Arthur H. Aufses, Jr. MD Archives Blog

The Legacy of a St. Luke’s School of Nursing Alumna

The trials of life can crush one’s spirit or force one to overcome and create something exceptional out of the rubble. Mary Breckinridge, a 1910 St. Luke’s Hospital School of Nursing alumna, is a fine example of later. Born into a Kentucky family of influence and means, Breckinridge was well educated and well-traveled. She was married in 1904 and widowed by 1906, at age 26. She then completed St. Luke’s nursing program and worked teaching French and hygiene in an Arkansas women’s college. In 1912, she married the president of that school and had two children with him, but her daughter was premature and did not survive; her son died suddenly two years later at age four.

Additional struggles broke the marriage beyond repair and she left her husband in 1918 and worked as a public health nurse while awaiting a posting with the American Red Cross in France. She arrived there after the armistice of WW I and helped to initiate a program to provide food and medical assistance for children, nursing mothers, and pregnant women. While in France, she also spent time in England, observing the conditions of children and mothers there, and became convinced that American women in rural areas would benefit from the help of trained midwives. Ad educational visit to Scotland demonstrated how to provide medical care to a dispersed population.

Returning to the United States, she relocated to Leslie County, Kentucky, which had the highest maternal mortality rate in the country. Here Breckinridge, pictured left, introduced nurse-midwives into the region with the founding of The Frontier Nursing Service in 1925, eventually bringing maternal and neonatal death rates down well below the national average. In 1929, The Frontier Nursing Service staff started the American Association of Nurse-Midwives, a precursor of the American College of Nurse-Midwives, and the first American school of midwifery in New York in 1932. Mary Breckinridge served as director of the FNS until her death on May 16, 1965.

Spotlight on St. Luke’s Early Years: Admissions

In today’s world, the only way to check into a hospital, without an emergency, is for a doctor to arrange for some kind of test or surgical procedure. But in the 19th century, hospitals functioned a bit like today’s walk-in clinics, at least in regards to admission. A person could come to the Hospital, speak with the Admitting Physician and request treatment for ‘X’ problem. But there were rules governing who would be accepted or refused.

By 1859, St. Luke’s published the first of their annual reports, which included reports from the Board President, The Pastor/Superintendent and the House Staff, along with lists of donations, occupations and diseases of those treated, and the publication of rules – for staff for patients and for visitors, and for Admission. Admission rules separated out patients with certain diseases. Those with contagious diseases were refused admission – this was a common practice for private hospitals at this time. The 1904 annual report is the first year the Hospital reported which applications were declined under the Rules of Admission, and their numbers. Ten persons were declined admission due to contagions like Erysipelas, scarlet fever and scabies.

Another group – the chronic or incurable – included paralytics, rheumatics, the mentally ill, incurable cancer patients, and those with an opium habit or delirium tremens, where also refused admission. Chronic cases in acute attack might be accepted, but were discharged once they returned to the ordinary health of one in that condition. Incurable cases might be admitted, but “only at the discretion of the Executive Committee of the Hospital.” These were also probably discharged as soon as they regained what was ordinary health for that condition. In 1904, 128 cases were refused admission to St. Luke’s for one of these reasons.

One exception to the rules was pulmonary consumptives (tuberculosis). In the 19th century, consumption was considered a hereditary disease, rather than a contagious one. The 1859 report of the Board of Managers, explains, “To provide for the incurably ill, particularly of this class, was one of the objects of the Hospital, and therein to supply an urgent want in the community… there was no resort for consumptives, so numerous in our climate, that St. Luke’s, as a church institution, felt bound to open to them her doors.“


The woman’s tuberculosis ward at St. Luke’s Hospital, circa 1900

The Pastor’s report often notes the comfort, and at times cure, these patients received, and their expressions of gratitude. In 1891, nine years after the discovery of the tubercle bacillus by Dr. Robert Koch, St. Luke’s accepted control over the House of Rest for Consumptives in the Tremont section of the Bronx, eventually moving all its patients to the main hospital and selling the property to support their care. Throughout the years annual reports note that consumptives made up to a quarter of the total census of patients in any given year.

These rules on admission disappeared early in the 20th century as hospitals’ ability to recognize and control germs was established, and as out-patient clinics opened to treat patients that might not have been admitted to the Hospital’s care in prior years.


Spring Traditions

In years past, as the weather warmed up, the staff and alumni looked forward to renewing old acquaintances and socializing with colleagues from across the hospital’s departments. This blog post will highlight the three main traditions of spring, mention their roots and how they evolved.  

The first event was the annual alumni dinner, which gathered all the graduates of the Resident training program together to enjoy a good meal, good conversation, and informative lectures. The Society of the Alumni of St. Luke’s Hospital of New York City was established in 1891 and was formed with the intent to “foster collegiality and scientific discourse and to honor accomplished colleagues at an annual dinner.”

The image above, taken from the News of St. Luke’s newsletter, depicts the dinner held on April 30, 1965, at the New York Hilton Hotel.

 

This photo memorializes the St. Luke’s 1973 alumni dinner at the 7th Regiment Armory.

In 1896, Roosevelt Hospital ‘ex-interns’ met at the hospital to plan the twenty-fifth anniversary of its opening and organize The Roosevelt Hospital Alumni Association. Its stated purpose was “…maintaining loyalty to the institution and promoting its broader usefulness.”  Unfortunately, the Archives does not have any photos documenting their celebrations over the years.

 

Every June during the 1960s, St. Luke’s Attendings invited the Residents to join them for a “Field Day.” Held at New Jersey’s Englewood Country Club, the usual barriers of position, age, and authority were ignored during an afternoon of hotly contested athletic events (softball, golf, and tennis, swimming, etc.), followed by a casual dinner and evening entertainment.  

Evening offerings were often films created by actor/director wannabes, Drs. Harry Roselle and Theodore Robbins and the various colleagues they could round up to help. One year’s offering was a Dr- Kildare-meets-Dracula-at-St.-Luke’s horror flick titled, “Anemia of Uncertain Origin.” Another was a spy thriller á la a 1960s TV comedy favorite titled ‘Get Smart,’ called “Aardvark,” in which Secret Agent 95.6, battled Aardvark, a Fu Manchu-type enemy who developed an infamous blood sludging device.  

Each year’s outing was documented with a panoramic photograph of attendees. These photos, usually between four and six feet long and about ten inches high, have proven to be a challenge to store in the Archives.  About ten of them arrived, each individually tightly rolled. They required re-humidifying in a makeshift humidification tank in order to relax the paper enough to allow them to be flattened for storage. They are available for viewing for those who wish to walk down memory lane.

In case you, dear reader, are curious, the Field Day photo was cut in two in order to be printed in the former newsletter, The News of St. Luke’s. The images used here were scanned from the newsletter because the originals are too large to fit on current in-house scanners. It may also be of interest to note that the dinner photographs, whose originals are two to three feet long and eight to ten inches high, were taken with a fish-eye camera, which has curved lenses to allow the whole room to fit into one image.  The author is not sure what equipment was used to capture the huge Field Day images.

Unfortunately, one year in the early 1970s the event was cancelled due to unforeseen circumstances, and it was not picked up again in the following years. 

 

The final big spring event for many years was the St. Luke’s Hospital School of Nursing graduation ceremonies held at the Cathedral of St. John the Divine, just south of the Hospital. Nursing students would line up at the Hospital and proceed down Amsterdam Avenue, marching up the front steps to enter the Cathedral and take seats at the front while their families observed the ceremonies from behind them.  At the end of the ceremonies the graduating class would pose for a group photo on the Cathedral steps.

 

 

 

 

 

The above images, taken from the News of St. Luke’s newsletter, are of the graduating class of 1955; the image below shows the graduating class of 1974, the year the St. Luke’s Hospital School of Nursing program closed its doors and merged with the Columbia University School of Nursing Bachelor of Science program. 

 

Roosevelt Hospital also had a School of Nursing, founded in 1896. At first, students were accepted on a rolling admission any time, and as students successfully completed the required coursework, diplomas, graduate caps and pins were awarded with little fanfare in the Administration Building. By the 1920s a formal cycle of classes developed, and graduation was set at a fixed time of year. At first, ceremonies were held in the Syms Operating Room, and later, as the number of students grew, the ceremony was moved to a hotel ballroom. Unfortunately, the Archives does not have images from the Roosevelt Hospital School of Nursing graduations, and like St. Luke’s, the hospital-based school also closed its doors in 1974, but the Alumni Association is still fairly active and enthusiastic about staying connected.

 

Michala Biondi for the Aufses Archives.

Disappearing Hospitals, Where Did They Go? Woman’s Hospital

Portrait of J. Marion SimsThe Woman’s Hospital, often considered the first hospital in this country dedicated to treating the diseases of women, opened on May 4, 1855 in a house on Madison Avenue. It was founded by the currently controversial J. Marion Sims, MD, pictured right, in concert with a group of influential New York City women. Sims arrived in New York in 1853 from his home in Alabama, where he developed a procedure to close vesicovaginal fistulas. He relocated to New York in hopes of improving his own chronic health condition.

At first, Sims was welcomed into the medical community of New York and invited to demonstrate his fistula procedure. Unfortunately, once local doctors learned the procedure, they lost interest in him. Sims was unable to establish a strong practice or find a hospital that would offer him operating privileges.

The wife of one of Sims’ few medical friends in the city offered to gather a group of interested and influential women to discuss the state of women’s health care in the city. Thirty-Five women met on February 6, 1855, the outcome of which was the establishment of the Woman’s Hospital Association. The group would move to establish and direct a hospital devoted to the reception and cure of women suffering from “diseases peculiar to their sex.” The Association set up a Board of Managers, referred to as the ‘Board of Lady Managers,’ comprised of thirty-five women, to guide the Hospital. An Executive Committee of seven women, appointed by the Board of Managers, managed the day-to-day affairs of the institution.

In 1857 the Hospital was re-incorporated by the New York State Legislature as the Woman’s Hospital in the State of New York, and re-organized under an all-male Board of Governors. The twenty-seven Governors were responsible for the overall concerns of the Hospital, including filling vacancies of non-female staff, enacting the By-Laws and organizing the Medical Department. Women, however, were still very much in charge of running the Hospital. The former Board of Lady Managers became the Board of Lady Supervisors, and managed the operations of the Hospital, including the appointment of nurses and other female attendants. A smaller Board of Lady Managers remained responsible for handling the day-to-day business of the Hospital. By 1887, the Board of Governors invited four women from the Board of Lady Supervisors to join them. They found this integration “to be most acceptable in its results,” and soon after the Board of Governors was reorganized and evenly divided between men and women.

Sketch of Woman's HospitalAs mentioned above, the first Woman’s Hospital was a rented four-story brownstone at 83 Madison Avenue, off 29th Street, pictured left. The brownstone held forty beds and welcomed its first patient in May of 1855. The response to the Hospital’s opening was so great, by fall of 1855 that another surgeon, Thomas Addis Emmet, joined Dr. Sims as the second surgeon on staff. It wasn’t long before the Woman’s Hospital Board was seeking larger accommodations to meet patient demand.

In 1858, approving the petition of Dr. Sims, the City of New York offered the entire block bounded by 49th and 50th Streets between Lexington and Park Avenues as a site for a new, larger hospital. Originally a Potter’s Field, or Stranger’s Burial Place, the plot was filled with coffins; more than 35,000 of them had to be removed. The first building, the Wetmore Pavilion, opened in 1867 and held seventy-five beds. A matching building, the Baldwin Pavilion, added in 1877, doubled that number. A Mr. Baldwin, who wished to remain anonymous, funded the construction of the second pavilion, contributing $84,000, provided the Association raised the balance of $50,000 to complete it.

Photograph of Woman's HospitalOver the years, the Board recognized the need to develop additional services. A post-graduate school of nursing admitted its first class in 1888. The establishment of a hospital pharmacy in 1881, a maternity ward in 1910, and a social services department in 1912 are examples of the additional services made available at Woman’s Hospital.

The 49th Street location proved to be an unsatisfactory one, as the ground tended to be wet, and the basement and ground floors had leaks and dampness. In 1902, all hospital services, except the Out-Patient Clinic, were suspended and the facility was sold. (On a side note, the Waldorf-Astoria Hotel opened on this same plot in 1931.)

Hospital services resumed in 1906, when a newly constructed Woman’s Hospital opened on West 109th Street, between Amsterdam and Columbus Avenues, pictured left. The hospital functioned here until 1965, when it moved just a few blocks north into a newly constructed  building on the St. Luke’s Hospital campus at Amsterdam Avenue at 114th Street, pictured right.

In 1952, realizing that their histories and ideals were parallel, and that it would be beneficial to each to consolidate their resources, which would also strengthen medical services offered to the broader Morningside Heights community, the Board of Trustees of St. Luke’s and Woman’s Hospitals decided to merge.

On January 1, 1953, the Woman’s Hospital became the Woman’s Hospital Division of St. Luke’s Hospital. The Board added “Center” to the Hospital’s name in the mid-1960s to acknowledge distinctions between the different Hospitals. The Woman’s Hospital Board of Governors merged with the corresponding board at St. Luke’s, but the Ladies Associate Board, which handled day-to-day business of the Hospital, continued to meet for some years.

Architect’s drawing of Woman’s Hospital Division

In 1979, St. Luke’s Hospital Center merged with the Roosevelt Hospital forming St. Luke’s-Roosevelt Hospital Center. In 1997, the Hospital Center joined with Beth Israel Medical Center under the Continuum Health Partners banner. In 2013, the Continuum Health Partners merged with Mount Sinai Medical Center forming the Mount Sinai Heath System. The Woman’s Hospital Division on St. Luke’s Hospital campus continued as such for a few years, but eventually duplicated services throughout the combined System. Services re-located, former names were changed, and Woman’s Hospital was consigned to history.

The Woman’s Hospital finding aid is available online here.

Celebrating Two Notable Anniversaries in 2021

On St. Luke’s Day, October 18, 1846, the Rev William A. Muhlenberg announced to his congregation the of the Church of the Holy Communion that he believed they should established a church-related hospital in New York City to help support the poor in the community. He proposed that half of that morning’s collection be the first donation towards the goal of building such a hospital. Muhlenberg described the future hospital as a “Hotel Dieu,” – God’s Hotel, ‘a large hotel full of sick guests,’ or a “Christian family entertaining their guests, all of whom were sick.” After twelve years, and much fundraising, the doors to St. Luke’s Hospital opened to care for the sick poor of the City.

 

St. Luke’s Hospital’s 1858 site on W. 54th St.

Likewise, Mount Sinai Morningside’s sister hospital, Mount Sinai West, formerly Roosevelt Hospital, was also established to aid the city’s sick poor. James H. Roosevelt (1800-1863), experienced a life-altering illness that left him invalid. He decided to close his legal practice, cancel his wedding plans and devote his life to living frugally, carefully managing his fortune, to “establish … a hospital for the reception and relief of sick and diseased persons and for its permanent endowments.” Under the terms of James Henry Roosevelt’s will, the hospital was to be a voluntary hospital that cared for individuals regardless of their ability to pay. The Hospital opened in 1871 on West 59th Street between Ninth and Tenth Avenues. At its opening, Roosevelt Hospital was considered one of the most modern hospitals in the country.

Roosevelt Hospital in 1871

This year, 2021, we celebrate the 175th anniversary of the founding of St. Luke’s Hospital, now called Mount Sinai Morningside, and the 150th anniversary of the opening of Roosevelt Hospital, now called Mount Sinai West. During a time of pandemic, it may not be possible to have a big bash to celebrate the contributions, sacrifices, and simple hard work completed by the staff of these two hospitals.  However, we can note the dates and celebrate in small ways, and be grateful for both hospitals that have provided dedicated health care, research, and innovations in medicine over so many years of service.