., 49

Quine, William, 29

ROTC at Rush, 106
Rafelson, Max E., 168
Rawson, Frederick H., 74
Rawson building, 77
Rea, R. L., 59
Rehabilitation facilities, 171
Rhoads, Paul S., 91
Richter, Richard B., 80
Ricketts, Howard Taylor, 105

214

GOOD MEDICINE

Rockefeller, John D., 67, 73

Ross, Joseph Presley, 21, 25, 58, 59

Rowan, P. J., 29

Rush Cancer Center, 100

Rush Home Health Services, 189

Rush Medical College, 3, 6-7, 13, 15, 19,

54, 55, 56, 57, 61, 62, 63, 152, 153

clinical education and, 22, 31, 70, 78

curriculum of, 5, 12, 14, 69-70

entrance requirements for, 15, 72

facilities redevelopment in, 170

hospital created by, 23

Lake Forest University and, 36-37, 66

postwar development of, 122

reopening of, 164

South Side campus of. See South Side

campuses

student behavior at, 28

teacher recruiting for, 1 1

University of Chicago and. See University

of Chicago

women's admissions at, 69

See also Cook County Hospital;

Presbyterian Hospital
Rush Model for Nursing, 173
Rush Occupational Health Network, 189
Rush University, 154, 155, 192

nursing program of, 172
Rush University Academic Facility, 170
Rush, Benjamin, 2
Rush-Presbyterian-St. Luke's Medical

Center, 158, 159, 165, 166, 168, 179,

188, 192
Russe, Henry P., 170, 190
Rutter, David, 13
Ryerson, Martin, 72
Ryerson, Mrs. Joseph T., 44

Schmidt, Barbara, 144

Schwartz, Theodore, 130, 136, 140

Schweppe-Sprague building, 143

Sedwick, Herbert, 147

Senn, Nicholas, 31-32, 58, 115

Shambaugh, George E., Jr., 83

Shaw, Charles H., 186

Sheridan Road Hospital, 175

Shorey, Mrs. Clyde E., 24, 104, 109

Sickle-cell anemia, 89

Simpson, John M., 138

Sippy, Bertram W., 94, 114

Smith, Harold Byron, Jr., 156, 157, 160,

179, 184
South Side campuses, 69, 73, 76-84
Southwick, Harry, 126
Speed, Kellogg, 101
Sprague Institute, 96
Sprague, Albert A., 96

St. Luke's Hospital, 38-52, 65, 100,

105-9, 118, 119, 124

closing of, 141

merger with Presbyterian, 137-49

nursing at, 45-49, 143

rechartering of, 44
Stehman, Henry B., 98
Stewart, Ellen, 106
Stickney, Mrs. E. H., 49
Straus, Francis, 32, 94-95, 107
Stuppy, George, 107, 141, 151
Surgery, 35, 80, 112

Taylor, Samuel G., Ill, 100, 131
Technology, 174, 187
Temple, John T., 3
Tice, Frederick, 92
Todd, George, 46
Toll, William, 42
Transplantation, organ, 190
Trobaugh, Frank, 130
Trufant, John E., 190
Tucker, W. Randolph, 164
Turner, Irene, 164

U.S. Cadet Nurses Corps, 107

Uniforms, 135

University of Chicago, affiliation with

Rush, 67, 69-70, 72-75, 76-82, 82-85
University of Illinois 73, 121, 164-65

Vandervort, Lynnette L., 106
Verbrugghen, Adrien, 143

Watson, Mrs. Hathaway, 104

Weaver, George H., 95

Weinberg, Milton, Jr., 157

Wells, H. Gideon, 96, 97, 105

West Side campus of Rush, 70, 73, 76-84

Wheeler, Tolman, 45

Whitehouse, Henry J., 40

Wiggins, W. S., 162

Wilder, Russell M., 80

Williams, Daniel Hale, 51

Woman's Auxiliary Board, 24, 60

Woman's boards, 25, 103, 120, 139, 142, 180

Woman's admissions, 69

Wood, Arthur M., 164

Woodward, Frederic, 78-79

Woodyatt, Rollin T., 101

World War I, 105-7

World War II, 107-9

Young, George B., 137, 147, 156

'<W;

It begins with Dr. Daniel Brainard,
whose recognition of the need for
highly professional training for physi-
cians provided quality health care to
inhabitants of many frontier towns in
the expanding west. It moves toward
the present through the era of Dr.
James Campbell, the architect of the
merger that united traditions for pa-
tient care, education and research of
three Chicago institutions, to today's
leaders who, like their predecessors,
are pioneering new ways for health
care.

Like any other great institution.
Rush has had its share of visionaries,
crusaders, philosophers, pragma-
tists — and the occasional oddball. The
telling of their struggles and triumphs
in the quest for quality health care
makes lively reading.

I' SP;(

600 SC
CHIC

Good Medicine: The First 150 Years oj
Rush-Presbyterian-St. Luke's Medical Center
is Jim Bowman's third institutional or
corporate history. His Booz, Allen &
Hamilton, Seventy Years of Client Service:
1914-1984 was published in 1984, his
More Than a Coffee Company: The Story of
CFS Continental, in 1986. A former
Chicago Daily News reporter and former
Chicago Tribune columnist. Bowman has
written on business and historical mat-
ters for various periodicals, including
Chicago History, a publication of the
Chicago Historical Society. He writes
from his home in Oak Park, Illinois.

ISBN: 1-55652-015-8

Of the more than 6,800 hospitals in the United States, about
450 are teaching hospitals and, of these, only some 120 are
joined with medical colleges to form academic health centers.
Over the course of an often tumultuous 150-year history,
Rush-Presbyterian-St. Luke's Medical Center in Chicago has
emerged as one of the nation's leaders in this select group of in-
stitutions with multiple missions in patient care, education and
research.

GOOD MEDICINE is the lively account of the strong medical
personalities and institutions who, since the medical center's
founding as Rush Medical College in 1837, have led Rush-
Presbyterian-St. Luke's to its present eminence.

RUSH-PRESBYTERIAN-ST. LUKE'S
MEDICAL CENTER